Feedback
Setting Individual Program Goals
Before the start of the program or during the very first class, take the time to have your clients write down 3 to 4 goals that they would like to accomplish as an outcome of being in your balance and mobility program. These goals should meet four requirements: They should be measurable, specific, realistic, and behavioral. For a goal to be measurable, the client should be able to ascertain whether it was or was not achieved at some point during the program. A specific goal specifies when the behavior will take place (e.g., on specified days of the week or times during any given day), while a realistic goal is one that can actually be achieved. Many clients will be quite unrealistic in their expectations when they first begin your program, so it will be your job to make sure that the goals they establish are small enough that you can be certain that they will be successful. You are going to do little to enhance their self-efficacy if they do not experience success in the program. Finally, your clients should set goals that are more behavioral than outcome oriented because they have more control over their behavior than they have over a particular outcome. For example, a goal of climbing a set of 10 stairs without holding onto the handrail is an outcome-oriented goal. Conversely, a behavioral goal of attending your balance and mobility class two times a week and performing a home exercise program (that includes strength, balance, and flexibility exercises) at least three times a week for the next month is one that is likely to be achieved much more quickly and will lead to less frustration caused by progress that appears to be slow. Of course, a goal of climbing the stairs without holding onto a handrail is probably not a good idea in the first place because it encourages a potentially unsafe behavior.
Your clients should set both short- and long-term goals, with the short-term goals constituting the stepping stones to achieving the long-term ones. Just as the short-term goals should be behavioral, so too should the long-term goals that you ask your clients to set. For example, the short-term goal of attending class two times a week and performing a home exercise program at least three times a week might, in the long-term, increase to attending your balance class two times a week and performing the home exercise program five times a week.
Although it is important to set goals with your clients, it is equally important to review their progress toward those goals on a regular basis (every week or two during the early stages of a program and monthly or bimonthly as success with achieving goals occurs). In some cases, you may have to adjust some goals based on your participants' progress, health status, and long-term objectives. Always be prepared to discuss participants' successes as well as struggles toward achieving a certain goal. In that way you can identify what factors help your participants meet their goals and then point out these factors during the times your clients are struggling. Finally, help your clients develop their self-monitoring skills by having them keep logs in which they record their activities that are related to the goals they set. Making your clients responsible for their own behavior is crucial if you want them to continue engaging in the behaviors and activities that will lower their risk for falls.
