How to Set Goals to Match Your Wants and Needs After Stroke or Brain Injury

Without a direction, without a specific goal in mind, it’s very easy to get discouraged, and to feel adrift without a plan. In today’s post, we talk about how to set goals that are right for you and will drive your path to stroke or brain injury recovery.

Writing goals is actually a lot harder than it sounds. There are some key components to a good goal that make it much more effective than the simple, “I want to not be embarrassed to hang out at the beach this summer”.

Start with BIG goals. Many therapists call these “Long-Term Goals”. The idea here is that these goals are more overarching and will take more time to meet.

Long-term goals should…

1. 1. Be motivating. This is the thing you’re working for! Make it something you really want.
   2. Be specific. If your goal is too general, you won’t really be able to define to yourself.
   3. Be measurable. You need to know if you met the goal or not.
   4. Be individualized. Goal banks are great, and you might see some floating around on the Internet, but one of the most important characteristics of a great goal is that it be the right goal for you. What one person needs isn’t necessarily the same thing as what someone else needs.
   5. Be achievable. Yes, we always want to reach high and choose goals that will be challenging. But we also need to be realistic. Setting a goal that is too hard to achieve from where you are right now, and then never meeting that goal, can be very discouraging. You want to make sure your goals are reasonable for you right now. That doesn’t mean your big pie in the sky goal can’t come back later – you need to think about the big goals that lead up to that HUGE goal and accomplish those goals fist.

Examples (note: The best way to start goals is with “I will” statements – it’s an empowering phrase, and gets you ready to lay out an action or a task that you will accomplish)

I will walk to Starbucks and order and pay for a cup of coffee independently.

• This is motivating – who doesn’t love coffee, after all.
• This is specific – we know that we need to be able to do this on our own, how we will get to Starbucks, and what we will order.

This is measurable

• – either we got the coffee on our own or we didn’t!
• This is individualized – it’s just right for us and our caffeine addiction, and being independent is something that is personally important to us. This is also something we really want to do that we can’t do yet.
• This is achievable – we know that with some practice, we’ll be able to meet this goal within the next few months.
• I will get a job as an assistant teacher.
• This is motivating – returning to or obtaining a career is important to everyone! It brings money and a sense of independence.
• This is specific – we know exactly what job we’re working towards.
• This is measurable – either we get a job as an assistant teacher or we don’t.
• This is individualized – teaching is something we love, so this is a good goal for us.
• This is achievable – note that we didn’t put getting a job as a college professor. We know our limitations as they stand right now, and know that this is just one amongst many steps. It may take us a year to complete even this goal, but it’s something that’s in the right ballpark at this time.

Next, identify the smaller steps needed to meet those BIG goals. We call these “short-term goals”. These are goals that build up to that big, long-term goal. They are the pre-requisite knowledge and skills that you need to accomplish your long-term goal. Each long-term goal will have multiple short-term goals.

Short-term goals should…

• Be sequential. What I mean by this is, they should go in order of difficulty. They don’t necessarily need to go in order you’d carry them out in within the major task you’re working up to, and the order of difficulty may be different for different folks.
• Meet you where you’re at. Make sure that your first goal is one that’s right for you. It shouldn’t be something you can already do – but it also shouldn’t have any easier skills before it that you can’t do.
• Be measureable. This is especially important for short-term goals because you need to know when you’re ready to move on to the next short-term goal in your progression.
• Be achievable. These goals should be tough, but should be goals that you feel you can meet.

Examples of goals for brain injury recovery

• Long-Term Goal: I will order and pay for a cup of coffee at Starbucks independently.Short-Term Goal 1: I will identify which credit card is appropriate to use to buy coffee 4 out of 5 times.
• Short-Term Goal 2: I will “Thanks” accurately 4 out of 5 times.
• Short-Term Goal 3: I will say “A small cup of coffee please” with written cues accurately 4 out of 5 times.
• Short-Term Goal 4: I will identify what a reasonable price would be for coffee in 4 out of 5 attempts.
• Short-Term Goal 5: I will read a map to plan the most efficient way to reach Starbucks in 3 out of 4 trials.
• Short-Term Goal 6: I will read the word “milk” to make sure I select the correct liquid to add to my coffee in 4 out of 5 trials.
• Short-Term Goal 7: I will walk to Starbucks and back home with a caregiver with me leading the way accurately 2 out of 3 times.
• Short-Term Goal 8: I will walk to Starbucks and back home independently 2 out of 2 times.

Find activities that help you practice each short-term goal

For example, if I were using Constant Therapy, I might try the “Read a map” task to prep for Short-Term Goal 5, or if I didn’t want to use a credit card, I could use the “Count money” task to prepare to pay for my coffee. You could use our “Understand written words” task to work on reading to prep for having to read information while at the coffee shop. Other goals lend themselves easily to straight routine and practice. You and your caregiver might make the walk to and from Starbucks once a day until you’ve got it down.

Parting words of advice for those recovering from stroke or brain injury

Note that I didn’t demand perfection on most of my short-term goals. Often it was “4 out of 5 times” – you don’t want to make your expectations so high that you can’t move on to harder goals. In fact, sometimes working on harder goals makes those easier skills move along. If you find yourself stuck on an easier goal, try out a harder one just to test out if that actually might help.

Goals did require, however, 100% accuracy on something that would affect my safety – walking to Starbucks and home independently (Short-Term Goal 8). Safety first!!

Goals are not set in stone. If you need to, change them! Oftentimes, the more you work towards a long-term goal, the more short-term goals you’ll realize you need, or the more you’ll realize that this goal just isn’t for you. It’s OKAY to change your goals! The purpose of goals is to help you improve, and if a goal isn’t doing that, or is just making you feel discouraged, it’s time to tweak it.