The Collaborative Goal Technology (CGI) is a new goal ... Theory ond reseorch ftom goal striving, motivotion ond mentol .... clarifying the person's [ife dreams or.
Collaborative GoaITechnology: Theoryand Practice t Samantha P.Ctarke, LindsayG.Oades,TrevorP. Croweand FrankP.Deane lJniversity of Wotlongong NSWAustratia
motivation,whichis importantfor psyGoolsttivingpromoteshopeondenhances (CGI)is a TheCollaborative GoalTechnology chosocialrehabilitationandrecovery. newgoalstrivingintervention thatis usedto supporttheautonomyand recovery processes protocoland its utiliofthe personwitha psychiatricdisobility.TheCGT ty areoutlined.Theoryondreseorch ftom goalstriving,motivotionondmentol of CGTaredescribed. A healthrecoverydomainsthotinformedthe development caseexampleis alsoprovidedKewords: goal striving, reavery, psychosocialrehobilitotion,cosemonagement
-T' I h i sa r t i c l e d e s c r i b et hsea p p l i c a t i o n the of a newgoaLstrivingintervention, (cGT), Coltaborative GoalTechnology rewithinmentalheatthpsychosocial habilitation andcase-management contexts. TheCGT is an individuatized g o a l s t r i v i ni ngt e r v e n t i o an i m e da t e n h a n c i ncgl i n i c aplr a c t i caen da l l o w i n g ctinicians to cotandpeoplein recovery laboratively monitorgoaIprogress at grouplevel.Theoveran individualand is to assistpeoatLobiective of the CGT ptewitha psychiatric disability progress recovery withtheirindividual processes. to faTheCGT wasdesigned person between a cilitatecollaboration inrecovea r yn dh i s / h em r entalhealth workerin retation to developing and recovery monitoring individuatized "recovery goatsandan overaLl vision," own"recovery DeveLoping the person's yision"hetpslocatetheCGT withinthe
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contextof the mainthemesemerging fromthe mentalhealthrecovery literature(e.g.,Andresen, 0ades,& Caputi, 2o03;Anthony, 1991,1993;Anthony, Cohen, Farkas & Cohen, zooo).TheCGT is alsodescribed in retation to the Collaborative Recovery Mode[(Oades, Deane, Crowe, Lambert, Lloyd,& Kavanagh,2oo5) whichemphasizes the principles of recovery, collaborationandsupportof autonomy, asweLl asotherkeyctinicalskills suchas needsassessment andhomework a s 5 r gmn e n t . GoatSettingwithin MentatHeatth Contexts Goalsettingis widetyacknowledged to partof psychosocial be an important (Ades,2003;cohen, rehabiLitation Farkas, Cohen, & Unger199o;Lecomte, Wallace, Perreault, & Caron,2oo5).A
o o rl e c h n o l o g y c o l l a b a r a t iG ve
P S Y C H I A T R I CR E H A B I L I T A T I O N l o u R N A L
reviews, Collaboration andSupporting comes). Duringgoalprogress goalattainment scoresaregenerated Autonomy byweighing thelevelof goatprogress c o n s u m earn dc l i n i c i aang r e e m e rnet w i t ht h ei m p o r t a n a ce l l o c a t i of onre a c h gardingtreatment goatsis associated g o a tT. h i ss c o r e n a b l easni n d i v i d u a l ' s withincreased decreased satisfaction, progress andif reto be monitored, distress, reduced symptomatology q u i r e dc, o m p a r eodv e rt i m ea n dw i t h outcome andimproved treatment as of otherindividuals, theprogress (Michatak, Klappheck, & Kosfelder, w e l l a se n a b l i negv a l u a t i oant a s e r v i c e 2o04).Bettertreatment are outcomes leve[(seeKiresuk et al.,1994for more associated withthe degreeto which detaits). the personin recovery is an active participant in treatment andgoaI TheCGTis an adaptation of 645,incor2oo1). settingOryon& Winograd, principLes porating fromgoal several C G T h a s b e e nd e C o n s e q u e n t t h l y e . 1996; striving(Austin& Vancouver, s i g n e t d o e m p h a s i s t h e e i n dividuat's indiEmmons, 1992,1996;Little,1989; Whengoalsareclearlyspecified, her/hisownlife freedom to determine 1991,1996;Locke& Latham, them Locke, vidualsaremorelikelyto achieve plan pathways and the to getthere. (Locke & Elliot,1998,1999), 199o).Several meas- r99o;Sheldon & Latham, Furthermore, using the CGT to promote (Bandura, & r99o;Bandura motivation to assist ureshavebeendevetoped self-determination shouldincrease the beck& Williams. g s y c h o s o crieahl a b i l i t a - Simon,7977 i Hollen w i t hm a k i n p a d l i k e t i h o o t h d a t t h e i n d i v i d u a l w i l l opt (Andresen 1987)andrecovery literatures Theseinclude: the tiongoalsexplicit. and maintain specific health behaviors et aL.,2o03;Anthony, ClientAssessment of Strengths, 991,1993' ( S h e t d oW n ,i l l i a m&s J o i n e zr ,o o 3 ; (CASlG, Lecomte et Anthonyet al.,2ooo). Interests andGoats Anthony, 1993;Anthonyet al.,zooo; Technology on al.,zoo5),theTraining greater on TheCGTptaces emphasis Richards, zooz). Rehabititation Goal Settingan Overalt by coltaboration andgoaIownership (cohenet at.,1990),andGoal Thefollowingexample demonstrates andinvotves the personin recovery (GAs,Klresuk, Attainment Scating coLlaboration the perand supporting fourmajoradaptations of GAS.1)The 1994). Smith& Carditto, person The indicated reviewpro- son'sautonomy, inclusion of a goalprogress yet had he wanted to become a doctor, to extocotthatrequires the conSumer GASis a widetyutilizedgoalsetting Rather than not completed high school. (e.g.,Burns,zooz; plore,discuss solvea andproblem intervention g o a l i m m e d i a t e d l i y s m i s s i n t h g i s a s when rangeof difficutties experienced & Leichsenring, Biskup,Kreische, unrealistic, the supportworkerassistzoo3; p u r s u i nhgi s / h egr o a l sT. h i sp e r m i t s Staats,2oo5; McLaren & Rodger, e d t h e i n d i v i d u a t it do e n t i f m y anage" andfacilitabothsocialreinforcement Malec& Moessner,2ooo). GAS,origi(shorter-term goats) able steps with to address barand tionof problemsotving nallydeveloped in 1968byKiresuk progress which to his longer towards riersto goalprogress.2) Incorporation Shermaa n i, m e dt o e v a l u a taen dc o n term vision. The supported the worker of an overallrecovery visionaimedat t r a s t h et r e a t m e ni m t p a cot fv a r i o u s providing individual's autonomy by op[ifedreams or clarifying the person's mentalhealthinterventions on the tions through which he coutd complete Typically, keyvalueswhicharetinkedto theconbasisof goalattainment. adult goals.3)ThecGT highschool(e.g.,attending is evaluated sumer'sshorter-term treatment effectiveness [earning institutions or edusupported the numberof goalprogress outcome measures reduces usingstandardized part-time cation on a fultor basis). theneg' levelsfrom5 to 3 andremoves thatfocuson symptomseverity. Furthermore, theworkerhelpedthe goaI progress. However, GASrepresents an outcome ativeratingsof 4J person explore whatit wasaboutbeing practices are Motivation enhancement measure basedon the individual's a doctor that was important to him. intothegoatsetprogress furtherincorporated treattowardidiosyncratic goats Subsequent short-term andrelatprocess byinctudgoalsto be tingandmonitoring mentgoaLs. GASrequires edtasksconsistent withthisvision ratingof the inga quantitative i d e n t i f i ep d r, i o r i t i z ei ndt e r m so f i m were set. Atthough the recovery vision regarding portance, confidence consumer's andgradedin termsof five may change over the time, reasons for goalprogress his/herabilityto attainthedesired outlevelsof potential wanting to be a doctor remain relativeoverthereview levelof goalprogress to comesfor eachgoal(bestexpected provide and Ly stable ongoing motivagoalprogress period. worstexpected outtion.In thisway,autonomy was
[iterature recentreviewof the recovery hopeasbeinganimidentified ctearly portantaspectof psychological recovery (Andresen etat.,2o03).Establishing goalswithpeo' personalty meaningfuI promotes ptewithpsychiatric disability regarding one'srecovery hopefulness (Ades,zoo4:Baumeister & Leary, withindiconducted 1995).Interviews psychiatric disabilities vidualswith of goatsin confirmed the importance process assisting the recovery (Marshatl, Turner& Oades,Crowe, Huntriss,2oo5).
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s u p p o r t e da n d b o t ht h e m e a n i n ga n d manageabilityof specificgoalswere maintained. Componentsof the CGT The CGTincorporates severaIprocedures.TheseincLude:r) orientingthe personto the conceptof recoveryand recoveryprospectsand hetpinghim/ her shapehis/her personalrecovery vision;z) developingtime-framed goatswith threelevelsof goal progress;3)prioritizinggoalsin terms of relativeimportance;4) negotiating goal progressindicatorsin relationto goaIattainmentconfidence;5) reviewand ing goal progresssystematicalty; 6. upon reviewgeneratingan overal[ goalattainmentindex.Theseproceduresare brieflydescribedin Tabler, a n d a n e x a m p l eo f a c o m p l e t e cdG T form is disptayedin Figurel. PersonalRecoveryVision The associationbetweenPersonal meaningin one'slife and psychological heatthhas long beennoted(Franl(1, 1963;Jung,1966;Yatom,1980). Meaningand purposein life haveconb y p e o p l ei n s i s t e n t l yb e e ni d e n t i f i e d recoveryas importantfor psychological
tweengoalsandvisionis reciprocalin of clarification termsof onefacititating theother.
is, "to beableto standon myowntwo of the importance feet,"whichreflects p e r s o n . f e e l i n ign d e p e n d et no t h e
visionscanalsobe explored Recovery visionensures the recovery Although o i n ka b o u t b ya s k i n tgh ei n d i v i d u a l t h mI e a n i nigs c e n t r a t ttoh e t h a tp e r s o n a "rote-model," he/she adsomeone a emphaprocess, theCGTalso recovery "manageability" what it is he/she By exploring of morecon- mires. sizesthe can abouttheirrole-model admires cretegoals.Littte(1989)notedthat principles and values the help clarify by ensur' goalattainment is enhanced For to thelndividuat. i n gt h a tb o t hm e a n i nagn dm a n a g e a b i l -thatareimportant person Kate selected one example, in thegoalsetting ity areoptimized (the because shewas actor), Winstet process. attainment GoaI striving and great a mother perceived confident, as bY canbe enhanced andmotivation making l i n k i n tgh ep e r s o n 'asb s t r a cmt e a n i n g - andfun loving.Alternatively, by withpeoplein recovery goals coltages ladenvisionto moreconcrete pictures or identify to purmagazines using the eticit that andtasks.Questions " w h y " people what articulate hetp wordscan t h ei n p o s eo r m e a n i nbge h i n d meaningful. certaingoalscan theyfindpersonally selected dividuathas his/her assistthe personin clarifying "WhY vision.ForexamPle, recovery "What wouldyouliketo geta iob?", woutdit meanforyouto be emin ployed?" Theexample Provided e t h e s eq u e s t i o n s F i g u rrei n r e s p o n st o
T h ed i s c u s s i oonf m e a n i n vg a, l u eas n d v i s i o ni s q u i t ep e r s o n a l a nf odrs o m e thinkingaboutthefuture individuaLs or appearpointless. canbe frightening C o n s e q u e nittl iys.i m p o r t a nt ht a ta is nurrelationship strongtherapeutic
recovery(Andresenet a[., 2o03; Spaniol& Koehler,r994).AnthonY (r99r) discussedthe "recoveryvision" as a way ot tying togetherthe princiadjustment ples of self-determination, to disability,empowermentand self esteeminto existingconceptionsof recoveryfrom mentalillneds The person"recoveryvision" incorporatedinto al the CGTaimsto articulatethe individual's hopesand dreamsfor the future y e a n i n g f ul il f ep r i n ' a n d / o rp e r s o n a l lm that can be activatedas ciples/vatues the personpracticesbeingthe Person she/he wantsto be.The re(overyvi' t h a ta n s i o na i m st o m a k et h e d i r e c t i o n p u r s u e e x p l i c ibl e i n d i v i d u ahl o p e st o fore usingthis as a guidewhen developing moreconcretegoalsand tasks. However,oftenthe relationshiPbe-
An objectiveindexcanbe calcutatedby multiplying the importancetating with level of attainmentfrom each goa[. A percentageof current goal attainment
progress, withotherindividuats'
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F A L L2 O O 6 - V O L U M E3 O N U M B T R 2
if specifictaskscannotbe experienced goals thataresettoofarin the tiedto The3& Simon,1977). future(Bandura steps monthperiodallowsmeaningful progress, while be taken that [ead to to Itshoutd a l s ob e n o t e dt h a ts o m ei n d i remaining closeenoughto the present v i d u a l ds i a g n o s ewdi t ha m e n t a t h e a l t h t o e n g a gteh ei n d i v i d u a t a nmda i n t a i n disorderlikeschizophrenla mayexperiHomework tasksaligned motivation. enceproblems withexecutive cognitive goats withthe person's aresetandrefunctioning. Thismaymakeit difficult viewedovershorterperiods(e.9.at to elicitan abstract vision(Buchanan & Therefore, oneor twoweeklntervats). Carpenter, 2ooo;Cancro & Lehmann, biweekly stepsare smaLler concrete zooo).Therefore clinicians needto be tinkedto larger3 monthlysteps,whlch patientyet persistent whenlinking in turnaretiedto the moreabstractrewhileensuring specifictasksto goaLs covery vision. recovery theyalignwiththe person's It is important forthe clinician to work vision.Althoughabstraction mayb( person byaskwiththe d i f f i c u l ti yt s h o u l dn o tb ea s s u m etdh a t cotlaboratively thatassistwithgoat t h ei n d i v i d u a t d oneosto r c a nn o th a v e ingquestions vision,People whoexperiidentification anddevelopment. a recovery suchas"whatcouldyoudo encedifficulties withexecutive func. Questions t i o n i n gh a v eb e e ns h o w nt o b ec a p a b t e in thenext3 monthsthatwill hetpyou (Recovery Vision)?" theirneeds(Buhler, movetowards... of identifying practice helpfut. This increases Liecester, Bensley, & Fox, can be oades, goals thatthe selected z o o r )T. h u st,h ec l i n i c i a nr'os l ei s t o the tiketihood , te. of these a t i g nw i t ht h ep e r s o n v' sa l u e si n helpwiththearticutation identity,whichasestsandpreferred needsandto elaborate strategies to motivation and Hogg sistswithmaintaining meettheseneeds.Furthermore, (Sheldon (1995) goatattainment goats & Elliot, asserted thatselecting & Houser-Marko, thatarein linewithpersonaLinterests 1998,LgggtSheldon & Kasser, 1995). The andhelpcoun- 2oo1;Sheldon canpromotemotivation in the example symptoms of schiz' threegoalsidentified teractthe negative (Figure 1)were:r) to do myownshopophrenia. ping,2)to finda iob,and3)to improve goals Three-monthly medication taking.Thesewerethree goalsas"a con- goalsthattheindividuat Ades(zoo4)describes believed he between couldworkon overthe nextthree creteroadmapthatmediates wherethe personis andwherehe or monthsto assisthim in workingtoward atshedesiresto go" (p.r5).TheCGT vision,"to standon my hisrecovery ofthreegoalsto be towsa maximum owntwo feet." pursuedovera 3-rronthreviewperiod. s d - RelativelmportanceSystem L i m i t i ntgh enu mb e ro f g o a l sa l l o w a andmotivational re' Toassistbothpartiesin determining equateattentionat to eachof the h o wb e s t o s p e n dt h e i rt i m ea n dr e ' to be devoted sources goals.The3-monthreviewperiodis s o u r c e tsh, ei n d i v i d u iasla s k e dh o w 10points purposely setected to maximize the de- she/hewoulddistribute goals setected. g r e eo f m o t i v a t i oann dc o m m i t m e n t acrossthe maximum 3 (r987)found andWittiams Whereresources Hollenbeck fromthe individuat. a goalis seen progress sup- thatthe moreimportant altowandwherepositive p e r i o dm s a yb e l p o r t si t , s h o r t erre v i e w t o b e ,t h em o r ea n i n d i v i d u a L wc iot m mitandstrivetowardit. Corrigan, e na tyb e a p p r o p r i a tDei.s e n g a g e mm turedso thatindividuats feelsufficientt ys a f ea n ds u p p o r l eedn o u g tho d i s cusstheirwishesandto exploresome of theirfearsandconcerns.
A R TI C L E
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Mccrackenand Holmes(zoor) also notethat unlessa personis focusedon goatsthat they are motivatedtowards achieving,engagementin strategiesto changewiLlhavelimited impact. Therefore,identifyingthe person's goal prioritiescan be vital to ensure sustainedmotivation.As seen in the example(Figure1)the individualaltot" ted five pointsto goal one,three points to goattwo,and two pointsto goaI three.Thisindicatesthat the person's motivationis more tiketyto be directed towarddoing his own shopping(goal one). Levelsof GoaI Progress Foreachgoal,three tevels(low to high) goal progressare identiof measurable fied and cleartydefined.Makinggoats explicitwith indicatorsof goal progress increases the likeLihood of goalattainment(Locke& Latham,1990). Furthermore, commitmentto pursuing a goaLis increasedif there is a sufficientdegreeof difficultyin attaining Shaw,Saari& Latham, the goat(Locke, 1981).Therefore, to enhancegoalat. level of difficulty,indicattainment,the ed by the degreeof goal progress targeted.shouldreflectthe relativeimportanceof goals. Self-efficacy relatedto completingthe tasksrequiredto attaina goalis assoclatedwith motivationd.uringthe goal strivingprocess(Locke& Latham, r99o).Therefore,acknowledgement and supportfor any progressthat has b e e na c h i e v e b d y t h e p e r s o nc a ne n hanceself-efficacy. Thiscan also help to increasethe person'sfuturegoal strivingeffortswhilst bolsteringthe beliefthat he/she hascontrolover his/her life (Ades2o04; Locke,1996).. Thedescriptors"Awesome,""Success" and "Keepgoing" were chosento representdifferentlevelsof goaI progress. The "Success"leveIrepresentswhat t h e p e r s o nb e t i e v ew s o u l db e a n i n d i catorof successfulprogresstowards
II I C a l l o b o r a tG i vaea l T e c h n a l o g y
P S Y C H I A T R I CR E H A B I L I T A T I O N J O U R N A L
period, t h e g o a lo v e rt h e n o m i n a t e d a n dt h a t h e / s h ei s a d e q u a t e tcyo n f i d e n tt h a t h e / s h ec o u t da c h i e v ei t . Cliniciansare advisedto ctarifythe "5uccess"levetfirstin orderto provide a n a n c h o fro r t h e o t h e ri n d i c a t o ros ' goaIprogress.Sometimespeople achievemorethan expected,so the "Awesome" teveLaltows reviewand rei n f o r c e m e notf e x c e p t i o n ap lr o g r e s s . The "Keepgoing" leveLrepresents little or no relativeprogresstowardsattaini n gt h e g o a l .T h e" K e e pg o i n g "l e v e li s a necessary inclusionto altowminimaI progressto be trackedwithout deftating the person'smotivationwhile encouragingfurthereffort.The tabelsof these differentlevelsof goal progress can be amendedto reflectlanguage t h a t i s m e a n i n g f uf ot r t h e p e r s o n . ConfidenceRating Individualshaveto havesufficientbelief that they are ableto attain or progresstowardgoats(Snyder,2ooo). T h ea d o p t i o no f p r e f e r r e hd e a l t hb e haviorsis influencedby the individ" u a t ' sb e l i e fr e g a r d i n h g i s / h e ra b i l i t y to achievespecificgoats(Boretti& Mermelstein,1994;Winkteby,Flora& Kraemer,1994).Whenestablishingthe "success"tevelof goaIprogressfor eachgoal,the individuaIis asked,"On a scaLeof 1 to 1oo how confidentare y o ut h a t y o uw i t l a c h i e v teh i s l e v e l o f goalprogress?"lf the individualreported beingLessthan 70% confidentthen that particularlevelof goal progressis a d i u s t e du n t i l t h ep e r s o nf e e l sa t l e a s t 70% confident.This is to ensurethat goalsare tailoredto the individualand commitmentto goaLsis enhancedb: consideringtevelof importance,difficuttyand confidence.lf confidenceis h i g ha n dt h e i n d i v i d u a l v i e wt h s eg o a l as importantshe/he is more likelyto maintainmotivationand achievethe set goal(Bandura& Simon,1977;Locke et at.,1981).
Feedback and Monitoring F e e d b a cakn d m o ni t o r i n go l p e r f o r r n a n c eh a sa L s ob e e ns h o w nt o e n h a n c e goaI progress(Frost& Mahoney,1976; Locke,1996).Feedback enablesan ind i v i d u atlo c o n s i d ewr h a tt h e yh o p e d to achievein comparisonwith what they actualtyachieved(Lockeet al., 1 9 8 1 )E. n h a n c i nagw a r e n e sosf t h e p o tentiaIdiscrepancybetweenactuaLand ideaIperformancecan motivatepeopte to reducethis gap (Bandura,1990). Uponreviewan indexof goal progress acrossthe three goatscan be caLculated, by muttiptyingthe Levelof attain ment (Awesome2, Success1, Keep goingo) by the number of pointsallocatedfor importancefor eachgoaIselected.Thesethreescoresare then s u m m e da n d d i v i d e db y t h e m a x i m u m possiblescoreof zo. This scoreis then muttiptiedby 1oo,to yield the percentage of goal attainment.CGT= I (Attainmentx lmportance)/zox roo. ln t h e e x a m p t ep r o v i d e dt ,h e C G Ti n d e x scorewould be (5xz + 3xr + zxo) = 13120x 1oo = 650/o. Similarto GAS,the indexindicatesthe levelof attainment, but in this casetakesinto accountthe importanceof the goal for whichthe taskswere performed.Veryhigh scores or very low scoresmay indicatethat the tasksthat were set wereeithertoo easyor too difficultrespectively. The indexscorenot only enablescomparison of an individual'sgoal progress overtime, but also providesinformation aboutgoatprogressacrosscons u m e rg r o u p S , Monitoringgoaland task achievement promotesawarenessof obstaclesthat havearisen,so problemsolvingcan take place.Monitoringensuresthat problemsassociatedwith goat progressare identifiedand routinely managed(Buchanan& Carpenter, 2 o o o ;C a n c r o& L e h m a n n , 2 o o oT) h. e CGTprovidesfifteencommondifficulties (andan "other" option)to prompt
ARTICLT --f134
i d e n t i f i c a t i oann d d i s c u s s i orne g a r d i n g commonissuesthat may haveimpact, ot e d o n g o a l a t t a i n m e n( et . 9 . n e n o u g hs u p p o r u .
Conclusion TheCGT aimsto facititate the goalsetprocess. tingandstriving lt drawson importantprinciples fromgoatsetting, motivation research andthe recovery l i t e r a t u rTeh. eC Gf : i m st o b a l a n cteh e p e r s o n aml e a n i n g f u t n a en s sdm a n a g e abitityof goalsto ensureprogress with processes individual recovery can o c c u rT. h eC G T r e c o g n i r et hsei m p o r goalprogress. tanceof reviewing The relationship between the personin recoveryandthe ctinician is vitaltopromotesafeexploration of interests, goaLs andproblems. lf usedcorrectly the CGT canbean effective tootinassistingpeoplewithpsychiatric disabilit y i n f i n d i n gh o p em , e a n i n gi d, e n t i t y andresponsibility fortheirownrecoveryprocesses. Future research regardingthe CGT willaimto investigate whetherusingthisapproach Leads to a particularly betterrangeof outcomes, recovery basedoutcomes. Further researchwitlexplore whetherthisapproachimproves the experience of goaI settingwithinmentalhealthcontexts fromthe perspectives of individuaLs witha psychiatric itlnessaswetlas goalattainment. teading to improved Whilstouranecdotal evidence to date indicates bothpositiveexperiences goatattainment andimproved for individuals, these promorestructured gramevaluation resultswill be reported assufficient databecomes availabte.
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