what is a smart goal how do i write one do all of the goals on my treatment plan need to be smart goals these are exactly the questions we are tackling in today's video and we're even going to write a goal together so you can see how it works hi i'm dr melissa mccaffrey founder of the free private practice paperwork crash course and today we are talking about smart goals first let's dive into what the heck is a smart goal anyway a smart goal is a specific way of writing a goal that makes the goal really observable easy to understand and easy to track smart is an acronym and it stands for specific measurable attainable or achievable realistic and time-bound now at this point you might be saying uh melissa that sounds complicated and do i really need to write all of my client goals as smart goals as is often the case in documentation the answer that question is maybe so if you work with medicare or medicaid yes all of your goals should be smart goals 100 of the time if you work with private insurance or if you give clients a super bill and their insurance might actually review your files at some point then it's a good guideline to have you don't have to worry so much about sticking to the specific formula i'm going to teach you but it's a helpful guideline and trust me it's going to be pretty easy once you learn this formula anyway if your clients are 100 private pay then you can take it or leave it as far as smart goals go but you still want to follow a lot of the same principles of making the goal really observable easy for anyone to understand and easy to track this helps both you and your clients with knowing whether or not therapy is working let's go step by step together and write a smart goal first we have specific so specific is talking about the type of behavior for example maybe we want to create a goal to reduce depressive symptoms so you might think well depression or depressive symptoms are specific enough but they are not because how do we measure depression and any good therapist and actually most people know that depression looks different in different people so we want to be specific about what depression or depressive symptoms look like in this specific person and if you checked out our last video where we talked about the only two goals you need for every treatment plan you'll see that we're going to go with the symptoms goal right now so if you haven't checked that video out go do that now we'll put a card here so it's easy to link to okay so the easiest way to get specific is to use our symptoms so depressive symptoms anxiety symptoms we're going to stick with depression for this video client will reduce depressive symptoms and then use parentheses so your parentheses are going to describe what depression looks like for this particular client so for example client will reduce depressive symptoms parentheses depressed mood insomnia low concentration low motivation etc so you don't have to list out every single criteria but a good sample of what depression looks like for this person another example would look like client will reduce depressed symptoms parentheses depressed mood passive suicidal ideation feelings of guilt and hypersomnia so there we have two very different sets of depressive symptoms but they both meet the criteria and you're able to see specifically how depression is impacting this person next is measurable so this is literally assigning a number to the symptoms or whatever it is that your goal is about so that you can track it for a symptoms goal we want to know how often these things happen for a client and yes it is a little weird you're probably not going to ask someone how many times a day do you experience a depressed mood or lack of motivation and it can be difficult for people to track and put into a number but we're still going to do it and we're going to make it easy and it's actually going to be helpful clinically so the easiest way to do this is to ask your client and give them some help with figuring out that time frame and it's okay at times like this to tell your clients something like i know this sounds a little weird or i know this is kind of difficult to put into numbers but this is how insurance wants to see this goal written or this is how it will make things easier for us to track so acknowledge if you feel awkward doing it or if the process feels awkward or like it's not quite capturing everything most people will be understanding as long as you acknowledge the awkwardness of the process the easiest way to get people to give you some numbers as far as how often things occur for them is to break down their day so about how often do you think these thoughts or have these feelings or notice these feelings in the morning so between the time that you wake up until you go to work or before you go to school or between the time you get and then literally break it down between the time you get to work and before you have your first lunch break or between the time you get to work and leave leave from work and then you just keep continuing through the day break it down based on whatever your client's schedule is and what makes the most sense for them now i know it seems kind of silly but this is another one of those things that can actually turn into a really valuable clinical discussion because sometimes people are surprised by how often or how little they're experiencing a symptom that they were previously telling you about especially with kids this is really helpful to do with the parents involvement because it helps parents later on down the line when they might be thinking he's still having a tantrum every day but if you were able to identify that a child had a tantrum three times a day and now it's only once a day you're able to highlight the progress they're making over time and one last tip about measurement the m part of our smart goal stick with times avoid percentages percentages just get really confusing and no one understands what you're tracking and it's too ambiguous whereas times per day are a lot easier to track regardless of what it is stick with times per day times per week or times per month and you're good to go so what does our goal look like so far well we have reduced depressive symptoms example depressed mood passive suicidal ideation hyperinsomnia and feelings of guilt from six times a day to two times a day so now this is a goal we can actually track and it's pretty specific to this client and why from six times a day to two times a day well that comes into the rest of our smart goal attainable and realistic we all know it's probably not realistic for our client to have zero depressive symptoms in a matter of a few months so this is a combination of creating a goal that is attainable and can show progress and be encouraging in that way for your client but still capture enough of what you need to cover over a longer period of time so you're not constantly having to redo all of your goals lastly we have time bound so now our goal is fully smart and time bound just means what's the time frame within this treatment plan or within which you'll be working on this particular goal this time frame can vary based on what contracts you might have sometimes medicare or medicaid want you to check in on the goals every three months not necessarily redo the whole treatment plan but a good rule of thumb is that your treatment plan is for a year and you probably want to check in on the goals after the first three months and at least within the first three to six months that's one of my guidelines because practically when you meet with people things often come up or change as you get to know your clients so the first three months you're still kind of in that process of getting to know them but between three to six months you have a good idea of what's impacting them and if there was something they didn't feel comfortable sharing with you then they might have brought that up by then and if you're just private pay and not really worried about insurance then i would recommend create some good broad goals that will apply over time and just check in on your treatment plans annually and no you don't usually need to actually write the time frame within the goal because it's kind of inherent in the treatment plan for however long you've set that up if you want more examples of smart goals and how they intertwine with your progress notes and your intake assessment and all the wonderful things that you need for medical necessity then check out my paid course documentation made easy it is your one stop shop as a therapist for everything you need related to documentation so click in the description below to check it out and until next time happy writing