The development and evaluation of the goal attainment scaling process
Creators: name: Hover, Gerald Robert
Publisher: name: University of British Columbia
Year: 2010

description: The purpose of this study was to develop a group process to assist clients in a goal-oriented problem-solving approach to brief therapy. The Goal Attainment Scaling Process (GASP) described in this paper was to become an important part of the treatment program of a voluntary inpatient psychiatric unit. An evaluation was conducted, comparing hospitalization with and without the GASP. The theoretical rationale underlying the GASP is based upon the assumption that as people work on minute steps of progress they will receive reinforcement at their lower levels of goal attainment. Such reinforcement will serve as an impetus for attaining higher levels of goal attainment. Further, as clients identify themselves as responsible for change, they gain more control over their fate. Thus as the clients clarify their expectations and goals, they are less likely to feel anxious about their lives. As they exercise decisions and choices for control, there is an expected increase in assertiveness. With a concrete life-focus, such as the GASP provides via small sequential steps, it is logical to assume that clients' enthusiasm for both themselves and life in general would rise as the goals are attained. Concomitantly, as their goals are attained, clients become more self-reliant, enthusiastic, and less anxious. Then, less time is spent worrying about "where I went wrong" or the guilt of past mistakes. This process is consistent with the notions of: time limited goals, talking about present events, fostering ventilation, and rapidly developing a facilitative interpersonal relationship. The therapist managed the problem-solving session directly; supportive administrative interventions screened appropriate clients and fostered therapeutic flexibility. The GASP taught clients self-control through a direct assessment strategy that encouraged clients to regulate their own behavior by examining the definition of the problem and coping skills. The conclusion was that the afore-mentioned factors could be combined in developing a needed therapy for a short-term psychiatric hospitalization program. Specifically, an instrument used to measure psychotherapeutic outcome, the Goal Attainment Scale, could be modified into a procedure to aid voluntarily hospitalized psychiatric patients. The subjects were 32 voluntarily hospitalized patients of the psychiatric unit of Valley General Hospital. An adaptation of the non-equivalent control group design was chosen. They were administered the Rotter Internal-External Locus of Control Scale, the Target Outcome Assessment Sheet, and the Sixteen Personality Factor Questionnaire upon admission, and again eight days after their initial interview. Eleven subjects in both treatment groups and a pre-experimental group were administered the Ward Atmosphere Scale. The purpose was to see if the atmosphere during hospitalization with the GASP was different than the atmosphere of hospitalization without the GASP. It was hypothesized that there would be no differences in the ward environment six months before testing and during the two evaluation periods, that there would be no differences between pretest scores, that there would be a difference in attaining both the clients' "most important" goal, as well as all their other goals; that there would be a difference in the subjects' subsequent scores of self-control; that the clients would have more personality integration, be more assertive and enthusiastic, and less guilty and anxious; and that the length of hospitalization time would be shortened. A multivariate analysis of variance did not reveal any differences in ward atmosphere during the two treatments and for the six months prior to the evaluation. Further, the pretest scores of both groups at admission were not found to be different. For the most part the goals identified at admission were in the same categories as those identified during the GASP. Also, clients' goals at admission and during the GASP were stated in the same direction. Analysis of the posttest revealed there was no significant difference between the groups relative to goal achievement, ego strength, assertiveness, and quilt. The GASP clients were significantly more internal, more enthusiastic, and less anxious. Finally, hospitalization with the GASP was shorter by 16.3 per cent, but this was not statistically significant.