Goal Setting

Goal setting may encompass targeting particular areas for all patients, e.g. work or domestic duties, to individualized and iterative goal setting. Patients find it hard to set goals and aiming to restore pre-pain activities may not be appropriate. Goals, such as reducing work hours, may be the means to improve quality of life and should not be rejected. Obstacles, pain-related or otherwise, to goal attainment should be identified and consideration given to how other aspects of the program might address these. A good strategy is to teach the specification of interim and proximal goals, often as simple as sitting or walking tolerances, and the application of a steady incremental approach known as pacing, with the particular activity carried out in a time-contingent manner. Thus, a patient would be encouraged to plan to do a task for a specific period of time rather than engaging in it until the task is completed. For example, the task of doing the family ironing can be partitioned into periods of 10 or 15 minutes with intermittent rest rather than achieving it in an unrelenting period of an hour or more.

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