Do you set goals? If you do, do you actually ever achieve them? 

I have never really been a goal setter by its common understanding; such as: 

• Running marathons 
• Quitting drugs 
• Starting businesses 
• Ending homelessness 
• Writing a Book 
• Getting a promotion 

When I say I am not much of a goal setter, I mean; I rarely focus on accomplishing a goal or setting a new resolution. Every year we come to the point in which it is time to make New Year’s Resolutions. Some argue it’s a waste of time because they always fail, others continue to try for the same goals year after year.  But I have had success with changing my behavior and habits. Below is an essay video made to illistrated the point. The details and research is elaborated on in the article below.

Introduction

In this article, I intend to elaborate in detail, the evidence behind the argument I make in the video above. I want to “un-pack” the myths, history, and practical reality of what works with goal setting, as it applies to day-to-day life. I am not making a case for what corporate strategic planning should do. I want to know what the common person should do, in order to live healthier.  

I will make the final point: If anything, a functional, practical, useful, personal goal should be: 

• Everyday – (Something you can DO nearly every day) 
• Action-oriented – (Don’t avoid things – always plan to DO something) 
• Short-time – (make it easy to DO, such as 2-20 minutes) 
• Your Purpose –  (it should relate to your purpose and values!) 

Is Goal Setting Itself, Part of the Problem? 

There is significant evidence we are all trying too hard. It’s possible the mere act of goal setting itself is part of the problem, or at least the way the average person approaches goal setting. As the professor and researcher Roy Baumiester points out in his book Willpower (Baumeister & Tierney, 2012), we have limited reserves of willpower that get used up throughout the day. With modern technology and media, we are often faced with attention and decision fatigue. While goal setting should hypothetically, allow us to focus on our priorities, it often distracts us from behavior change with vague ideals, overwhelming complexity, and high activation energy.  

Rather than complexity, healthy behavior should be simplistic. There is a massively common theme among true expert experts, to whom I will identify in an upcoming article. In these various areas of health, the theme is in relation to the simplicity of health. 

A Few Areas of Health Simplicity

• Dieting: Researchers Lisa Mann and Brian Wansink, note this simplicity in nutrition and dieting, and argue that part of the problem is trying too hard (Mann, 2015; Wansink, 2007). 
• Nutrition: Journalist Michael Pollan and Researcher Collin T. Campbell back this anti-diet movement up with evidence that healthy eating should be simple and traditional, rather than complex (Campbell & Jacobson, 2013; Pollan, 2008). 

• Hydration: In an interesting video by Thomas Frank titled How to Stay Hydrated: Here’s Everything You Need to Know (2018), in reviewing the research behind what healthy hydration actually is, points out that the “8 glasses of water a day” is a myth. Thomas Frank cites his sources in showing that, taking time to drink water when our bodies cues us with thirst, for the average adult, is all that is needed. 
• Sleep: Sleep studies show a similar trend in those suffering with insomnia, that a poor understanding of how good sleep is acquired is equally matched by complicated approaches. Better sleeping will often come from trying less; that we need to listen to our bodies rather than constantly be trying to manipulate them (Carney et al., 2010; Carney & Manber, 2013). 

What Else Does Health Simplicity Apply To?

Might it be a stretch if I predict these same principles could be found in other areas of health? For example, could it be, that healthy exercise may include nearly no exercise regimes? That while working out with iron weights is acceptable, it’s also not nearly as health producing as reducing the amount of time you sit during the day or a simple walk instead? 

Could it be that mental health is also the same in its simplicity? 

In addition to the over complexity we make of health and change, we drain our reserves. Goal setting, then, if effective at all, should be helpful for identifying priorities in order to simplify our lives. This however, is not the case. Certainly, there is evidence that failing to achieve goals has a negative impact on the individual (Fishbach & Ferguson, 2007; Förster, Liberman & Friedman, 2007). Often, goal setting is simply a reminder of failure and can detract from our already spread-thin ability to make focused decisions (Moberly & Watkins, 2010; Jones et al., 2013). 

The Major Mistakes People Make with Goals 

The major mistakes people make with goals include: 

• Setting broad goals that are not clear (I.e. “be a better person”) 
• Setting avoidance goals (I.e. “don’t smoke”) 
• Not making an action plan to achieve the goal 

The bigger problem is this: If one’s goal was to quit smoking, in some ways, they never “achieve” that goal so long as they are still alive. Secondly, if at any point you smoke once, you’ve failed your goal.  Therefore, the goal of trying to quit smoking is notoriously failed because it’s nearly impossible to achieve in the first place. In having this discussion during an OT group discussion I was facilitating, a patient once pointed out to me: 

“I disagree, I believe quitting smoking can be achieved, because I quit a long time ago and don’t ever think about smoking now.” 

In this patient’s case, I would agree. Yet for the majority of people, this state of freedom from temptation is rarely the case for any goal from food, drugs, to weight-loss. In looking for more details as to what the failure or success rate of goal setting is, I find it difficult to find adequate information. Most literature I found, is related to corporate planning or a new years resolution.  

New Years Resolutions

Statisticbrain.com (2018) found the top three most common New Year’s resolution was:  

1. Lose Weight/Healthier Eating at 21.%. 
2. Life / Self Improvements at 12.3% 
3. Better Financial Decisions at 8.5% 

Statista.com (2018) found the top three most common New Year’s resolution was:  

1. Save money at 53% 
2. Lose weight or get in shape at 45% 
3. Have more sex 25% 

Notably, these goals have a high failure rate, which is likely due to the fundamental error of being vague. These results also show dramatic variation, making the likelihood of accurate results, poor. The methods used to obtain the statistics are likely influential in the results. Statisticbrain.com also reports that the highest demographic for achieving their goals by self-reported means were the 20-something year olds at 37.8%. One could likely find support that those who are better at achieving their goals are more likely to also answer questionnaires, surveys, and participate in studies in the first place.  As the researchers Epton et al., found in 2017, the majority of goal setting research was conducted on the 20-something, male, white, students.  

Where Did Goal Setting Come From? 

What I want to know is the hard truth: how can we live healthy lives? In what way is goal setting actually helpful for the average person on a day-to-day basis? The average person being, NOT high-level exceptional athletes or mega-rich CEO’s. I want to know about how goal setting positively effects the store clerk, the college student, or the stay at home parent. 

Goal setting is one of those modern catch-phrases that has been drilled into my head by TV, books, classes, and work. It’s a shocking moment to ask oneself:  

• Where did goal setting come from? 
• Who determined goal setting was so needed? 

The word Goal, itself is listed by Merriam-Webster as being first used in 1531 as a middle English word for boundary or limit. Merriam-Webster’s (2018) definition of

“Goal: the end toward which effort is directed : aim “ 

Henry David Thoreau born 1817 is credited with the quote: 

“What you get by achieving your goals is not as important as what you become by achieving your goals.” 

The above quote might lead one to think “goal setting”, as it’s used today, has been around for centuries. Quote investigator (2016) found that this Thoreau quote is not confirmed to have come from Thoreau but instead a misquote of Zig-Ziglar’s 1974 quote: 

“What you get by reaching your goals is not nearly so important as what you become by reaching them” 

Goals and Purpose  Versus Goal Setting

However, it’s primary uses have been related to sports or as a synonym for purpose. This is a very different type of goal, than say, “losing weight.” Unless your life’s purpose was to lose weight, in which case you would not live long. I was surprised to find out, goal setting has been around for less than 100 years. I am sure in some way, we can contribute the success of modern industry and technology to goal setting, if you believe those are good things.  

Almost all available sources credit Edwin Locke and Gary Latham as the primary developers of “goal setting” as it’s used today. Others have been credited such as Cecil Alec Mace, with beginning the research that led to goal setting in 1935. However, it’s Edwin Locke, who first established goal setting in a 1968 article titled Toward a Theory of Task Motivation and Incentives (1968). 

Though this goal setting theory has only been around 50 years, it is treated like an 11th commandment of the bible. The problem is, this goal setting theory is almost entirely aimed at the workplace environment for labor, production, industry, and management. I am not arguing this is wrong, I am arguing it’s misplaced in society and health for the common-person.  

Though goal setting was used for the workplace, it has been found to have influenced a variety of major movements in the social sciences as Lunenburg (2011) explains: 

• Maslow’s (1970) Hierarchy of Needs 
• Skinner’s (1979) Operant-based behaviorism 
• Vroom’s (1994) VIE theory 
• Bandura’s (1986) Social Cognitive theory 
• Herzberg’s (2009) Motivation theory 

Edwin Locke and Gary Latham have continued to develop the theory involving goal setting.  They report “goal setting is an open theory” and” can be used effectively on any domain in which an individual or group has some control over the outcomes” and “can be applied in numerous other settings” in which they include sports and rehabilitation (Locke & Lathem, 2006). 

Are S.M.A.R.T Goals Actually Smart? 

There is a variety of goal setting acronyms, most which include the same elements. I’ve found the most common and familiar to be S.M.A.R.T goals. 

1. Specific 
2. Measurable  
3. Achievable 
4. Relevant  
5. Time-Bound 

It appears S.M.A.R.T goals really are the gold-standard of goal setting and as explained by Epton et al., (2017) “Goal setting theory (Locke & Latham, 2002; Locke & Latham, 2006) postulates that goals are optimally effective if:  

1. the goal is sufficiently difficult,
2. people are committed to the goal,  
3. the task complexity is not too high,  
4. feedback on goal progress is provided, and  
5. there are adequate situation resources / few situational constraints. “ 

There are several problems however. These goals are primarily for concrete, quantitative, metric oriented, and workplace long term goal setting. Yet despite the fact that S.M.A.R.T goals are for long-term, there is little evidence that goal setting changes behavior longer than 1 year (Epton et al., 2017). As researcher Traci Mann argues in regards to dieting and weight loss, there is few studies and in-fact poor support for dieting beyond 2 years (Mann, 2015).  

However, S.M.A.R.T goal setting was designed at the outset for corporate use, not personal daily use. My focus is not to attack the use of S.M.A.R.T goals. In fact, there is research evidence to support the use of S.M.A.R.T. goals, as S.M.A.R.T. goals are a direct derivative of Edwin Locke and Gary Latham work and research. The researchers Epton et al., (2017), in a recent large Meta-analysis of 141 research articles on goal setting re-evaluated the goal setting ideals explaining evidence that goal setting is effective if: 

1. difficult,
2. set publicly, and
3. was a group goal.  

But Does This Apply to Mental Health?

Unfortunately, Goal setting as it relates to mental health care falls short in a variety of ways including; the lack of studies including those with low socioeconomic status, in primary care, behavior versus performance, diverse populations, or beyond a year of use (Epton et al., 2017). 

Practically everyone I work with, goal setting has not been applied effectively too. 

The most important distinction and point I would argue Epton et al., (2017) make in their meta-analysis, as it applies to the common person and to mental health use, is the difference between behavior versus performance goals. Epton et al., (2017) argues, little research addresses this difference. 

I used to utilize S.M.A.R.T goals in my mental health groups. As you may or may not expect, this was quite possibly the most boring group I had. I tried to make it interesting, adding treats, trying paint swatches and creative materials, using games, but with no avail. The reality is, practically no one kept the goal setting materials, and it’s unlikely anyone used the S.M.A.R.T method. It’s unlikely anyone used any method.  

How Do Goals Relate to Occupational Therapy? 

One of the definitions of occupational engagement in the occupational therapy practice framework cites Christiansen et al., (2005): 

“Goal-directed pursuits that typically extend over time, have meaning to the performance, and involve multiple tasks” 

The word “goal” occurs 52 times in the occupational therapy practice framework (AOTA, 2014). Goal setting, certainly has a major role in the profession of occupational therapy. It’s implied that the founders of occupational therapy emphasized goals in addition to a client’s environment, values, and desires back in 1922. However, as Locke hadn’t developed goal setting until 1968, it’s likely the use of the concept “goals” initially was similar to “purpose in life.” The use of goal similar to purpose is different however, than this example of goal use as found in the occupational therapy 3rd practice framework (AOTA, 2014): 

“Financial Management: Using fiscal resources, including alternate methods of financial transaction, and planning and using finances with long-term and short-term goals” (AOTA, 2014). 

What OT’s Do in Mental Health

Occupational therapists however, have provided a variety of interventions in inpatient mental health including; Leisure, counseling, anxiety management, ADLs, creative activities, assertiveness, social skills, and work (Craik, Chacksfield, & Richards, 1998). As Lloyd et al. (2010), list, occupational therapists primarily provide services through: 

Individual assessment 

Individual treatment 

Therapeutic groups 

Discharge planning 

It appears however, there is great variation in what interventions that are used in mental health settings and how groups are conducted (Lipskaya-Velikovsky, et al., 2014). Still, in a recent meta-analysis by Ikiugu et al., (2017), occupational therapy was found to have a positive small to medium effect in long-term outcomes. While the words “small” and “medium” do not sound ground-breaking, those words reflect a valuable outcome: behavior change. 

The Need for Better Goal Setting

Goal setting however, is quite metric focused; in most-cases it relates to the care-plan. Goals then, as used in occupational therapy, tend to be performance based or else broadly related to an individual’s purpose. While occupational therapy, incorporating goal-directed behavior has supported evidence in positive outcomes for providing mental health treatment, it’s likely, S.M.A.R.T goals are ineffective for the day-to-day lives of those struggling to practice positive mental health. While I may not have sources to back up that claim, there are equally, NOT sources available to support the use of S.M.A.R.T. goals or performance goals, or goal setting in general, with the mental health population, and particularly the inpatient setting. As Sames (2010), explains in Documentation in Occupational Therapy:  

 “In acute care settings where clients are seen for a short time, the occupational therapy staff may not distinguish between short- and long-term goals. There are just goals. It is not necessary to separate goals by length of time when the occupational therapy practitioner is only going to work with the client for less than a month. Some facilities or programs may not separate long- and short-term goals if the clients are seen for 90 days or less…” 

In short, goal-directed behavior is important. Goal setting as it’s commonly used is poorly supported for the mental health population. It appears, goals and goal setting whether performance based or behavior changing, has not been adequately studied. Occupational therapy provides goal-directed treatment for the mental health population. While goal setting may be valuable in other areas of occupational therapy practice, the mental health setting, could likely use more effective tools when it comes to supporting clients, patients, or participants in treatment with goal setting; that is, if goal setting is to have long-term behavior changing positive outcomes. 

My Goal Setting Epiphany

One day, an epiphany hit me: 

“how, if I didn’t practice goal setting as a healthy, educated, mental health practitioner, was I supposed to expect people going through a low point in their lives to actually set and adhere to their own goals?” 

This motivated me to re-evaluate my approach. 

Like a message from heaven, I came across two videos within days of having my previously mentioned epiphany. In the first video, Adam Alter (2017) engages in an interview-style discussion for Big Think about how goal setting is a “broken process.” Adam continues to argue that we should scrap goal setting and instead make “systems” which focus on changing daily behavior. This sounded convincing to me. Then a viral video about the value of the “daily sketch” was produced by a Youtuber by the name of Kesh (2017), this video was the perfect illustration of using a system instead of a goal.  

At this point I was won over with this new method of creating systems instead of goals.  

However, I still knew opinion was not enough to begin teaching new methods in an inpatient mental health hospital, I needed more. I needed an evidence-based, literature supported, scientific, and medical reason to redesign the goal setting process group. 

Fortunately for me, within a week from watching those videos, I read an article in my professional magazine called OT Practice. That article was titled Putting Goals Into Action for Health Behavior Change (Baily, 2017). This article could not have come at a more opportune time. 

In this article, the author describes exactly the same thing as a system, but instead calls it a “Mastery Goal” as its cited in previous research. 

A Theme Among Experts

I find a theme in these types of debates. One expert argues for this, another expert argues for something else. Yet the fundamentals are relatively the same, it seems the biggest issue is not goal setting. The issue is the process that takes place when people intend to achieve change.  

In a pragmatic approach, while different things work for different people at different rates of change; it might be that the process of change remains the same.  

Goals as they are traditionally set, when applied to the daily lives of the common person, are as Adam Alter describes as “being in a failure state” until reaching that goal, feeling good for quick unsatisfying moment and making a new hopeless goal that leaves you feeling like a donkey chasing a carrot. 

The issue again, is not the term goal or system, it’s the process. In some ways, the whole philosophy behind my profession as an occupational therapist is to use systems or mastery goals for day to day tasks. You can set a S.M.A.R.T goal if you would like, such as run a marathon, at a certain speed, on a particular day, in order to consider yourself health.  

Practical Goal setting for the Real Person 

Earlier I explained that goal setting was initially designed for the workplace environment. The research by Epton et al., (2017) argued that there was a poorly defined distinction between performance goals versus behavior goals. Behavior goals come with a variety of names also including mastery goals or systems. While the meta-analysis and study by Epton et al., (2017) found there to be little research into the use of “behavior goals”, I’d argue, that there is a massive amount of evidence, research, and support for them; just not in the realm of “goal setting.” Instead, the support is found in behavior changes in the fields of science such as dieting and nutrition as addressed by Traci Mann (2015). The main differences of types of goal setting are listed effectively by Mann, Kentaro & Ridder (2013) below: 

Performance vs. Mastery Goals 

Performance goals place emphasis on a future desired outcome like losing weight or trying to quit smoking. 

Mastery goals sets the emphasis on developing a particular skill and tends to be time based like walk or draw for 15 minutes every day. 

Approach vs. Avoidance Goals 

Approach goals describe what you are trying to do such as eat salad or go for a run 

Avoidance goals involve avoiding things like desert or cigarettes

Challenging vs. Easy Goals 

Challenging can sometimes be motivating but not if unrealistic 

Easy goals can be quite useful for momentum building

However, instead of procrastinating, the more effective goal is to make a goal that features these elements; achievable on a near daily basis, time-based, and easy to start. This is creating a habit. Habits create behavior change. That is why Brian Wansink (2007), the nutrition and diet scientist/researcher makes the claim “The best diet is the one you don’t know you’re on.” If anything, a functional, practical, useful, personal goal for the common person that will actually change habits and behaviors is likely to be: 

Everyday – (Something you can DO nearly every day) 

Action-oriented – (Don’t avoid things – always plan to DO something) 

Short-time – (make it easy to DO, such as 2-20 minutes) 

Your Purpose – (it should fit into your life and purpose!) 

Summary 

Where am I going with all this? You might be wondering the same thing I’m wondering; what is the point of creating large written articles about the complexity and misconceptions about goal setting if it just adds to the heap of words written in places that few will read?  

I agree. 

I don’t think this article will change the understanding, health, or lives of many. What I hope to do in the future is, simplify this information into handouts and materials that might be useful to the common-person. With the website MillennialOT.com, my vision is to advocate that positive mental health is simple rather than complex and can be engaging rather than boring. Before I do that, I must know what I’m talking about.  

These articles are comprehensive approaches to topics of information, building an evidence-based, research supported, and grounded, epistemology of sorts.  

Similar to how I addressed the issue of the negative impact of vague and broad definitions of health and well-being; there appears to also be an issue of vague and broad definitions of the use of goals and goal setting. 

On one hand, there is the use of “goal” similar to purpose such as “it’s my goal in life to have grandkids” versus the use of goal as a concrete objective measure such as “It’s my goal to make 1,000 sales this year”. As Epton et al., (2017) point out, there is a poor differentiation from performance goals “it’s my goal to make 1,000 sales this year” and behavior change goals like “I am going to exercise every day.” 

If one theme is reoccurring, it’s the importance of specific definitions and clarity. If one’s goal is to be healthy, then one better define what a goal is and what health looks like; or they won’t accomplish either.  

References

American Occupational Therapy Association.(2014).Occupational therapy practice framework: Domain and process (3rd ed.).American Journal of Occupational Therapy, 68(Suppl.1), S1–S48.http://dx.doi.org/10.5014/ajot.2014.682006 

American Occupational Therapy Association. (2013a). Guidelines for documentation of occupational therapy. American Journal of Occupational Therapy, 67(Suppl.), S32–S38. http://dx.doi.org/10.5014/ajot.2013.67S32  

Alter, A [Big Think]. (2017, June 21). Goal setting is a hamster wheel. Learn to set systems instead [Video file]. Retrieved from https://youtu.be/x44zEK39GOM

Baily, R. R. (2017, July 10). Putting goals into action for health behavior change. OT Practice.  

Baumeister, R. F., & Tierney, J. (2012). Willpower: Rediscovering the greatest human strength. Penguin. 

Campbell, T. C., & Jacobson, H. (2013). Whole: rethinking the science of nutrition. BenBella Books. 

Carney, C. E., Edinger, J. D., Morin, C. M., Manber, R., Rybarczyk, B., Stepanski, E. J., Wright, H., & Lack, L. (2010). Examining maladaptive beliefs about sleep across insomnia patient groups. Journal of Psychosomatic Research, 68(1), 57–65. http://doi.org/10.1016/j.jpsychores.2009.08.007 

Christiansen, C., Baum, M. C., & Bass-Haugen, J. (Eds.). (2005). Occupational therapy: Performance, participation, and well-being. Thorofare, NJ: Slack. 

Craik, C., Chacksfield, J. D. & Richards, G. (1998). A survey of occupational therapy practitioners in mental health. British Journal of Occupational Therapy, 61(5). 227-234.

Epton, T., Currie, S., & Armitage, C. J. (2017). Unique effects of setting goals on behavior change: Systematic review and meta-analysis. Journal of consulting and clinical psychology, 85(12), 1182. 

Fishbach, A., & Ferguson, M. F. (2007). The goal construct in social psychology. In A. W. Kruglanski & E. T. Higgins (Eds.), Social psychology: Handbook of basic principles. (2nd ed., pp. 490–515). New York: Guilford Press. 

Förster, J., Liberman, N., & Friedman, R. S. (2007). Seven principles of goal activation: A systematic approach to distinguishing goal priming from priming of non-goal constructs. Personality and Social Psychology Review, 11, 211–233. Doi: 10.1177/1088868307303029 

Goal. 2018. In Merriam-Webster.com. Retrieved March 15, 2018, from https://www.merriam-webster.com/dictionary/goal

Ikiugu, M. N., Nissen, R. M., Bellar, C., Maassen, A., & Van Peursem, K. (2017). Centennial Topics – Clinical effectiveness of occupational therapy in mental health: A meta-analysis. American Journal of Occupational Therapy, 71, 7105100020. https://doi.org/10.5014/ajot.2017.024588 

Kesh [Kesh]. (2017, January 9). Man who drew everyday for 10 years [Video file]. Retrieved from https://youtu.be/Cwne8d2FZ6E

Lipskaya-Velikovsky, L., Avrech, B. M., Bart, O. (2014). Context and psychosocial intervention in mental health. Scandinavian Journal of Occupational Therapy. 21(2). 136-144.  

Locke, E. A. (1968). Toward a theory of task motivation and incentives. Organizational behavior and human performance, 3(2), 157-189. 

Locke, E. A., & Latham, G. P. (2002). Building a practically useful theory of goal setting and task motivation: A 35 year odyssey. American Psychologist, 57, 705-717. doi: 10.1037/0003-066X.57.9.705.  

Locke, E. A., & Latham, G. P. (2006). New directions in goal setting theory. Current directions in psychological science, 15(5), 265-268. 

Lloyd, C., & Lee Williams, P. (2010). Occupational therapy in the modern adult acute mental health setting: a review of current practice. International Journal of Therapy and Rehabilitation, 17(9), 483-493. 

Mann, T. (2015). Secrets from the Eating Lab. New York: HarperCollins. 

Mann, T., Kentaro. F., & Ridder, D. D., (2013). Self-Regulation of Health Behavior: Social Psychological Approaches to Goal Setting and Goal Striving. Health Psychology. 32(5). 487-498. Doi: 10.1037/a0028533 

Pollan, M. (2008). In defense of food: An eater’s manifesto. Penguin. 

Quote Investigator. (2016 December 6). What you get by reaching your goals is not nearly so important as what you become by reaching them [webpage]. Retrieved from https://quoteinvestigator.com/tag/henry-david-thoreau/ 

Sames, K. M. (2010). Documenting occupational therapy practice (2nd ed.). Pearson. 

Statisticbrain. (2018). New Years Resolution Statistics [Webpage]. Retrieved March 15, 2018 from

https://www.statisticbrain.com/new-years-resolution-statistics/

Statista. (2018). United States: “What are your 2018 resolutions?” [Webpage]. Retrieved March 15, 2018 from https://www.statista.com/statistics/378105/new-years-resolution/

Thomas, F. [Thomas Frank]. (2018, January 29). How to Stay Hydrated: Here’s Everything You Need to Know [Video File]. Retrieved from https://youtu.be/OEdR116n-78 

Wansink, B. (2007). Mindless eating: Why we eat more than we think. Bantam.