"I want to get better" is where most people start. But better at what? The clearer your answer, the more your therapy can be built around the life you want back.
Ask ten patients what recovery means and you will get ten answers. For one person it is walking a grandchild to school without stopping to rest. For another it is getting back to a job, kneeling in the garden again, or climbing the subway stairs at rush hour without gripping the rail.
Those answers matter. Your therapist knows how to rebuild strength, motion, balance, and endurance. You know what you need that strength for. Good physical therapy, occupational therapy, and speech therapy bring both kinds of knowledge together, and the meeting point is your goals.
What the Research Says About Goals in Rehab
The largest look at this question is a Cochrane review of 39 studies with 2,846 adults in rehabilitation for conditions such as musculoskeletal problems, brain injury, chronic pain, and heart disease (Levack et al., Cochrane, 2015). Compared with no goal setting, setting goals was linked to better health-related quality of life and emotional well-being, and to higher self-efficacy, which is your confidence that you can do what it takes to recover. More structured goal setting was also linked to higher satisfaction with care.
It is worth being honest about the limits. The review rated the quality of this evidence as low to very low, and the results for physical measures like strength or activity levels were inconclusive. Goals are not a treatment on their own. What they do well is give the treatment a direction and help you believe you can get there.
Patients want a say, and do not always get it
In a study published in Physical Therapy, the journal of the American Physical Therapy Association, researchers recorded first visits between 22 physical therapists and 73 patients aged 65 to 94 (Baker et al., 2001). Both therapists and patients said that involving patients in goal setting was important. Yet in most visits, therapists did not take full advantage of the chance to do it. The authors called for education for patients and therapists alike. That is part of why we wrote this post: so you can walk in ready to lead that conversation.
Meaningful goals keep people engaged
When researchers surveyed 199 physical and occupational therapists across the United States about what helps patients stay engaged in therapy, the most common answer was making therapy tasks meaningful and clearly tied to the patient's personal goals (Lequerica et al., 2009). Fear of pain, low mood, and memory or thinking problems were the barriers therapists saw most often.
Why Goals Help You Stick With Your Home Exercises
Much of your progress happens between visits. Your home exercise program is where strength and new movement patterns are built day by day. It is also where many people drift. A systematic review of 30 studies found that non-adherence to home-based physical therapy can reach 70% (Essery et al., 2017).
The same review found that people were more likely to keep doing their exercises when they had:
- A clear intention to do the program
- Strong self-motivation
- High self-efficacy, or confidence in their ability
- A history of sticking with exercise before
- Support from family and friends
Personal goals touch almost every item on that list. Ten heel raises are easy to skip. Ten heel raises that get you closer to standing at your daughter's wedding are harder to skip.
How Therapists Turn "Better" Into a Real Plan
SMART goals
Many therapists write goals using the SMART format: specific, measurable, achievable, realistic or relevant, and timed. One practical guide for rehab teams suggests building each goal from up to four parts: the activity, the help or equipment needed, how well or how much, and the time frame (Bovend'Eerdt et al., 2009).
Here is how that changes a vague goal:
- Vague: "I want my knee to feel better."
- SMART: "In 6 weeks, I will walk my grandson the four blocks to school and back, using no cane, without stopping to rest."
The second version tells your therapist exactly what to train: walking distance, endurance, curbs, and maybe crossing the street before the light changes.
Goal attainment scaling (GAS)
Some therapists also use goal attainment scaling. Each goal is rated on a five-point scale from -2 to +2, where 0 means you reached the expected result, and the scale can be weighted by how important the goal is to you (Turner-Stokes, 2009). In plain terms, it lets you see progress even before you reach the finish line. Going from -2 to -1 on "climb one flight of stairs" is real progress worth noticing.
Goals That Fit Real Life: Examples From PT, OT and Speech
Your goals should sound like your life, not like a chart. A few examples of the kinds of goals we hear across our New Jersey and New York clinics:
Physical therapy
- Climb the subway stairs at your station near our Bronx or Brooklyn clinic without stopping halfway.
- Walk a grandchild to school, or keep up on the walk to church.
- Kneel and get back up in the garden, or carry a full watering can across the yard.
- Get through a full shift on your feet when you return to work after an injury.
- Get up off the floor safely, or walk to the mailbox in winter without fear of falling. Our fall prevention program and No Fall Protocol® are built around goals like these.
Occupational therapy
- Button a shirt and get dressed on your own after a stroke.
- Cook a family meal standing at the stove for 20 minutes.
- Type for a full workday without hand or wrist pain.
Speech therapy
- Order your own coffee or make a phone call to a grandchild.
- Eat and drink safely at a family dinner.
- Follow and join a conversation at work again.
Children have goals too, even if a parent helps put them into words: riding a bike, climbing the playground ladder, holding a pencil, or asking for a snack with words. Our pediatric therapy team builds plans around goals that matter to the child and the family.
How to Talk With Your Therapist About Goals
You do not need special words. These steps help:
- Come with one big "why." Before your first visit, write down the one activity you miss most. That becomes the north star for your plan.
- Add two or three smaller ones. Short-term steps, like walking 10 minutes three times a week, make the big goal feel reachable. The National Institute on Aging says goals work best when they are specific and realistic, and suggests reviewing them regularly as you progress (NIA, 2025).
- Share the details. Does your knee hurt only on the stairs at home? Do you have 30 steps up from the train platform? Details let your therapist practice the real task, not just a general exercise.
- Ask how each exercise connects to your goal. If you understand why you are doing it, you are more likely to keep doing it.
- Track your progress. The NIA suggests a step counter or written log, and sharing your progress with a friend or professional for accountability (NIA, 2025). Our free balance self-checks, like the 30-second chair stand and Timed Up and Go, are simple ways to see change over time.
- Bring your support team. Family members can help with home exercises and keep you motivated. Social support is one of the strongest predictors of sticking with a home program (Essery et al., 2017).
- Update your goals. Goals should change as you improve, or if your life or health changes. Reaching one is a reason to set the next.
When to Check In Sooner
Working toward a goal should feel challenging, not harmful. Tell your therapist or doctor before your next session if you have pain that keeps getting worse, new swelling, a fall, or new numbness or weakness.
Call 911 for chest pain or pressure, sudden shortness of breath, or stroke signs such as face drooping, arm weakness, or trouble speaking.
Start With Your Goal at Holsman
At your first visit, your therapist will ask what you want to get back to, test how you move today, and build a plan that connects the two. You can schedule physical therapy, occupational therapy and speech therapy directly. Some insurance plans require a referral for coverage; our staff will verify your benefits. See our insurance page for details.
We have 17 clinics across New Jersey and New York, including the Bronx, Brooklyn, Lyndhurst, and Fair Lawn. If your goal is to move better in your own home, ask about in-home therapy in Northern New Jersey; in New York, in-home care is provided by our sister practice, Home Therapy PT. Call 1-855-465-7626 or contact us.
Frequently Asked Questions
Why do goals matter in physical therapy?
Goals connect your exercises to the activities you want back, like climbing stairs, gardening, or returning to work. A Cochrane review found goal setting in rehabilitation was linked to better quality of life and higher confidence, although the quality of that evidence is low. Goals also help your therapist choose which tasks to practice.
What is a SMART goal in rehab?
A SMART goal is specific, measurable, achievable, realistic or relevant, and timed. Instead of saying you want your knee to feel better, a SMART goal might be walking your grandchild four blocks to school and back without a cane and without stopping to rest within 6 weeks.
What should I tell my therapist at my first visit?
Share the one activity you miss most, a few smaller steps toward it, and the details of your daily life, such as stairs at home or at your train station, your job tasks, and when pain or weakness shows up. Ask how each exercise connects to your goal.
How can I stick with my home exercise program?
Tie each exercise to a goal you care about, track your progress with a log or step counter, ask family or friends for support, and tell your therapist if the program is too hard or too long so it can be adjusted. Research links motivation, confidence, and social support with better adherence.
Do occupational and speech therapy use goals too?
Yes. Occupational therapy goals often focus on daily tasks like dressing, cooking, or working at a computer. Speech therapy goals may include ordering food, making a phone call, following a conversation, or eating and drinking safely.
Do I need a referral for physical therapy?
You can schedule physical therapy, occupational therapy and speech therapy directly. Some insurance plans require a referral for coverage; our staff will verify your benefits.
Sources
- Levack WMM, Weatherall M, Hay-Smith EJC, Dean SG, McPherson K, Siegert RJ. Cochrane Database of Systematic Reviews. Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation. 2015.
- Baker SM, Marshak HH, Rice GT, Zimmerman GJ. Physical Therapy 81(5):1118-1126. Patient participation in physical therapy goal setting. 2001.
- Lequerica AH, Donnell CS, Tate DG. Disability and Rehabilitation 31(9):753-760. Patient engagement in rehabilitation therapy: physical and occupational therapist impressions. 2009.
- Essery R, Geraghty AWA, Kirby S, Yardley L. Disability and Rehabilitation 39(6):519-534. Predictors of adherence to home-based physical therapies: a systematic review. 2017.
- Bovend'Eerdt TJH, Botell RE, Wade DT. Clinical Rehabilitation 23(4):352-361. Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. 2009.
- Turner-Stokes L. Clinical Rehabilitation 23(4):362-370. Goal attainment scaling (GAS) in rehabilitation: a practical guide. 2009.
- National Institute on Aging (NIA), National Institutes of Health. Tips for Getting and Staying Active as You Age. 2025.
This article is for general education and isn't a substitute for an evaluation by a licensed clinician.