On the validity of goal attainment scaling as an outcome measure in mental health

Abstract

Goal attainment ratings by therapists were found to be poor predictors of all outcome measures. On the other hand, clients' ratings of goal attainment were found to correlate significantly with most other measures of treatment outcome. However, clients' goal attainment ratings did not correlate significantly with overall community adjustment which is one of the more important long term outcome measures. As well, the regression analysis indicated that clients' ratings were only slightly predictive of recidivism, and were considerably less powerful predictors than other outcome measures such as length of stay, employment, or community adjustment. These results suggest that goal attainment, as it was measured in the present study, had inadequate concurrent and predictive validity especially when measured by clients' therapists. The validity of goal attainment is vastly improved when clients are used as a source of rating. It is suggested that goal attainment scaling can only remain a viable tool for evaluation of hospital based mental health programs if clients are used as raters and if it is used conjointly with other more traditional measures of treatment outcome.