SOUTH AFRICAN LIFESTYLE MEDICINE ASSOCIATION

Goal-Setting Theory in Action

By Dr Megan Michaux

Goal-setting theory has been studied for decades, and the psychology behind setting appropriate goals is particularly (although not exclusively) applied in promoting physical activity. However, despite the efforts of public health agencies, most individuals do not meet the physical activity recommendations outlined by the WHO1. As lifestyle medicine practitioners, our role is to assist patients in instituting behavioural change and identifying what those changes entail is a crucial step. Setting appropriate goals for physical activity – and for any of the pillars of lifestyle medicine – can be the difference between success and failure in improving our patients’ lifestyles.

Goal-setting theory: Where did it start?

In 1990, Locke and Latham2 formalised the concept of goal-setting theory. Subsequently, they published multiple papers exploring the relationship between goal difficulty, specificity, and the likelihood of success. 3 4 5 6 The findings from these studies indicate that specific and challenging goals are the most effective, with four moderators serving as caveats: ability, feedback, commitment, and resources. These caveats highlight the importance of assessing each patient individually, within a social context, and with regular follow-up.

Another aspect of goal-setting that can influence success is the type of goal. In 2002, Locke and Latham3 discussed the difference between learning goals and performance goals. Learning goals concentrate on the strategies and skills one develops to achieve success, whereas performance goals focus on the task itself. For instance, a performance goal could be “to walk 10,000 steps per day,” while a learning goal would be “identify three methods to increase your daily step count.” For individuals who are new to a complex task, learning goals can often lead to greater success and can also be used to generate positive outcomes from negative feedback.5 7 8 In fact, learning goals can be used to address the four moderators, helping to build confidence in abilities and resources related to the goal. As a patient progresses towards a goal, feedback may highlight areas of knowledge or ability deficit, directing more learning goals along the way. Another option is a process goal. These are akin to learning goals but are more focused on behaviours. While the distinction may be subtle, process goals can result in greater confidence, satisfaction, and reduced anxiety compared to outcome-focused goals. 9 10

These theoretical goal-setting strategies can appear complex and overwhelming; however, in practice, they can be utilised in simple and creative ways to help patients establish appropriate goals likely to lead to successful outcomes.

Applying the theory in practice

Complicated theories often become far simpler when applied in practice. Here’s a short example: A patient might say to you, “My goal is to be more fit.” This is a very general and abstract notion that lacks direction and, with no defined endpoint, will be challenging to work towards.

With discussion, you might find the patient would like to try a specific sport. I will use jogging as an example.

A learning goal in this context might be:

Find three ways to achieve 30 minutes of physical activity per day.

A performance goal might be:

I will jog for 30 minutes three times a week.

A process goal could be:

I will jog while maintaining my heart rate in Zone 2.

Good goal setting is a collaborative effort, and the prescription is not simply an order from the doctor. Considering the patient’s current activity level, previous experiences, and time restraints, for example, is crucial for goal setting. 30 minutes might be far too much for one session for someone who has never gone jogging, but too short for an experienced runner. Delving into any barriers, finding out what resources are available, and directing people to coaching or support services might be of value.

Another strategy is to have multiple goals that run concurrently. One may be an “outcome” goal that is set up as a long-term ideal, combined with multiple process-based goals that can be achieved while working towards this long-term goal. For our patient above, the long-term goal may be a marathon, but the short-term goals could be to run consistently for 10 minutes, then 15 minutes, and so on to build endurance.

Setting goals the SMART way

While goal-setting theory is rooted in complex psychology, there is a straightforward method for its practical application. The SMART method for crafting effective goals was developed by Doran in 1981.11 SMART stands for specific, measurable, attainable, realistic, and time-bound. This framework serves as a blueprint for applying goal-setting theory in practice. Each aspect of a SMART goal corresponds to a component of goal-setting theory and aids in developing meaningful goals with the highest likelihood of success. This method can be applied to goal setting across any of the pillars of lifestyle medicine, although most research on goal-setting theory has focused on physical activity. SMART goals are unlikely to be learning goals, as they necessitate specificity and time constraints, but they can be either process or performance goals, depending on the situation. 12

Updated reviews of several goal-setting studies, including those of Locke and Latham,13 emphasise that challenging and specific goals are most successful. SMART goals embody these characteristics while incorporating the four caveats previously mentioned, ensuring the necessary ability and resources to implement a goal. While a challenging goal is often more likely to succeed, the SMART framework encourages us to consider any limitations by ensuring the goal is both attainable and realistic. Setting unrealistic goals can lead to failure, resulting in diminished confidence and poor follow-through.

It is important to note that evidence suggests that goal setting itself is an effective strategy, especially for physical activity goals. This remains true even if the types of goals, the method used, the duration of follow-up, and the type of monitoring used are less than perfect.14

Goal setting in action

Goal setting can be a complicated task, heavily influenced by an individual’s psychology, confidence, and skills. When executed well, it can significantly impact the implementation of lifestyle changes. What can we learn from goal-setting theory to make this process easier and more successful?

  • Consider learning goals for individuals with little or no experience, knowledge, or skills in the area they wish to improve.
  • Process goals often yield greater success than outcome-based goals.
  • Performance goals are best for those who already possess confidence in their abilities.
  • Utilise the SMART framework to ensure the effective application of goal-setting theory in your practice.
  • Feedback is a vital component of goal setting. If things aren’t working, negative feedback can inspire positive changes. This may be an opportune moment for some learning goals!

Applying goal-setting theory to assist your patients in adopting new behaviours enhances their chances of success. As lifestyle medicine practitioners, we employ a variety of coaching methods and motivational interviewing techniques to empower our patients to make lasting lifestyle changes. Goal-setting theory and the SMART goals framework are both useful tools that can help inspire and maintain lifestyle and behaviour changes.

References:

  1. World Health Organisation. (2010). Global recommendations on physical activity for health. Geneva, Switzerland: World Health Organization.50 C. SWANN ET AL.
  2. Locke, E. A., & Latham, G. P. (1990). A theory of goal setting & task performance. Englewood Cliffs, NJ: Prentice-Hall.48 C. SWANN ET AL.
  3. 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(9), 705–717.
  4. Locke, E. A., & Latham, G. P. (2013). New developments in goal setting and task performance. New York, NY: Routledge. Locke, E. A., & Latham, G. P. (2015). Breaking the rules: A historical overview of goal-setting theory. In A. J. Elliot (Ed.),Advances in motivation science (Vol. 2, pp. 99–126). Waltham, MA: Academic Press.
  5. Locke, E. A., & Latham, G. P. (2019). The development of goal setting theory: A half century retrospective. Motivation Science, 5, 93–105.
  6. Locke, E. A., Shaw, K. N., Saari, L. M., & Latham, G. P. (1981). Goal setting and task performance: 1969–1980. Psychological Bulletin, 90(1), 125–152.
  7. Latham, G. P., & Locke, E. A. (2006). Enhancing the benefits and overcoming the pitfalls of goal setting. Organizational Dynamics, 35(4), 332–340.
  8. Latham, G. P., & Locke, E. A. (2007). New developments in and directions for goal-setting research. European Psychologist,12(4), 290–300.
  9. Weinberg, R. S. (2013). Goal setting in sport and exercise: Research and practical applications. Revista da Educação Física,24(2), 171–179.
  10. Kingston, K. M., & Hardy, L. (1997). Effects of different types of goals on processes that support performance. The Sport Psychologist, 11(3), 277–
  11. Doran, G. T. (1981). There’s a SMART way to write managements’s goals and objectives. Management review, 70(11).
  12. Bjerke MB, Renger R. Being smart about writing SMART objectives. Eval Program Plann. 2017;61:125-127. doi:10.1016/j.evalprogplan.2016.12.009.
  13. Swann C, Rosenbaum S, Lawrence A, Vella SA, McEwan D, Ekkekakis P. Updating goal-setting theory in physical activity promotion: a critical conceptual review. Health Psychol Rev. 2021;15(1):34-50. doi:10.1080/17437199.2019.1706616.
  14. McEwan, D., Harden, S. M., Zumbo, B. D., Sylvester, B. D., Kaulius, M., Ruissen, G. R., … Beauchamp, M. R. (2016). The effectiveness of multi-component goal setting interventions for changing physical activity behaviour: A systematic review and meta- analysis. Health Psychology Review, 10(1), 67–88.