When it comes to behaviour change theory, the success of individuals with SMART goals has long been documented. Clients that have a SMART goal for their health are more likely to reach a positive outcome compared to those with a wish or a dream. The development of SMART goals in a dietetic setting has been found to be effective and fundamental in treatment continuation after the first consultation.
Therefore, it is essential that we provide you with some tips for creating SMART goals for your clients.
What is a SMART Goal?
A SMART goal is Specific, Measurable, Achievable, Realistic and Timely. Each of these factors should be considered when developing SMART goals and should be discussed during your initial consultation with your clients.
- Specific: The exact outcome a client is hoping to achieve must be identified. For example, if they want to lose weight, find out how much. e.g. 10kg and include this detail in the goal.
- Measurable: Goals around weight are easily measurable through scale results, skin folds and waist circumference values however, other goals may be more difficult to measure and can be forgotten. Be creative through utilising other resources and tools such as number scales, quizzes, food analysis software and/or pathology results.
- Achievable: An achievable goal is a goal that is a challenge however, possible to reach. This aspect of goal setting allows you to ask, does the client have the knowledge, money, time and skills to achieve the goal?
- Realistic: It’s important to set a goal that is realistic to avoid setbacks. Clients will feel much more motivated to continue to make small changes over time if they are able to really see themselves achieving their overarching goal, rather than struggling to come close.
- Timely: Goals without timeframes can easily get neglected. Therefore, it is essential and SMART to put a timeframe on all goals. For example, “I want to improve HbA1c by 1% in the next 12 months”.
How Many SMART Goals Should Be Set?
Each client should have one overarching SMART goal at a time, with 1-3 strategies put in place to achieve that goal. This makes the focus of the sessions clear to the client.
It is possible to have two goals such as improving cholesterol and weight loss. However, it is important to have a SMART goal for each, as well as their own specific strategies. If your client has more than two SMART goals, it is recommended to prioritise them, focusing on one at a time.
Realistic Time-Frames for SMART Goals
Weight loss timeframes suggest 1-4 kg per month and weight gain timeframes suggest that 0.25-0.5 kg per week is possible depending on nutrition, physical activity and genetics. This is recommended to monitor your clients progress regularly, particularly if they have a long-term goal such as losing 10-12kg over the next year. Realistic time-frames for goals should also account for time required to make behaviour changes, in which research suggests habits can be formed between 18 to 254 days, with variability between individuals.
Developing SMART Goals
SMART goals should be prompted by the dietitian but it needs to come from the client. As their dietitian you need to actively listen and identify specifically what the client wants to get out of the sessions.
Gaining clarity around this is one of the most important aspects of the entire relationship. If you make recommendations based on what you think the client wants verses what the client actually wants, this can be detrimental to the rapport you have built and interfere with the outcomes achieved by the client.
There are nutrition principles and ethics that need to be considered when guiding clients to reach their goals. If a client wants to lose or gain a certain amount of weight that isn’t realistic or would put them at risk of health complications it is important to:
- acknowledge what they want
- let them know you want to help them with their goals
- explain to them the risk involved
- suggest a more realistic goal and explain why it is more appropriate
A common example is elderly clients hoping to lose weight because they think that they should be the same weight they were when they were much younger. One way to navigate this would be to discuss the difference in lifestyle now compared to back then. This allows for a shift in perspective from weight loss to healthy lifestyle changes.
- SMART goal setting is particularly effective within a dietetic based setting and should be completed during initial consultations with all new clients.
- SMART goals are Specific, Measurable, Achievable, Realistic and Timely.
- It is realistic to set 1-2 SMART goals at a time and this should be a process that is facilitated by you to acknowledge and consider the client’s wants and needs.
- Always consider any risks and harm associated with a client’s goals, and make alternative suggestions were applicable to minimise these risks.
- Goal setting is a proven method of health behaviour change and vital to client success.