OT Goal Writing Tips for Adults & Older Adults

Goal writing in occupational therapy can feel tough. Goal writing correctly and effectively can be even tougher. This is especially true when you’re an OT student or are a new grad occupational therapist. 

This article will help simplify the goal writing process for OTs working in adult rehab settings, such as inpatient rehab, subacute rehab, home health, and acute care.

These goal writing tips will help make writing your goals a bit easier for those of you who have to write them free-hand (as opposed to checking boxes for pre-set goals), since many OT documentation systems don’t have the pre-set goal option.

This method is how I learned to write my goals, and these goals are examples of my typical goal writing style. To play it safe, always be sure to first talk with your clinical instructor or rehab manager to determine how your specific setting prefers their goals to be written. 

I also highly recommend writing your own goals without AI help throughout school and as a practitioner for your first several years so you can solidly learn how to write them yourself. 

If you are instead looking for pediatric OT goal resources, here is a great article on pediatric OT goal writing from the Note Ninjas as well as a human-written free pediatric goal bank.

OT Goal Writing Tip #1: Write SMART Goals

You likely already know that both short term and long term goals need to be objective, measurable and realistic. There are many different formats you can use to make sure your goals include these components.

The SMART method of writing goals (SMART meaning Specific, Measurable, Attainable, Realistic, Time-bound) leads you through all of the necessities of the goals.

Along with being a great option as a therapist, the SMART goal writing method is a widely popular goal setting method in management and in almost every arena where goal-setting is commonplace.

OT Goal Writing Tip #2: Try the COAST Method

If SMART feels a bit generic for therapy documentation, the COAST method is worth learning. It was developed by Gateley and Borcherding in their Documentation Manual for Occupational Therapy and is popular among OTs specifically because it’s occupation-centered by design. It forces you to name the occupation in every goal.

COAST stands for:

C–Client. The goal is written in terms of what the client will do, not what the therapist will do. Every goal starts with the client as the actor. “Patient will…”

O–Occupation. The specific functional task being addressed. This is what makes COAST distinctly OT. “…complete lower body dressing…”

A– Assist level. The level and type of assistance expected (physical assist levels, number of verbal cues, or visual cues). Be careful not to mix assist types within one goal.

S–Specific condition. Under what conditions will the client perform this? Seated versus standing, with adaptive equipment, in a specific environment. 

T–Timeline. By when. “…within 2 weeks.”

Put together: Patient will complete lower body dressing with min assist with adaptive equipment as needed within 2 weeks.

One useful flexibility: the elements don’t have to appear in COAST order. You can begin with any element as long as all the components are present. Reorder them however the sentence reads best.

Why some OTs prefer COAST: because it requires you to name an occupation, it makes it much harder to accidentally write a goal that isn’t occupation-based. It also produces goals that clearly communicate our focus on occupational performance to third-party payers, which matters for reimbursement.

SMART vs. COAST: Which Should You Use?

They’re not competing methods so much as different lenses, and a well-written goal usually satisfies both.

SMART is a quality check–a way to test whether a goal you’ve written is actually usable. COAST is a construction template–a way to build the goal in the first place. Many OTs draft using COAST and then review against SMART.

You may also encounter RUMBA or RHUMBA (Relevant, How long, Understandable, Measurable, Behavioral, Achievable), particularly in school-based settings.

As always, ask your CI or rehab manager what your setting prefers when in doubt.

Writing Short Term and Long Term OT Goals

Short Term OT Goal Example

Your patient is currently Max assist at admission for toilet transfers in inpatient rehab, getting OT services 5x per week. A short term goal, focusing on ADL transfers, for this patient is as follows: 

In 7 days, patient will transfer to toilet with Mod assist using DME as needed.

This short term goal is specific because we know exactly what type of transfer we are going to work on.

The level of improvement for a short term goal typically should not be written for more than one level of assist to ensure success. An example of this: If my patient is Max assist for toilet transfers at the evaluation, I will not write a short term/one week goal for the patient to be Min assist, instead I will set the goal for Mod assist for toilet transfers to be realistic.

The goal is measurable. We can test to see whether or not the patient is still requiring Max assist after the 7 day period or if they now only require moderate assist.

This is an achievable goal for a typical patient. With experience, you will gain a better feel for what is an achievable goal and what is not. If you are not sure if a goal is achievable, don’t be afraid to ask your manager or another experienced OT on site.

This goal is relevant to occupational therapy and to the patient because all patients in this situation ultimately want to be able to move around safely on their own during their self-care tasks.

The goal is time bound since the goal must be achieved within 7 days.

Long Term OT Goal Example

You can write a long term goal (this one is again based on a toilet transfer) by modifying the time and assist level.

By discharge, patient will transfer to toilet with Min A using DME as needed.

For long term goals, improvement is typically two levels of improvement for the assist, as seen in the above goal.

Another example: Your patient is Min assist for toilet transfer at evaluation, so you can set their long term goal to Modified Independent for their toilet transfer long term goal.

With any adult OT setting, you can upgrade the goals if your patient is meeting them early. To play it safe, I typically stick to the two-level rule and update the goals if/when the patient is exceeding them.

It is also very important to keep your patient’s goals functional and occupation-based. Functional goals may include toileting, toilet transfers, dressing (upper and lower body), and bathing-related goals (including tub or shower transfer if appropriate).

I rarely write strength/MMT goals in my acute care or inpatient rehab settings as a personal preference, but some therapists do include these goals along with a functional component, which is also fine. 

Writing Higher Level IADL Goals

For higher-level IADL goals, you can incorporate a meal prep goal, medication management goal, or a community re-entry goal if these IADLs are relevant to your patient.

The community re-entry goal will usually depend if outings can be facilitated at your location. Your facility will likely have their own preference, and you can learn a lot from looking at your OT coworkers’ goals.

Patient goals should always relate to what will benefit your patient the most and help them achieve their highest level of independence.

Lastly, don’t forget to ask your patient for ideas of what they want to achieve. This will help to make your intervention plan client-centered and the most helpful plan for your patient.

For a great in-depth OT goal writing analysis with additional goal writing styles, be sure to check out this podcast from adult-based OT Mandy Chamberlain here: 

 

Do you have any additional occupational therapy goal writing tips or favorite OT goal resources that you would add? Please feel free to share them in the comments below!

Looking for more OT Goal Writing resources? Be sure to check these out!

Adult OT Goal Bank (My OT Portfolio)

Documentation Writing Orientation (Holsman Healthcare)

This post was last updated on September 1, 2026.