One of the many kinds of interventions that we offer at ModernOT is the Progressive Goal Attainment Program (PGAP).1 Our OTs, like Lisa Daly and Lois Detlefsen, use the PGAP with many of their clients. They’ve shared some of their thoughts on the program, and why it’s a good treatment option for some of their clients.
A little background
This 10-week evidence-based program was developed to reduce disability associated with pain, depression, cancer, and other chronic conditions. The program works to identify and lessen things that are standing in the way of rehabilitation progress. It also works to “promote re-integration into life role activities, increase quality-of-life, and facilitate return to work.”2
Julia: What is it about PGAP that you like?
Lisa: For the right clients, it can be a valuable tool to concretely track progress, successes, and areas of improvement. I’ve found that it can be a motivating factor in clients actively engaging in their rehabilitation.
Lois: I agree. It’s a great way for clients to see the link between behavioural changes and function. For example, if someone sets a goal to walk for 15 minutes three times per week, the PGAP can track the impact that this has on an array of areas, including pain, post-traumatic stress, fatigue, and cognitive and emotional issues.
Julia: Is PGAP appropriate for all clients? How do you determine if it’s the right fit?
Lisa: There is a screening process that helps to determine if the program is right for a client.
Lois: As an OT, I also look at a client’s history, function, goals, and abilities and evaluate if the program would be of benefit.
Julia: As OTs, you work with a wide diversity of the population, are there specific groups that you find this program works with best?
Lisa: I’ve use the program with clients suffering from post-traumatic stress disorder or other mental health issues, people who have been in serious car accidents, active service members in the military, or people who are struggling to return to work after experiencing an incident.
In short, no, PGAP is a program that can have value for all clients who have experienced disruption in their lives, whether social, family, recreational, or work activities. That being said, as discussed earlier, our clients are assessed formally and informally to determine if PGAP is the appropriate tool to help in rehabilitation.
Julia: What kind of gains can someone expect to make if PGAP has been deemed as appropriate?
Lois: It really depends on the client, their circumstances, and how engaged they are in their rehabilitation process. I’ve worked with clients who have noted improvements in sleep, reduction in pain and depressive symptoms, less fear surrounding exacerbating symptoms through activity, and feeling less overwhelmed by their symptoms. Sometimes gains that are a made are big, like being able to start a return-to-work program, and other times they’re small, like eating two healthy meals per day.
Lisa: That being said, PGAP isn’t a one-time, magical fix. A client’s rehabilitation journey isn’t necessarily over after the 10-week program, the client will need to continue to invest their time and energy into maintain the gains that they’ve made and working towards new goals.
1. PGAP was developed at McGill University’s Centre for Research on Pain and Disability.