Progressive Goal Attainment Program




PGAP was developed by University Centre for Research on Pain and Disability which states, “Resumption of occupational activities is a central objective of PGAP”. This program was designed as a disability prevention program and is used to identify and treat individuals who are considered to be “at risk” for the development of chronic disability resulting from pain. As individuals become disabled due to an injury or debilitating illness, they avoid participation in many important activities of daily living. Some of these tasks are abandoned due to significant functional limitations whilst others are due to psychosocial factors like fear of re-injury, pain “catastrophizing” or client’s high “perceived disability” which result in subsequent loss of confidence and a pessimistic outlook on their lives delaying their overall functional recovery. PGAP is a 10 week standardized program that can be provided one-on-one in-clinic or in-home once a week by our trained physiotherapist or occupational therapist. The initial treatment sessions focus on activity re-integration by providing education on hurt vs. harm, encouraging strategies like pacing, activity planning and energy conservation. Later sessions focus on decreasing the psychosocial barriers identified via the initial assessment. Return to meaningful vocation is encouraged towards the end of the program based on the client’s initial goals, overall success, and compliance within the program. The main goal of the program is to improve quality of life and “maximize activity in spite of pain”. The main focus of PGAP is on disability reduction as opposed to pain reduction. However, pain management strategies are provided through the course of the treatment.

Who is an appropriate client for PGAP?
PGAP is appropriate for clients who suffer significant loss of function, have poor awareness of pain science, high perceived disability, ++pain focused behaviour or are unable to return to meaningful vocation due to persistent pain either through injury or illness. An initial evaluation to determine the fit/appropriateness for participation in the PGAP is done by asking the potential clients to complete three questionnaires which when scored, place them in one of the three categories; low risk, moderate risk or high risk to develop chronic disability.