Goal Attainment Scaling for ________________________________________
Levels of  Predicted  Attainment	Scale 1 (Wt.) ____ Employment	Scale 2 (Wt.) _____ Self-Esteem	Scale 3 (Wt.) ____ Appointments	Scale 4 (Wt.) ____ Education Progress	Scale 5 (Wt.) ____ Attitude toward Birth Control	Scale 6 (Wt.) ____ Depression
+ 2  Much more than  expected  outcome	Without prompting expresses strong desire to work 1 2 3 4 5 6 7 8	Seeing options and making decisions without prompting 1 2 3 4 5 6 7 8	Attends all Appointments 1  2  3  4  5  6  7  8	Expresses excitement or thrill regarding education 1  2  3  4  5  6  7  8	Highly motivated w/ birth control 1  2  3  4  5  6  7  8	None 1  2  3  4  5  6  7  8
+1  More than  expected outcome	1 2 3 4 5 6 7 8	Can see some options and make some decisions 1 2 3 4 5 6 7 8	When missing an appointment calls most of the time. 1  2  3  4  5  6  7  8	Discusses educational needs w/out being prompted to do so 1  2  3  4  5  6  7  8	Shows some motivation 1  2  3  4  5  6  7  8	Low degree 1  2  3  4  5  6  7  8
0  Expected  outcome	With prompting expresses desire to work 1 2 3 4 5 6 7 8	Sees options and able to make decisions with prompting 1 2 3 4 5 6 7 8	When missing an appointment calls to reschedule most of the time 1  2  3  4  5  6  7  8	Discusses the need for education 1  2  3  4  5  6  7  8	Unsure about the use of birth control 1  2  3  4  5  6  7  8	Manageable 1  2  3  4  5  6  7  8
-1  Less than  expected  outcome	Prompted, but feels reluctant or unsure about job 1 2 3 4 5 6 7 8	Will pursue a decision if pushed by clinician/law 1 2 3 4 5 6 7 8	Rarely calls to reschedule an appointment 1  2  3  4  5  6  7  8	Will address education when prompted to do so 1  2  3  4  5  6  7  8	1 2 3 4 5 6 7 8	High degree 1  2  3  4  5  6  7  8
-2  Much  less than  expected  outcome	Prompted but expresses no interest in job 1 2 3 4 5 6 7 8	Cannot make decisions or consider options 1 2 3 4 5 6 7 8	Never keeps appointments 1  2  3  4  5  6  7  8	See no need for educational advancement 1  2  3  4  5  6  7  8	No motivation about using birth control 1  2  3  4  5  6  7  8	Clinical depression (Needs additional services) 1  2  3  4  5  6  7  8

GAS Composite Scores 1 = ____ 2 = ____ 3 = ____ 4 = ____ 5 = ____ 6 = ____ 7 = ____ 8 = ____