March 2026 – Progressive Goal Attainment
I would like to introduce you to one of our claims consultants, Ellie Bedard, who attended Professor Michael Sullivan’s training course on the Progressive Goal Attainment Program (PGAP).
This program is, in our experience, the “gold standard” in interventions for claimants with psychosocial issues, helping them return to work.
To become an accredited clinician is not a push-over, and requires some out of hours study-time, as Ellie found out. From her experience she has provided the following write-up.
Ian Bridgman
The Claim Lab
An Overview of the Progressive Goal Attainment Program
By Ellie Bedard
Introduction
In disability management, recovery for individuals can stall even when medical care is appropriate, and symptoms are stable. This reality was a central focus of a recent webinar course I completed on the Progressive Goal Attainment Program (PGAP), led by clinical psychologist Dr. Michael Sullivan. The training highlighted how psychosocial factors often play a decisive role in prolonged disability, and delayed return to work.
PGAP is an evidence-based intervention designed to address psychological and behavioral barriers that interfere with recovery. Commonly used in occupational rehabilitation and disability management settings, the program targets factors such as catastrophic thinking, fear avoidance, perceived injustice, and entrenched disability beliefs. Research by Dr Sullivan and his colleagues has shown that psychological responses, such as catastrophic thinking, often predict disability more strongly than pain intensity, highlighting why PGAP targets these factors directly (Sullivan et al., Pain, 2005).
The PGAP Clinical Framework
PGAP follows a standardized 10-session framework delivered by trained clinicians from a range of health backgrounds. Treatment begins by assessing the psychosocial risk factors known to contribute to prolonged disability. Clients are scored on:
- Pain catastrophizing
- Fear-avoidance beliefs
- Perceived injustice
- Disability-related beliefs
Once completed and scored, the PGAP clinician can use these specific factors as building blocks to understanding the clients specific psychosocial barriers when it comes to home and work.
These factors are addressed through collaborative goal setting, activity scheduling, and problem-solving strategies that encourage gradual re-engagement in meaningful activities, while maintaining clear expectations around progress and recovery.
Goal Directed Activities
One of the most impactful takeaways from the training was PGAP’s emphasis on goal directed activity, rather than symptom elimination.
Dr. Sullivan consistently encouraged PGAP clinicians to move beyond waiting for individuals to “feel better” before re-engaging in life. Instead, PGAP promotes structured, incremental goals that support rebuilding function, confidence, and self-efficacy alongside ongoing symptoms.
A feasibility study published in October 2025 found that participants and providers observed increased participation in activities, including work, when PGAP was delivered to workers with long-term health issues (European Journal of Public Health, 2025). This evidence highlights the value of goal-directed activity in promoting meaningful engagement, even before full symptom resolution.
PGAP clinicians use charts and workbooks to track clients’ progress weekly, gradually reintegrating pre-injury activities into daily routines. This approach frames recovery as an active process, showing that measurable progress is possible even when symptoms remain present.
Final Reflection
From my perspective working in claims management, PGAP aligns closely with The Claim Lab’s approach to disability management.
Firstly by measuring the Psychosocial Influencing Factors using The Claim Lab’s Questionnaires and then by supporting recovery through structure, clinical awareness, and meaningful engagement.
This training reinforced the importance of looking beyond diagnosis alone, and addressing the psychosocial factors that influence function and claim duration. I greatly appreciated the opportunity to learn from Dr Sullivan and would highly recommend this course to professionals interested in the PGAP approach.