The demand for clinical accountability and the documentation of therapeutic effectiveness continues to increase in health-related settings. Therapists are attempting to address this increasing demand by adapting methods based on traditional experimental models of research to evaluate their clinical practice. Experimental and quasi-experimental designs, however, are often of limited usefulness in clinical environments for a variety of practical and ethical reasons. This paper presents a method of evaluating the effectiveness of a therapeutic intervention called goal attainment scaling, which involves goal setting procedures and assessment techniques that are practice-based and practitioner-oriented. The procedures are presented and the argument made that goal attainment scaling is a viable method by which one can document therapeutic change and demonstrate clinical accountability.