Goal setting is considered to be an essential part of providing focused, time-sensitive rehabilitation. The goal of the chapter will be to discuss questions that the author have in relation to goal setting with PWA in particular, and whether goals in the general sense of the word should be the focus for therapy with PWA. Based on her own clinical experience, and in line with her preference for taking a more systemic approach to aphasia therapy, she outlines the challenges she saw arising from the usual goal setting process and explain her preference for intrinsic goals arising from collaborative therapy. In neurorehabilitation, where the MDT are involved with the client, attending to physical, cognitive, and psychological changes, goals can be set by the client, with the support of the therapists. Ongoing conversations with the client and close others, which allow for changing priorities and redefining goals are all essential to a dynamic therapeutic process.