Published on February 19, 2018
Goals: Goals Slide2: This module will seek to review some of the concepts learned about goals in OTAP 1220 while introducing new concepts about writing goals for a mental health population. Types of goals (Pg 137-140): Types of goals ( Pg 137-140) Your text discusses 6 types of goals: Restorative (Regaining a skill that was once present) Habilitative (Teaching new skills) Maintenance (Keeping client at current level of functioning despite disease processes) Modification (seeks to change environment/activity demands instead of client abilities and skills) Preventive (addresses risks of someone developing an occupational problem) Health promotion (enriching or enhancing occupational performance if a disability is not present) Goals in a mental health setting: Goals in a mental health setting In her book, Mental Health Concepts and Techniques for the Occupational Therapy Assistant, Mary Beth Early addresses the types of goals commonly used in mental health practice. She states that these types are Maintenance Prevention Habilitation She states there are two types of habilitative goals: Habilitative typically focuses on those who never developed functional abilities because the illness onset was very young. So they never gained those abilities. Rehabilitative focuses on restoring what the client once had, but was lost due to the mental illness. Rehabilitative cannot begin though until the mental illness has been treated medically (through medication or psychiatry) (Early, 2009) Linking what you want to accomplish with the goal type: Linking what you want to accomplish with the goal type If you identify your purpose of the goal then it makes writing the goal easier. You will think about what you are trying to accomplish and then choose the type that best fits. If you want to retrain a lost skill or train a new skill Habilitation type (new skill) or Rehabilitation (retrain a lost skill) So you will use phrases such as: to develop, to restore, or to improve If you want to keep the skills the client has Maintenance Type So you will use phrases such as: to maintain ability to Client involvement in setting goals: Client involvement in setting goals Your goals should address deficits identified in the evaluation. It is always important to work with your client to determine what he/she feels is important. This is EXTREMELY important with a population who has mental illness. Remember Anne discussed how important it is to empower those who have mental illness. What is more empowering then to be able to assist in directing and deciding what to work on in OT? (We discuss WRAP later in the semester that I mention in the audio) Slide7: One of the biggest challenges in writing goals for mental health deficits is you need to write about something tangible. A good way to do this is to focus on behaviors things that can be observed. You cannot measure self-esteem objectively so it can be difficult to make a goal directly concerning self-esteem. But how do you know that person has poor self-esteem? The client could have poor hygiene due to the low-self esteem so the goal could address the hygiene. The client could have negative self-talk so again the goal could address reducing the negative self-talk. Writing the goal: Writing the goal Last semester we focused on the COAST method of writing goals. This time we will talk about RHUMBA. Neither one is more correct than the other. They are just different ways of approaching goal writing. Review page 146-148 in your textbook. These pages discuss RHUMBA. Let’s practice identifying each part in a goals.: Let’s practice identifying each part in a goals. The client will identify three primary functions and tasks of her role as a mother of a preschooler by the end of three weeks . R: relevant H: how long U: understandable (this is all of the goal) M: Measurable B: Behavioral A: Achievable (This you would know by reading the evaluation and/or interacting with the client and using your judgment) Slide10: If you would like further practice practicing identifying each part of RHUMBA , the textbook has some practice goals beginning on pg 148. These are optional, but you may find them helpful. Let’s create a goal: Let’s create a goal Betty is a client at a PSR who has depression. Betty relates that she has difficulty remembering to take her medicine now that she has to take it morning and evening instead of just once a day. (Listen to the audio to hear me work through writing this goal). Slide12: Betty will verbalize three strategies for remembering to take her medication twice day within three weeks. R: Remembering to take her medication is very relevant to Betty H: How long? She will be able to do this in three weeks. U: This goal is plainly written and understandable. M: three strategies to help her remember her medicine B: The behavior is that Betty is going to tell us these strategies. A: Achievable? More than likely This is a good short term goal. Once she has met this goal, you could make goals for her to demonstrate the strategies such as filling a pill minder with her medication with no assistance and cues or setting an alarm on her phone to utilize as a reminder. One more note… about how long : One more note… about how long Remember that the H (for how long) is a DEADLINE for the goal. It cannot be fulfilled by saying “ pt will perform grooming task every morning Mod I with good quality.” The “every morning” part of this is a condition really. You have to set a deadline: Pt will perform grooming for every morning for 7 consecutive days Mod I with good quality within 1 month. I added more information that helps make the goal more clear and measurable and now it has an appropriate H part. Slide14: I would like for you to try RHUMBA for this week’s assignment. You may like the COAST method more, but I like to teach you two different ways to write goals so that you have a choice. Slide15: Early, M. (2009). Mental health concepts and techniques for the occupational therapy assistant (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.