WEBINAR REMINDERS

WEBINAR REMINDERS
PLEASE BE COURTEOUS!
USE *6 TO MUTE YOUR PHONE OR USE THE MUTE FEATURE ON
YOUR PHONE.
IF YOU ARE HAVING PROBLEMS HEARING OR VIEWING THIS
PRESENTATION PLEASE CALL 501-707-0950 AND ASK FOR
ASSISTANCE.
IF YOU WOULD LIKE A CERTIFICATE OF ATTENDANCE PLEASE
CONTACT ME AFTER THE WEBINAR AT:
[email protected]
THE SLIDES FOR THIS PRESENTATION WILL BE POSTED ON OUR
WEBSITE AFTER THE WEBINAR AT:
http://arkansas.valueoptions.com/provider/prv_training.htm
1
Goals and Measurable
Objectives:
2
Importance of Treatment Planning
 Treatment plans are essential (and required) tools that provide a map
to assist beneficiaries.
 The treatment plan addresses problems identified in the beneficiary’s
Mental Health Evaluation/Diagnosis, defines and measures
interventions and provides a measure for the beneficiary’s progress in
treatment.
 The treatment planning process is key in demonstrating the
effectiveness of treatment interventions for beneficiaries.
 Good progress notes begin with effective treatment planning.
 Comprehensive treatment planning leads to easy documentation in
progress notes; poorly developed treatment planning leads to
incomplete or unclear documentation of services.
3
The Master Treatment Plan is:
 The “Physician’s Order” for treatment
 Based on “identified needs/problems” from the Mental Health
Evaluation/Diagnosis
 Developed in collaboration with the beneficiary and/or
guardian
Problems identified during the Mental Health Evaluation/Diagnosis
should be prioritized and included in the Master Treatment Plan.
There should be a “flow” between the Mental Health
Evaluation/Diagnosis and the Master Treatment Plan.
4
Diagnosis: Depressive Disorder NOS
Example
Example
Goal: Sally will report no
panic attacks at the store.
Goal: Sally will report no
episodes of crying without
cause.
5
Outcomes Should be the Focus of
Treatment
 Outcomes can clearly be attributed to the treatment.
 Outcomes are measurable.
 Outcomes are realistic.
 Outcomes can be achieved within the target dates.
 Outcomes are agreed upon or determined by the beneficiary.
6
Goals are:
 An observable and defined result having
one or more objectives to be achieved
within a fixed timeframe.
 A behavioral outcome statement.
7
Developing Treatment Goals
 Review the beneficiary’s Mental Health Evaluation/Diagnosis
and other assessments.
 Develop the long term goal for the beneficiary and begin to
formulate, with the beneficiary and/or guardian, what
objectives would need to be met in order to achieve the goal.
8
Developing Treatment Goals
Ask the beneficiary the questions?
 What do you want to accomplished?
 What do want to do differently?
 How do you think therapy can improve your life?
 What new skills do you want to learn to improve your quality
of life?
9
Treatment Objectives Are:
 The roadmap on the path toward achievement of
the goals.
 A statement in specific and measurable terms that
describes what the beneficiary will accomplish as a
result of treatment and interventions.
10
Why are Treatment Objectives
important?
Nothing happens without a plan!
Objectives:
 Set treatment priorities
 Monitor progress toward goal/s
 Set targets for accountability
 Provide framework for treatment and outcomes
11
Treatment Objectives are
Individualized
 Symptom severity and chronicity vary by beneficiary with the
same diagnosis.
 Developmental and intellectual factors result in symptoms
being expressed differently by beneficiaries with the same
diagnosis.
 Expression of symptoms varies between genders.
 Cultural issues which impact treatment must be considered.
 Community, support systems, and environmental factors must
be considered in the formulation of objectives (i.e. toxic
environments, transportation, family support, access to basic
necessities, etc.).
12
Treatment Objectives are Specific
 What will the beneficiary do that indicates that a goal is
attained?
 How would you differentiate between the beneficiary who
achieves the goal and the one who does not?
 The objective must be measurable and specific.
 Objectives must be written from the perspective, “The
beneficiary will….
 The objective must be realistic, something the beneficiary can
achieve or accomplish.
 Each objective should have only one focus.
13
Treatment Objectives
Should be: SMART
 Specific: concrete, detailed, and well defined.
 Measurable: numeric or descriptive, quantity, quality or
comparative
 Achievable: feasible, attainable, actionable
 Realistic: considers resources, barriers, strengths, can be
achieved
 Time Specific: identifies target dates, includes interim steps to
monitor progress and defines a time line in which objectives
are to be achieved
14
Treatment Objectives
Specific:
State specifically what the beneficiary wants/needs to achieve.
 Describe the action, symptom, or behaviors to be addressed
 Include both the current “level” (frequency, intensity, etc.) and
the “level” of behavioral change desired.
 State the specific target behavior
 Should be brief, to the point and understandable by the
beneficiary and/or guardian.
15
Treatment Objectives
Measurable:
Be able to determine the extent to which the action, behavior or
objective has changed from the baseline to desired outcome.
 Identify a device, system, person, or method to track and
record the target action, symptoms or behaviors.
 The type of measurement or measuring tool must be specified.
 Whatever the means of measurement, it should be valid and
reliable.
16
Treatment Objectives
Measurable: (Continued)
 If the objective is measurable, the measurement source/s is
identified and the beneficiary and/or guardian and treatment
team are able to track progress toward the objective.
 It is important to have measures that will encourage and
motivate beneficiaries on their way as they see change. This
may require interim measures or short target date intervals.
 Measurements go a long way to help all members of the
treatment team as well as the beneficiary and/or guardian to
know when the objective/s have been achieved.
17
Treatment Objectives
Achievable:
Can it be accomplished?
 There should be a reasonable belief in the beneficiary’s ability
to accomplish the objective.
 Consider beneficiary’s symptoms, behaviors, skills, strengths,
abilities, limitations, as well as any potential barriers to
achieving the objective.
 Objectives should be achievable within the identified target
date and should keep the beneficiary motivated.
18
Treatment Objectives
Realistic:
Realistic means that the beneficiary has the ability to accomplish
the objective within the identified target date
 Achievement of the objective/s should be meaningful to the
beneficiary and/or guardian.
 Are the resources available or can they be developed to
achieve this objective?
 Are family/significant others supportive and involved in
attaining the agreed upon objective?
19
Treatment Objectives
Time Specific:
When should the objective be accomplished?
 Time specific means setting a deadline for the achievement of
the objective.
 Target dates need to be achievable and realistic.
 Target dates create the necessary urgency and prompts for
action.
 Clearly state the target date for each specific objective.
 Consider any real or perceived obstacles,(what are they and
can they be overcome), to accomplishing the objective on or
before the target date.
20
Diagnosis: Depressive Disorder NOS
Example
Example
Objective: Sally will learn three
coping skills to manage
sadness.
Objective: Sally will learn three
coping skills to reduce her
sadness. Sally will report the use
of one or more of these skills
for each incidents of sadness
for three consecutive weeks,
as noted in her feelings diary.
21
Objectives lead to development of
treatment activities
What will the treatment team do to bring about the change?
Treatment Activities
 All services to be provided by the treatment team must be
specific to the objective.
 There may be several treatment activities/interventions
pertaining to each objective or to more than one objective.
 The goal, objectives, treatment activities and progress are
described in the progress notes.
22
Interventions/Treatment Activities
 In the context of behavioral health, a treatment
activity/intervention may be any outside process that has the
effect of modifying an individual's behavior, cognition, or
emotional state.
 Treatment activities/interventions are the unique treatment
activities provided to a beneficiary by a Mental Health
Professional or Mental Health Paraprofessional, which require
specific licensure, certification and/or training.
 Interventions that could be performed by someone without
specific licensure, certification, and/or training should be
evaluated for appropriateness under the RSPMI program.
23
What is not an
intervention/treatment activity?
 Transporting
 Delivering food, medication, etc.
 Completing forms and paperwork
 Being a best friend, support system, etc.
 Creating dependency
 Helping with homework, tutoring
 Mentoring (System of Care Service)
24
Diagnosis: Depressive Disorder NOS
Example
Example
Intervention: I listened to the
Sally talk about her sadness
due to the death of her mother
and her guilt over things she
wished she had not said or
done.
Intervention: I actively listened
to Sally describe her sadness
and guilt. I pointed out her use
of “should” and “would”
statements indicating her
rumination over the past and
events that she could not
change. Discussed how she
felt when she used positive self
statements, rather than
negative self statements and
she was able to note the
difference.
25
Discontinuing or Changing Goals
and/or Objectives
When should a goal or objective be discontinued or changed?
 The beneficiary chooses not to work on the objective.
 The objective was not achieved and is not likely to be
achieved.
 There are too many objectives (not specific enough or diffuse
attention)
 New information has been provided that was not known earlier
and the objective is no longer a focus of treatment.
 Goals and/or objectives have been accomplished.
Be sure if you discontinue or change a goal or objective, you
state why it has been changed or discontinued in the update.
26
Let’s put it all together!
27
Measurable Objectives
Example
• Beneficiary will attend
rehab day and participate
in milieu.
28
Example
• Beneficiary will learn 2
skills necessary to
independently make and
keep appointment with
MD and therapist.
Measurable Objectives
Example
• MHPP will monitor
beneficiary’s behavior at
school.
29
Example
• Beneficiary will have
documentation of no
more than two office
referrals for classroom
disturbance per week.
Measurable Objectives
Example
• Beneficiary will participate
in group three days per
week and share feelings.
30
Example
• Beneficiary will express
one feeling in each group
session.
Measurable Objectives
Example
• Beneficiary will reports
80% decrease in
depression.
31
Example
• Beneficiary will report
sleeping 7-8 hours per
night, 5 out of 7 nights
per week.
Measurable Objectives
Example
• Mom will use appropriate
discipline when
beneficiary acts out.
32
Example
• Beneficiary will report
going to bed without
playing video games five
nights per week. Mom will
place beneficiary in time
out per schedule each
time beneficiary screams
at her.
Measurable Objectives
Example
• Beneficiary will attend
psychiatric evaluation and
will keep medication
management
appointments.
33
Example
• Beneficiary will take
medication as ordered by
MD and report
compliance, symptoms
and side effects to MD
and nurse.
Thank You
Kerri Brazzel, LCSW
Phone: 501-707-0919
[email protected]
Patricia Gann, LPC
Phone: 501-707-0920
Cell: 501-351-8223
[email protected]
34