TREATMENT PLANNING ESSENTIALS: SKILL BUILDING FOR CLINICIANS Week 4: Being SMART about our Treatment Plans 1

Welcome Back!  Review of last class  Connection before Content: Selfie Forum  What are we talking about today?  Culture/diversity  SMART Goals

BECOMING CULTURALLY COMPETENT 3

What is Diversity ◦ Diversity refers to the differences that exist among people and groups. Understanding diversity involves knowing that there are a variety of groups of people around us with various characteristics that may or may not be familiar to you. Age Gender Race Language Religion Sexual Orientation Political Affiliations Physical and Mental Abilities

Cultural Competence in Mental Health Cultural Competence: The ability to relate effectively to individuals from various groups and backgrounds. Respond to the unique needs of members of minority populations Sensitive to the way that people with disabilities experience the world The connection between Human Resources and Cultural Competence should be obvious. But we still overlook it. 5

Personal Reflection Do you have specific knowledge about your own racial and cultural heritage and how it personally and professionally affects your definitions and biases of normality/abnormality and the process of counseling? Do you familiarize yourself with relevant research and the latest findings regarding mental health and mental disorders of various ethnic and racial groups? Do you value bilingualism and do not view another language as an impediment to counseling (monolingualism may be the culprit)? Are you aware of your discomfort when you encounter differences in race, color, religion, sexual orientation, language, and ethnicity? Are you aware of your stereotypes as they arise and have developed personal strategies for reducing the harm they cause?

Evaluation, Treatment Planning & Culture I.Engage Clients II.Familiarize client and family with treatment evaluation process III.Endorse collaboration in interviews, assessment and treatment planning IV.Integrate culturally relevant information and themes V.Gather culturally relevant collateral information VI.Select Culturally Appropriate Screening and Assessment Tools VII.Provide Culturally Responsive Case Management VIII.Incorporate Cultural Factors Into Treatment Planning

GETTING SMART ABOUT THE PLAN

Rapid Reference: Potential Purposes of Treatment Plans ◦ Clarification of treatment focus ◦ Provision of standard against which to judge treatment progress ◦ Clarification of realistic treatment expectations ◦ Communication with other providers ◦ Provision of records for QA purposes

Parts of the Treatment Plan Problem Statement Goal Statement Objective Statement Intervention Statement

The Goal End Up Here

Parts of the Treatment Plan: Goal Statements Reframes the problem into a statement of what the client wants to achieve during treatment and is reasonably achievable in active treatment Guidelines: 1.Does the client understand the statement? Is it free of clinical jargon? 2.Is the statement clear and written in a complete sentence? 3.Is the goal attainable during the time the client will be active in treatment? 4.How comfortable are you with the statement? Is it agreeable to the client and other members of the staff? - Stilten, P, Roget, N. & Wendler, A. (2005)

Objectives Measurable Specific Achievable Realistic Time-Sensitive

Interventions VS Objectives What the clinician will do to help client reach the objective intervention Objectives What the client will do to reach the goal

Sample Treatment Plan for Katniss Problem Statement : Client experiences severe PTSD symptomatology regularly, which contributes to isolation, substance abuse, paranoia and depression. She states she is motivated by fear. Goal Statement : Client will manage PTSD symptoms and experience relief from fear. SMART Objective I : Client will identify 3 primary triggers of fear response. Intervention(s) : Therapist will teach consumer how to maintain a fear response log, in which consumer will record instances during which feelings of fear and anxiety increased, location, situation, and related details. Client will maintain log for 1-week, followed by a review/processing with therapist to identify possible triggers.

What is a SMART Objective? SMARTDescription SpecificWho is the target population? What will be accomplished? Measurable Is the objective quantifiable? Can it be measured? How much change is expected? Achievable Can the objective be accomplished in the proposed time frame with the available resources and support? Realistic/Relevant Does the objective address the goal? Will the objective have an impact on the goal? Time-Sensitive Does the objective propose a timeline when the objective will be met?

Examples of GOOD Objectives Client will identify 2 to 3 triggers to having a low or sad mood through keeping a daily journal to review each week in therapy. Client will engage with at least 1 friend in a social activity 1x weekly and document in activity scheduling log Client will keep a sleep journal to track 3 to 4 components to poor sleep patterns at least 4 out of 7 nights per week.

Another Class Example Problem Statement : Client has a difficult time completing ADLs because of the anxiety symptoms. Goal Statement : Improve coping skills regarding anxiety to increase ADL abilities. SMART Objective I:Identify and verbalize at least 3 anxiety symptoms. Intervention(s) : Through narrative therapy, the client will verbalize the anxiety symptoms and the therapist will help the client develop a list of situations the anxiety occurs. Target Date: July 1, 2015

Name that SMART Objective Which of the following objectives is SMART? Katniss will identify her thought pattern Katniss will process her feelings of fear, anxiety, and depression through weekly talk therapy sessions and/or journaling in her notebook 3 out 5 days each week for 6 months. Client will identify triggers of anxiety as evidenced by client self-report one out of seven days a week. In three months (September ), Katniss will show a 15 point reduction on the PTSD checklist, from a 65 to a 50

Homework Assignment If you have any questions, please contact us at Please remember that the deadline for Homework Assignment #2 is Thursday June 11 th at midnight. NO LATE SUBMISSIONS WILL BE ACCEPTED

References Cultural Competence Checklist: ural-Competence-Checklist-Service-Delivery.pdf Culturally Responsive Evaluation & Treatment Planning: Maruish, M.E. (2002). Essentials of treatment planning. New York: Wiley.