Your assignment is to write three measurable goals for each case study.  You can use any format you want but the following must be in place for each goal.

1: Why is this important?

2.  What is the outcome you are looking for?

3.  What are the action steps to get to this goal?  This can have several action steps.

4.  Who is responsible?

5.  By when (this needs to be specific)

Week 5:Writing Goals and Objectives

Why are developing goals and objectives important? • They create an environment where the person’s needs, wants, and desires are identified. • They are required by regulatory agencies that provide funding • They are required by federal statute • They provide the most systematic way to measure success. Goals should be SMART Goals should also: • Be a reflection of personal desires • Are based on a team process that includes the person receiving the support. • State the “big-picture. • Are long-term aims that the person wants to accomplish • Are less structured than objectives • Are driven by assessments (both formal and informal) Long-term goals are often the most important goals for the person receiving supports. However, it is important to note that the time it will take to achieve these goals is often far in the future. As a result, it is hard to maintain the same level of focus and motivation over such a long period of time. Many times it is helpful to set up several short term goals to help the person move toward their larger achievement. For example, think of the television show The Biggest Loser, the weekly weighins (ie. Short-term weight loss goals) keep the contestants movitaved from week to week. When they have a bad week, they know that they have another chance to succeed. Do you think if they only weighed the contestants at the beginning and the very end that they would have the same motivation and result throughout? Short-term goals – can be achieved in the near future Long-term goals- are goals that the person will achieve over a longer period of time. When writing goals it is important to ask the following: What am I measuring? How will I measure it? How do I know when the goals has been accomplished? With the example of The Biggest Loser it can be applied in the following way… What am I measuring? Weight Loss How will I measure it? Weekly Weigh-Ins How do I know when the goal has been accomplished? When the person loses the amount of weight identified. What is an Objective? • Objectives are ways to clearly define successful completion of a stated change. • Objectives are measurable steps toward goal achievements. For example, an objective of a weight loss goal might be: Jane will perform 30 minutes of cardiovascular exercise 5 out of 7 days per week. Qualities of well written objectives are: directly related to the goal, measurable, stated so the change is observable, are simple. How to document goals: There are many ways to document goals, however, the most important thing to remember is to KEEP IT SIMPLE. Based on the field or agency you are working in, others may be responsible for tracking or keeping data on goals, if that is the case simplicity is important to ensure consistency and accuracy. Examples of documentation can include a calendar, narrative notes, percentages, self-report by the person,etc. In the example of weight loss, a person can track their progress on a calendar, or keep a narrative self report on how they felt after completion of exercise. Action Plan Date Individual: Address: Why is this important to the individual: DOB: What is the outcome that is desired? Be specific and make each step measurable Action Steps: Step 1: Step 2: Step 3: Step 4: Step 5 Who Is Responsible By When: (Give a time frame) Case Study Alex comes to your office and shares with you that he is having a difficult time adjusting since he came back from war. He reports that he feels like he has nowhere to belong. He tells you that he is struggling to connect with family, friends and most importantly, his wife. He is afraid to share what he experienced but can’t seem to get passed what he experienced. He tells you that he feels alone. He tells you that he can’t seem to find employment which makes him feel even worse about himself. He shares that he can only sleep when he “passes out.” He feels tired all the time. He finds himself drinking throughout the day but most often, he drinks late at night. He tells you that he was referred to a “nerve doctor” but he never went. He tells you that he just doesn’t know cope. He used to enjoy fishing and hiking but as of late, nothing seems to bring him joy. He is afraid that his wife will leave him. He tells you that he just wants to feel the way he did prior to going to war. Case Study Ana was referred to Child Guidance after several DCF investigations were called on behalf of her children. Ana shares with you that she has been sexually victimized as a child and was diagnosed with an anxiety disorder as well as depression. She currently is not seeking counseling or medical treatment for these medical diagnoses. Referral stated that Ana is not sending her kids to school. Ana reports that she just doesn’t have the energy to fight with her kids to go to school. Ana reports that she struggles with parenting and finds that she often doesn’t know what to do. She shares that she is stressed because she is not working and there is barely enough money to pay rent and put food on the table. She tells you that she just doesn’t know how to go about getting a job. She says everything seems so overwhelming and she just doesn’t know where to begin. TREATMENT PLAN GOALS / OBJECTIVES Note: Always make objectives measurable, e.g., 3 out of 5 times, 100%, learn 3 skills, etc., unless they are measurable on their own as in “List and discuss [issue] weekly…” Abuse/Neglect Goal: Explore and resolve issues relating to history of abuse/neglect victimization ▪ ▪ ▪ Share details of the abuse/neglect with therapist as able to do so Learn about typical long term/residual effects of traumatic life experiences Develop two strategies to help cope with stressful reminders/memories Alcohol/Drugs and Other Addictions Goal: Be free of drug/alcohol use/abuse ▪ ▪ ▪ ▪ Avoid people, places and situations where temptation might be overwhelming Explore dynamics relating to being the [child/husband/wife] of an [alcoholic/addict] and discuss them each week at support group meetings Learn five triggers for alcohol & drug use Reach ____ days/months/years of clean/sober living Adoption/Foster Care Placement Goal: Explore and resolve issues related to adoption/out-of-home placement ▪ ▪ Discuss ongoing concerns and issues related to adoptive and/or biological parents during weekly sessions Talk about his/her wishes with regard to permanency planning Anger Goal: Increase and practice ability to manage anger ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Walk away from situations that trigger strong emotions (100%) Be free of tantrums/explosive episodes Learn two positive anger management skills Learn three ways to communicate verbally when angry Be able to express anger in a productive manner without destroying property or personal belongings Be able to express anger without yelling and using foul language Explore and resolve conflict with ____ (list triggers) Get through an entire day without an angry mood swing (or breaking/punching…) Get through a whole week without fighting with ____ Take a time-out when things get upsetting Learn and practice anger management skills especially in situations where people are not treating him/her respectfully 1 Anxiety Goal: Develop strategies to reduce symptoms, or Reduce anxiety and improve coping skills ▪ ▪ ▪ ▪ ▪ Be free of panic episodes (100%) Recognize and plan for top five anxiety-provoking situations Learn two new ways of coping with routine stressors Report feeling more positive about self and abilities during therapy sessions Develop strategies for thought distraction when fixating on the future Behavior Problems Goal: Improve overall behavior (and attitude/mood), or Maintain positive behavior (and attitude/mood) ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Be free of _____ behavior Develop a reward system to address ___ (target problem) Learn two ways to manage frustration in a positive manner Share two positive experiences each week in which X is proud of how he/she has behaved Stay free of fights Stay free of drug & alcohol use and abuse (100%) Be free of violent behavior Be able to keep hands and feet to self Be able to express anger in a productive manner without destroying property or personal belongings Be free of threats to self and others Complete daily tasks (e.g. chores, pet care, self care, etc.) Avoid leaving clothing/toys/personal stuff all around the house Listen to parent and follow simple directions with one prompt Put all dishes, glasses, cups, and food items back in the kitchen after meals/snacks Clean up after himself/herself Admit and accept personal responsibility for own actions/behavior Be respectful of adults and avoid talking back Get through a whole week without fighting with ____ Avoid behavior that would result in a loss of custody Be able to play with others peacefully for ____ minutes Come home each day by ______ (time) Keep parents informed about where you are and when you will be home Be in bed by _____ each night Be free of bedwetting Be free of wet/soiled underwear If an accident happens, be responsible and clean it up Be free of any behavior that could result in loss of job Remain free of behaviors which would lead to arrest Comply with all aspects of probation/parole and avoid behavior that could violate Eat/swallow only items intended to be food 2 Communication Skills Goal: Learn and use effective communication strategies ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Talk nice or do not say anything at all Learn three ways to communicate verbally when angry Be able to express anger in a productive manner without destroying property or personal belongings Be able to express anger without yelling and using foul language Be able to express wants and needs through spoken language Be able to ask questions and tell about instances Be able to stick up for self assertively Speak in a clear and concise manner so others fully understand him/her Learn to express feelings verbally without acting out Crime Goal: Remain free of behaviors which would lead to arrest/violation ▪ ▪ ▪ ▪ ▪ ▪ Keep working and comply with all aspects of probation Be able to express anger in a productive manner without destroying property or personal belongings Be free of threats to self and others Comply with all aspects of probation/parole and avoid behavior that could violate Be free of violent behavior Stay free of drug & alcohol use and abuse (100%) Decision Making Goal: Improve decision making skills ▪ ▪ ▪ ▪ Make short and simple “to do” lists and complete three tasks each day Celebrate little successes each day using positive self talk and/or journaling Be able to weigh options and make simple decisions within 5 minutes List three options for any major decisions and then discuss with therapist or family Depression Goal: Improve overall mood ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Be free of suicidal thoughts Call crisis hotline if having suicidal thoughts Report feeling more positive about self and abilities Get 7-8 hours of restful sleep every night Avoid napping/sleeping to escape other people and activities Shower, dress, and then do something every day Report feeling happy/better overall mood Make short and simple “to do” lists and complete three tasks each day Celebrate little successes each day using positive self talk and/or journaling Get through a day/week without a crying spell Develop strategies for thought distraction when ruminating on the past 3 Eating Disorders Goal: Resolve eating disorder ▪ ▪ ▪ ▪ ▪ ▪ ▪ Eat a balanced diet of foods and maintain good overall health Gain ____ pounds Loose ____ pounds Be free of binge eating/purging Remove junk foods from home and limit future purchases Recognize/list environmental and situational triggers and develop alternative behaviors for coping with them Recognize emotional triggers and develop alternative ways of strategies for meeting emotional needs Enuresis and Encopresis Goal: Be free of wetting/soiling ▪ ▪ ▪ ▪ ▪ ▪ Avoid drinking near bedtime Eat high-fiber foods and avoid foods that constipate Go to the bathroom before going out of the house Sit on the toilet for 10-15 minutes after meals Avoid hiding wet/soiled clothing Take responsibility for helping clean up (e.g., put wet/soiled items in soak bucket) Expression of Feelings, Wants and Needs Goal: Learn appropriate ways to express different feelings ▪ ▪ ▪ ▪ ▪ Share two positive experiences each week in which client is proud of how he/she has behaved Gain knowledge of different feelings Turn to adults for help when feeling sad, angry or negative feelings Express feelings verbally rather than whine and/or cry about them Learn to express feelings verbally without acting out Family Conflict Goal: Learn and use conflict resolution skills ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Recognize patterns of family conflict discuss weekly in therapy Avoid angry outbursts by walking away from stressful situations Get through X days out of 7 without fighting with siblings Be respectful of ____: Listen, follow directions and avoid talking back Be able to live together peacefully, free of all angry physical contact Learn three ways to communicate verbally when angry Be able to express anger without yelling and using foul language Explore and resolve conflict with ____ Be able to stick up for self assertively, not aggressively Be respectful of adults/don’t talk back Get through a whole week without fighting with ____ Speak in a clear and concise manner so others fully understand him/her Learn to express feelings verbally without acting out 4 Grief and Loss Goal: Explore and resolve grief and loss issues ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Give sorrow words – discuss issues of grief weekly with therapist Continue to explore and resolve issues of grief/loss as they arise Get through a week without a crying spell Learn about the typical 2-7 year process of grieving the loss of a loved one Explore spirituality and the role it plays in redefining views about the meaning and purpose of life Create (write/draw) a soul sketch of the deceased loved one Plan a memorial service for the anniversary of the loss Develop appropriate rituals to remember and honor _____ Harm to self or others Goal: Be free of thoughts of self-harm/self mutilation, or Be free of thoughts to harm to others ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Learn two ways to manage frustration in a positive manner Explore triggers of thoughts to harm self or others Call crisis hotline when needed Report feeling more positive about self and abilities Explore and resolve stress from ____ Develop a crisis plan and share it with key people Remove weapons from the home [and other means] List three emergency contacts who will be able to stay with you till a crisis passes Health Issues Goal: Manage physical healthcare conditions and cope with related stress ▪ ▪ ▪ ▪ ▪ ▪ ▪ Learn as much as possible about the condition(s) and needed treatment Take medications/treatments as prescribed on a daily basis Attend all scheduled appointments with the doctor Maintain good overall physical health and healthcare practices Report any medication concerns to the prescribing doctor ASAP Seek additional advocacy services from _____ Seek additional support from _____ 5 Hyperactivity Goal: Improve overall behavior, or Maintain positive behavior ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Be able to keep hands and feet to self Complete daily tasks (e.g. chores, pet care, self care, etc.) Listen to parent/teacher and follow simple directions with one prompt Behave in an age-appropriate manner Maintain passing grades Will be able to focus attention and complete school-related tasks each day Listen and take notes in all classes Will review homework and other projects with parents on the day they are assigned Be respectful of adults and avoid talking back Be able to play with others peacefully for ____ minutes Be free of any behavior that could result in detention/suspension Develop a reward system to address ____ (target problem) Medication Management Goal: Medication management ▪ ▪ ▪ ▪ Take medications as prescribed on a daily basis Attend all scheduled appointments with the psychiatrist Maintain good overall physical health and healthcare practices Report any medication concerns to the doctor ASAP Mood Management Goal: Maintain stability of mood, or Improve overall mood, or Maintain even mood, or Increase ability to manage moods ▪ ▪ ▪ ▪ ▪ ▪ Learn two ways to manage frustration in a positive manner Be free of suicidal thoughts; call crisis hotline if having suicidal thoughts Report feeling more positive about self and abilities Report feeling happy/better mood (4 days out of 7) Get 7-8 hours of restful sleep every night Get through a week without a crying spell Parenting Goal: Improve parenting skills ▪ ▪ ▪ ▪ ▪ Set two limits and stick with a plan that will require more responsible behavior Focus on positive behavior and give attention then, rather than focus on negative things Learn and be able to effectively use transactional analysis to stay in “adult” mode Use “I” statements rather than You” when communicating with _____ Develop and consistently use a behavior modification plan, to increase/eliminate _____ 6 Personal Hygiene and Self-care Goal: Improve personal hygiene and attentiveness to independent/age appropriate self-care ▪ ▪ ▪ ▪ ▪ Brush teeth ____ times each day and floss _____ Shower (take a bath) every day Use antiperspirant / deodorant every day after showering Brush/comb hair every morning Do a thorough job of wiping after toileting (100%) Physical Health Issues Goal: Cope with stress of physical health issues and chronic pain ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Explore and resolve thoughts and feelings that arise as a result of medical conditions and medications Learn two new strategies for coping with the above thoughts and feelings Reduce weight by _____ pounds Exercise for 20 minutes every day Learn strategies to advocate for him/herself with medical personnel Quit smoking (or drinking) Take medications as prescribed on a daily basis Attend all scheduled appointments with physicians Maintain good overall physical health and healthcare practices Report any medication concerns to the doctor ASAP Make and keep an appointment with _____ (dentist) for needed diagnosis and treatment Relationships Goal: Establish/maintain civil and supportive behavior ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Avoid angry outbursts by walking away from stressful situations Be free of affairs Be able to live together peacefully, free of all angry physical contact Learn three ways to communicate verbally when angry Explore peer and dating relationships to improve X’s chance of staying safe and legal Be able to keep hands to self Be able to express anger without yelling and using foul language Explore and resolve conflict with ____ Be able to stick up for self assertively Be respectful of parents/don’t talk back Get through a whole week without fighting with ____ Speak in a clear and concise manner so others fully understand him/her Be able to play with others peacefully for ____ minutes Learn to express feelings verbally without acting out Associate with healthy people and continue to make new friends Continue to explore relationship issues and slowly see new opportunities for dating Figure out why relationships fail and better plan for finding next partner Associate with people outside of work and make one or two new friends 7 School Issues ▪ ▪ ▪ ▪ ▪ ▪ ▪ Go to school every day Behave in an age-appropriate manner Maintain passing grades Will be able to focus attention and complete school-related tasks each day Listen and take notes in all classes Be free of suspensions and detentions Will review homework and other projects with parents on the day they are assigned Self Image Goal: Explore and resolve issues related to self image ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Discuss life events that led to and/or reinforce a negative self image during weekly therapy Use positive self talk daily Exercise daily (or _____ times per week) Drop _____ pounds Report feeling more positive about self and abilities Return to school and work on getting _____ (degree/diploma/GED) Change jobs to one that…(offers more pay and/or better suits skill set) Openly discuss issues relating to sexuality and become comfortable with sexual identity Explore spirituality and the role it plays in the meaning and purpose of life Engage in volunteer work and/or other meaningful activity at least three hours each week Sleep Problems Goal: Get 7-8 hours of restful sleep each night ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Limit consumption of food and drinks before bed Limit intake of caffeine (coffee, tea, soda) and chocolate after _____ (noon meal) Cut back on things that may impede normal sleep patterns (e.g., alcohol and some medications) Be in bed by _____ each night Have 30 minutes of quiet time before going to bed each night (e.g., read, meditate) Avoid overly stimulating shows/movies/video games before bedtime Avoid watching TV and chatting on the phone while in bed If not asleep in 20 minutes, get up and do something for a bit, rather than try to force sleep Leave a paper and pen to write worries down instead of ruminating on them Learn best practices for sleep (cooler room, limit caffeine, calming time before bed) Listen to relaxation/meditation music to aid falling asleep 8 Social Skills Goal: Improve social skills ▪ ▪ ▪ ▪ Speak in a clear and concise way so others fully understand him/her Learn to express feelings verbally without acting out Make a new same-age friend Spend two hours playing with peers each week Stress Goal: Be able to cope with routine life stressors and take things in stride ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Assess personal risk traits and resiliency traits and discuss the role each plays in coping with daily stresses during the time between therapy sessions Learn two ways to manage frustration in a positive manner Get 7-8 hours of restful sleep every night Talk out routine stress events during weekly therapy sessions Explore and resolve residual stress from ____ (e.g., years as a first responder) Foster two new activities/interests that will help mitigate stress Exercise 20-30 minutes per day Learn and use meditation and relaxation techniques daily Suicide Goal: Be free of suicidal thoughts/attempts ▪ ▪ ▪ ▪ ▪ Explore and resolve stress from ____ Call crisis hotline if having suicidal thoughts Develop a crisis plan and share it with key people Remove weapons from the home [and other means] List three emergency contacts who will be able to stay with you till a crisis passes Thought Disorder Goal: Improve ability to see world as others do ▪ ▪ ▪ ▪ ▪ ▪ Be free of false perceptions and [see/hear/smell/feel] things as others do Be free of false beliefs Be free of thoughts that others are out to get you Spend 2-3 hours each week visiting with others Visit the clubhouse and/or the consumer drop-in-center each week Report feeling comfortable spending time with others 9 Trauma Goal: Explore and resolve issues related to ____ (traumatic event) ▪ ▪ ▪ ▪ ▪ ▪ Explore and resolve residual stress from ____ (e.g., years as a first responder) Share details of the trauma with therapist, as able to do so Reframe negative perceptions, when possible, and focus on finding meaning and drawing strength from the event Learn about typical long term/residual effects of traumatic life experiences Explore spirituality and the role it plays in life after traumatic events Learn about the typical 2-7 year process of rebuilding life after trauma Vocational/Educational Goal: Find a new job, or Keep present job, or Re-enter the work force ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Earn G.E.D. Explore options for returning to school/training Become an active member of a local clubhouse Complete college/technical school Develop a resume Seek two people who will serve as references Be free of any behavior that could result in loss of job/educational grants Find and settle into a new job 12/10/09 jdw 10 11