Enhanced Therapeutic Skills for Inpatient Mental Health Professionals

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Dorset HealthCare NHS Trust North Dorset
Primary Care Trust

• Enhanced Therapeutic Skills for In-patient Mental
  Health Professionals
• Problem Centred Goal Setting Care Planning

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AIMS

• TO UTILISE OUTCOMES FROM FUNCTIONAL ANALYSIS.
• TO LINK TO CARE PLANNING PROCESS.
• TO PRACTICE WRITING PROBLEM AND GOAL STATEMENTS.

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Funnel Model of Assessment
General Hx, Notes, Referral, BPRS,
CAN Prioritise problem list collaboratively Spec
ific Rating scales Functional
Behavioral analysis Conceptualisation Problems
Goals Working Hypothesis
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PROBLEM STATEMENTS

• PROBLEM STATEMENTS
• FACTUAL ACCOUNT.
• EXPRESSED BY PATIENT
• FOCUS ON THEIR DISTRESS
• THAT REQUIRES A SOLUTION.
• THEY SHOULD BE
• JARGON FREE.
• NOT OPEN TO INTERPRETATION.
• MEANINGFUL TO PATIENT.

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COMPONENTS OF PROBLEM STATEMENTS

• 1. THE PROBLEM
• 2. THE FEARED CONSEQUENCE (Meaning for the
  individual).
• 3. THE ANTECEDENT.
• 4. THE BEHAVIOUR.
• 5 THE CONSEQUENCES.

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FOR EXAMPLE

• I keep running away because the devil will harm
  me if I stay. When I hear the voice of the
  devil, I feel so afraid that I have to run. But
  you stop me and inject me.
• Anxiety due to people talking about me when Im
  in the day room, leading to avoidance of any
  crowded area resulting in me staying in my room
  and not attending meals or groups.

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GOAL STATEMENTS

• A description of something that is currently
  difficult due to the problem and
• Something they wish they were able to do.
• They should be
• Identified from problem statement.
• Positively written.
• Patient centered.
• SMART.

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SMART

• Specific
• Measurable
• Achievable
• Realistic
• Time Orientated

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EXAMPLES OF GOAL STATEMENTS

• During the next three days, when I hear the voice
  of the of the devil, I will try to listen to my
  walkman and if this doesnt help I will tell a
  member of staff
• Today I will try to spend five minutes in the
  day-room

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PRACTICAL EXERSISE

• In groups of two, practice devising a problem and
  goal statement.
• Target this at the patient you role played during
  the functional analysis workshop.
• Present back to group.

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CARE PLANNING

• How does this approach relate to your current
  format?