FIDELITY AND QUALITY ASSURANCE FOR TREATMENT PLANNING

Transcription

1 Faculty Disclosure Bryan J. Zolnikov, PhD Dr. Zolnikov has listed no financial interest/arrangement that would be considered a conflict of interest. FIDELITY AND QUALITY ASSURANCE FOR TREATMENT PLANNING Bryan Zolnikov, Ph.D. 1

2 TREATMENT PLANNING Guided by mental health values such as: Recovery Psychosocial rehabilitation Resilience Trauma-informed Client voice is included A framework to guide the treatment process towards a treatment goal Not a list of problems that must be addressed Emphasis on skills and strengths Emphasis on how staff support the plan Language is simple and easily understandable Personal safety plan is essential TREATMENT TEAM PROCESS Manualized process with identified responsible staff including a designated team leader DO: Start and stop the meeting on a positive note Focus on success and positively reinforce appropriate behavior May need to point out behaviors that interfere with meeting the treatment goal DO NOT: Surprise the client with negative information Engage in a power struggle Gang up on the client 2

3 TREATMENT PLAN Usually flows from client identifiers to signature page Standard identifiers include: Full name and aliases Record # Date of admission Date of plan Admission code, e.g.,: 14-day Civil Competency Restoration Adult Outpatient Reason for admission Criteria for discharge Diagnosis Supports including staff, family, and social services TREATMENT PLAN: PERSONAL SAFETY PLAN A simple and useful guide to staff for how to understand the perspective of the client with regards to safety Usually organized by sections including: History of trauma and how trauma impacts daily living, e.g.,: Client has been struck in the head and other areas of the body at least twenty times (some incidences with baseball bats and others by closed fists) in his life and was raped three times while incarcerated. Almost all of these traumatic events have been the result of the client s interactions with men in the community and in secured settings. Client reported being afraid of people that from his perspective are men and he tends avoid interactions with males including staff and client peers. Triggers to escalating behavior Behaviors seen when the client is losing control Techniques that help the client de-escalate and regain control Techniques that may continue to escalate the client 3

4 TREATMENT PLAN: OUTCOME LIST An outcome is a statement that maps to the goal of treatment, e.g.,: Mr. Smith wants the judge to find him competent to proceed to trial. Ms. Smith wants to develop social skills. Mr. Smith needs (for the client who does not identify with the outcome that staff do) to develop skills to manage his paranoid delusions and auditory hallucinations. Ms. Smith needs to develop a substance use relapse prevention plan. FOR EACH OUTCOME Describe: Strengths that support the achievement of the outcome Obstacles that could interfere with the outcome Resources that support the outcome Objective A measurable, observable behavior that contributes to achieving the outcome, e.g.,: Mr. Smith will verbalize the role of the judge, jury, defense attorney, and prosecuting attorney during legal proceedings. Intervention Actions taken that increase, decrease, change or alter behavior, e.g.,: The competency restoration specialist staff will provide group therapy that teaches the roles of court personnel in order to assist Mr. Smith with improving his understanding of legal knowledge Start date, frequency, and person(s) responsible 4

5 GOLDEN THREAD The thread that binds: Outcome to Objective to Intervention to Charting The thread should be readily evident and: Clear to the client Clear to the treatment team Help an auditor to be able to easily follow the thread throughout the documentation Make decision making regarding the criteria for discharge simple for assessors, utilization review, judges, and any other entity with a role to assess progress in relation to discharge criteria THE END! Thank you for participating Discussion, questions, comments, etc. Presenter contact info: Bryan.Zolnikov@DSHS.WA.Gov 5