NCJ Number
50228
Journal
EVALUATION Issue: 1 Dated: SPECIAL MONOGRAPH (1973) Pages: 6-11
Date Published
1973
Length
6 pages
Annotation
AN AUTOMATED GOAL-OREINTED TREATMENT APPROACH TO THE CARE OF MENTAL HEALTH PATIENTS IS DESCRIBED THAT FORCES THE USER TO BECOME CONCERNED WITH THE COURSE AND END OF TREATMENT RATHER THAN WITH PROBLEMS AND LABELS.
Abstract
PRIOR SPECIFICATION OF GOALS NOT ONLY FACILITATES THE ASSESSMENT OF PATIENT PROGRESS BY DESCRIBING IT AS MOVEMENT TOWARD A FIXED POINT OR GOAL BUT ALSO ENCOURAGES PRECISION IN DESCRIBING A PROBLEM AND SELECTING APPROPRIATE METHODS FOR EFFICIENTLY REACHING THAT GOAL. GOAL-BASED EVALUATION SCHEMES HAVE THE ADDED ADVANTAGE OF BEING ABLE TO COMPARE HIGHLY INDIVIDUALIZED AND OFTEN WIDELY DIFFERENT TREATMENT METHODS ON THE BASIS OF A COMMON DENOMINATOR; THAT IS, WHAT HAS HAPPENED TO A PATIENT WITH RESPECT TO HIS OR HER PARTICULAR GOALS AS THE RESULT OF THERAPEUTIC INTERVENTION. THE FORT LOGAN MENTAL HEALTH CENTER (DENVER, COLO.) SET OUT TO DEVELOP A CLINICALLY AND LEGALLY ACCEPTABLE AUTOMATED PROGRESS NOTE, TO DEVELOP AN INSTRUMENT THAT WOULD INCORPORATE SPECIFIED TREATMENT OBJECTIVES AND METHODS FOR ACHIEVING THEM, TO EXAMINE AS MANY ASPECTS OF THE GOAL-ORIENTED APPROACH TO TREATMENT PLANNING CAN BE APPLIED TO INDIVIDUAL PATIENTS, AND TO CONSTRUCT AN EVALUATION SCHEME USING EACH PATIENT'S GOAL SUCCESSES AND FAILURES. THE GOAL-ORIENTED AUTOMATED PROGRESS NOTE CONSISTS OF 703 GOAL STATEMENTS GROUPED BY MEDICAL, SYMPTOM, SELF-CONCEPT, PATIENT-INITIATED INTERACTION, OTHER-INITIATED INTERACTION, AND DISPOSITION PLAN DOMAINS. ALTHOUGH STAFF ALONE MAY USE THE PROGRESS NOTE, IT IS URGED THAT PATIENTS AND COMMUNITY MEMBERS BE INVOLVED IN GOAL SETTING. PROCEDURAL ASPECTS OF THE AUTOMATED GOAL-ORIENTED PROGRESS NOTE ARE DESCRIBED AND ILLUSTRATED. AN 11-MONTH TRIAL PERIOD OF THE AUTOMATED TECHNIQUE WAS CONDUCTED BY 3 CENTER ADULT PSYCHIATRIC TEAMS. FOR A SAMPLE OF 67 PATIENTS WITH TRI-INFORMANT GOALS, ALL STAFF GOALS WERE RATED, 79 PERCENT OF PATIENT GOALS WERE RATED, AND 84 PERCENT OF COMMUNITY GOALS WERE RATED. AN ADDITIONAL 18 PATIENTS WITH ONLY STAFF AND PATIENT GOALS WERE RATED. IT IS CONCLUDED THAT THE AUTOMATED GOAL-ORIENTED PROGRESS NOTE HAS GREAT POTENTIAL FOR EVALUATING PROGRESS TOWARD GOALS IN A WIDE RANGE OF HUMAN SERVICE SETTINGS BECAUSE IT EMPHASIZES PLANNING AND FEEDBACK. (DP)