Goal setting approaches and principles used in rehabilitation for people with acquired brain injury: A systematic scoping review

Prescott, Sarah; Fleming, Jennifer; Doig, Emmah

doi:10.3109/02699052.2015.1075152

Cited by 47 publications

(94 citation statements)

References 104 publications

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“…When considered together, these factors mean that goal setting with people with ABI in clinical practice is a highly individualised process (Lloyd, Roberts & Freeman, 2014;Scobbie, Duncan, Brady & Wyke, 2015), but research examining goal setting in routine practice is limited (Prescott, Fleming & Doig, 2015). Additionally, it has recently been recognised that there is a need to understand occupational therapy practice through interprofessional research (Cusick, 2017).…”

Section: Introductionmentioning

confidence: 99%

Refining a clinical practice framework to engage clients with brain injury in goal setting

Prescott

Fleming

Doig

2019

Aus Occup Therapy J

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Background/aim: Client-centred goal setting is fundamental to occupational therapy practice and has been increasingly embraced by all rehabilitation practioners. Goal setting in clinical practice is a highly individualised process and may be more challenging with people with acquired brain injury. However, research examining practice is limited. We developed the Client-Centred Goal Setting Practice Framework to explain how client-centred goals are developed in brain injury rehabilitation. This framework was based on interview data and may reflect practitioner's theoretical knowledge rather than goal setting processes used in routine practice. The aims of this study were to explore the application of the framework to every-day practice, examine the extent to which goal setting was client-centred and refine the framework. Methods: A mixed methods approach was employed. Participants were community dwelling clients with ABI and their practitioners, drawn from a hospital outpatient service and community private practices. The communication exchange between practitioners and clients during routine goal setting was audio-recorded, transcribed verbatim and analysed using framework analysis. Quantitative measures evaluated the client-centredness of goals. Results: A total of 65 goal setting sessions with 36 clients and 17 practitioners (n = 8 occupational therapists) were analysed. The three goal setting phases of the framework and associated processes and strategies were represented. The 'establishing trust' process was interwoven throughout all phases and an additional strategy, 'social connection' was identified. Conclusion: The framework provides preliminary evidence about the core processes and strategies which uses establishing trust to engage clients with ABI in goal setting, and may be a useful tool to guide client-centred goal setting practice in similar services.

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Section: Introductionmentioning

confidence: 99%

Refining a clinical practice framework to engage clients with brain injury in goal setting

Prescott

Fleming

Doig

2019

Aus Occup Therapy J

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“…Goal attainment scaling (GAS) was the most commonly used method (Prescott et al . ). Initially introduced by Kiresuk and Sherman (), GAS goals have the advantage of being ‘measurable, attainable, desired by all, and socially, functionally, and contextually relevant’ (Ottenbacher and Cusick, : 520), and can be used to improve self‐awareness for people with ABI (Malec ).…”

Section: Introductionmentioning

confidence: 97%

“…For this population, making goals person centred and collaborative is widely documented as important (Prescott et al . ). Person‐centred goals take account of the complex and heterogeneous nature of CCDs following an ABI (Togher et al .…”

Section: Introductionmentioning

confidence: 97%

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Setting and achieving individualized social communication goals for people with acquired brain injury (ABI) within a group treatment

Behn

Marshall

Togher

et al. 2019

Intl J Lang & Comm Disor

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Background: Cognitive-communication disorders are common following an acquired brain injury (ABI). Remediation should involve individualized goal-setting, yet few reports describe the effectiveness of setting communication goals in a group setting. Aims: To describe a process for setting and achieving goals for people with ABI. Methods & Procedures:A total of 21 participants with ABI participated in a group treatment (triads and dyads) over 6 weeks (20 h in total). Specific social communication goals were set using goal attainment scaling (GAS) with the participant and their communication partner. Goals targeted strategy use that accounted for existing cognitive abilities. The participant and their communication partner evaluated the goals post-treatment and 6-8 weeks later. Data were analysed using Friedman's test to identify the achievement of GAS goals. Outcomes & Results: A total of 20 participants recalled goals independently post-treatment. Significant improvement post-treatment on GAS goals was rated by both the participant (p < 0.001) and their communication partner (p < 0.001). This improvement was maintained at follow-up. No significant differences in ratings were found between participants and their communication partners at either time point. Conclusions & Implications: Individualized social communication goals can be set and achieved for people with ABI in group treatment, even when participants are several years post-injury. GAS offers a method for structuring and quantifying goal progress. Involving communication partners and cognitive strategies were effective in improving communication. What this paper addsWhat is already known on the subject Communication problems are common and pervasive following an ABI and can have a significant impact on a person's life. Setting individualized person-centred goals to address these problems is considered an important aspect of the rehabilitation process, though currently little is known about the process for setting, measuring and achieving goals, particularly within a group context. What this paper adds to existing knowledgeThis paper describes a process for setting and achieving individualized social communication goals within the context of a group setting for people with ABI. Use of a range of strategies including use of video-recorded stimuli, communication partner involvement, text message reminders and drawing on metacognitive skills within the group setting were useful for helping people with ABI to set and achieve their goals. Moreover, GAS was an effective Individualized social communication goals for people with ABI 829 method for demonstrating achievement and maintenance of goals, which people with ABI could rate as well as their communication partner. What are the potential or actual clinical implications of this work?People with chronic brain injuries can set and achieve meaningful social communication goals many years after their initial injury. Clinicians and researchers should consider the use of a multi-component approach that is person cent...

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“…Both research and clinical practice has in the past tended to focus on the individual with ABI and their rehabilitation goals and needs (Prescott, Fleming, & Doig, 2015). In contrast, this thesis focuses on family members and shows the extent of the impact of driving disruption directly on them.…”

Section: Driving Disruption Affects Family Members In Multiple Waysmentioning

confidence: 95%

Family members’ needs and experiences related to driving disruption following acquired brain injury

Liang¹

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Family members often assume the caregiving role after an individual sustains an acquired brain injury (ABI). A mandated period of driving disruption following an ABI means that individuals will often rely heavily on family members for transport and emotional support.However, research on driving disruption has largely focused on the impact, assessment and rehabilitation of the individual with ABI, with little attention given to family members. In order to develop an understanding for approaches to support family members better, this thesis aimed to explore the needs and experiences of family members during driving disruption following an ABI.The first aim of the thesis was to gain a broader understanding of the issue by conducting a scoping review of the literature on family members' needs and experiences during driving disruption across all health conditions. The scoping review found that driving disruption is a stressful and complex issue with communication and emotional implications for family members. The review highlighted differences in experiences according to health condition, permanence of driving disruption and nature of the caregiver occupation, and identified the need for further research on the issue of driving disruption for family members of individuals with ABI.A prospective, mixed methods, longitudinal study, with a phenomenological approach was conducted with family members of individuals with ABI who were experiencing driving disruption. Recruitment was stratified according to time post-ABI to gain a range of perspectives. Data were collected from 15 family members at three time-points: recruitment to study, 3 and 6 months later. Self-report questionnaires measuring family members' quality of life and well-being were administered at the first time-point, and semistructured interviews were conducted at each time-point. All interviews incorporated the use of a map to elicit qualitative and quantitative data about family members' current travel patterns as a result of driving disruption. The data were analysed using different approaches in a series of four studies.The first two studies aimed to gain an in-depth understanding about the experiences of family members of individuals experiencing driving disruption due to ABI across the recovery continuum. Both studies examined the mixed methods cross-sectional data from the first time-point. The first study explored the differences in family members' experiences iii at the early (<1 year post-ABI) and later stages (>1 year post-ABI) using a mixed methods, phenomenological approach. Family members in the later group reported more challenges with greater intensity. These challenges included changes in everyday activities, the impact on their emotions, consequences for the whole family, and effects on physical health. The later group had lower ratings of health and well-being, and higher caregiver strain.The second study investigated the specific changes family members experienced in everyday activities with a focus on the impact of driving disru...

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Goal setting approaches and principles used in rehabilitation for people with acquired brain injury: A systematic scoping review

Abstract: Use of formal goal setting approaches appears more prevalent in research studies compared with routine clinical practice. There is a strong theme in the literature that client-centredness and collaboration are necessary components of effective goal setting.

Cited by 47 publications

References 104 publications

Refining a clinical practice framework to engage clients with brain injury in goal setting

Refining a clinical practice framework to engage clients with brain injury in goal setting

Setting and achieving individualized social communication goals for people with acquired brain injury (ABI) within a group treatment

Family members’ needs and experiences related to driving disruption following acquired brain injury

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