Transcript Improving Quality of Rehabilitation/Treatment Planning in Outpatient

Improving Quality of
Rehabilitation Planning in
Outpatient Mental Health
Dr. Samson Omotosho, PhD, RN-BC
Levels of Psych Rehab Planning
1. Rehabilitation Program Development (RPD) –
done by the program director, proprietors and
board of directors.

2. Individual Rehabilitation Planning (IRP) – done
by the rehab treatment team every 3-6 months.

3. Rehabilitation Contact Planning – (RCP) done by
the counselor prior to each patient contact.
1. Rehab Program Development
State the mission & goals of the program
Form a board of directors
Develop the program
Follow State regulations (e.g. COMAR)
Consider accessibility, collaboration with other
agencies, community reintegration, availability of
personnel, culture, administration, staff
development, program sustainability and funding.
2. Individual Rehab Planning-IRP
Developed within a month of admission
Based on rehab assessment, diagnostic
assessment and/or psychiatric evaluation
Developed by the Rehab Treatment Team
Reviewed every 3 months for a child
Reviewed every 6 months for an adult
Rehabilitation Treatment Team
The client or client’s parent/guardian
The therapist
The psychiatrist
The counselor
The plan must be signed by the client plus
at least 2 of the other 3 above.
Any of the above may request a
modification to the plan before signing.
Content of IRP
The psychiatric diagnoses and rehab needs
Long term goals – to be achieved by discharge
Short term goals – to be achieved in few sessions
Target dates - for achieving the goals
Goals must be objective, observable, measurable
Activities or intervention to achieve the goals
Signatures of at least 3 team members
(See sample IRP)
3. Contact Planning & Implementation
Counselor’s plan towards next contact
Based on knowledge of the client, issues
from previous contacts, content of the IRP
Should address at least one goal from IRP
Must be achievable within the planned time
Symptoms & Feelings to be Addressed
Stress and distress caused by the illness
Stigmatization – including sense of shame
Feeling of loss of relationship, vocation,
interests, etc
Difficulty in accepting mental illness
Need for acceptance by others
Hopelessness
Behaviors to be Addressed
ADL (activities of daily living)
Interpersonal relationships
Self esteem
Motivation
Adherence to medications and rehab plan
Living Skills to be Addressed
Physical
Emotional
Intellectual
Cleaning
Shopping
Cleaning
Hygiene
Fitness
Transportation
Recreation
Human relations
Self control
Expressing anger
Conversation
Impulse control
Assertiveness
Patience
Goal setting
Time planning
Money management
Community
resources
Problem solving
Learning Skills to be Addressed
Physical
Emotional
Intellectual
Punctuality
Being quiet
Paying attention
Staying seated
Observing
Listening
Question asking
Volunteering answers
Speech making
Asking for directions
Following directions
Reading
Writing
Arithmetic
Study skill
Typing
Hobby
Working Skills to be Addressed
Physical
Punctuality
Transportation
Job strength
Use of job tools
Job tasks
Emotional
Job interview
Decision-making
Human relations
Self control
Job seeking
Job tasks
Intellectual
Knowledge
Job skills
Qualifying
Job search
Job tasks
Values to be Addressed
Respect of self, authority figures, and others
Respect of other’s properties
Respect of other’s personal space
Respect of other’s rights
Honesty
Determination
Good attitude
Caregiver Support to be Addressed
Emotional Support– acceptance, understanding,
empathy, commitment, partnership
Feedback Support– listening, affirmation, talking
Information Support– the illness, coping, decision,
perspective, behavior management, medications.
Instrumental Support– resources, respite, care help
Evaluation
1. Program evaluation – usually annually
Are the program’s vision and goals being met?
Is it cost-effective and regulation-compliant?
2. Rehabilitation evaluation – 2 to 4 times a year
How many and how well are the goals achieved?
3. Contact evaluation–at end of each contact/month
Are the goals for these contact/month achieved?