A mechanism for delineating and tracking the attainment of individual client goals instituted during fiscal year 19992000 continued to be used throughout this reporting period. As part of service delivery, mental health and case management providers develop individualized 12-month case plans with clients. Plans are based on an individualized outcome-oriented services planning model and include a broad service goal, outcome indicators and service methods. The goal attainment scaling provides a method for assessing individual and aggregate client outcomes. On a quarterly basis, the service providers prepare a brief narrative of progress made in achieving the previously delineated client outcomes, as well as including other issues relating to service delivery.
In addition to the brief narrative, the provider rates on a 5-point scale her client's achievement of the designated goal. Last year the project director worked with the individual providers to incorporate scaling into their practice. A group training session was also staged to reinforce application during this fiscal year.
Figures 19, 20 and 21 show the goal attainment scaling results for those
clients who have completed a 12-month
treatment plan.
Figure 19 shows goal attainment for the support groups in 4 domainscommunication, education, skills building and support. Mean attainment for the 44 clients ranged from 3.27 in skills building to 3.61 in communication. Goal attainment across the 4 types of support groupsteen boys, teen girls, boys and girls, as well as high participators and low participators is also compared. Means differences are greater across the age and gender based groups than between those who attended over 75% of the sessions and those fewer than 75%. 8
Figure 20 shows the results of goal attainment for the 11 art therapy clients who completed 12 month plans. The treatment plans delineated goals in 3 domainscommunication, family process and skills building. Mean attainment tended to increase from the first through the fourth quarter.
Kinship care goal attainment for 17 clients with completed treatment plans containing a total of 44 goals is presented in Figure 21. Goal domains included education, housing, financial, grief, family processes, life planning, coping, health care, behavior management and disclosure. Kinship care goal attainment appears to have varied more across domains than by quarter.
These goal attainment results were presented in a Family Ties Project team meeting January 25, 2002 to the Family Ties Project team members who formulated the goals and tracked attainment scores over the 12-month period. A discussion of the meaning and usefulness of the data ensued. 1 team member pointed out that many of the factors affecting goal attainment are beyond her control. In considering support group goal attainment variation across age/gender categories, Pediatric Care, Inc. staff offered several possible explanation: the group facilitators are female, which may contribute to greater engagement of female participants; girls are more compliant than boys; each group has it unique dynamics; and given the small number of clients and groups, differences in goal scores are not meaningful. It was also agreed that since goals are not standardized, and ratings are subjective and not independent, interpretation is difficult. Ways of incorporating these results on goal attainment into individual practice have yet to be institutionalized.