Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To (1) Describe a collaborative clinical procedure to establish person-centered goals, and; (2) Discuss this procedure in the realm of a case example.
Design : The individual underwent an established, one-hour assessment protocol before this session. Following this, a speech-language pathologist and client completed a person-centered procedure which includes collaboratively identifying short-term goals and three subdomains/areas that (s)he would like to target. To select these domains for therapy, the clinician provided: education about cognitive (sub)domains, feedback about the appropriateness of the selected goals, and data from client's assessment that exemplify deficits. Next, the client generated example activities in her/his life where she relied on each subdomain. Throughout the protocol, the individual's feelings are addressed and education regarding ecological validity and expectations for therapy are provided as needed. At the end of the session, the clinician and client determined appropriate and feasible therapy frequency and intensity and the client engaged in a brief activity exemplifying future therapy.
This procedure was completed in a research laboratory in the Speech, Language, and Hearing Sciences Department at the University of Arizona. The laboratory space is quiet and has a dedicated space (i.e., a table and two chairs) where research participants are seen.
Participants (or Animals, Specimens, Cadavers) :
This was a case study completed with one female participant (AS) who sustained a mild traumatic brain injury approximately one month before she underwent this procedure.
Main Outcome Measure(s) :
Subjective participant information (i.e., patient report) and objective vocational and personal consequences were used as outcome measures in this study.
The procedure described above was used to inform therapy activities. Subjective and objective information for this individual reflect that this protocol was effective, motivational to the client, and yielded positive outcomes.
This procedure may be an effective means of implementing person-centered care for rehabilitation professionals working with individuals who have sustained traumatic brain injuries. We will highlight clinical implications for rehabilitation professionals creating goals with individuals in this population.