Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

Abstract

Collaborative goal setting between clinicians and clients/families is considered a fundamental component of the pediatric rehabilitation process. However, truly client-centered goal setting is not without its challenges. The purpose of this paper is to highlight theoretical concepts relevant to rehabilitation goal setting, review clinical studies directly evaluating relationships between goal setting and pediatric rehabilitation outcomes, and provide recommendations to facilitate collaborative goal processes. Four theoretical frameworks were identified that may lie behind and help explain the effectiveness of collaborative goal setting. The four relevant outcome studies found in the review revealed that individualized goal setting is an important component of the intervention, engages families more actively in therapy, and is associated to some extent with positive outcomes. The evidence suggests that the impact of fully collaborative goal setting is sufficiently positive to support investment of organizational and individual time, energy, and resources to make it an integral part of the rehabilitation process.

Parents' perspectives on a collaborative approach to the application of the Handwriting Without Tears® programme with children with Down syndrome

“…Finally, given the need for professional education in relation to collaboration and working with families identified in recent commentaries (e.g. Brewer et al, 2014) the findings can inform and pre-and postgraduation education in relation to working with families and children with DS.…”

“…Contemporary authors are advocating for the need for continuing professional development post graduation on collaborative goal setting and facilitating a collaborative process (e.g. Brewer et al, 2014).…”

“…Yet, substantial therapist time and expertise are required to support the elements of the collaborative approach used in this study (which involved parent/teacher education, collaborative goal setting, ongoing support, and coordination as well as group intervention with child and parents). Authors have acknowledged the amount of time required to negotiate collaborative goals and advocated for the need for the creation of a work culture, proper resource allocation and supportive working environment to enable staff to engage in family-centred care (Kolehmainen et al, 2012;Brewer et al, 2014). This is challenging in an Irish context where occupational therapists are not typically employed by Department of Education, there is a lack of interagency infrastructure to support occupational therapist/teacher collaborative work practices and there are ongoing issues regarding lack of adequate therapist resources to meet needs of children with SEN (NCSE, 2013).…”

Parental Adherence to a Research Protocol to Investigate the Effect of the Wilbarger Therapressure ProgramTM: A Qualitative Study

“…Novak, Cusick, and Lannin (2009) concluded that the use of occupational therapy home programs leads to observable gains in function and quality of movement. It is recommended that therapy should focus on the expectations of parents (Cohn, Kramer, Schub, & May-Benson, 2014) and that family-focused intervention, with collaborative goal setting, will result in improved outcomes for families (Brewer, Pollock, & Wright, 2014). Foster, Dunn, and Lawson (2013) and Graham, Rodger, and Ziviani (2009) mutually advocate for a parent coaching intervention model instead of direct child-focused intervention.…”

Impact of mastery motivation on occupational performance outcomes following upper limb intervention for school-aged children with congenital hemiplegia

“…Within the context of UL intervention for children with CP, clinicians work within a framework of family-centred (King & Chiarello, 2014), goal-focussed (Brewer, Pollock, & Wright, 2014), functionally-oriented (Law & Darrah, 2014), and activity-based practice aimed at promoting the development of skills and mastery of tasks required for successful occupational performance, participation and engagement. Individualised goals typically focus on developing skills for increased independence in the areas of self-care, productivity, and leisure.…”