ABSTRACT
Goal planning is a commonly used practice in rehabilitation; however, approaches vary with no gold standard. Despite its widespread use in rehabilitation, research on the effectiveness of goal-planning approaches is still an emerging area (Levack et al., 2006). This chapter seeks to describe and discuss a client-centred, occupation-based approach to goal planning, as well as present recent evidence related to the clinical utility and effectiveness of this approach with clients in a rehabilitation setting. By the end of this chapter, it is expected that the reader will have knowledge about what occupation is and the potential benefits of occupation-based goal planning, how occupational therapists use occupation as
CONTENTS
10.1 Introduction ........................................................................................................................ 181 10.2 Occupation .......................................................................................................................... 182
10.2.1 Occupation in Occupational Therapy ................................................................. 182 10.2.2 Determining Meaningful Occupational Goals ................................................. 185 10.2.3 Client-Centredness ................................................................................................ 185
10.3 Canadian Occupational Performance Measure ............................................................ 186 10.3.1 Benefits and Limitations of the COPM ............................................................... 187 10.3.2 Top-Down versus Bottom-Up Assessments ...................................................... 189 10.3.3 Combined Use of COPM and GAS ...................................................................... 192 10.3.4 Clinical Utility of the Combined Use of the COPM and GAS ........................ 198
10.4 Key Elements of an Occupation-Based Client-Centred Goal-Focused Intervention ................................................................................................................... 199 10.4.1 Goal Based ..............................................................................................................200 10.4.2 Structured ...............................................................................................................200 10.4.3 Environment Focused ........................................................................................... 201 10.4.4 Case Example Illustrating the Treatment Approach ........................................ 201
10.5 Client-Centred Goal Planning in Different Rehabilitation Settings .......................... 204 10.5.1 Community Rehabilitation Settings ................................................................... 205 10.5.2 Inpatient Rehabilitation Settings ......................................................................... 205 10.5.3 Goal Planning in Teams ........................................................................................ 207
10.6 Conclusion .......................................................................................................................... 208 References ..................................................................................................................................... 208
a therapeutic tool in rehabilitation, how occupation can form the basis for goal planning in rehabilitation, client-centred practice, the Canadian Occupational Performance Measure (COPM) and the clinical utility of the combined use of the COPM and goal attainment scaling (GAS) to plan goals and structure a rehabilitation programme. This chapter will also discuss the application of and challenges to applying client-centred goal planning in teams, challenges of goal planning in different rehabilitation environments and strategies to enhance consideration of environmental factors when goal planning.
