Review from Session 4 Learning Objectives

Zakia Clay, MSW, LCSW

Zakia.Clay@shrp.rutgers.edu

Ann Reilly MA, LSW, CPRP

Reillya2@shrp.rutgers.edu

Anthony Zazzarino MA, LPC, CPRP

Anthony.Zazzarino@shrp.rutgers.edu

Rutgers, The State University of New Jersey

Review from Session 4

• Comprehensive Rehabilitation Needs Assessment

• Knowledge, Skills, Resources Form

Department of Psychiatric Rehabilitation & Counseling Professions

Learning Objectives

• Review Knowledge, Skills, Resource (KSR) and its connection to the rehabilitation plan.

• Practice developing an Individualized Rehabilitation Plan.

• Identify stages of change and its importance in developing appropriate interventions.

• Develop a framework for documentation (Data, Assessment,

Plan - DAP).

• Describe the critical components of a progress note.


Rehabilitation Plan Process

CRNA: Identifies goals.

KSR Form: Helps identify the critical components needed to achieve the goal.

Once prioritized to 3 to 5 identified areas, written in S-M-A-R-T format, becomes the objectives in the Rehabilitation Plan.

Rehabilitation Plan: Incorporates the CRNA with the KSR form. Adds S-M-A-R-T interventions to match objectives and drives the intentional billable services.


Why Individualized Rehabilitation Planning?

• Links the steps to achieve the goal with the interventions

– Interventions aim to eliminate the deficits

• Identifies who is responsible for doing what , by when , for how long , and where

– Increases sense of accountability

• Operationally defines the rehabilitation team approach

(Anthony, Cohen, Farkas, Gagne, 2002)


Individualized Rehabilitation Plan (IRP)

Rehabilitation and recovery goals

Objectives

Strategy/intervention to be employed

Anticipated outcomes

Expected frequency and duration of each activity

Type of practitioner to provide the service

Location service to be provided

(Larosiliere, 2011)


Individualized Rehabilitation Plan Example


Interventions…

• Assist

• Review

• Check-in

• Support

• Encourage

• Transport

– Are these terms you currently use?

• What is the intended service that you are providing?


Individualized Rehabilitation Plan –

Activity Part 1 (10 min)

• Step 1: Partner up with someone that you don’t know

• Step 2: Identify a NEW goal that you are working on

• Step 3: Work with your partner to break the goal down into the critical components utilizing the KSR Form

Switch roles at the buzzer




• Step 1: Identify your strengths and areas for improvement by checking off the appropriate boxes on the KSR form.

• Step 2: Talk with your partner; prioritize 3 to 5 areas of need that your want to work on first.

• Step 3: Break down the 3 to 5 prioritized items into S-M-A-R-T format.





• Transfer the information from the KSR Form to your Individualized

Rehabilitation Plan

– Keep in mind:

• Strengths

• S-M-A-R-T objectives

• Develop S-M-A-R-T interventions to match each objectives



Rehabilitation Plan Process

CRNA: Identifies goals .

KSR Form: Helps identify the critical components needed to achieve the goal.

Once prioritized to 3 to 5 identified areas, written in S-M-A-R-T format, becomes the objectives in the Rehabilitation Plan.

Rehabilitation Plan: Incorporates the CRNA with the KSR form. Adds S-M-A-R-T interventions to match objectives and drives the intentional billable services.


Stages of Change

Maintenance

Precontemplation

Action

Preparation


Contemplation

Stages of Change

• Pre-Contemplation-Not seeing a problem behavior or not considering change.

• Contemplation-Acknowledging that there is a problem but struggling with ambivalence. Weighing pros and cons and the benefits and barriers to change.

• Preparation-Taking steps and getting ready to change.

• Action-Making the change and living the new behaviors, which is an all-consuming activity.

• Maintenance-Maintaining the behavior change that is now integrated into the person's life.

(Miller, 2009)


Goal: I will secure a part time job by 12/15/14


Stages of Change Activity


How does this translate to visits

Pre-Contemplation

Contemplation/Preparation

Action

Maintenance

• Outreach

• Trusting Relationship

• Practical Support

• Assessment

• Motivational Interventions

• Education

• Skill building

• Social Support

• Cognitive Behavioral

Interventions

• Planning

• Recovery Lifestyle

• Social Support


Rehabilitation Plan Revisions

• Goal (s) have been accomplished

• Consumer no longer wants to work on chosen goal (s)

• Unforeseen events

• Disengagement

• Incarcerations/Hospitalizations


Documentation

• Should be:

– Concise

– Timely

– Readable

– Easily understood

– Complete

– Accurate

– Must relate to a service on the rehabilitation plan

– There is adequate content for time billed

– Should reflect the intervention(s) being addressed during the visit


D-A-P Format

Data Assessment

Plan


Data

Linkage to the rehabilitation goal

Review of consumers follow-up activities

Specific interventions

Consumer report

Data


Assessment

Consumer response to the intervention

Assessment of progress towards IRP goals, objectives, and interventions

Assessment of change in consumer behavior


Plan

Staff/Consumer next steps

Date and time of next service delivery


Plan

Progress Note Example


D-A-P Checklist


Golden Thread of Documentation

CRNA

Rehabilitation

Plan

Progress

Note


Documentation Do’s and Don’ts

• Why do some claims get returned?


References

Alexander, M. J., & Haugland, G. (2000 ). Integrating services for cooccurring disorders. Final report prepared for the New York State

Conference of Local Mental Hygiene Directors. Orangeburg,

NY: Center for the Study of Issues in Public Mental Health,

Nathan S.Kline Institute for Psychiatric Research. Retrieved from http://www.clmhd.org/UploadedFiles/Resources/Integrating%20

Services%20for%20CoOccurring%20Disorders_12835913305

2805216.pdf

Anthony, W., Cohen, M., Farkas, M., & Gagne, C. (2002).

Psychiatric rehabilitation . (2nd ed., pp. 141-151). Boston: Center for

Psychiatric Rehabilitation.

Larosiliere, V (2011). Community Support Services [memo].

Retrieved from http://www.state.nj.us/humanservices/dmhs/info/CSS_Notice_t o_provi ders.pdf.


References (continued)

Miller, W.. & Rollnick, S. (2009). Ten things that Motivational interviewing is not. Behavioral And Cognitive Psychotherapy , 37, 129--140.

Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing.

New York:

Guilford Press.

New Vitae. (2014). Documentation, the D.A.P. Format, and Writing Incident

Reports [Module #5]. Quakertown, PA: Human Resources.


References (continued)

Pratt, C. W., Gill, K. J., N.M, & Roberts, M. M. (2014). Psychiatric

Rehabilitation. (3 rd ed.) San Diego, CA: Elsevier Inc.

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of selfchange of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology , 51(3), 390-395.

Retrieved from http://www.sfu.ca/medialab/archive

/2010/426/Readings/Theoretical%20Framework/Stages%20of

%20Change%20%20Prochaska%201983.pdf


Review from Session 4 Learning Objectives

Data Assessment

Plan

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Data Assessment

Plan

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