Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ.
Department of Speech Pathology & Audiology, Miami University, Oxford, OH.
Am J Speech Lang Pathol. 2021 Nov 4;30(6):2394-2413. doi: 10.1044/2021_AJSLP-21-00078. Epub 2021 Sep 16.
Purpose Speech-language pathologists (SLPs) have many available procedural options when setting treatment goals. Extant literature supports goal setting protocols that include and value the perspectives of the client; however, in practice, rehabilitation professionals may lean toward expert models of care when planning treatment. Our purpose is to describe a newly developed approach for SLPs and individuals with mild traumatic brain injury (mTBI) to work together to build meaningful, relevant goals. Method We utilized a multiple case study format to exemplify goal setting procedures. Specifically, we describe procedures and outcomes for a 29-year-old female 28 days postinjury and a 70-year-old male 9 months postinjury. Results Clients who engaged in this protocol worked collaboratively with a clinician to identify strengths and challenges postinjury, select and prioritize goal areas, and discuss and develop meaningful, personalized treatment activities. For both participants, use of the proposed protocol resulted in meaningful goals that addressed their self-reported deficits as well as their respective cognitive-linguistic deficits noted on objective, standardized measures. Conclusions Clinician and client collaboration during treatment goal development can facilitate increased client motivation and functional outcomes. The described approach is feasible from a clinical resource standpoint and promotes a systematic approach to placing the client at the forefront of clinical decision making to enhance therapeutic gains. Such client-centered approaches may be particularly valuable for individuals with mTBI who experience substantial cognitive and communicative challenges but may maintain high levels of self-awareness postinjury.
目的 言语语言病理学家(SLP)在制定治疗目标时有许多可用的程序选项。现有文献支持包括并重视客户观点的目标设定协议;然而,在实践中,康复专业人员在规划治疗时可能倾向于专家护理模式。我们的目的是描述一种新开发的 SLP 和轻度创伤性脑损伤(mTBI)患者共同制定有意义、相关目标的方法。
方法 我们采用了多个案例研究的格式来举例说明目标设定程序。具体来说,我们描述了一名 29 岁女性受伤后 28 天和一名 70 岁男性受伤后 9 个月的程序和结果。
结果 参与该方案的患者与临床医生合作,共同确定受伤后的优势和挑战,选择和优先考虑目标领域,并讨论和制定有意义的个性化治疗活动。对于两个参与者,使用拟议的方案导致了有意义的目标,这些目标解决了他们自我报告的缺陷以及他们在客观、标准化测量中指出的各自认知语言缺陷。
结论 在治疗目标制定过程中,临床医生和患者的合作可以促进患者的积极性和功能结果的提高。从临床资源的角度来看,所描述的方法是可行的,并促进了一种系统的方法,将患者置于临床决策的前沿,以增强治疗效果。这种以患者为中心的方法对于经历大量认知和交流挑战但在受伤后仍保持高度自我意识的 mTBI 患者可能特别有价值。