To Prepare

Consider the potential of influence you might have on a client. Think about the cautions that you must take as a Human and Social Services professionals when creating client goals.

By Day 3

Post your response to the following: Given your potential for influence, how can you as a professional maintain the balance between guiding the client toward appropriate goals and objectives for the situation, while ensuring that one is not deciding the goals FOR the client? How can this relationship be used or misused to facilitate social change?

Use sources from the literature to support your position.

BOOK: Summers, N. (2016). Fundamentals of case management practice: Skills for the human services (5th ed.). Boston, MA: Cengage Learning. 

CHAPTER 25: Developing Goals and Objectives at the Provider Agency

Introduction

It is important to note at the outset that goals and objectives like the ones we will be discussing in this chapter are done in many different settings. Case managers in many agencies develop these more specific goals and objectives with clients. This would be particularly true if the agency did their own intakes and provided the services as well. For example, it might be that a program for domestic violence would do the intake, learn the goals the woman wanted for herself, and develop a specific goals and objectives plan with her. Perhaps in an agency that served individuals with substance abuse issues, the case manager would learn that abstinence was the goal the person had set for himself and the case manager might go on to develop with the person the specific goals and objectives to get him there.For our purposes in this textbook, we have case managers outlining the general goals with people that these clients have for themselves. These goals are then sent to the provider agency where the actual service will be given and a very specific plan with goals and objectives is developed there with the person. In other words, these more specific goals and objectives become the steps or the plan to achieving the general goal.Therefore, at the provider agency they have received your broad general goals for the client. That person has arrived there, and the people at the provider agency have read over the general goals you wrote on your referral sheet. Now they will sit down and develop with the person very specific goals and objectives to address the larger goals you put on the referral form. In other words, they develop the goals you sent over in much greater detail.In this chapter, you will step out of your role as case manager at the case management unit and step into the role of the person primarily responsible for implementing the client’s service plan at the provider agency. In the agency where the service is actually given (the provider agency), goals and objectives are written very specifically and in greater detail. Here the broad general goal supplied by case management is broken down into more specific goals and objectives. The objectives tell us how the goal will actually be met. The objectives are a plan or blueprint for reaching each goal. This enables the staff at the case management agency to know exactly what the plans are for the client.When the referred person arrives at the treatment or service agency, that agency’s staff takes their turn looking at the stated goals on the referral form that were worked out with the individual. They then decide with the person just how to meet those goals in the time allotted by the case manager. Completion of the more specific goals is expected to take place during the time for which the case manager has authorized payment of services for the client. Sometimes the client cannot meet the goals in that time or needs more time because of other issues that have surfaced or new problems that have occurred. For example, a person who has periodic difficulty with asthma was hospitalized on a pulmonary unit for a week and missed several weeks of services, necessitating an extension to the agreement. In another case, a person did not do well in the program where she went 4 days a week to learn more about independent living. Although she appeared to make progress, her progress was slower than anticipated, so the case manager extended the authorization for 6 more weeks. In these cases, the case manager authorized additional time for the person in that agency.Much of the material in this chapter is based on the work of Arnold R. Goldman (1990), from his newsletter Practical Communications.

Client Participation/Collaboration

We would not make goals for people without collaborating with them. If you are working with a child, you want to note that the parent or parents were involved in the decisions. For an adult, you need to include the fact that the adult has participated in determining his own goals. If the person is unable to participate at the time due to her mental or physical condition, try to learn who the person would want to participate in the planning on her behalf. For example, Ardith assisted her mother in developing a plan with the worker because her mother was in the beginning stages of Alzheimer’s disease.Assessment and evaluation forms usually have places to record people’s answers when you ask them what they see as the main issues to be resolved and what they expect of services. Each of these forms addresses this issue in a different way, but look at this material when developing goals with people. The information you collect from the person should indicate that you and the person developed the goals and objectives together. Someone reading your plans should see it clearly indicated that the client participated and agreed with the direction the goals tend to lead.

Make Objectives Manageable

Goals and objectives can overwhelm people. Sometimes when working with people to develop goals and objectives, case managers develop objectives that are too difficult. It is not always possible to foresee that what you and the client have planned will overwhelm the client when she attempts to meet the objectives. It is best to choose small objectives, small attainable steps that you know the person will be able to accomplish. Meeting these objectives shows progress toward the goal much faster and gives people a sense of having accomplished something important and a sense of moving forward. You can stress to them that they have accomplished something important. When you develop your objectives, work with the tasks you are sure people will be able to attain.In addition, be careful not to overwhelm people with too many goals and objectives to accomplish. Try only two or perhaps three to start so that people do not feel buried in to-do lists right from the start.Here is an example of a goal and the objectives that were developed for a woman who wanted to leave welfare. In this example, the case manager overwhelmed the person.Goal: Larita will become self-sufficient financially by 2019 as evidenced by:

• Objective 1: Larita will go to college in nursing by fall 2015
• Objective 2 Larita will attain a nursing degree by June 2017
• Objective 3: Larita will attain a position in the local hospital by July 2017

In this example, Larita has a plan but the goals are large and could be overwhelming. In addition, she would not accomplish anything before the fall of 2015. Here is a better way to plan with Larita.Goal: Larita will go to college in nursing by fall 2015

• Objective 1: Larita will get the college catalog
• Objective 2: Larita will choose a course of study
• Objective 3: Larita will enroll at the college
• Objective 4: Larita will choose her courses for the semester
• Objective 5: Larita will complete her first semester

In this example, your service interventions might be to assist her with these tasks and support her as she tackles her first semester. Larita, however, has a clear step-by-step plan to begin her degree. As she checks off each task she will sense she is moving forward. This example has a greater chance of being successful and a greater opportunity to instill confidence.

Expect Positive Outcomes

Goals are actually the outcomes you expect to occur as a result of the treatment, service, or intervention you have chosen (Goldman, 1990). Goals are written, therefore, in the positive—what will happen, rather than what will not happen or what might happen.