PARTICIPATION OF PERSONS WITH A COGNITIVE DISABILITY IN THE GOAL SETTING PROCESS

Background: Goal setting is an essential phase of a rehabilitation process. Cognitive problems may cause challenges in identifying, prioritizing and deciding the appropriate goals for rehabilitation. The aims of this study... [ view full abstract ]

Background:
Goal setting is an essential phase of a rehabilitation process. Cognitive problems may cause challenges in identifying, prioritizing and deciding the appropriate goals for rehabilitation. The aims of this study were to evaluate the participation of rehabilitees with cognitive problems in the goal setting process and to identify methods which support their engagement.
Method:
20 persons with a dual diagnosis of developmental disability and mental illness (PwDDMI) set their goals for rehabilitation with a multidisciplinary team using goal attainment scaling (GAS). A three phase data collection started with the observation of the goal setting discussions. Then the rehabilitees were interviewed individually and the professionals in focus groups about their experiences in goal setting. Qualitative content analysis was used to analyse text data.
Results:
The rehabilitees’ participation in the goal setting process varied from limited verbal expressions to shared power and responsibility in decision making. The rehabilitees’ trust in professionals and professionals’ commitment to work in a person-centered manner were essential. The questions, comments and visual techniques used by the professionals were essential for PwDDMI to identify, prioritize and concretize their own goals.
Conclusion:
A cognitive disability is not a barrier to active participation in the goal setting process with PwDDMI if professionals use adequate, person-centered methods to support decision making.
Application to Practice:
Professionals working with PwDDMI should utilize person-centered methods such as questions, supportive comments and visual techniques to assist rehabilitees during the goal setting process and encourage them to take power and responsibility in decision making.