Goal-Setting

Based on the overall assessment and perspectives of Gabi and her health-care team, the Global Goal was established for community integration and peer relationships. The Service Program Goal for this three-week rehabilitation program would be increased independence and the two Cycle Goals would aim to improve mobility and self care.

Figure 2: ICF Categorical Profile:

Figure 2: ICF Categorical Profile: *ICF Qualifiers range from 0 = no problem to 4 = complete problem in the components of body functions (b), body structures (s), activity and participation (d) and from -4 = complete barrier to +4 = complete facilitator in the environmental factors. In personal factors, the sign + and - indicates to what extent a determined pf has a positive or negative influence on the individual’s functioning. °CG1,2 mark the relation to Cycle Goals 1,2,3; SPG is related to Service Program Goal, GG related to the Global Goal

In addition to her impairments in body functions/structures and limitations in several activities, Gabi’s psychological needs were also central to many of the interventions.

Her psychologist undertook regular weekly counseling sessions to concentrate on emotional functioning and improving skills for complex interpersonal interactions, informal social relationships and school education.

In both individual and group sessions Gabi’s needs to be more assertive and to improve her social competencies were addressed. Each of these interventions focused to improve her peer relationship Cycle Goal.

Many of the activity-focused interventions performed by the nurse, the physical therapist and occupational therapist were at the center of both the mobility and self-care Cycle Goals. These included transfer and wheelchair training, as well as trainings in dressing and toileting.

Self-management training should contribute to improving Gabi’s ability to carry out successfully her daily routine.

Assignment and intervention

Figure 3: ICF Intervention Table

Figure 3: ICF Intervention Table* The values are rated within the ICF qualifier.

Gabi’s health-care team for the three-week program included a physician, a nurse, physical, occupational and sports therapists, a psychologist and a music therapist. Additionally, a vocational trainer would be available to address her career needs.

Each intervention target was assigned to one or more health professionals and the according intervention (Figure 3).

The program was comprehensive and each day included a full schedule of both individually focused activities and interventions as well as numerous group activities.

In addition to her impairments in body functions/structures and limitations in several activities, Gabi’s psychological needs were also central to many of the interventions. Her psychologist undertook regular weekly counseling sessions to concentrate on emotional functioning and improving skills for complex interpersonal interactions, informal social relationships and school education.

In both individual and group sessions Gabi’s needs to be more assertive and to improve her social competencies were addressed. Each of these interventions focused to improve her peer relationship Cycle Goal.

Many of the activity-focused interventions performed by the nurse, the physical therapist and occupational therapist were at the center of both the mobility and self-care Cycle Goals. These included transfer and wheelchair training, as well as trainings in dressing and toileting. Self-management training should contribute to improving Gabi’s ability to carry out successfully her daily routine.

And a group excursion to a nearby city built confidence in the use of public transportation. Swimming was undertaken to simply encourage and build on one of Gabi’s favorite leisure activities.

Additionally, a number of interventions centered on body functions and structures: circuit training was introduced to help improve muscle power and arm support; music therapy was intended to improve respiration; and movement therapy was used to help counter pain sensations.

Importantly, the adolescent-tailored program went beyond just these individually focused interventions. Every day Gabi took part in a wide range of group activities (Table 1).

These included a group project culminating in a final performance at the end of the three weeks; a visit to an art studio and a farm; an outdoor picnic with a barbeque; a group music session; a “wellness” evening with massage; and even a workshop where parents were included.

Each of these activities doubtlessly contributed, if not directly to a Cycle Goal, then to the Program Goal of increased independence and even to the Global Goal of Community integration and Peer Relationships.

Table 1: Gabi’s schedule of group activities

Table 1: Gabi’s schedule of group activities