248 Using Adult Learning Theory to Improve Treatment Delivery and Planning

Adult Education & Teaching Skills to Improve Treatment/Service Planning
Dr. Dawn-Elise Snipes, PhD, LMHC
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery

Find CEUs for this podcast on the Counselor Toolbox CEU spreadsheet

Objectives
~ Redefine treatment plans
~ Examine how adult learning theory can help us create more individualized plans and objectives
What are treatment plans?
~ Opportunities for teaching clients
~ Problem solving skills
~ Identifying and using personal strengths
~ Dynamic documents
~ Address client’s current functioning and needs
~ Evaluate client’s progress toward specified goals and objectives
~ Guide treatment for identified problems or issues
~ Enhance multidisciplinary team communication

What is Treatment Planning?
~ Process in which counselor and client:
~ Identify and rank problems needing resolution
~ Establish agreed upon immediate and long-term goals
~ Decide on treatment methods
~ Identify necessary resources
Treatment Plan Foundation
~ Biopsychosocial assessment
~ Current stressors
~ Coping skills
~ Self-esteem
~ Mental health
~ Substance abuse
~ Social network
~ Physical health
Treatment Plan Development
~ Individualized treatment plan
~ Structured
~ Goal-oriented
~ Schedule of services
~ Developed jointly with client
~ Written document
~ Treatment-related goals
~ Measurable objectives
~ Interventions grounded in client’s learning style

Adult Learning
~ Adults need to be involved in the planning and evaluation of their instruction.
~ Adults are most interested in learning subjects that are practical and have immediate relevance and impact to their job or personal life.
~ Adults are more engaged when there is a presenting crisis
~ Adult learning is problem-centered rather than content-oriented
~ Explain the reasons specific things are being taught
~ Instruction should be task-oriented instead of promoting memorization
~ Adult learners prefer collaboration and ability to think critically
~ Instruction should take into account the wide range of different backgrounds of learners
~ Since adults are self-directed, instruction should allow learners to discover things and knowledge for themselves without depending on people
~ Adults are juggling multiple responsibilities
Adult Learning Methods
~ Concrete learning (role play or activity)
~ Reflective observation (What did you learn? How does this change things for you?)
~ Abstract conceptualization (How might this apply to your life/other situations? How could you teach this to your kids?)
~ Active Experimentation
~ Apply it in a variety of contexts and discuss with group
~ Role play a variety of situations (applying ot or teaching it)

Learning
~ 3 parts to the learning process:
• Cognition
~ How people acquire knowledge
~ seeing, hearing or doing
• Conceptualization
~ How people process information
~ abstract, specific, memory pathways
• Affective
~ People’s motivation, decision-making styles, values and emotional preferences
~ how much does this information matter

Understanding Learning Styles
~ Active/Reflective
~ Processing information
~ Auditory/hearing, visual/seeing, or kinesthetic/doing
~ Receiving information
~ Attitudinal or Emotional (Thinking or Feeling)
~ Conceptualizing information
~ Global vs. Specific (Sensing vs. Intuitive)
~ Parts to whole or vice versa
Active/Reflective Learner Tips
~ Reflective learners
~ Think it through first
~ Prefer working alone

~ Active learners
~ Difficulty sitting quietly through lectures
~ Like group work
~ Need discussion or problem-solving activities

~ Action without reflection
~ Trouble
~ Reflection without action
~ Inaction
Auditory, Visual, Kinesthetic
~ Kinesthetic learners
~ Mentally or physically work with material
~ Auditory learners
~ Need to hear the material
~ Visual learners
~ Need to see the material
~ To meet different learning needs, present material:
~ Visually (notes, graphs)
~ Verbally (talk about it)
~ Manipulatively (questions, group activities)
Attitudinal/Emotional
~ Thinkers vs. Feelers
~ Present compelling information
~ Appeals to people’s emotions
~ Ex: Statistics on child abuse with pictures of kids
~ Answer the question—
~ “Why do I care?”

Specific/Sensing vs. Global/iNtuitive
~ Big picture vs. details
~ Bottom Up or Top Down
~ Think puzzles: Box or no box?
~ Think DVDs: Read the back or no?
~ Present a general overview
~ Provide an outline/agenda for direction
~ Find a balance
~ Present big picture and basics then let participants ask questions

Learning Style Summary
~ Create an emotionally and objectively meaningful and positive goal (Emotional, Attitudinal, Global)
~ Create steps/objectives to achieving that goal (Sequential)
~ Write steps/objectives in a positive, KSA format
~ Will, will learn, gain, practice vs.
~ Will not, will avoid, will eliminate
~ For each sub-goal
~ Provide written information
~ Discuss it
~ Apply it
~ Regularly address how each goal builds on the last
Where to now?
~ What we know after initial meeting
~ Who they are
~ Their issues
~ Their learning style

~ What we still need to know
~ What they are motivated to change and why
Steps of Treatment Plan Development
~ Step One: Problem Selection
~ Step Two: Goal Development
~ Step Three: Problem Definition
~ Step Four: Objectives
~ Step Five: Interventions
Problem Selection: Motivation
~ Changeable
~ Variable
~ Components
~ Emotional
~ Cognitive
~ Social
~ Physical
~ Situational
Problem Selection: Meaningful
~ Reward must be worth the effort
~ Create mutually beneficial goals if needed
~ Help client identify motivations and corresponding goals
~ Use the miracle question

Writing the Plan: AM SMART
~ Individualized
~ Use positive language
~ Address the reasons for not changing

~ Goals are:
~ Assessment based
~ Meaningful to the person
~ Specific
~ Incremental
~ Written in the KSA progression
~ Measurable (observable)
~ Achievable given skills and resources
~ Results-focused (not activities)
~ Time limited
Problem Definition
~ How is the problem evidenced in the client?
~ How is the problem affecting the client’s overall functioning?
~ What is the client’s perception of the problem?
~ What are the client’s strengths?
Goal Development
~ What is the broad goal for resolution of the problem?
~ What is the absence of the problem?
Objectives
~ Steps toward the goal
~ S.M.A.R.T
~ Specific
~ Rome was not built in a day
~ Frequent reinforcement
~ Logical sub-goals
~ KSAs
~ Measurable (duration, frequency, intensity)
~ Attainable
~ Results-focused
~ Time-limited
Pitfalls
~ Failing to consider why currently do (or do not) engage in certain behaviors
~ Setting goals that are too big
~ Setting goals that are too hard
~ Setting too many goals
~ Setting goals without sufficient rewards
~ Setting goals that are too specific
Common Issues
Anxiety/Depression
~ Identify sub-goals (SMART)
~ “What would it be like if you were not anxious/depressed anymore?”
~ Statement
~ “Sally will be calmer/happier resulting in improved concentration/focus, increased energy, improved sleep and reduced headaches.”
~ Knowledge/Skills
~ Educate her about anxiety causes, short/long term effects
~ What skills does Sally have?
~ What skills does sally need to learn?
~ Teach, discuss, role play, practice, report
Anxiety/Depression
~ Statement
~ “Sally will be calmer resulting in improved concentration/focus, increased energy, improved sleep and reduced headaches.”
~ Sally will rule out any physical causes of depression/anxiety by getting a physical and discussing her symptoms, nutrition and sleep patterns with her doctor.
~ Sally will follow any prescribed treatment from her physician
~ Sally will learn about the causes of anxiety/depression and identify which things may be causing it for her by attending Tuesday night groups for 8 weeks and reading X text
~ Sally will make a list of 5 things she currently does that help manage her mood issue
~ Sally will develop a plan to minimize triggers and vulnerabilities for her mood issues as identified in Tuesday night’s group and will share with her therapist each week.
~ Sally will keep a journal of her sleep, energy, ability to concentrate and headaches to share with the treatment team to track improvement and identify connections between symptoms and vulnerabilities/triggers.

Psychosocial Issues
~ Identify sub-goals (SMART)
~ “What would it be like if ______________________?”
~ Your relationships were improved
~ You weren’t stressed about finances all the time
~ You had a job you enjoyed
~ Statement
~ “Sally will _________ resulting in _________.”
~ Knowledge/Skills
~ Educate Sally about the issue, what might be causing it for her and how it may be impacting her.
~ Educate Sally about available resources
~ What skills/resources does Sally have?
~ What skills/resources does sally need?
~ Teach, discuss, role play, practice, report
Problem Statement
~ “Alcohol Dependence”
~ Not individualized
~ Not a complete sentence
~ Doesn’t provide enough information
~ A diagnosis is not a complete problem statement
~ Is a negative statement

~ Better: Sally meets the criteria for a substance use disorder as evidenced by problems in her marriage and at work because of her drinking, development of a tolerance to alcohol and the presence of withdrawal symptoms when she is not drinking.
“AS EVIDENCED BY…..”
Goal Statement
~ “Will refrain from all substance use now and in the future”
~ Cannot be accomplished by program discharge
~ Negative: Does not identify alternatives

~ Better: Will develop alternate skills and tools to deal with stress and peer pressure in order to remain substance free for the next 30 days so she can remain in compliance with her performance improvement plan and keep her job
Objective Statement
~ “Will participate in outpatient program”
~ A level of care is not an objective it is an intervention
~ Better: Will learn about coping skills to deal with distress by participating in IOP to aid in reducing the desire to drink

Summary
~ By working with your clients to develop goals, they will determine:
~ How they learn the best
~ How to identify appropriate sub-goals
~ How to create an effective change plan