The goal bank is a list of possible general goals for psychological treatment in the WSIB Mental Health Programs. These goals help prompt thinking and discussion between the patient and treating psychologist.
Psychologists and patient are encouraged to think about the ways that work-related injury causes difficulties, whether emotional symptoms or their ability to do daily activities and identify related general goals for treatment. This discussion can lead to more individualized and detailed versions of the goals, including the development of related SMART goals.
Note: the below domains, problems and general goals are often overlapping and interactive.
Emotional
Examples of problems that may become the focus of treatment goals
- excessive worry or fear
- fear of separation
- feelings of worthlessness
- hypervigilance
- irritability
- labile mood
- low mood
- lack of enjoyment
- maladaptive guilt
- negative outlook on life
Examples of general goals that may be developed into SMART goals
- Increase ability to regulate emotions
- Increase ability to experience joy and pleasure by identifying and participating in pleasurable activities
- Learn and apply positive self talk
- Learn to accept or release undue feelings of guilt
- Plan desensitization hierarchy
- Practice distress tolerance skills
- Reduce emotional arousal in response to triggers
- Reduce frequency, intensity and duration of worry by learning and practicing worry appointments and postponement
- Reduce thoughts of suicide and feelings of hopelessness
- Develop a safety plan
Behavioural
Examples of problems that may become the focus of treatment goals
- avoidance of triggering stimuli/feared situations
- maladaptive behaviour
- substance use
- unduly controlling or passive behaviour
- use despite physical danger or medical warnings
- suicidal/self-harm behaviours
Examples of general goals that may be developed into SMART goals
- Learn to identify warning signs and reduce maladaptive behaviours
- Learn to identify/reduce behavioural response to triggers
- Improve proactive, problem-focused coping skills
- Improve self-awareness
- Increase sense of personal safety
- Reduce avoidance and gradually increase exposure to triggering stimuli
- Reduce controlling behaviours
- Reduce/stop substance use
- Research/attend/complete Alcoholics Anonymous or Narcotic Anonymous type program
Cognitive
Examples of problems that may become the focus of treatment goals
- dissociative reactions
- impaired complex attention
- impaired concentration
- impaired executive function
- impaired memory
- impaired perception
- impaired social cognition
- negative thinking
- rumination
- suicidal thoughts
Examples of general goals that may be developed into SMART goals
- Learn to identify dissociative symptoms
- Learn and practice relaxation techniques
- Improve concentration through application of graduated concentration exposures (e.g., reading, computer work)
- Improve executive functioning using strategies such as planning, prioritization and checklists
- Increase physical activity to improve cognition (e.g., concentration, memory)
- Reduce dissociative symptoms
- Reduce ruminative thinking and practice focusing on the ‘how’ or problem-focused coping instead of ‘why’
Physiological
Examples of problems that may become the focus of treatment goals
- agitation and restlessness
- conversion/somatic symptoms
- fatigue
- flashbacks
- intensified startle response
- panic attacks
- sleep disruption
- weight change/appetite loss
Examples of general goals that may be developed into SMART goals
- Improve appetite/regularize eating
- Identify stressors and practice stress management technique
- Increase understanding of physiological arousal in stress
- Learn/practice relaxation skills to reduce agitation, restlessness
- Learn and practice coping strategies to manage physical symptoms
- Learn and use self-monitoring/appetite cues
- Learn to identify/challenge beliefs/expectations about health or physical symptoms
- Learn to identify and recognize symptoms/triggers for panic attacks
- Learn to identify triggers for flashbacks and practice grounding techniques
- Learn and use sleep hygiene techniques to improve sleep
- Reduce frequency and intensity of panic symptoms
Personal
Examples of problems that may become the focus of treatment goals
- poor hygiene
- poor completion of activities of daily living
Examples of general goals that may be developed into SMART goals
- Identify and engage in meaningful activities
- Increase functional tolerance to optimize independent performance of activities of daily living
- Increase sense of purpose and meaning
- Regain realistic sense of life control: practice
- Problem-focused coping to control the controllable and emotion-focused coping to tolerate the rest
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Resume participation in meaningful roles (e.g., employee, caregiver)
Social
Examples of problems that may become the focus of treatment goals
- reduced interests and activities
- self-isolation
- social impairment
Examples of general goals that may be developed into SMART goals
- Increase social support and social activities
- Learn and practice assertiveness and interpersonal skills
- Learn to be around larger groups of people
- Learn to be in social situations that may arouse anger and irritability
Occupational
Examples of problems that may become the focus of treatment goals
- avoidance of worksite
- difficulty
- adjusting to change
- fear of return to work
- job dissatisfaction
- perceived injustice
- strained workplace relationships
- work-related triggers
Examples of general goals that may be developed into SMART goals
- Apply learned strategies to improve coping with workplace situations and factors
- Consider job search training
- Consider volunteer opportunities
- Learn to let go of former work identity (if pre-injury job has been ruled out)
- Practice creating daily structure and work routine i.e., getting up and dressed earlier
- Prepare to respond to questions about time away from work
- Reach out to trusted co-worker
- Start preparing for return-to-work and consider discussing with return-to-work services