Setting goals can be a difference-maker in youth mental health outcomes. Meet the Atlantic-based researchers dedicated to optimizing the process.
In delivering effective mental health interventions for youth, working with goals serves as a powerful tool. Goals guide treatment focus, offer tangible evidence of progress and success, foster communication and alliance between patients and providers, help tailor approaches, and inform continuous improvement. Perhaps most importantly, they empower youth patients to take an active role in their mental health journey with a focus on positive change.
However, without best-practice guidelines, working with goals can lose efficacy. Clinicians require guidance on how to work with different types of goals, interpret goal-based data with youth and help with strategies they can use to ensure goal-setting practice reflects principles of equity and inclusivity.
"Goal setting shows up in so many different contexts around mental health: everything from self care to school based programs to our community outpatient and inpatient services," notes Dr. Lori Wozney, Scientific Lead in mental health and addictions at Halifax-based IWK Health and an adjunct Assistant Professor at Dalhousie University's psychiatry department.
"If an approach is used that broadly and often across the continuum of care, we want to make sure that we're doing it in a way that's meaningful. However, we don't currently have a set of practice principles that might guide our approaches to be better than what we're doing now."
A patient-centered approach
To address this knowledge gap, Dr. Wozney and her team have embarked on the project "Where do you want to go?": Developing Practice Principles for Inclusive Goal-Based Outcome Monitoring With Youth in Community Mental Health Services supported by the Catalyst Grant: Towards Pan-Canadian Standards for Children and Youth Mental Health Services.
The multi-phased project aims to equip clinicians with best-practice principles on goal setting through an equity, diversity and inclusion lens, and to foster knowledge exchange for ongoing improvement in youth mental health interventions and outcomes.
"A goal-based approach is a necessary and important part of truly being person-centered in the care that we provide," says Dr. Jill Chorney. The IWK Mental Health and Addictions Advanced Practice Leader and Dalhousie Associate Professor of Psychiatry is a co-principal investigator on the project.
"Working with goals ensures that the care we provide is making a difference on outcomes that are meaningful to youth and families, and that we're taking a holistic view of what they want and need to get out of the treatment that we provide."
Meaningful engagement for meaningful outcomes
Drs. Wozney and Chorney and their team are currently engaged in a literature review and they'll soon start to hold consultation round tables and conversations with youth and caregivers. Next, they'll shift to dialogue with clinicians. In the final stages of their project, patients, caregivers and clinicians will come together to discuss key findings and prioritize goal-based practice principles.
"We're working with a lot of youth organizations as a pathway to connect with youth and caregivers," Dr. Chorney says.
"We don't want to start from scratch: We want to leverage those partnerships. While we can't talk to 2,000 youth, we can work hard to ensure pan-Canadian representation and target our recruitment to make sure that we're connecting with youth that are from historically underrepresented groups."
Two main products are planned as outcomes for the project: clinician-focused guidelines, and education for youth in advocating for their goal-related needs when interacting with clinicians.
"From the outset, we noted this has to be something that truly is useful and guides practice on the ground right away," she adds.
"The final format will be co-developed with our clinicians and with our youth, but I think at the core, it's really about learning what tools we need to directly influence how we provide care."
Leveraging Atlantic and global expertise
The Atlantic setting from which this pan-Canadian project is being conducted offers unique opportunities in leveraging talent and existing data. The pair highlights support from partnering organizations like the Maritime SPOR SUPPORT Unit, part of CIHR's Strategy for Patient-Oriented Research.
"The East Coast is home to a lot of amazing post-secondary institutions, so we can engage incredible local trainees, clinician-scientists, and faculty who are experts and leaders in these areas."
As one of the region's leading pediatric acute care facilities, IWK Health has a mandate to serve as a resource to provinces throughout.
"Working in the Atlantic region, we're used to pooling our resources, sharing our expertise and collaborating. I don't think this project will be any different" says Dr. Wozney.
The project features ongoing engagement from international groups as well, including the United Kingdom's Child Outcomes Research Consortium. As they carry out their work, Drs. Wozney and Chorney and their team envision a positive impact on a global scale.
"Although our focus is on Canadian standards," says Dr. Chorney, "we're able to bring an international lens to both informing the project as well as knowledge translation opportunities."
Wherever the impact, the team's ultimate priority remains clear: ensuring goals are a meaningful and empowering tool for youth in achieving optimal mental wellness.
"We need to make systems work for people, not just have processes that are tick boxes that really don't hold a lot of meaning for youth," says Dr. Wozney.
"I want to see that when youth and families reach out for mental health support, they don't experience a bureaucratic process, they experience something that's really personable, that's tailored to their needs, and where the most important measure of change is the one they have chosen for themselves."
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