Introductory comments:

Aims and Goals should flow directly from the Formulation that you develop collaboratively with a young person; this is because formulating a young person's story is really about Mentalizing them accurately, and mentalizing is directly related to making sense of their Intentional stance.

Compared to the immediacy of the concrete steps suggested by a plan, treatment Aims and Goals are more distant pointers/directions - that act like the compass and map for the therapeutic journey, describing the Intentional stance and intermediate waymarks against which progress can be measured.

The Aims and Goals will shape those changes that various parts of the system (Family, ProfessionalNetworkMembers) consider to be the minimum change necessary to make a real, and positive difference.

Taking Aim

Taking Aim is a specific aspect of the AMBIT approach to Active Planning, that takes into account the fact that a young person's, the family's and also the worker's ideas about the goals of work may change over time, but that Goals-based outcome measures are also immensely helpful. Aims and Goals cannot be set until there is first clarity about what resiliencies and problems are present within, and around the young person/their family/carers. We recommend the AIM assessment as one way to approach determining What's the problem? that you as a worker are being invited to help with.

Consulting widely

The Treatment aims are drawn up in consultation with the young person and ideally with their FamilyInformalNetworkMembers, too; they represent the best attempt to reach a prioritised and achievable set of outcomes.

In order to understand (Mentalize) these desired changes accurately you will need to understand the young person's views, as well as those of other parts of the young person's system; the FamilyInformalNetworkMembers, and the ProfessionalNetworkMembers. Use the Dis-integration grid to help with this task. The use of SupervisoryStructures in your team is crucial in this stage of Active Planning

Drawing up Aims

AMBIT is not a monolithic approach, with predefined treatment aims - although developing the young person's or their family's Relationship to help is likely to be one aim.

Consider all the major functional domains:

Patient priorities

What does the young person most need to see changing in order for him or her to think "since seeing you, things have started to get better." (In the event of disagreement about the extent, or worrisomeness, of mental health symptoms, you can also make reference to professional observations/aims on mental state under "Health priorities" below.) Consider also the StrengthsResiliencies that might usefully be built upon.

Family/carer priorities

Ditto for the family/carers. Include professional observations on family-functioning, and be clear whose aims are whose if there are differnt perspectives on what the problem(s) is (are).

Health priorities

Are there significant health priorities, such as mental or physical health-related risks? Include the risk of deterioration, and bear in mind the developmental trajectory of the young person (in childhood and adolescent developmental terms, 'standing still is going backwards'.)

Education + Vocation priorities

Are there requirements for new opportunities or support in order to maintain or recover trajectories into adulthood?

Social-ecology and Cultural priorities

Is there a need to support culturally relevant integration into normative activities and contact with existing local community resources? Think of sports groups, youth resources, faith networks, groups serving specific cultural or ethnic populations...

Professional network priorites

Are there examples of Dis-integrativeProcesses or Dis-integratedInterventionsthat require correction? In relation to the Care Plan consider what conversations may be required to achieve the desired integration/coordination... Use a Dis-integration grid to help clarify what you know and do not know about the different aims within the system, and to determine how best to reduce Dis-integration between these.

Conflicting Aims:

Sometimes there are CONFLICTING treatment aims:

the family wants more control over their son who they see as behaving recklessly... the son wants more freedom for himself, from a family that he sees as overlooking his nearly-adult status, and treating like a younger child..

In this case the task of the KeyWorker is to find a position to which all parties can sign up as the MINIMUM change that they could agree upon. (In the example given, they might not agree on practical details, but they might agree that they want to see the number of arguments at home reduce from twice daily to once weekly, and for them not to escalate to violence.

Changing Aims

Sometimes aims need to be altered during the course of treatment (new information, changing circumstances, etc)

...then record these in a NEW Formulation (if you are using the manual in ICR mode, you can do this at Make or View Client Notes

Once aims are agreed:

You should record these as the conclusion of your Formulation and Treatment Aims of the case.

Aims and the Plan

Treatment Aims should shape the Care Plan - they are overarching targets, where the Care Plan is more specific and practically-oriented. See Active Planning for advice on how to do this.