Understanding relationships

[shaunburke]

I am new to Access. I'm trying to create a database that has treatment plans and progress notes for a school based behavioral health program.



The students have treatment plans. In the treatment plans they have 3 goals (A, B, and C). Each goal has 1-3 measurable objectives (A1, A2, B1, B2, C1, C2, etc.). Each measurable objective has a list of interventions that can be used to assist the student in working towards those measurable objectives. There are person(s) responsible for a group of those interventions.

We write daily progress notes that have the date, start time, end time, type of service, Purpose, measurable objectives addressed, interventions used to address those measurable objectives, the effectiveness of each intervention used, the response of the student, and a plan for moving forward.

I am trying to set it up (poorly I might add) so that the staff person can select the student's measurable objective being addressed, select the interventions from the student's treatment plan, and whether each intervention was effective. However, when I used the lookup and relationship option, all I get is the numbers and not what the measurable objectives and interventions are. Also, I'm not sure how I am able to select on measurable objective and then select the intervention(s) I used.

any help would be appreciated.

[mike60smart]

Hi Shaun

On first look I would suggest that your table structures are wrong.

You said that Many Students have Many Goals

You have a table for Students linked to a table for their Treatment Plans which is a standard 1 to Many Relationship

What you need is a Junction table to link both Students and Plans

Also you are using Lookup Fields in your tables which are not advised.

[mike60smart]

Hi Shaun

When you when you allocate a Goal Letter (A, B or C) to a specific Student, would you then manually type in the Goals associated with that Goal Letter?

[orange]

Shaun,
In addition to Mike's comments/advice I recommend that you work through 1 or 2 of the tutorials from RogersAccesssLibrary mentioned in this link. The tutorials lead you through a process to identify and understand your tables and relationships. You will experience the process by working through the tutorial (about 45 minutes). And what you learn can be used with any database.
Good luck.

[shaunburke]

so, it sounds like I have to create a couple of junction tables, one to link many students to many treatment plans, one that links many goals to many measurable objectives, one that links many measurable objectives to many interventions, and one that links interventions to many person(s) responsible?

[shaunburke]

Yes, the Goal letter is just a designation. Each goal is specific to the student.

For Example,

A Ed will bring hostile, defiant behaviors within socially acceptable standards.
A1 Ed will learn and implement problem-solving and/or conflict resolution skills to manage interpersonal problems constructively with both peers and adults 60% of the time.

A2 Ed will verbalize feelings of frustration, disagreement, and anger in a controlled, assertive way 60% of the time.

B Ed will reduce irritability and increase normal social interactions with both peers and adults.
B1 Ed will learn and implement impulse control skills by identifying triggers that increase her impulsivity 60% of the time.
B2 Ed will increase verbalizations of acceptance of responsibility for misbehavior 60% of the time by utilizing coping skills to help regulate her frustration level.

C Ed and her family will participate in services offered through the OC PREP Program.
C1 Ed’s parent will communicate weekly with staff.
C2 Ed and her family will attend 60% of monthly PREP Family Nights and all scheduled meetings over the course of the plan of care.
C3 Family will increase understanding and skills necessary to support Ed’s treatment and build competencies in the home setting.

[mike60smart]

Hi Shaun

This is my first attempt at a solution and it only covers the initial phase of Selecting a Student

Selecting a specific Goal Letter ie A

Then selecting a number of Goals

Is this what you are after?

[shaunburke]

Yes, although the person responsible is more connected to the types of interventions that are used

[mike60smart]

Hi Shaun

So the prefix A1 A2 A3 B1 B2 B3 is not really needed.

All you need to be able to do is add a specific list of Objectives for a Specific Goal ?

[shaunburke]

you are correct. and then there are specific interventions used to address the measurable objectives

For example:


Regular therapeutic groups and discussions partially focused on strengthening assertiveness and social skills.
Opportunities to share how he is feeling in a safe environment where he can be given constructive feedback to help improve his self-image and self-regulation skills.
Life Space Crisis Intervention (LSCI)
Circle of Courage
RAP methodologies
CLEAR method of problem solving
provide opportunities to practice coping skills
role play
modeling
reminders of skills
environmental structuring
sterile attention
cognitive restructuring
redirection
scripting
impulse control strategies
token economy system
assist with making a list of acceptable coping skills
assist with using honesty provide a safe place for de-escalation
Work on developing a better emotional vocabulary so to avoid noncompliant and avoidance behaviors.
Active listening
Validation of feelings
Affirmations
Task analysis (breaking large tasks into smaller ones)
Sterile attention (planned ignoring)
Social stories/narratives
Assist in identifying ‘thought-feeling-behavior’
Environmental structure
If/then statements
Hurdle help
Coaching
Time reminders
Video modeling (short videos showing examples of positive skills)
Positive reinforcement
Non-verbal cues
Redirection
Review expectations before transitioning
Have student repeat directives/expectations back in their own words
Token economy
Modeling
Reminders of skills
Limit choices
Comic strip conversations
Full body listening
Restate teacher directives
Corrective feedback
Positive feedback
Work on developing a better emotional vocabulary, so to avoid noncompliant and avoidance behaviors.
Assistance in using emotion words that may reflect her affect or nonverbal communication when she is having difficulty identifying how she is feeling.
A safe place to de-escalate and take a break when she is having difficulty expressing herself appropriately.
Staff support throughout the school day and on school funded activities.
Transfer of skills through discussions with collateral contacts in the school and community when determined to be clinically necessary by the treatment team to identify and support in using anger management skills.
Individual therapy as needed.
Will learn and practice a variety of coping skills. She will review and process whether the technique was successful.
Will participate in therapeutic social skills groups to practice impulse control skills and increase appropriate social interactions with others.
Will work with staff to develop socially acceptable ways to share her feelings and identify a safe place for her to share her thoughts and feelings.

[mike60smart]

Hi Shaun

If you select a specific Objective are there then specific Interventions that only relate to the Objective Selected?

[shaunburke]

Yes, and then there are specific people responsible for those interventions.

In the list above, everything from the first one all the way down to "Transfer of skills through discussions with collateral contacts..." would be the responsibility of the BIS I, BIS II, Clinical Manager, and teachers

Individual therapy as needed would be the responsibility of the BIS II and the Clinical Manager

The last 3 would be the responsibility of the student.

Although there could be more people responsible for those.

There are other interventions that we use and we add new interventions all the time as we learn what works with a student. We also will take out interventions that don't work with a student

[mike60smart]

Hi Shaun

Do you have a List of Objectives without any reference to People's names?

[mike60smart]

Hi Shaun

Do you have a List of Objectives without any reference to People's names?

I have just sent you a PM

[mike60smart]

Hi Shaun

Do you have a list of All Interventions together with a list of the Person(s) responsible for a specific Intervention?