Too Many Cooks in the Kitchen: A Practical Guide for Establishing Multi-Disciplinary Goals

Disclaimer: Though below I discuss situations in which there are multi-disciplinary quarrels, successful collaboration can be done! You'll just have to read to the end to find out how...

We all know what happens when there are 'too many cooks in the kitchen'; a recipe for conflicting opinions on measurements and cook times, disagreement on 'how to' steps and an overall mess to clean up. I am sure you can imagine how this all plays out when it comes to developing multi-disciplinary goals for your exceptional kiddo; everyone wants to best for your little one, and yet--mutual agreement can be hard to achieve.

Here's how it can play out perhaps in a worst case scenario; each professional brings with them an absolute opinion about what is 'most important'. We talk in circles about what to do and how to do it; many of us disagree, despite sharing some common threads in our reasoning. Diverging theoretical perspective cause confusion for the parent, and conflict between professionals.

Let the good times roll, right?!

Here's how it can play out, perhaps in a best-case scenario; each professional brings with them an open mind, a sense of the child's current skill set and an understanding of the goals of the various stake holders (parents/family, school, clinical teams). Both long and short term goals are considered, and top priorities for programming are identified in both long and short term.

​I bet you like the sounds of that, huh?

Here are some practical steps to sway your team in the direction of mutual agreement, not internal conflict.

Step 1. Less is more! Have each professional come up with 2-3 goals to communicate to the group (that means no one communicates their entire treatment plan, just a taste). Of these 2-3 goals, at least one should be LONG TERM and at least one should be SHORT TERM; this is really important because it's important that interdisciplinary professionals understand the big picture. Without understanding the big picture, you risk another professional questioning goal choice. We recognize that these 2-3 goals are not the only goals this professional will target in his or her sessions, but also recognize that targeting a few inter disciplinary goals (i.e. targeting a few speech goals during OT, a few OT goals during school, and so on) is far more manageable than targeting an entire IEP worth of goals or being asked to extrapolate attainable goals from a larger set.

Step 2. Re evaluate goals after 6 months.

Goals can change in a moment's notice. Don't get stuck on them just because it's what you've communicated to your team! If the goal is reached, the program is revised or the goal is changed, communicate it with the group. In order to successfully complete this step, you'll need Step 3...

Step 3. Open communication

It can be a lot for professionals to keep track of massive email threads which dictate goal changes, revisions and so on (been there, had the migraines to prove it!). Provide your professionals with consent (assuming you do consent) to get in touch as needed, but that said--don't expect that this will happen without your involvement. As the parent, you are the only person who interacts with all of the professionals on your team on a regular basis. Every 6 months, compile some revised goals from each professional and send it out to your team. Ask professionals if they are having any challenges with the goals, and coordinate the discussion as needed to rectify.

Step 4. Each professional is the captain of their own ship, but you're the coast guard in charge of the whole body of water. Wear your 'coast guard badge' loud and proud. Recognize that some of your professionals may come from different schools of thought, that they may be experts in their field, and that their approaches may vary. This is par for the course. As the 'coast guard' it's your job to ensure that with the application of their various theoretical frameworks, they all work towards goals that address your top priorities. Ask their opinion, listen carefully, but don't be afraid to 'shelf' a goal for now in favour of something more meaningful to your particular needs.

Step 5. Don't put all your eggs in one basket.

As the 'coast guard' you may be inclined to focus intensely on a particular goal; for example, communication, social or behavioural skill building. If you opt for this path, proceed with caution. Though you may have a top priority which takes primary focus, it doesn't mean that other domains are ignored or 'shelved' entirely.

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