Rehabilitation & Outcomes

At Optima Care we retain a clear focus on outcomes and work collaboratively with the individuals we support to achieve person-specific goals and aspirations through the use of outcome-based models.

As part of our continuing person-centred work ethic we are to implement the Emotional Problem Scales across all of Optima Care’s settings and the framework provided by The Learning Disability Life Star model at The Chilterns:

The Chilterns’ outcomes are formulated utilising the framework of the Learning Disability Life Star

The Outcomes Stars (Recovery Star and Life Star) measure and support the progress of individuals with regards to personal goals.

At The Chilterns, using the Learning Disability Life Star domains as a framework for assessment, individuals are assisted to explore different areas of his/her life, e.g. health, daily activities and keeping safe. This is done to measure what is going well and what needs to be improved upon. The ten areas addressed and currently captured in all Review Reports are:

  • Your Health
  • How you Spend your time
  • Being responsible
  • Being safe
  • Money and letters
  • Living skills
  • Communicating
  • Feeling good
  • People you know
  • Mental health and other conditions

The Emotional Problem Scales: Behavioural Rating Scale (BRS) and Self-Report Inventory (SRI)

The person-centred focus of our work highlighted the need for an outcomes model that would further capture progress in terms of changing behaviour, psychological distress as well as specific challenging behaviour. This knowledge then to be utilised throughout the planning of specific interventions. The implementation of the Emotional Problem Scales is therefore to be rolled-out over all Optima Care units.

The Emotional Problem Scale-Behavioural Rating Scale (Prout & Strohmer, 1991) consists of 12 sub-scales, assessing a variety of domains, namely:

  • Thought/Behaviour Disorder
  • Verbal Aggression
  • Physical Aggression
  • Sexual Maladjustment
  • Non-compliance
  • Hyperactivity
  • Distractibility
  • Anxiety
  • Somatic concerns
  • Withdrawal
  • Depression and
  • Low Self Esteem

The four sub-scales (Physical Aggression; Verbal Aggression; Hyperactivity and Non-compliance) combine to form an Externalizing Behaviour Problem Score, and the three subscales (Anxiety, Depression and Low Self-Esteem) combine to form an Internalising Behaviour Problem Score.

Research has proven that the Emotional Problem Scales, both the BRS and SRI, show high predictability and a high correlation with the Historical, Clinical and Risk-20 Scales (HCR-20), further assisting professionals to manage challenging behaviour (Lindsay, William, Hogue, Todd E., Taylor, John, Steptoe, Lesley, Mooney, Paul, O’Brien, Gregory, Johnston, Susan and Smith, Anne (2008); Risk assessment in offenders with intellectual disability: a comparison across three levels of security. International Journal of Offender Therapy and Comparative Criminology, 52 (1). pp. 90-111.