Program Plan Description Form

Center for Life Skills

Please Note: This form must be submitted one week prior to your programs implementation.
Title of Program: Word Game and Bucket List
Purpose of Program: To allow participants to reflect on their past and share some of their positive
experience. The activity will also allow participants to recognize the importance and benefits of goal
setting.
Client Characteristics: Each client has experienced a stroke or TIA. Clients should be able to
communicate to the group. Clients should also be able to reflect on the past and think about the future.

Clients to be involved in the program: Stacey, Helene, Sophia, Norman, Meredyth, Andrea, and Jennifer
Program goals and measurable objectives:
1. To increase communication skills.
a. By the end of the session, each participant will have shared at least 2 stories with the
group, as judged by staff.
b. Throughout the session, participants will practice turn-taking during conversations, as
judged by staff.
2. To increase executive functioning.
a. Throughout the session, participants will use their shot-term and long-term memory to
reflect on the past in order to share past experiences, as judged by staff.
3. To increase self-awareness.
a. By the end of the session, each participant will become aware of how their past
experiences have influenced the person they are today, as judged by staff.
b. By the end of the session, each participant will become aware of at least 2 goals they
have for the future, as judged by staff.
Program Description: For the first activity, participants will take turns picking a random word out of a
container. They will read the word aloud and think of a story/experience/connection they they have had
with that word and share it with the group. Each participant should get 2 turns. As this activity reflects/
reminisces on the past, the next will focus on the future. For the second activity, participants will come up
with a bucket list of things they want to do or goals that they have for themselves. I will also discuss the
importance and benefits of goal setting before debriefing.
Supplies and Equipment: slips of paper with random words, container to hold words, paper, pens/pencils
Staff interaction/intervention strategies: Staff should let the participants be as independent as possible, but
help out when necessary.
Staffing requirements: Staff members will be asked to work with their client during the program. They
should listen and provide encouragement or examples when necessary. During the bucket list activity, I
will ask that each staff member discusses the goals with their client and then allow clients to share with
the group if they choose.

Method of evaluating programs value and worth: Post Session Report Form
Method of evaluating client progress toward goals: Clients Progress on Objectives

List of Words

Happy
Proud
Family
Accomplishments
Children
Excitement
Helpfulness
Learning
Funny
Love
Fun
Leisure
Vacation
Beautiful
Nature
Music
Peaceful
Friendship
Holidays
Work
Gifts- given or received