To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here.
If your therapist is the GPS, you are the driver. Ultimately, you have control over where you are going emotionally.*
Therefore, outlining courses of action that you will take is as vital to your success as are your therapist’s courses of action, which we discussed in our blog post Your Therapist’s “To Do” List. The next section of the mental health treatment plan I use is called the Patient’s Objectives—in a nutshell, your own “to do” list. These objectives are the actual courses of action you will take to help you reach your goals. They will usually be a reflection of your therapist’s objectives.
Your therapist will help you formulate your objectives and will be in tune with what you need to focus on next, as well as help you develop your own awareness of where you need to go. He may be a step or two ahead of your own readiness to proceed, and may gently push you to move forward. Occasionally, your therapist may be a step or two behind you. But he must be in sync with you on the essentials.
Let’s continue with the example of Alexis:
At this point in Alexis’s session we have already discussed and written up the:
1) Problem Statement(s)
Alexis is exhibiting signs of depression.
Alexis feels her worst problem is her insomnia.
Alexis feels her secondary problem is her sadness.
2) Treatment Goal(s).
Alexis will be free from the signs and symptoms of depression.
3) Therapist’s Objectives
Help Alexis identify and talk about what the signs and symptoms of depression are.
Help Alexis identify and talk about three external factors that trigger her symptoms of depression.
Help Alexis identify and talk about three internal factors that trigger her symptoms of depression.
Teach Alexis proven methods to help alleviate or manage the signs and symptoms of depression that she is experiencing.
Now Alexis, with my input, is going to describe her objectives.
Patient’s Objectives
Alexis will identify and talk about what the signs and symptoms of her depression are.
Alexis will identify and talk about three external factors that trigger her symptoms of depression.
Alexis will identify and talk about three internal factors that trigger her symptoms of depression.
Alexis will, during therapy sessions, learn and then go on to use proven methods of alleviating or managing the signs and symptoms of depression and will report back in subsequent sessions about how she employed these methods and how effective they were.
Naturally, some proven methods may not work for Alexis, despite being chosen for clinical reasons. We may have to try several methods over time. That is why it is essential that we really talk about the ways and situations in which these methods were used, and rate their effectiveness. Just like the science and art of prescribing the right medication often takes time, usually requires dosage adjustments, and requires regular monitoring, in therapy the chosen courses of action (interventions, techniques, and even methods) will also have to be adjusted.
The next blog entry in the Treatment Plan series will address section number 5: setting the Target Dates for Check-Ins.
*From Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money.
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TPG at 7:45 pm on
February 16th, 2010Thanks for your comments–they are much appreciated.In fact, they really help us focus on what we should be writing about.
In answer to your first question, I can say that the therapists who work in clinics are still using the treatment plan format that I and/or other administrators put in place (it is important to remember that there are many different variations of the treatment plan–my particular format works for me but many other formats are equally effective). However, unlike with patients, unless therapists in private practice contact me, I have no way of knowing if they are still following through on using the treatment plan.
We are in the initial stages of developing a training program that addresses some of these issues.
What initially inspired me to write my book was hearing from patients and their families that they weren’t being given treatment plans.
We will attempt to answer your questions when we get to the next post, Target Dates for Check Ins. But I do want to assure you that if a therapist believes he or she does not have the resources or training to adequately help a patient and refers that patient to a professional or program who can do a better job, if the reasons are articulated clearly and are done with sensitivity my opinion is that the patient will be appreciative. It must be stressed that this is not a rejection of the patient.
The Problem With To-Do Lists (February 17, 2010)
Last reviewed: 16 Feb 2010
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This continues to be one of the most informative nuts-and-blogs blogs on Psychcentral. What percentage of therapists whom you’ve trained actually do treatment plans this detailed, after they’ve been in practice for a while?
When you get to the section on Check-ins and assessments, can you please talk about benchmarks for measuring progress? Also, what happens if these benchmarks are not reached? At what point does the therapist say, “I wonder if I’m the best person for you. Maybe you should see XXX.” And make the referral. How devastating is that to most clients?
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