Treatment Planning

R. Lyle Cooper, Ph.D., LCSW, ICADAC II

Assistant ProfessorUniversity of TennesseeCollege of Social Work

Treatment Planning

Treatment planning should address all the domains covered in assessment

Treatment includes choosing the appropriate type of SERVICE DELIVERY SYSTEM as well as the best THERAPUETIC APPROACH

Also certain PRINCIPLES need to be in place to ensure treatment success

Principles of Effective Treatment

Early detection, including screening and brief interventions: for non-dependent problem drink/drug user

Comprehensive assessment and individualized treatment plan: each client experiences problems differently)

Care management: All elements of the problem should be addressed and coordinated

Individually delivered, proven professional interventions: Clients deserve treatments that are supported by research, and treatment providers should offer more than one

Principles Continued

Contracting with patients: Also called contingency management or behavior contracting

Social skills training: Teaching clients to manage stress and engage in prosocial behavior

Medications: Medications improve outcomes (not a cure)

Specialized services for medical, psychiatric, employment or family problems (problem to service matching)

Principles Continued

Continuing care: Most who enter treatment have at least one relapse

Strong bond with therapist or counselor: Rapport is central to all therapeutic success

Longer duration for dependent users: 90 or more days alcohol/heroin 180 or more crack

Support groups: attendance and participation

Strong client motivation: All treatments relay on patient desire to change

Exercise 1

In small groups discuss the principles presented above

Discuss whether all these principles are in place at your agency

If they are not a part of the center you work for discuss how they could be added

Service Delivery Systems

DETOX Medical Non-Medical

INTENSIVE TX Inpatient Outpatient Day treatment

RESIDENTIAL Halfway house Therapeutic

communities Missions

OUTPATIENT TX Individual counseling Group Treatment Conjoint Therapy Family therapy Multimodal

Approaches Brief Interventions

Exercise 2

You have been given a case-study In small groups discuss what factors

identified in your case might cause you to might cause you to choose one delivery method over another

Should multiple delivery methods be used over time? Why or why not?

Therapeutic Approaches

Evidence Based Practice (EBP)

Client wishes/character/ demographics

EBP

Counselor ExperienceBest

Research Evidence

Evidence Based Practice

There are many EBP’s available These interventions can be

searched on the NREPP website We as counselors have an ethical

responsibility to provide interventions that are based in research not just our experience

Examples of EBP

Adolescents A-CRA MRT MSFTAdults TSF Brief SBCM Broad Spectrum

Therapy RPT Drinkers Check-up

Co-occurring Adolescent A-CRA 7 Challenges MSFTCo-occurring Adult Boston Consortium:

Trauma informed treatment for women

DBTOlder Adult Brief SBCM Alcohol Behavioral

Couple Counseling

Exercise 3

In small groups review the case study you have been given

Review the EBP interventions described in the accompanying sheet

Determine the appropriate intervention for your client explain why you chose this intervention

Documenting Treatment Planning

Treatment Plans should be: Collaborative: both counselor and

client agree on the course Specific: it is clear what goals need

to be met in order to treat the problems

Measurable: there must be a clear goal that can be measured to determine the success of the intervention

Treatment Plan Example

Problem Intervention Outcome

Ct is unable to refuse cocaine when offered

Drug refusal skills administered over 6 weeks

Increased ability to refuse as indicated by coping skills inventory

Ct has no non-drug use activities to fill time

Functional analysis of pro-social behavior 2 session

Increased prosocial activity as indicated by happiness scale