Counseling treatment plans are blueprints for constructing the changes the client wishes to make. The counselor is not solely responsible for developing the client's plan. Most treatment plans that respect the client's rights to self-determination and informed consent are the result of a collaborative effort between the client and the counselor. The counselor's primary responsibility is to provide feedback that evokes the client's workable problems, long-term goals and short-term objectives, as well as necessary therapeutic interventions.
From Diagnosis to Objectives
An effective treatment plan begins with an accurate diagnosis. A diagnosis is determined by assessing the client's symptoms and comparing them to the diagnostic criteria establish by the American Psychological Association. The client then determines which problem to address first. With the assistance of the counselor, the client selects a long-term goal of change for this problem. For example; if the problem is feeling depressed every day, the goal might be to experience depression only 2 out of 7 days. This process is repeated until objectives are determined for each problem.
Making Objectives Manageable
Objectives are broken into short-term goals. The number of short-term goals per objective varies, primarily because they are based on the unique resources, skills and abilities of the client. For example; if the objective is to reduce days of depression to 2 per week, the client may decide to eliminate unresolved guilt and pessimistic thinking patterns, and then identify motivations for change. Each short-term objective is matched with a therapeutic intervention from the counselor. This may include the use of motivational interviewing to help resolve guilt, cognitive restructuring to change pessimistic thinking and value clarification to identify motivations for change.
Accountability
There are several layers of accountability built into a treatment plan, and this is often responsible for the client's success. The counselor is accountable to the client to make available only those interventions that fall within their scope of practice and are based on research that has demonstrated their efficacy. With a plan in place, the counselor's responsibility is clearly defined. The client is also held accountable as he has created and agreed to a plan of action to which he feels he can comply.
Changing Problems
A treatment plan is never static. It should be in a constant state of change. There are many reasons for this. As the client moves down the list of problems to be addressed, new problems surface and old ones subside. It may also be necessary to make changes to the objectives once improvement is made. For example, the client who once hoped to reduce days of depression to only 2 per week, after making progress and feeling more optimistic, may want to set a new objective of only 2 days of depressed mood per month.
Changing Short-Term Goals
Short-term goals and interventions are in a state of flux as the client discovers new resources, and loses others. The counselor should be active in this process, noting newly emerging strengths or weaknesses as work with the client progresses. It is also important for the counselor to suggest therapeutic intervention changes based on newly acquired skills or information.
References
- Linda Seligman; Diagnosis and Treatment Planning in Counseling, 3rd Edition; 2004.
- Sheila R. Woody Ph.D., et al; Treatment Planning in Psychotherapy: Taking the Guesswork Out of Clinical Care; 2004.
- Arthur E. Jongsma Jr., et al; The Complete Adult Psychotherapy Treatment Planner; 2006.
