What is a Treatment Plan and Why Is One Necessary?

You go to the counselor to talk about your child’s interesting behavior and he/she wants you to sign a “treatment plan.”  This term may sound a bit off-putting, and may be confusing if it hasn’t yet been explained properly. 

The What
A tx plan is the “why are you here and what are we doing” of therapy.  It is a document that includes presenting problems, goals related to addressing those problems, and interventions that will be implemented to reach those goals.  It’s a road map to help guide therapy sessions so that they are more effective in helping you do whatever it is you want to do in therapy.  It’s a way for you and your therapist to stay on track and watch for progress.

While you may state your goals for therapy as “just feel better,” “stop being so anxious,” or even, “I don’t really know,” your therapist will (or should) help you identify the reason for seeking service and create measurable, sometimes behaviorally-based benchmarks to identify progress- or lack thereof.

For example, an identified problem may look like this: “Cl presents with anger outbursts and inability to control impulses at home and school.” 
This will often be followed by frequency, intensity, and duration indicators such as “as evidenced by yelling, throwing self on floor and kicking legs around 3X per day for 30-45 minutes each incident at moderate intensity.”

A goal, or “measurable objective” may be something like, “Cl and/or family will identify and process 3-5 coping skills to assist cl in managing strong emotions,” or “Cl and/or family will identify triggers to outbursts in 3 out of 5 situations,” or any variation applicable to family and circumstance.

While this all sounds medical-ish, tx plans are not meant to pathologize or sterilize the therapeutic relationship.  The actual sessions can still be warm, fuzzy, supportive and compassionate.  You won’t even have to worry about the technical jargon- it’s only used with these sorts of required clinical documents that allow your therapist to meet ethical, legal and other requirements.

And the Why
Which brings us to the “why” of tx plans… to sum it up, mostly for insurance billing.  Insurance companies want to know that services rendered are for cause, or meet “medical necessity” (this is why we also have to diagnose, but that’s another story altogether). 

In therapy, just like in medical practice, providers must perform services that are necessary and appropriate for the client.  You don’t go to your doctor for an ear infection and get a cast put on your leg.  It’s the same with the mental health profession- law, ethics and money demand accountability.
Tx plans can be updated whenever issues, needs, or goals change, but must be updated every 6 months to one year, depending on where you live and what insurance company you use. 

Tx plans don’t limit services.  You can have a few in-progress issues at the same time, complete all of your stated goals, and then get a new treatment plan based on new issues that have popped up- either by therapeutic insight or life, in general.
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Things you should know about your treatment plan:
1) It’s a GPS of emotional-relational sorts.
2) You should be a collaborative part of its creation.
3) You can ask to have things changed on it before you agree to sign.
4) You are allowed to ask questions about it and about therapeutic progress.
4) It can and should be updated regularly.  
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