Treatment Planning - Dr. Diane Gehart

1. Counselling Skills and Techniques
UNIT 4

2. Treatment Planning
History of treatment planning
● Medical model (20th century) : it’s what medical doctors use for medical
treatment.
● Jongsma and his colleagues - symptom-based treatment plans
● Gehart and Tuttle (2003) - theory-based treatment planning
● Gehart - Model that draws from the best of theory-based and symptom-based
treatment plans and adds more recent elements of measurability.

3. Elements of clinical treatment plan
● Introduction - planned modalities (individual, couple, family and/or group),
frequency, and expected length of treatment.
● Treatment tasks - “standard practice” tasks that the counselor should perform
at each stage of counseling (initial, working and closing phases)
● Diversity - how specifically the counseling process will be adjusted to address
diversity issues. (age, gender,ethnicity, ability, sexual identity)
● Client goals - unique to each client and describe what behaviors, thoughts,
feelings, or interactions will be either increased or decreased as a result of
treatment
● Intervention - 2-3 interventions for each goal (theory driven)
● Client perspective - agreement on the plan

4. Theory specific case conceptualization

5. Treatment plan format
(Book)

6. Writing useful treatment task
● Initial Phase
● Working Phase
● Closing Phase
● Diversity and Treatment Task

7. Goal Writing
(a) the client’s description of the problem
and
(b) findings from the case conceptualization
to help you quickly identify the key
personal and relational dynamics that
should be targeted for change.
Goal writing worksheet
(Book)

8. Sample Goals:
● Increase positive self-talk about body to reduce binging and body image distortion.
(cognitive-behavioral)
● Reduce compliance to socially imposed “shoulds” related to making others happy to
reduce AF sense of hopelessness and depression. (person-centered)
● Increase frequency of social interaction and re-engagement in music and sports hobbies
to reduce severity of depressed mood. (solution-focused)

9. Initial Phase -stabilizing crisis symptoms
Working Phase
● Psychodynamic: Reduce rationalization to increase ability to directly experience emotions
and reduce depressed mood.
● Humanistic: Increase ability to experience authentic emotions in the present moment to
reduce depressed mood and increase sense of personal agency.
● Cognitive-behavioral: Reduce negative self-talk related to social acceptance to increase
positive mood.
● Narrative: Reduce influence of family and societal evaluations of self-worth to increase sense
of autonomy and reduce depressed mood.
Closing Phase - (a) address larger, more global issues that clients bring to counseling and/or
(b) move the client toward greater “health”

10. Writing measurable goals
Measure: Able to sustain for period of ❑ weeks ❑ months.
Examples:
● Able to sustain positive mood for period of 2 weeks / months.
● Able to sustain positive relational interactions for period of 2 weeks / months.
● Able to sustain sobriety for period of 6 weeks / months.
● Able to sustain C grade point average for period of 4 weeks / months.

11. How useful can treatment plan be?
● Treatment plans help counselors think through which dynamics need to be
changed and how.
● Treatment plans provide counselors with a clear understanding of the client
situation so that they can more quickly and skillfully address new crisis issues
or stressors that arise.
● Treatment plans give counselors a sense of confidence and an increased clarity
of thought that makes it easier to respond on the spot to new issues.
● Treatment plans ground counselors in their theory as well as understanding of
how their theory relates to clinical symptoms.