Treatment Planning R. Lyle Cooper, Ph.D., LCSW, ICADAC II Assistant Professor University of Tennessee College 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 relapseat 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 Experience Best 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  MSFT Adults  TSF  Brief SBCM  Broad Spectrum Therapy  RPT  Drinkers Check-up Co-occurring Adolescent  A-CRA  7 Challenges  MSFT Co-occurring Adult  Boston Consortium: Trauma informed treatment for women  DBT Older 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 ProblemInterventionOutcome 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