What makes a good Treatment Plan Any behavioral treatment plan should specify the exact behavior that is “targeted” for improvement. The plan must say exactly what is to be reduced or eliminated.

Treatmentplansthatworked.com By the same token, the plan must say exactly what is to be taught in replacement of the “targeted” behavior. It is rarely helpful to tell a child what not to do; you always have to specify what he/she should do as well.

Treatmentplansthatworked.com A treatment plan should explain exactly what the treatment provider should be doing to accomplish the replacement of the “target” behavior. A treatment provider should be able to look at the treatment plan and know precisely which techniques are to be used, how often and in which circumstances.

Treatmentplansthatworked.com When terms like “contingency contracting” are used, a glossary of terms that is accessible to the treatment provider is essential. How else can the treatment provider know exactly what to do?

Treatmentplansthatworked.com A treatment plan should always contain a simple and easy means of measuring progress from the perspective of the treatment recipient not the treatment provider.

Treatmentplansthatworked.com Outcome progress measurement should include a “baseline” measure, which is a starting point in the measurement of treatment outcomes that precedes the start of the treatment period. How else will you know how far you’ve come (or how far you’ve gone astray) if you don’t know where you started?

Treatmentplansthatworked.com Treatment plans must include a planned stop date, so that the treatment team can prepare to present information to funding authorities prior to that date in order for funding to be continued.

Treatmentplansthatworked.com Continued funding is necessary and therefore justifiable whenever the child is within the age range served by the funding entity, the treatment plan is working, but the work has not yet been satisfactorily completed.

Crisis and Emergency Plan To reduce or eliminate the probability of serious injury to [NAME] or others, in the event of a life-threatening emergency, a caretaker or any staff member will call 911. Efforts will be made to prevent [NAME] from injuring self or others. A licensed psychologist who provides supervision to BHR service providers will be contacted. The psychologist will facilitate and assist in the completion of an emergency mental status evaluation, including consultation with a psychiatrist if required to adequately respond to the emergency. In the absence of a psychiatric consultation, [NAME] will be transported to the nearest hospital emergency room for a physician’s evaluation. The Managed Care Organization funding [NAME]’s treatment shall be contacted and, if an Intensive Case Manager is involved, that person will also be contacted. Appropriate notification of County Children and Youth authorities will be made. In a non-life-threatening mental health emergency, [NAME]’s Behavior Specialist will provide direct intervention and consultation to [NAME] and any adult caretakers involved in the crisis, and will notify a licensed psychologist who provides supervision to [NAME]’s BHR service providers. Copyright © 2008 The Institute for Behavior Change All Rights Reserved Unauthorized duplication is unlawful.

“Titration” in the real world titration One entry found. Main Entry: ti·tra·tion Pronunciation: \tī- ˈ trā-shən\ Function: noun Date: circa 1859 : a method or process of determining the concentration of a dissolved substance in terms of the smallest amount of reagent of known concentration required to bring about a given effect in reaction with a known volume of the test solution.

“Titration” in the MCO world titration One entry found. Main Entry: ti·tra·tion Pronunciation: \tī- ˈ trā-shən\ Function: verb Date: circa 1996 : a process that reduces the hours of BHR Service delivered to a disabled child so that the child gets less and less of the service over time -- and no service in the shortest amount of time possible. DPW and every MCO has its own inspired definition of “titration”

“Titration” that helps children Reduce the intensity of the service without acting like you’re Nostradamus. Reduce the level of prompting (physical to verbal to visual cues) Increase the physical distance separating you from the child (deliver prompts from farther and farther away) Copyright © 2008 The Institute for Behavior Change All Rights Reserved Unauthorized duplication is unlawful.

Titration Plan The Titration Plan is to "titrate" (reduce the intensity of) TSS support provided to [NAME] as conscientiously as possible throughout the treatment period without depriving [NAME] of necessary support, especially in emergencies. The TSS provider will seek to decrease the level of prompting (move from direct and physical prompts to indirect and verbal or symbolic prompts) and will seek to increase the physical distance separating him/her from [NAME]. This will eliminate excessive dependency on the TSS provider and will assure that the TSS provider is available to [NAME] to deliver the least-restrictive and least- intrusive level of intervention necessary at any given time in the treatment period in accordance with CASSP Principles and BHRS Best Practice Guidelines. The level of prompting typically used with [NAME], and the TSS provider's typical distance from *gender3* will be recorded on the TSS Progress Note to facilitate evaluation of the progress and success of the Titration Plan. Copyright © 2008 The Institute for Behavior Change All Rights Reserved Unauthorized duplication is unlawful.

Discharge Planning BEFORE TSS AFTER TSS TSS effect on behavior – 13 weeks

Discharge Planning BEFORE TSS AFTER TSS TSS effect on behavior – 13 weeks

Discharge Plan The average of [parent and/or teacher] ratings of [NAME]’s involvement in target behavior over the past four weeks is reported in the chart below. A score of 2 or lower is within normal limits for a typically-developing child of the same age. A score above 2 indicates abnormal behavior that requires professional intervention. The highest possible score is 10. The higher the score, the more intensively and urgently this professional intervention is needed. The Plan is to discontinue BHR Services in the least amount of time possible in which to enable [NAME] to attain and generalize behavioral goals, which is defined as the time when the average of [parent and/or teacher] frequency and severity ratings of the target behavior reaches the Discharge Criteria. Copyright © 2008 The Institute for Behavior Change All Rights Reserved Unauthorized duplication is unlawful.