GEHART CHAPTER 13 - TREATMENT PLANNING

Question 1

SYMPTOM BASED TREATMENT PLANS

Answer 1

PLANS FOCUSED SOLELY ON CL MEDICAL SYMPTOMS
PROBLEMS:
-UNDERUTILIZE THEORY
-FOCUS ON SYMPTOMS
-FORGET TO ASSESS LARGER PICTURE

Question 2

THEORY BASED TREATMENT PLANS

Answer 2

USES THEORY TO CREATE MORE CLINICALLY RELEVANT TREATMENT PLANS THAN SYMPTOM BASED MODELS OFFER.

Question 3

TREATMENT PLAN GOALS

Answer 3

GOALS SPECIFY WHAT DYNAMICS ARE GOING TO CHANGE

E.G.; “INCREASE” OR “DECREASE”

Question 4

TREATMENT PLAN INTERVENTIONS

Answer 4

DESCRIBE WHAT INTERVENTIONS WILL BE USED TO ACHIEVE THE CHANGE DESCRIBED IN THE TX GOALS

Question 5

WRITING TX GOALS

*STEP 1 - CASE CONCEPTUALIZATION AND CLINICAL ASSESSMENT

Answer 5

-CASE CONCEPTUALIZATION USES THEORETICAL CONCEPTS TO CL ACTUAL SITUATION
-REQUIRES REFLECTIVE AND CRITICAL THINKING
-IS DIFFICULT
CLINICAL ASSESSMENT -I.E., BIOPSYCHOSOCIAL HISTORY ASSESSMENT

Question 6

WRITING TX GOALS

*STEP 2 - CRISES OR PRESSING ISSUES

Answer 6

IN CLINICAL ASSESSMENT, CO SHOULD HAVE IDENTIFIED CRISES
- SI OR HI, ABUSE, DOMESTIC OR SOCIAL VIOLENCE,
SUBSTANCE ABUSE, NEED FOR EVALUATION FOR MEDICATION OR OTHER MEDICAL ISSUES, EATING DISORDERS, SELF-MUTILATION, SEVERE DEPRESSIVE, PSYCHOTIC, OR PANIC EPISODES THAT NEED TO BE STABILIZED FOR OP TREATMENT.

Question 7

WRITING TX GOALS

*STEP 3 - THEMES FROM THE CASE CONCEPTUALIZATION AND CLINICAL ASSESSMENT

Answer 7

• WHAT TWO OR THREE KEY PATTERNS EMERGED IN THE CASE CONCEPTUALIZATION?
• HOW DO THESE FIT WITH THE CLINICAL ASSESSMENT?
• WHAT THEORY DO I WANT TO USE, AND HOW WOULD IT DESCRIBE THESE KEY THEMES?

Question 8

WRITING TX GOALS

*STEP 4 - LONG-TERM GOALS

Answer 8

SOME THEORIES HAVE THEORETICALLY DEFINED LONG-TERM GOALS. WHEN USING SUCH MODELS, BEGIN WITH LARGER GOALS IN MIND AND DESIGN THE WORKING-PHASE GOALS TO PREPARE CLIENTS FOR THE CLOSING-PHASE GOALS.

Question 9

WRITING TX GOALS

*STEP 5 - COMPLETE GOAL WRITING WORKSHEET

Answer 9

-CAN ONLY BE WRITTEN AFTER DOING CLINICAL ASSESSMENT AND CASE CONCEPTUALIZATION
LINK TOGETHER CLIENT’S REPORTED PROBLEMS, PROBLEMATIC RELATIONAL DYNAMIC IDENTIFIED IN THE CASE CONCEPTUALIZATION
-PSYCHIATRIC OR RELATIONAL SYMPTOMS (FROM CLINICAL ASSESSMENT)

Question 10

GUIDELINE FOR WRITING USEFUL GOALS

Answer 10

1. START WITH A KEY CONCEPT OR ASSESSMENT AREA FROM THE THEORY OF CHOICE - START WITH “INCREASE” OR “DECREASE,” FOLLOWED BY A DESCRIPTION USING LANGUAGE FROM THEORY ABOUT WHAT IS GOING TO CHANGE
2. LINK TO SYMPTOMS - DESCRIBE WHAT SYMPTOMS WILL BE ADDRESSED BY CHANGING THE PERSONAL OR RELATIONAL DYNAMIC (FROM CLINICAL ASSESSMENT)
3. USE THE CLIENT’ NAME - ENSURES THE GOAL IS UNIQUE RATHER THAN FORMULAIC

Question 11

WRITING MEASURABLE GOALS

Answer 11

USE A NUMBER TO MAKE IT MEASURABLE

Question 12

EARLY PHASE CLIENT GOALS

Answer 12

FOR FIRST 1-3 SESSIONS - GENERALLY INVOLVES STABILIZING CRISIS SYMPTOMS (HI OR SI, EATING OR SLEEPING PATTERNS, SEVERE DEPRESSIVE OR PANIC EPISODES, MANAGING ABUSE ISSUES, ADDRESSING SUBSTANCE ABUSE ISSUES, STOPPING SELF-HARM BEHAVIORS, ETC.)

Question 13

WORKING-PHASE GOALS

Answer 13

GOALS THAT ADDRESS THE DYNAMICS THAT CREATE AND/OR SUSTAIN THE SYMPTOMS AND PROBLEMS FOR WHICH THE CLIENT CAME TO THERAPY

• USES THEORETICAL LANGUAGE
• LINKS TO PSYCHIATRIC SYMPTOMS

Question 14

CLOSING-PHASE GOALS

Answer 14

ADDRESS LARGER, MORE GLOBAL ISSUES AND MOVE CL TOWARD GREATER “HEALTH” (AS DEFINED BY CO THEORETICAL PERSPECTIVE)

Question 15

WRITING USEFUL THERAPEUTIC TASKS

Answer 15

“TRAINING WHEELS” OF THE PLAN, EASIEST

• NOT TYPICALLY INCLUDED IN TX PLAN
• PRIMARILY TO HELP NEWER CO’S
• ARE MOST FORMULAIC

Question 16

WRITING USEFUL INTERVENTIONS

Answer 16

• USE SPECIFIC INTERVENTIONS FROM CHOSEN THEORY (IF USING INTERVENTION FROM DIFFERENT THEORY THEN CLEARLY DESCRIBE MODIFICATIONS)
• MAKE INTERVENTIONS SPECIFIC TO THE CL - USE CONFIDENTIAL NOTATION (AF = ADULT FEMALE, ETC.) TO MAKE THE GOAL AS SPECIFIC AND CLEAR AS POSSIBLE
• INCLUDE EXACT LANGUAGE WHEN POSSIBLE - CO SHOULD USE EXACT LANGUAGE THEY WILL USE TO DELIVER THE INTERVENTION