INTERVENTION: Subdomain 10: Effective Treatment Planning

Question 1

What should you keep in mind about treatment planning?

Answer 1

(APA, 2006)

Treatment Planning

• Setting goals and tasks for treatment – collaboration with client
• Consider:
  —Client’s problems, expected benefits, worldview, sociocultural context, and available resources
• Know research/effective interventions for different patients

Question 2

What is the Systematic Treatment Selection model? (basics)

Answer 2

(Beutler & Clarkin, 1990; Nguyen, 2007)

Systematic Treatment Selection (STS)

• Eclectism model – systematic guidelines for treatment planning
• Common factors approach in psychotherapy
• 4 Core Variables (see next cards)

Question 3

Systematic Treatment Selection (STS): 4 Core Variables: 1st variable

Answer 3

1st Core Variable - STS:

Predisposing Client Variables

• Most powerful influence on outcomes
• Non-diagnostic client variables
• Functional Impairment:
  —Family problems, social isolation, supportive relationship = INTENSITY of tx
• Coping Style
  —Externalizing (acting out) or internalizing (passivity/turning inwards) coping style = TYPE of tx
  —Externalizer = behavioral/symptom focus
  —Internalizer = conflict focus
• Resistance Level:
  —Inclination to respond to interpersonal influence in an oppositional manner
  —Resistance Level = Style
  ——Low resistance = directive
  —–High resistance = non-directive
• Subjective Distress = Type of tx AND progrnosis
  —Persistent emotiona traits = poor prognosis
  —Acute emotional reactions = good prognosis

Question 4

Systematic Treatment Selection (STS): 4 Core Variables: 2nd variable

Answer 4

2nd Core Variable - STS:

Treatment Context

• Setting where tx will occur (inpatient vs outpatient)
• Mode/Format of therapy (psychosocial vs. medical/somatic)
• Frequency/Duration of therapy (crisis vs. short term vs. long term)

Question 5

Systematic Treatment Selection (STS): 4 Core Variables: 3rd variable

Answer 5

3rd Core Variable - STS:

Relationship Variables

• Therapeutic relationship
• Compatibiity matching criteria:
  —Demographic similarities (e.g., race, age, gender ethnicity, SES)
  —Interpersonal response patterns:
  ——Personal strivings – i.e., contrasting views are best (e.g., dependent client with autonomous therapist)
  ——Beliefs – humanitarian/intellectual values
  ——Attributions – similarity of perceptions of locus of control (i.e., where the control in their life is located – within/external)
• Relationship Enhancement Skills
  —Role Induction methods:
  ——Educate clients about therapy/therapy roles
  ———Direct info
  ———Videos about therapy
  ———Treatment contracting – deposit money as contingency
  —In-Therapy Environment Management
  ——Nonverbal styles (eye contact)
  ——Situational stimuli (seating, proximity)
  ——Verbal behavioral styles (verbal activity level)

Question 6

Systematic Treatment Selection (STS): 4 Core Variables: 4th variable

Answer 6

4th Core Variable - STS:

Specific Strategies

• Selecting focus for change (symptomatic, conflictual)
• Level of intervention (symptom focus, conflict focus)
• Mediating goals
• Conducting therapeutic work
• Maintenace and relapse rprevention

Question 7

How do you develop a treatment plan?

Answer 7

(Berman, 2015)

• Begin with theoretical perspective most appropriate for the CLIENT
• Premise
  —Assumptions of theoretical model
  —Strengths/weaknesses of the client
• Supporting material
  —Evidence for statements made in premise
• Conclusion
  —Clients overall level of functioning
  —Broad tx goals
  —Potential barriers to goals

Question 8

What are the styles of treatment plan writing? (6 styles)

Answer 8

1. Assumption-based style
   * Focus on assumptions of specific theory
2. Symptom-based style
   * Focus on symptoms
3. Interpersonal styles
   * Relate client’s relationships with others and themselves
4. Historically-based styles
   * Significant times and stressors in their life
5. Thematically-based style
   * Important theme that encompasses client’s bx or worldview (e.g., “world is unsafe”)
6. Diagnosis-based style
   * Similar to symptom-based
   * Focus on diagnostic criteria

(Berman, 2015)

Question 9

How to structure goals in treatment plan writing?

Answer 9

(Berman 2015)

• Long term goals followed by several short-term goals
  —Long term reflects main concepts in premise
  —Short term = specific and attainable
  ———Help demonstrate progress
  ———Instill hope
  ———Aid session planning
  —Most effective goals:
  ———Important to client
  ———Described concretely

Question 10

SUBDOMAIN 10 CITATIONS

Answer 10

SUBDOMAIN 10 CITATIONS

Question 11

APA, 2006

Answer 11

APA, 2006

• What should you keep in mind about treatment planning?

Question 12

Beutler & Clarkin, 1990; Nguyen, 2007

Answer 12

Beutler & Clarkin, 1990; Nguyen, 2007

• What is the System Treatment Selection model?

Question 13

Berman, 2015

Answer 13

Berman, 2015

• How do you develop a treatment plan?
• What are the styles of treatment plan writing?