Treatment Planning
Elements of a plan
An individualized plan links assessment problems to goals, measurable objectives, interventions, and a review date. Goals are broad desired outcomes; objectives are specific, measurable, time-bound client behaviors. Include strengths, culture, stage of change, and the ASAM rationale for level of care. The client should participate in developing the plan; a plan written without the client is a compliance document, not a treatment plan.
Traps
Look for objectives that describe counselor actions (“counselor will educate client about relapse”) rather than client behavior. Watch for goals with no measure, no time frame, or no link to the problem list. A mismatch between assessed severity and level of care is a common error. Also watch for plans that ignore legal, medical, or child-welfare issues, or that are never reviewed.
Rule of thumb
If you cannot count it, observe it, or set a date for it, it is a goal, not an objective. Each objective should answer: who will do what, to what standard, by when?
Worked example
Problem: “Client uses alcohol to manage anxiety and has had two relapses.” Goal: “Reduce relapse risk and improve coping.” Objective: “Client will identify three triggers and two coping strategies and report using at least one strategy during a craving episode within 30 days.” Intervention: CBT skills practice and MI. Review in 30 days.