TREATMENT

PLANNING
Lyndsay Schmidt, M.A.

Penn Psychosis Evaluation

and Recovery Center

University of Pennsylvania
Department of Psychiatry
Neuropsychiatry Section
Treatment Planning
• Person Centered approach
• Focus on the individual and their goals
• Strengths, preferences, support systems

• Necessary to identify current issues

• Provides guidance for treatment
• Allows for assessing progress over time
• Collaborative effort
• Responsibility and motivation is shared
• Signatures, regular adjustments, and timeframe
Treatment Planning

• Three steps to creating a treatment plan

• 1. Assessment
• 2. Formulation
• 3. Implementation
Assessment
• Why is the individual seeking help?
• How have these problem’s affected the individuals life?
• What are the precipitating, perpetuating, predisposing, and
protective factors?
• What do they hope to gain?
Assessment and Formulation
• Presenting problem
• History with the problem
• Family, Social, Educational, Employment, Medical and Mental
Health history
• Individual characteristics:
• Symptoms of mood, anxiety, unusual thoughts and perceptions
• Level of impairment
• Distress
• Risk of harm (self and others)
• Motivation
• Willingness or resistance
• Support
• Coping
Formulation
• Goals should be SMART:
• Specific
• Measurable
• Achievable
• Realistic
• Timely

• Integrative effort with other team members

• Medication management
• Cognitive remediation
• Clinical team

• Identify specific interventions

• Practical
• Assist in achieving goals
• Meets the individual at his/her level of functioning
Implementation
• Engagement
• Genuine
• Unconditional positive regard
• Accurate empathy
• Respect

• Maintain the same structure

• Set plans for sessions
• Identify obstacles
• Create assignments
• On-going assessments and adjustments
• Celebrate successes
Example of a PERC Treatment Plan
Participant:(___________________________________________________(
(
Date:(_______________________________________(
( (
Treatment(Plan:(Neuropsychiatry(
( ( ( ( ( Medical(Record(#:(________________________________________________(

Initial(((((((((((((((((((((((((((((((Update(
Initial(Tx(Plan(date:(______________________(( ( ( ( Next(TX(Plan(Update:(_____________________(
(
Strengths:(___________________________________________________________________________________________________________________( (((((((((((((((((((((((((Diagnosis:(((((((Axis(I:(_____________________________________________________(
(((((
Barriers((Internal/External):(_______________________________________________________________________________________________(( ((((((((((((((((((((((((((((((((((Axis(II:(____________________________________________________((
( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (((
Progress(towards(goals(since(last(Tx(plan:(________________________________________________________________________________((( ( ((((((((((((((((Axis(III:(___________________________________________________(
(
_________________________________________________________________________________________________________________________________(( ( ((((((((((((((((Axis(IV:(___________________________________________________(
(
( ( ( ( ( ( ( ( ( ( ( ( ( ( ((((((((((((((((Axis(V:(____________________________________________________(
Target(Symptoms(( Goals(( Objectives( Modalities/(Frequency(of(TX( Person(s)(Responsible( Expected(Duration(
(Behaviorally(Defined)( (Desired(Outcomes)( (Measurable)( (Specific(interventions)( (for(Implementation)(
1.( 1.( 1.( 1.( 1.( 1.(

2.( 2.( 2.( 2.( 2.( 2.(

3.(( 3.( 3.( 3.( 3.( 3.(

(
Participant(signature:(___________________________________________Date:(____________________________((((Therapist(signature:(_____________________________________________(Date:(________________________(
(
Supervisor(signature:(____________________________________________Date:(____________________________(((Psychiatrist(signature:(___________________________________________(Date:(_______________________(
Target Symptoms Goals Objectives Modalities/Frequency Persons Responsible Expected Duration
(Behaviorally (Desired outcomes) (Measurable) (Specific
defined) Interventions)

X experiences X will reduce the X will learn to 1. The counselor will X- Participant 90 days
auditory/visual provide psychoeducation
frequency of auditory implement at least 2 on diagnosis and
hallucinations, hallucinations. to 3 effective coping symptoms. Counselor
everyday, appx. 4-6 skills to reduce the 2. X and the counselor will
times a day. frequency of identify possible coping
skills (i.e. PMR, "Look-
auditory/visual Point-Name", activity
hallucinations. scheduling) to reduce the
attention on hallucinations.
3. X and the counselor will
practice implementing
skills in session.

X reported feelings of X symptoms of X will develop 1. Counselor will provide X-Participant 90 days
psychoeducation on
anxiety on a anxiety will strategies to reduce anxiety.
somewhat daily basis, significantly reduce to feelings of anxiety as 2. Counselor and X will Counselor
which limits her no longer interfere evidenced by a identify and practice
ability to interact with with his/her daily decreased score on implementing effective
coping skills to manage
others or leave the functioning. the BAI. anxiety.
home. 3. Counselor will aid X in
identifying feelings,
thought distortions, and/or
events that could lead to
anxious symptoms.

X experiences X will develop healthy X will replace 1. X will verbalize X-Participant 90 days
understanding of how to
depressed mood and cognitive patterns negative and self- use her/his supports when
suicidal ideations and beliefs about self defeating self-talk experiencing suicidal Counselor
everyday. and the world that with verbalization of thinking.
lead to alleviation of realistic and positive 2. X and the counselor will
explore how depression is
depressive cognitions as experienced in his/her day-
symptoms. evidenced by a to-day life through
decreased score on targeting cognitions that
the BDI. support depression.
3. The counselor and X will
practice using thought
records to track negative
automatic thinking that
leads to depressed mood
and suicidal ideations.
Target Symptoms Goals Objectives Modalities/Frequency Persons Responsible Expected Duration
(Behaviorally defined) (Desired outcomes) (Measurable) (Specific
Interventions)
X has struggled with X will connect with X will create a list of 1. X and the counselor will X-Participant 90 days
identify her/his particular
maintaining a job and community resources possible vocational educational and vocational
school functioning for additional support pursuits and interests. Counselor
over the past 6 in re-establishing the community agencies 2. X will explore and
months. ability to work and/or that support collaboratively contact
community agencies that aid
participate in school. vocational in vocational rehabilitation.
rehabilitation. 3. The counselor will aid X in
practicing to reframe
cognitions and implement
positive self-talk in order to
increase his/her confidence
in the ability to work.
 The End

• Questions or comments?