| Client Service Plan - Noah and his Family |
| Problems | Goals | Objectives | Intervention/Model/ Theory | Clinical Skill/Practice Strategy | Outcomes |
| Depression, grief, stress-related symptoms resuting from the death of his cousin | Provide a normative degree of resolutin for grief, resolve acute symptoms related to deth, cognitive appraisal of the death and further sense of danger | Carefully review child's understanding of circumstances of cousin's death and exaggerated fears of his own danger, review time with Damon and develop a scrapbook together | Cognitive therapy focused on resolving fears related to death and facilitiating grief:
Introduce emotion identification and scaling, explore cognitive distortions
Behavioral activation | Mindful listening
Engagement | Decrease score on index of suicidal ideation and index of hopelessness |
| Shyness, social anxiety with kids at school | Increase comfort level and improve socializiation skills to play after school for at least one hour | Graduated objectives: measured from a few minutes up to 60 minutes in after school program; instructors record number of minutes | Coping Skills to enhance relaxation through imagery and muscle relaxation, modeling and role playing of conversation and play; graduated exposure, contingency management with rewards for more playtime in afterschool program
Explore core beliefs that trigger avoidant behavior | Therapeutic alliance
Mutual agreement
Systems collaboration (school)
Reframing | Increase number of minutes playing with others in after school program from 0 to 10 to 20 to 40 then 60.
Increase number of times he initiates conversation druing play from 0 to 4
Decrease SUDS (subjective units of distress scale) to below 5 when approaching other children |
| Moderate OCD symptoms, perfectionism, excessive organizing to get things just right, feelings of responsibility for external events | Reduce expectations to be perfect: tolerate messiness with reduced anxiety and compulsive behaviors | Graduated objectives: to reduce level of perfectionism with regard to tidying up room, homework, prayer by reducing amount of organizing to 1-2 mintues daily at the end of each task. | In addition to coping skills, EXRP (exposure with response prevention) exercised early on until he can leave it alone, dailiy rewards for reducing organizing time
Mindfulness - relabeling, reattributing, refocusing, revaluing
| Exploration
Feedback
Reinforcement | Decrease number of minutes organizing at home and school from current rate to 5 then to 1-2
Level of subjective anxiety experienced if things are not perfect to under 5 |
josaca
common_assignment_part_3_-_noah_example.xlsx
