Help Needed

College of Social Sciences Master of Science in Counseling

Treatment Plan

Client Name:       Date:      

Clinical Placement Student:      

Type of service (check one): FORMCHECKBOX Individual FORMCHECKBOX Family FORMCHECKBOX Child FORMCHECKBOX Couple

1. Target Problem -(Should include a statement from the client identifying what he/she would like to change or improve upon)

Specific/Short Term Goals: (Short term goals should be specific and be measurable. For example, the client will increase his sleep time from 3 hours per night to 6 hours per night in 30 days)

     

Objectives: (Objectives are specific steps a client will take to reach his/her goals. An example for the above cited goals might be. 1. Client will practice deep breathing techniques an hour before bedtime. 2. Client will not take naps during the day. 3. Client will utilize a stress reduction app to provide relaxing music while sleeping.)

Strategies/Interventions to Achieve Goals: (these are strategies and interventions used by the COUNSELOR to assist the client reaching his/her goals. These should include theoretical tools/techniques, referrals, etc.)

2. Target Problem

Specific/Short Term Goals:

Objectives:

Strategies/Interventions to Achieve Goals:

Monthly Review date: ___________________________________      

Client Signature: _______________________________________ Date:      

Counseling Student Signature: ____________________________ Date:      

Supervisor Signature: ___________________________________ Date: