Choosing a Treatment Plan Template You (and your clients) Like

Search around you'll find lots of different types of treatment plan templates. Which one is better for insurance? Which one do I need to use to show I'm being ethical? Do I really need one?

These are questions I get all the time. Well, as in most paperwork situations, the answer is... it depends! 

So let's break things down. Yes, you should have a treatment plan for all your psychotherapy clients and no, there is no special requirement for which type of treatment plan you use. This can be both liberating and frustrating for counselors because you have flexibility but little guidance.

That's why I'm here ;)

Let's look at some different types of treatment plans and in what situations they work best...

Narrative

A narrative treatment plan may be as basic as writing out what your client says they would like to achieve in therapy. This may be a simple phrase or 1-2 sentences that you include in your session note, or even on a separate "treatment plan" document (or section of your practice management system). 

It's not very structured and doesn't require a lot of thought. This is great when you're working with clients who are very comfortable with the therapy process and may not need as much check in regarding specific progress. It's also a good fit if you are comfortable remembering the general topics your clients are seeing you for and just need a "home base" of sorts to check in with every once in a while. 

This is also a pretty common form of treatment planning... and a nice alternative if you're the type who never really writes anything down and shy away from a structured form.

Structured

Some counselors prefer to have something more structured. This takes away the ambiguity and allows you to create a framework. If you've ever looked up treatment planning books or worked in an agency, you likely found structured treatment plans that had specific categories and encouraged you to detail progress at certain times throughout treatment.

If you have no idea where to start, using a structure plan can be very helpful. Once you become familiar with the structure, you're able to easily discuss the plan with clients and complete the form quickly. 

Remember that even with structured plans you should make the treatment plan as individualized as possible. Simply choosing from a list of interventions or problems is typically not very meaningful and focuses more on doing the form than actually creating a successful therapeutic journey. 

Diagnosis based

Many structured plans that you'll find for purchase are based on diagnosis. These plans encourage practitioners to choose a problem focus (e.g. generalized anxiety or suicidal ideation) that relates to a particular diagnosis. Then the therapist will identify treatment interventions that relate to the particular problem.

There are benefits and drawbacks to this type of treatment plan. The benefit is that you can present a list of items to clients who may have difficulty identify goals or problems on which to focus. These plans also provide you with specific ideas for interventions that relate to diagnostic issues.

However, it is very easy to fall into the trap of not including your clients in this type of treatment planning process. Because the plan is often based on more intensive or negative behaviors, you may prefer to discuss generally with the client and then integrate that into the formalized plan later and on your own. This increases the amount of time you spend on treatment planning while also potentially making the plan less meaningful to your client. 

Client-centered

Rather than focusing on symptoms or diagnostic categories, client-centered plans focus on the client's identified goal for treatment. These plans may ignore external requirements for treatment and focus on integrating what the client chooses to bring to the session. 

That means you may choose to focus on something like improving communication or self-esteem, things that may or may not be associated with an actual mental health disorder. While every treatment plan should really be client-centered, these don't focus on ensuring the client meets specific criteria that may be important to other entities (e.g. insurance). 

So really, you have a lot of flexibility with treatment planning... but you can also give yourself varying levels of structure as needed. If you're looking for more structure with treatment plans, I offer a packet of 6 in my Therapist's Perfect Paperwork Packet (available June 20th). 

Or you can sign up for my FREE Private Practice Paperwork Crash Course and get one free template you can use right away. Either way, I've got you covered so you can focus on doing great work with your clients!