1. Treatment Planning R. Lyle Cooper, Ph.D., LCSW, ICADAC II Assistant Professor University of Tennessee College of Social Work

2. Treatment Planning  Treatment planning should address all the domains covered in assessment  Treatment includes choosing the appropriate type of SERVICE DELIVERY SYSTEM as well as the best THERAPUETIC APPROACH  Also certain PRINCIPLES need to be in place to ensure treatment success

3. Principles of Effective Treatment  Early detection, including screening and brief interventions: for non-dependent problem drink/drug user  Comprehensive assessment and individualized treatment plan: each client experiences problems differently)  Care management: All elements of the problem should be addressed and coordinated  Individually delivered, proven professional interventions: Clients deserve treatments that are supported by research, and treatment providers should offer more than one

4. Principles Continued  Contracting with patients: Also called contingency management or behavior contracting  Social skills training: Teaching clients to manage stress and engage in prosocial behavior  Medications: Medications improve outcomes (not a cure)  Specialized services for medical, psychiatric, employment or family problems (problem to service matching)

5. Principles Continued  Continuing care: Most who enter treatment have at least one relapseat least one relapse  Strong bond with therapist or counselor: Rapport is central to all therapeutic success  Longer duration for dependent users: 90 or more days alcohol/heroin 180 or more crack  Support groups: attendance and participation  Strong client motivation: All treatments relay on patient desire to change

6. Exercise 1  In small groups discuss the principles presented above  Discuss whether all these principles are in place at your agency  If they are not a part of the center you work for discuss how they could be added

7. Service Delivery Systems DETOX  Medical  Non-Medical INTENSIVE TX  Inpatient  Outpatient  Day treatment RESIDENTIAL  Halfway house  Therapeutic communities  Missions OUTPATIENT TX  Individual counseling  Group Treatment  Conjoint Therapy  Family therapy  Multimodal Approaches  Brief Interventions

8. Exercise 2  You have been given a case-study  In small groups discuss what factors identified in your case might cause you to might cause you to choose one delivery method over another  Should multiple delivery methods be used over time? Why or why not?

9. Therapeutic Approaches  Evidence Based Practice (EBP) Client wishes/character/ demographics EBP Counselor Experience Best Research Evidence

10. Evidence Based Practice  There are many EBP’s available  These interventions can be searched on the NREPP website  We as counselors have an ethical responsibility to provide interventions that are based in research not just our experience

11. Examples of EBP Adolescents  A-CRA  MRT  MSFT Adults  TSF  Brief SBCM  Broad Spectrum Therapy  RPT  Drinkers Check-up Co-occurring Adolescent  A-CRA  7 Challenges  MSFT Co-occurring Adult  Boston Consortium: Trauma informed treatment for women  DBT Older Adult  Brief SBCM  Alcohol Behavioral Couple Counseling

12. Exercise 3  In small groups review the case study you have been given  Review the EBP interventions described in the accompanying sheet  Determine the appropriate intervention for your client explain why you chose this intervention

13. Documenting Treatment Planning  Treatment Plans should be:  Collaborative: both counselor and client agree on the course  Specific: it is clear what goals need to be met in order to treat the problems  Measurable: there must be a clear goal that can be measured to determine the success of the intervention

14. Treatment Plan Example ProblemInterventionOutcome Ct is unable to refuse cocaine when offered Drug refusal skills administered over 6 weeks Increased ability to refuse as indicated by coping skills inventory Ct has no non-drug use activities to fill time Functional analysis of pro-social behavior 2 session Increased prosocial activity as indicated by happiness scale