Treatment Planning Application

You are working with Michael, a 26-year-old African American male. He is single, has a bachelor's degree in business management, and is employed as a manager at a local appliance store. He reports a history of hypertension (high blood pressure), which is well-managed using medication. During the session, he complains that although he can work with his employee team effectively and regularly meet individual and team sales goals, he has a long history of heterosexual social anxiety. He also claims he can socialize outside work without significant problems. When asked what he would like to accomplish in counseling, he states, "I want to have a date at least a couple times a month, and I want to ask the person out on the date without feeling like I'm going to have a heart attack every time I start to approach her." Michael also reports intermittent insomnia, muscular tension, and increased irritability, all three of which worsened after his mother passed away nine months ago. Develop a treatment plan for Michael using Jongsma and Peterson's (1995) model. Note: You may target one or more problems for Michael's treatment.

Step 1 Problem Selection:

Step 2 Problem Definition:

Step 3 Goal Development:

Step 4 Objective Construction:

Step 5 Intervention Creation:

Step 6 Diagnosis Determination:

1. Gain the most complete understanding of client problem(s) possible, given the limits of time; client expressive abilities; and client awareness. Use Lazarus's (1976) BASIC ID or some other guide to remind you of the many complex aspects of a client in need of assistance. Often, we use a model that includes a review of (a) social, (b) cognitive, (c) emotional, (d) physical, (e) behavioral, and (f) cultural aspects of the individual's functioning.

2. Gain the most complete understanding of your client's goal(s) that you can. Ask clients what their life would look like if things were better. What would be a tolerable outcome? What would be the best imaginable outcome? Sometimes, projective questions such as de Shazer's (1985) "miracle question" help clients articulate their goals (i.e., "Imagine tonight while you sleep, a miracle happens and your problem is solved. What will be happening the next day, and how will you know that your problem is solved?").

3. Do your homework, part one: Go over what you know about your clients and their problems. Ask yourself what you still need to know to fill in any crucial gaps and make every effort to obtain this information. If you have time limits regarding when you must have your treatment plan completed (e.g., after session one), you may need to ask clients to wait for a minute or two as you sort through the information they have given you. Then, moving back to a collaborative mode, summarize your thoughts about primary and secondary problems and establish a provisional treatment plan.

4. Do your homework, part two: After the session, review a short list of viable treatment options, given what you know from your problem conceptualization and client goal statements. If you are unable to identify clear and appropriate treatment interventions, read, consult, and, if needed, obtain supervision. At that point, you can rank-order the intervention alternatives and present them to your client during session two.

5. Develop meaningful objectives that help both you and your client know if you are moving toward the goal(s). Do this collaboratively with your client.

6. Frequently check in with clients regarding how therapy is progressing. Even if one of your central objectives is simply developing a healthy working alliance, check with clients regarding their perception of your work together. Clients are empowered by being asked if things are moving in the direction they imagined, hoped for, or need. Research supports the importance of an ongoing working alliance for treatment success (Gaston, 1990; Hubble et al., 1999; Raue et al., 1997).

7. Plan for termination at the outset of treatment. If a specified number of sessions are available, note this and use it constructively in all phases of your therapy work together. Research indicates that having a time limit can sometimes help clients reach their therapy goals (Barkham et al., 1996; Steenbarger, 1994). Regardless, termination is an important aspect of mental health work and should be addressed throughout the counseling relationship.

8. When termination occurs, follow a model for appropriate therapeutic termination (see Barnett, 1998; J. Sommers-Flanagan & Sommers-Flanagan, 1997, for termination guidelines).

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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