Therapist's Guide to Clinical Intervention

The 1-2-3's of Treatment Planning

Sharon L. Johnson

• Publisher: Academic Press
• Year: 2017
• eBook ISBN: 9780128111772
• Edition: 3
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Therapist's Guide to Clinical Intervention, Third Edition, is an essential reference for providing clinical services and associated case formulations requiring formalized goals and objectives. It is ideal for use in assessment, treatment, consultation, completing insurance forms, and/or participating in managed care. This practical, hand-on book, outlines treatment goals and objectives for each type of psychopathology as defined by the diagnostic and statistical manual by the American Psychiatric Association. It additionally provides skill-building resources and samples of all major professional forms likely to be used in clinical treatment.The third edition conveniently maps individualized treatment plans utilizing evidence-based best practices and standards of care. Diagnostic information is presented by associated disorder or theme for easier access. New special assessments and skill-building entries are included. Also new are numerous website/URLs associated with research articles, and consumer resources have been provided to complement clinical information and patient education.- Outlines treatment goals and objectives for DSM-IV diagnoses- Presents evidence-based best practices of intervention- Provides the basis for assessing special circumstances- Offers skill building resources to supplement treatment- Contains samples for a wide range of business and clinical forms- Supplies websites for additional clinical information and patient education

Chapter 1

Treatment Planning

Goals, Objectives, and Interventions

Abstract

The Therapist's Guide Treatment section presents evidence-based cognitive-behavioral therapy (CBT) treatment interventions that can be selected using an individualized approach to treatment planning. Evidence-based practice (EBP) is the integration of clinical expertise, patient values and motivation, and the best research evidence forged together into the decision-making process for collaborative treatment planning and effective patient care. The result is an optimal clinical outcome. EBPs are treatments that have been identified as the most effective interventions. CBT is an EBP that supports the idea that people can have better emotional, relational, and spiritual health if they utilize therapy to influence changes in their characteristic negative thinking and/or behavior patterns. Evidence-based treatment practices are meant to make treatment more effective for more people by using research-based and scientifically proven methods of clinical intervention.

Keywords

CBT; Clinical case management; Effective interventions; Evidence-based practice; Impulse control disorders; Individualized treatment planning; Medical causes of psychiatric illness; Mood disorders; Personality disorders; Separation anxiety; Symptoms of relapse; Treatment goals and objectives; Treatment planning

A diagnosis holds value in conceptual communication, multidisciplinary collaboration, and the development of an individualized treatment plan that improves the quality of life for a person. Commensurate with that defining foundation is evidence-based practice (EBP), which is weighted in the cognitive-behavioral therapy (CBT) realm. As with many diagnoses today, CBT is specialized to specific diagnostic challenges. For example, CBT for anxiety and depression, dialectical behavioral therapy for personality disorders, and for schizophrenia, CBT for psychosis is referred to as “CBT-P.” CBT has been shown to be as useful as antidepressant medications for some individuals with depression and may be superior in preventing relapse of symptoms. For decades it has been accepted that those in therapy who receive CBT in addition to treatment with medication have better outcomes than those who do not receive CBT as an additional treatment.

The literature review foundation for the treatment section was based upon: The Center for Implementation-Dissemination of Evidence-Based Practices Among States (IDEAS) (2015), SAMHSA Behavioral Health–Evidence-Based Treatment and Recovery Practices (2012), SAMHSA Evidence-Based WEB GUIDE (2014) were used as a review sources in identifying EBP treatment goals and objectives. The last resource was a comprehensive collection of EBP collaborations [Campbell Collaboration, Child Trends, Cochrane Collaboration, Effective Child Therapy EB MH Treatment for Children and adolescents, National Guidelines Clearinghouse (AHRQ)] and many others.

There are three essential principles to CBT:

1. Set specific goals

2. Provide rewards and consequences (life is about choices)

3. Consistency of rewards and consequences is a key

Neurodevelopmental Disorders

Intellectual Disability

Intellectual disabilities are described by learning, cognitive, and social characteristics. An intellectual developmental disorder is characterized by deficits in intellectual functioning (IQ of 70 ± 5 or below) with concurrent deficits in adaptive functioning, which includes social skills, communication, daily living skills, age-appropriate independent behavior, and social responsibility “without ongoing support.” However, in contrast with most other disability categories, children with mild intellectual disabilities are inclined to have more general, delayed development in academic, social, and adaptive skills. This delayed development is reflected in low achievement across content and skill areas as well as significantly lower scores on measures of intelligence and adaptive behavior when compared to their peers who do not demonstrate intellectual disabilities.

Cognitive performance influences acquisition of language and academic skills, specifically associated to attention, memory, and generalization. Attentional difficulties such as orienting to task, selective attention, and sustaining attention to a task present the need for creative interventions to increase effectiveness (Beirne-Smith, Patton, & Kim, 2006). Short-term memory deficit is benefitted from rehearsal strategies (Kirk, Gallagher, Anastasiow, & Coleman, 2006) and focusing on meaningful content during instruction to facilitate remembering information [i.e., rehearsal, clustering information, and mnemonic devices (Smith, Polloway, Patton, & Dowdy, 2012)]. Generalization difficulties interfere with generalized material learned in one setting and transferred to another (i.e., school to home and community) (Smith et al., 2012). These challenges benefit from:

1. Present initial stimuli that vary in only a few dimensions

2. Direct attention to these critical dimensions

3. Initially remove unnecessary/inessential stimuli that may result/increase distractibility

4. Increase difficulty of task over time

5. Teach...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Introduction
• Level of Patient Care and Practice Considerations
• High-Risk Situations in Practice
• Solution-Focused Approach to Treatment
• Common Diagnoses and Associated Codes
• Chapter 1. Treatment Planning: Goals, Objectives, and Interventions
• Chapter 2. Assessing Special Circumstances
• Chapter 3. Skill Building Resources for Increasing Social Competency
• Chapter 4. Professional Practice Forms Clinical Forms Business Forms
• References
• Index