The Couples Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition The Employee Assistance Treatment Planner. The Older Adult Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition The Behavioral Medicine Treatment Planner. The Treatment Planner for Severe and Persistent Mental Illness, with DSM-5 Updates, Second Edition The Planner for Mental Retardation and Developmental Disability.
Crisis Counseling and Traumatic Events Treatment Planner, with DSM-5 Updates, Second Edition Personality Disorder Treatment Planner. School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, Second Edition Sexual Abuse Victim and Sex Offender Treatment Planner. Veterans and Active Duty Military Psychotherapy Treatment Planner with DSM-5 Updates Progress Note Planners.
CONTENTS
The books in the PracticePlanners® series are designed to help practitioners meet these documentation requirements efficiently and professionally. Client Education Handout Planners provide brochures and handouts to help educate and inform clients about presenting problems and mental health issues and life skills techniques. To put it simply: We seek to help you spend more time with patients and less time on paperwork.
Being involved with editors and writers who share one vision allows us to help bring peace to those in need. Now I would like to acknowledge my addition of another friend to the list of professionals who clearly know their field and want to help others get up to speed. Your work shows a strong dedication to using best practice methods in a relationship of compassion to help those who are vulnerable after a crisis.
ABOUT PRACTICE PLANNERS ® TREATMENT PLANNERS
ABOUT THE CRISIS COUNSELING AND TRAUMATIC EVENTS TREATMENT PLANNER
The need for effective and efficient crisis intervention and trauma counseling has never been greater. This increased emphasis on early intervention, along with the multitude of crisis events, was the catalyst for revising this Treatment Planner. In the last 25 years, crisis intervention and trauma counseling has become a specialty like any other specialty in the mental health field (Roberts, 2005).
Crisis intervention and trauma counseling is a fluid process in which help must be given, and given immediately. Goals and interventions in this edition reflect the latest research and practices in crisis intervention and trauma counseling. This book goes hand-in-hand with several chapters from other Treatment Planner volumes, especially the Posttraumatic Stress Disorder chapter from The Complete Adult Psychotherapy Treatment Planner (Jongsma, Peterson, & Bruce, 2006), The Complete Adolescent Psychotherapy Treatment Planner (Jongsma) . , Peterson, McInnis, & Bruce, 2006a), and The Complete Child Psychotherapy Treatment Planner (Jongsma, Peterson, McInnis, & . Bruce, 2006b).
INCORPORATING EVIDENCE-BASED TREATMENT INTO THE TREATMENT PLANNER
In addition to references to empirical studies supporting these interventions, we provided references to therapist- and client-oriented books and treatment manuals that describe the use of identified EBTs or treatments in accordance with their goals and interventions. Of course, while acknowledging that there are STOs and TIs that clinicians have found useful but have not yet been empirically studied, we have included those that reflect common best practice among experienced clinicians. Most EBT-related STOs and TIs are described at a level of detail that allows for flexibility and adaptability in their specific application.
As with all Planners in this series, each chapter includes the option to add STOs and TIs at the discretion of the therapist.
Criteria for Inclusion of Evidence-Based Therapies
HOW TO USE THIS TREATMENT PLANNER
Interventions are actions by the clinician designed to help the client achieve goals. If the client does not achieve the goal after the initial intervention, new interventions should be added to the plan. Interventions should be selected based on the client's needs and the practitioner's full therapeutic repertoire.
The determination of an appropriate diagnosis is based on an evaluation of the client's complete clinical presentation. It is the clinician's in-depth knowledge of DSM-5 criteria and a complete understanding of the client assessment data that contributes to the most reliable, valid diagnosis. After completing these six steps, you should have a comprehensive and individualized treatment plan ready for immediate implementation and presentation to the client.
A FINAL NOTE ON TAILORING THE TREATMENT PLAN TO THE CLIENT
SAMPLE TREATMENT PLAN
PRIMARY PROBLEM: CRIME VICTIM
BEHAVIORAL DEFINITIONS
LONG-TERM GOALS
SHORT-TERM OBJECTIVES
THERAPEUTIC INTERVENTIONS
Assist the client in identifying trusted family members and friends with whom to share the experience of crime. Explore the client's feelings and thoughts that he/she experienced before and during the crime;. Teach the client strategies from stress inoculation training, such as breath control, to manage unrealistic fears about crime.
Identify, challenge and replace biased, fearful self-talk with reality-based, positive self-talk about the crime. Guide and assist the client in constructing a fear and avoidance hierarchy of trauma-related stimuli. Give the client homework exercises where he/she does exposure exercises to stimuli that evoke similar reactions as during the crime and record the reactions (see
DIAGNOSIS
Reduce anxiety related to the crime by having the client use an imaginary exposure to the trauma by describing the crime in an increasing but client-chosen level of detail; repeat until associated anxiety stabilizes; Teach family members healthy communication skills (e.g., reflective listening, eye contact, respect, etc.) that they can use when discussing the crime. Use cognitive behavioral techniques (modeling, role play, corrective feedback, and positive reinforcement) to teach the family communication skills, including assertiveness.
He experiences an initial state of stupor with dissociative symptoms of numbness, detachment, derealization, depersonalization, narrowing of attention, amnesia or narrowing of attention, inability to comprehend stimuli, and disorientation. It shows symptoms of hyperarousal such as difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness and agitation. He experiences physical symptoms of chest pain, chest pressure, sweating, shortness of breath, narrowing of blood vessels, headache, flushing, muscle tension, intestinal disturbances, heart palpitations, or dry mouth.
SHORT-TERM OBJECTIVES
Discuss facts of the trauma to explore the client's potentially distorted cognitive messages that reinforce negative emotional responses to the trauma. Work with the client to develop a timeline for symptom development to identify how the traumatic event has negatively affected his/her life. Ask the client to identify alternative pathways that would prevent exposure to the trauma site to avoid overwhelming stress responses associated with exposure to the trauma site.
Nurture the client's right to enjoy life as a countermeasure to his/her survivor's guilt. Go with the client to the scene; offer support and encouragement to use the techniques identified in the session to manage reactions. Use exposure therapy methods with the client in conjunction with learned relaxation techniques to reduce stress reactions as they develop at the scene.
DIAGNOSTIC SUGGESTIONS
Assess the focus, excessiveness, and uncontrollability of the client's worry and the type, frequency, intensity, and duration of his/her anxiety symptoms (eg, Anxiety. Assign the client to read appropriate books on calming strategies or ways to reduce general anxiety (eg, Mastery of Your Anxiety and Worry: Workbook, 2nd Edition by Craske and Barlow; Teach the client how to use automatic thought recording to identify and track cognitive biases regarding irrational worries and persistent anxiety symptoms;.
Teach the client how to use an automatic thought recorder (see I Want to Change My Life: How to Overcome Anxiety, Depression, and Addiction by Melemis) to identify and replace fearful self-talk with positive ones. Instruct the client to read self-help books or psychoeducational chapters of books. Strengthen the client's understanding of the role of his/her past emotional pain and current anxiety.
BULLYING VICTIM
Encourage the client to return to work, school, social engagements and/or daily routines. If necessary, refer and assist the client to the local law enforcement agency in filing a report of the incident. Help the client identify trusted family members and friends with whom to share the crime experience.
Refer the client to community-based and online self-help groups and to volunteer work. Inquire about the client's sleeping pattern and suggest strategies to help him/her fall asleep (e.g., journaling, relaxation techniques). Inquire about the economic impact of the crime on the client's finances (e.g. loss of income, paying bills, mortgage, etc.).
SERVICE PROVIDERS (ESPs)
Assess the client for increased use of alcohol and other mood-altering substances after. Encourage the client to look for irreplaceable and valuable items in the wreckage, assuming it is safe;. Encourage the client to return to work, social engagements and/or daily routines that occurred before the attack;.
Help the client develop ways to communicate effectively with others at the bottom line. Ask the client to list the factors that contributed to the abortion decision; process the contents of the list. Use the EMDR exposure technique to reduce the client's anxiety associated with the phobic stimulus.
PTSD) 1
Set up quiet, private or semi-private locations where the students and caregivers can reunite. Assure the students of their safety and use active listening skills to attend to students' and caregivers' questions. Use art therapy to explore and allow the students' expression of affective, behavioral and cognitive responses to the event.
Use active listening skills to explore students' affective, behavioral, and cognitive responses as they recount (or assign) the trauma in as much detail as they feel comfortable with. Use sand play or art therapy so that students express their affective behavioral and cognitive responses to the event. Use play therapy (e.g., coloring books, puppets, marionettes) to help students express affective, behavioral, and cognitive responses to the event.
Encourage and facilitate students to share affective, behavioral, and cognitive responses with a professional therapist, family member, and/or trusted friend. Allow space for students and family members to remember the deceased in accordance with school policy. Use active listening skills to allow students and caregivers to become aware of and express their feelings and thoughts.
Reassure students about their safety and use basic listening skills to listen to questions from children and carers. Provide students with assessment tools designed specifically for crisis and traumatic situations (e.g. Triage Assessment Form; Crisis). Use art therapy to explore and allow for students' affective, behavioral, and cognitive responses to the event.
Use active listening skills to validate and explore students' emotional, behavioral, and cognitive reactions as he/she recounts the trauma as detailed as it is. Support and facilitate students in sharing emotional, behavioral, and cognitive reactions with a professional therapist, family member, and/or trusted friend. Help students gain a realistic perspective of the event by using appropriate language (eg, assure students that they are not to blame for the event, injuries, or deaths if they occur).
