Why Your Clients Don't Fit With A Treatment Plan

We all know the ethical thing to do is to have a treatment plan for each client but you want to know a secret? Most therapists don't have one. And of the few that do, most don't follow it. 

So I thought I'd break down some of the common misconceptions and mistakes around treatment planning in psychotherapy. That way you can evaluate your own process.

Most counselors don’t write out their treatment plans. It’s in your head but not on paper. Why the hesitation to write it down? Because you know your client's needs will change, the focus of treatment may change, and you think why write it down when it won't apply a few months from now?

Or maybe you're just a little behind on paperwork and don't feel like writing that up when you still have to catch up notes... more about that in just a couple weeks.

Another reason is that the term "treatment plan" is a bit ambiguous without a framework. And ambiguity often leads to inaction. How long should a treatment plan be? How structured do the goals need to be? When do I make changes? Do I need to reference it in my notes?

There's no definitive answer for these questions so most therapists just avoid the whole task altogether. If there's no clear standard, there's no way for anyone to hold you to anything, anyway.

And for those who do write up a treatment plan, they make on really common mistake- not following it. This is often because you may not want to adjust it. Or you forget to adjust it. Or you write it up out of duty and put it away to never reference again. 

But you have to, we have to meet our clients where they are and so often that changes over time. No big deal. Adjust it as you need because treatment plans should be fluid, not keeping you stuck.

If you've read most of my blogs you've likely heard my recommendation to read through 1-2 of your client's files at regular intervals. This is a great time to check up on that treatment plan and see if it seems to make sense with what your notes are saying. If not, there's typically one of two things going...

  1. Your treatment plan needs to be adjusted because your client's needs have changed. This is easy! Just follow the recommendations I've already mentioned.
  2. You're getting caught up in the mundane weekly stuff your client brings to session rather than keeping a general focus. Of course, the types of goals you set will vary greatly depending on your style and modality of treatment, but in general you want to help your client identify an end game so the two of you can evaluate things along the way.

Want a little more detail, like a step-by-step training and walk-through? You're in luck! Sign up for my October video training series. In this week's video I show you how to write the easiest treatment plan you've ever created. 

And leave a comment below with your favorite strategies for writing a treatment plan. We all become better when we share strategies. Happy writing!