Treatment Plan: Page
COUN 603
Foundations of Mental Health Counseling
Treatment Plan
Date
Client DoB
Diagnosis
Services Recommended
Service Modality Frequency of Service
Individual Tx
Group Tx
Family Tx
Couples Tx
Parent Consultation
Medication Evaluation
Psychological Evaluation
Case Management
Other
Treatment Goal # 1:
Progress Monitoring
Treatment Objective
Treatment Activity
Outcome Criteria
Review Date
Not
Attained
In
Progress
Partially
Attained
Attained
#
#
#
Approved by:
Clinician Date
Client Date
Supervisor Date
Treatment Goal # 2:
Progress Monitoring
Treatment Objective
Treatment Activity
Outcome Criteria
Review Date
Not
Attained
In
Progress
Partially
Attained
Attained
#
#
#
Approved by:
Clinician Date
Client Date
Supervisor Date