Treatment Plans That Worked

     An appalling lack of standards exists as to what a child’s behavioral treatment plan should look like. As a result, parents are frequently at a loss to determine if the Plan proposed for their child is either adequate or appropriate. As an alternative to wishful thinking, misplaced trust in an unknown and untested service provider, and to raise the standards for treatment plans for children who are displaying challenging behavior, this internet resource has been created. Let’s define our terms, first of all.

A Treatment Plan should provide all of the information necessary for a conscientious person to deliver the correct treatment procedures, at the correct times, and with sufficient consistency to produce the changes in behavior that are described in the Plan — reducing or eliminating undesirable behavior and increasing or improving desired behavior, while providing a means to monitor progress on an ongoing basis that informs the process of treatment.

     With that in mind, the following “treatment plans that worked” are offered as examples to guide professionals in the creation of age-appropriate behavioral treatment interventions for children, and as examples of successful treatment planning documents that parents may provide to professionals as a means of setting basic standards for treatment design and monitoring. These plans were all successful in that they all produced reduction or stabilization in the target (undesirable) behavior of children. Although these plans were successful in these cases, it is clear that all children are different, and that the exact same plan may or may not be effective for any other child, and that professional guidance should always be sought before and during the implementation of any treatment plan or program.

     Subtle differences can change the outcome of any treatment plan. Because these plans are presented in the interest of helping to establish “standards” for the development of behavioral intervention plans for children, all of the treatment plans here are offered “as is” for informational and comparison purposes only, without any warranty whatsoever as to suitability for any particular purpose or child, or any claim of usefulness or value in the treatment of any disability. Results will vary in any treatment program; the fact that any one of these treatment plans "worked" in one case does not indicate that it will "work" in any other case.

     In this field, for every expert, there is an equal and opposite expert. Nevertheless, there are some basic standards on which everyone should agree. At a minimum for example, all behavioral treatment plans should provide the following information. The order of presentation isn’t as important as the level of understanding that it creates in the mind of the person who is to implement the plan, such as a mental health worker or a parent. A very simple plan, accompanied by a very high level of professional supervision, training and support, can achieve tremendous results. A highly complicated, lengthy, jargon-ridden treatment plan written by someone with impressive credentials obviously doesn’t guarantee success. The middle ground (where the treatment plan is complete in terms of its components, explicit in its directions to the person who will implement it, and which can be evaluated objectively as to its effectiveness) is ideal.

Any behavioral treatment plan should specify the exact behavior that is “targeted” for improvement. The plan must say exactly what is to be reduced or eliminated. By the same token, the plan must say exactly what is to be taught in replacement of the “targeted” behavior. It is rarely helpful to tell a child what not to do; you always have to specify what he/she should do as well.

A treatment plan should explain exactly what the treatment provider should be doing to accomplish the replacement of the “target” behavior. A treatment provider should be able to look at the treatment plan and know precisely which techniques are to be used, how often and in which circumstances. When terms like “contingency contracting” are used, a glossary of terms that is accessible to the treatment provider is essential. How else can the treatment provider know exactly what to do?

A treatment plan should always contain a simple and easy means of measuring progress from the perspective of the treatment recipient, not the treatment provider. Outcome progress measurement should include a “baseline” measure, which is a starting point in the measurement of treatment outcomes that precedes the start of the treatment period. How else will you know how far you’ve come (or how far you’ve gone astray) if you don’t know where you started?

Treatment plans must include a planned stop date, so that the treatment team can prepare to present information to funding authorities prior to that date in order for funding to be continued. Continued funding is necessary and therefore justifiable whenever the child is within the age served by the funding entity, the treatment plan is working, but the work has not yet been satisfactorily completed.

All of the “treatment plans that worked” in this collection meet these standards, to a greater or lesser extent. They are all actual real-life plans written by many different authors at the Institute for Behavior Change between 2002 and the present date, so some variation in quality and effectiveness will be apparent — but they were all successful, nonetheless. Some corrections in the use of punctuation, grammar and formatting were made to improve the consistency of the plans in order to facilitate rapid comparison between plans. It is a good idea to look at several plans and take “the best ideas from all” in the process of creating a plan for any given child.  You can view the current list of Treatment Plans that Worked in the database here

Suggestions for improvement or corrections to the plans are always appreciated.  

Visit www.ibc-pa.org for more information.

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