NUMBER 1165 • 2 MAY • Treatment plans
A major purpose of treatment teams is developing and implementing a treatment plan for each child and his or her family. These plans, which include specific techniques, programs and/or strategies, guide day-to-day interactions.
Whenever possible, treatment plans and the techniques and strategies that make up the plans are developed by consensus. When consensus can’t be reached, the team leader makes a final de termination. In either case, team members try to support final decisions with equal vigor and consistency.
Treatment planning begins with the initial screening of a child and his or her family. All team members have a chance to consider the reference material and, if possible, visit or interview potential clients. If a child or family is accepted for treatment, the information gathered from this early review is used to prepare for the intake stage of treatment.
The treatment plan eventually addresses at least three stages of treatment-intake, middle, and discharge. The intake stage covers the initial adjustment to the program and, if the child is placed away from home, the initial separation from the parents or guardians and siblings. The middle stage of treatment is the period when the bulk of interacting, teaching, and relationship building takes place. The discharge stage covers the child’s reintegration to a normalized condition. Although plans correspond to these stages, team members are constantly aware that planning for discharge begins on the first day. Their goal is to reintegrate as soon as possible.
The plan includes written comments and assessments from all team members, with each member focusing on his or her area of expertise. The plan also has at least four parts: a section identifying client strengths and weaknesses; a section for setting treatment objectives; a section listing techniques, strategies, and programs for meeting the objectives; and a section for evaluating progress.
Each decision about what to include or exclude from the plan is carefully weighed. Diagnostic assessments are based on the observations of all team members, which are objectively and cautiously analyzed. Decisions about what treatment techniques to include are also weighed with care and concern. Will it have a good probability of working in the current environment? Can we consistently carry it out? Is it compatible with our relationships with the child and/or family? Are they capable of meeting our expectations?
Across-the-board remedies, group programs, and standardized procedures are instituted with caution. For example, group grooming programs, positive peer groups, or privilege or level systems are instituted only when each participant’s individual treatment plan indicates that this is a suitable route to take. Decisions about the color of bedspreads, the lighting in the dining room, bedtimes, tucking-ins, getting-ups, grilled cheese lunches, monopoly games, camping trips, and locations for family sessions are also individually tailored. In other words, everything possible is directed toward meeting clients’ needs as identified in their treatment plans. If compromises are made because of a shortage of resources or a group management priority, they are made with a full awareness of and sensitivity to the potential drawbacks to individualized treatment.
Whenever they are using a technique or group program to eliminate or reduce a behavior or method of expression, team members are also using techniques and/or programs to teach more productive behaviors. In using a particular technique or program, they also take care not to allow them to get between themselves and the children [Trieschman 1981]. They do things with children and families and conduct their interventions with the full knowledge that their effectiveness depends directly on the quality of their relationships.
Krueger. M. (1990). Child and Youth Care Organzation. In Krueger, M. and Powell, N. Choices in Caring: Contemporary approaches to Child and Youth Care Work. Washington DC: CWLA, pp.14-15