Treatment planning

A successful treatment plan is developed with three important factors in mind. The first two factors must be balanced. First, a successful treatment plan must be comprehensive in order to address important variables that will enhance or hinder behavior change. Second, a well-devised treatment plan must not be so complicated or overbearing as to overwhelm a client. Therefore, a skillful therapist 

Don t make the treatment plan so complex that it overwhelms the client. 

On the other hand, identifying problem areas allows for interventions to be devised to reduce or remove roadblocks to recovery. In a well-designed treatment plan, a problem area and its specific links with the drug use are identified and described. After the descriptive portion of the problem area, the treatment plan prescribes specific courses of action on the part of the client, with therapist or counselor support, to change the problem behavior. Problems areas may be biological, environmental, behavioral, cognitive, or emotional domains, or in some cases may represent complex combinations in more than one of these areas. 

Treatment Review Date Targeted Problems Progress and Changes in Plan  

Sometimes there are problems for which no empirically validated strategies exist. These situations challenge therapists and counselors to develop creative approaches to addressing unusual problems. On the one hand, it is very important to use an empirically validated approach to correct a problem if such an approach exists, because it makes little sense to reinvent the wheel when a radial tire may already be available to you. However, if the wheel has not been invented or tested, therapists and counselors still have to do something. 

An integral part of social work intervention with depressed clients is the inclusion of outcome measures that provide empirical data on changes in the reported symptoms and treatment effectiveness. Gathering empirical, objective data allows the social worker to evaluate the course of treatment, make changes in the treatment, and evaluate overall practice effectiveness (Dziegielewski Leon, 1998). Assessment instruments that provide baseline data and subsequent changes provide consistency for the entire interdisciplinary team. 

These scales provide objective clinical data on the existence of and changes in a client s depression. Social workers should become familiar in the use of such instruments and utilize them as pretests during the assessment phase and as posttests during different treatment intervals. 

Whenever a client shows depressive symptoms, it is critical that a thorough assessment for suicidal ideation and intent be made. Direct questions should always be asked to determine the client s potential for 

Develop the ability to recognize, accept, and cope with feelings of depression 

Alleviate or decrease depressed mood enough to return to previous level of functioning 

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Antineoplastic drugs are potentially toxic and their administration is often associated with many serious adverse reactions. At times, some of these adverse effects are allowed because the only alternative is to stop treatment of the malignancy. A treatment plan is developed that will prevent, lessen, or treat most or all of the symptoms of a specific adverse reaction. An example of prevention is giving an antiemetic before administering an antineoplastic drug known to cause severe nausea and vomiting. An example of treatment of the symptoms of an adverse reaction is the administration of an antiemetic and intravenous (IV) fluids and electrolytes when severe vomiting occurs. 

Multiple factors interact in complex ways to result in opioid dependence. It is difficult to delineate, even for a specific individual, the precise etiology of dependence. In addition, each of the etiologic factors discussed in this section may play variable roles in initiation of use, maintenance of use, relapse, and recovery. Keeping in mind all of these potential factors is essential when formulating a treatment plan for each individual. 

The installation of appropriate lighting should be considered part of the ceiling treatment. Planning for this is best left up to a specialist, who will see to it that work areas receive the proper amount of light from the right directions. 

Even with the intense involvement of the inpatient program and a carefully devised treatment plan, many drop out of outpatient treatment and return to drug use. Nevertheless, we have found various psychotherapeutic strategies and methods worthwhile. 

Identify populations requiring special consideration when designing a treatment plan. 

Therapeutic lifestyle modifications consisting of nonpharmacologic approaches to blood pressure reduction should be an active part of all treatment plans for patients with hypertension. The most widely studied interventions demonstrating effectiveness include ... 

What additional information do you need to know before creating a treatment plan for RS ... 

Develop a nonpharmacologic treatment plan which includes patient education for managing heart failure. 

Develop a specific evidence-based pharmacologic treatment plan for a patient with acute or chronic heart failure based on disease severity and symptoms. 

Acute and chronic treatment plans to address BE s symptoms and prevent disease deterioration. 

Develop a treatment plan to alleviate symptoms and maintain euvolemia with diuretics. Daily weights to assess fluid retention are recommended. 

What additional objective information do you need in order to create a treatment plan for this patient ... 

A major component of any IHD treatment plan is control of modifiable risk factors, including dyslipidemia, hypertension, and diabetes. Treatment strategies for dyslipidemia and hypertension in the patient with IHD are summarized in the following paragraphs. Visit chapters in this textbook on the management of hypertension and dyslipidemia for further information. 

Devise a pharmacotherapy treatment plan for a patient undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction given patient-specific data. 

Devise a pharmacotherapy and risk-factor modification treatment plan for secondary prevention of coronary heart disease events in a patient following myocardial infarction. 

Design individualized drug therapy treatment plans for patients with (1) sinus bradycardia (2) AV nodal blockade (3) AF (4) PSVT (5) VPDs (6) VT (including torsades de pointes) and (7) VF. 

Develop specific drug therapy monitoring plans for the treatment plan implemented. Monitoring includes assessment of symptoms, ECG, adverse effects of drugs, and potential drug interactions. 

Formulate an appropriate treatment plan for a patient who develops a deep vein... 

Design an appropriate treatment plan for KK. Your plan should include acute and chronic therapy—specify the drug(s), dose(s), route, frequency of administration, and duration of each therapy, as well monitoring parameters, patient education, and follow-up plan. 

Prepare a treatment plan with clearly defined outcome criteria for a hypovolemic shock patient that includes both fluid management and other pharmacologic therapy. 

Patients should play an active role in their therapy. The development of a health care provider-patient partnership is vital to the success of any treatment plan. Goals for asthma treatment should be shared with the patient and family, and the patient and health care provider should jointly agree on the patient s personal treatment goals. 

Patients must understand the role of long-term control and quick relief medications in their asthma treatment plan. The importance of understanding asthma as a chronic disease and the need for daily treatment with long-term control medications should be stressed. Additionally, the importance of proper use of medication delivery devices should be continually reinforced. Basic education should be provided over several visits with the health care provider. 

Outline a treatment plan for this patient that includes nonpharmacologic therapy, pharmacologic therapy, and a monitoring plan. Justify your therapeutic selections. 

Assess the patient s adherence to long-term control therapy. If the patient is non-adherent, stress the importance of adherence to this therapy. Evaluate the complexity of the patient s treatment plan and simplify it as much as possible. Determine whether the patient would benefit from an inhaled corticosteroid/inhaled long-acting p2-agonist combination product. 

Create a patient-specific drug treatment plan based on symptoms, severity, and location of ulcerative colitis or Crohn s disease. 

Construct a drug treatment plan based on the disease severity and location. Identify potential contraindications or financial barriers to drug therapy. Inquire if the patient has an aversion to or inability to properly use certain drug formulations that you may wish to recommend, such as topical (rectal) products. 

Develop a treatment plan with the patient and other health care professionals if appropriate. Choose therapeutic options based on the underlying cause of nausea and vomiting, duration and severity of symptoms, comor-bid conditions, medication allergies, presence of contraindications, risk of drug-drug interactions, and treatment adverse-effect profiles. 

Apply knowledge of the pathophysiology of acute renal failure to the development of a treatment plan. 

The ultimate outcome goal for any patient with epilepsy is elimination of all seizures without any adverse effects of the treatment. An effective treatment plan would allow the patient to pursue a normal lifestyle with complete control of seizures. Specifically, the treatment should enable the patient to drive, perform well in school, hold a reasonable job, and function effectively in the family and community. However, due to the intractability of the seizures or sensitivity to antiepileptic drugs (AEDs), many patients are not able to achieve these outcomes. In these cases, the goal of therapy is to provide a tolerable balance between reduced seizure severity and/or frequency and medication adverse effects that optimizes the individual s ability to have a lifestyle as nearly normal as possible. 

What additional information would you collect before creating this patient s treatment plan ... 

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