Effective Treatment

Planning
Principles of Patient Management
Treatment Planning
Is based on a number of important factors.
According to Beutler and Clarkin (1990),
Effective treatment is a consequence of a
sequence of fine-grained decisions about a
number of treatment variables that are linked
together and contribute to synergistically to
effective client change.
Treatment Planning
Includes the following:
Problem Selection
Problem Definition
Goal Development
Objective Construction
Intervention Creation
Problem Selection
Clinician determines most significant
problems on which to focus treatment
process.
Usually a primary problem will surface,
and secondary problems may be evident.
If clinician attempts to deal with too many
of the clients problems then treatment
may loose its direction.

Problem Definition
Problems will behaviorally reveal
themselves differently in each client.
Each problem will then require a specific
definition about how it is evidenced in the
particular client.
Caregiver must develop and follow a
process of gathering information so a
quality of plan of care can be developed
and implemented.
Major components of the process
include:
1. Examination of the client (gather
subjective and objective information)
Subjective Information: can be
obtained from interviews with the
patient, family members, relatives,
friends, or other caregivers
Objective Information: can be obtained
from medical records, observation and
specific tests and measures




Objective Information
o Observation of Clients should involve the ff:
General Appearance: body build, deformities or absent
of body parts
Skin Appearance/condition: color, lesions, scars and
texture
Standing and sitting posture
Ambulation
Mobility and flexibility: bending, reaching
Balance, stability, coordination, equilibrium and motor
control when sitting, standing etc
Application of assistive devices: orthosis/prosthesis




2. Evaluation of the information and data to make clinical
judgments and decisions
3. Postulation of the diagnosis and prognosis based on
result of evaluation
4. Developing of a plan of care (leads to short or long
term goals)
Identify and select the intervention activities and
techniques projected to be most effective to attain
functional outcome
Establish the sequence, frequency, and duration of the
plan
Consider termination of treatment, including the
development of a home treatment program if it becomes
necessary

Goals
Short-term (interim) goals
Preparatory component of
long-term goals
Lead-in activity for long-term
goal
Sequential activities that
produce cumulative effect
Support and promote
functional outcome

Long-term (Terminal) goals
Evolves from short-term goals
Describe maximal
performance or outcome
desired
Describe functional outcome
as a necessary component
May be revised or modified
based on clients progress/
performance

5. Implementation of the plan
Selection of intervention activities and techniques
best suited to attain desired functional outcomes
Revise or modify the plan depending on response of
progress of client
Evaluate and document the patients response
6. Termination of the plan
Evaluation to determine the need for further
treatment elsewhere
Instruct family members or SO and provide time for
them to practice
Provide written home program
Document the clients functional outcomes
Document the time and date for reevaluation must b
Goal Development
Set goals for the resolution of the target problem.
Short term / long-term goals that indicate a desired
positive outcome to the treatment procedures.

General Concepts
Objective terms are used
Should be SMART
S- Specific
M- Measurable
A- Attainable / Achievable
R- Realistic / Reliable / Result focus
T- Time Bounded

Objective Construction
Objectives must be stated in behaviorally
measurable language.
It must be made clear for the managed
care providers to see when the client has
achieved the established objectives.
Intervention Creation
Interventions are the actions of the caregiver
designed to help the client complete the
objectives.
There should be at least one intervention for
every objective.
If a client doesnt accomplish the objective after
the initial intervention, new interventions should
be added to the plan.
Interventions should be selected on the basis of
the clients needs and the clinicians ability to
provide the intervention necessary.