Do therapists actually make treatment plans?

Neither of mine has ever really given me a treatment plan, though it's mentioned in their contracts. They did each give me a vague outline of how they hoped things would go at the beginning. This was OK with me at the time because it sort of fit my circumstances as a client (difficulty talking, nature of issues that brought me to therapy, medication not involved, etc.).

The lack of a plan is starting to get on my nerves, though, as it feels things become less and less focussed in therapy. I'm planning to press the issue (not necessarily to get a plan, but at least to deal with the lack of focus) with each of them next week, but to help me figure out how to approach the subject, I wonder about treatment plans: did you receive one or not? if you did, did you and your therapist adhere to it? discuss it whenever change might be warranted? if you didn't get a plan, why not? and do you prefer therapy with or without a plan?

Neither of the ones I see has ever mentioned such a thing. The first denied having any sort of structure or plan at all.

I have no plan. I would not want a plan, I'm happy doing open ended therapy like this.

Never heard of treatment plans outside of treatment centres. They don't work. They're someone else vision of what will work. If you then 'fail' it's all down to you. It's a trap. Set to fail to keep the - whatever it's is - going. Revolving door.

Treatment plan

Get better( very vague, open ended and subjective)

Stay out of hospital ( goal oriented)

With my current therapist there is a treatment plan which I get to look over and sign. I think they are mostly done for insurance because we never seem to have a plan for anything. It is just me sharing what is going on that week. I wish it was more working toward goals but it isn't.

I think he might like to have a treatment plan, but other more important things get in the way.

My T has a plan for me but it's not concrete and it's always changing.

We have never discussed it. Although I suspect she has one for my insurance company.

I have a treatment plan although it's vague.

I think this also depends on the approach they are using. For example, therapists who provide more short-term, goal-oriented treatment (eg. CBT) are more likely to make a plan and then evaluate the progress. Mine is psychoanalytical and while we did talk about my primary reasons for coming to therapy and goals in the beginning, it's much more a gigantic free drifting through time and space -- what they call free association and I find it comes the most naturally for me. I do bring up the original goals every now and then and what I am trying to do to work towards them in everyday life, and then we discuss that.

Generally, I very much enjoy this freedom, but do get a bit concerned sometimes that we just keep adding more topics and angles and perhaps the main goals may get lost and I get too distracted. However, with more time I'm now finding that things tend to pull together especially with repetitions (coming back to the same issues) and I feel it's an effective way to actually find other points of focus and areas that may need work but I was not aware of that initially. I think this allows a much greater depth and breadth of work than something where a few goals are sharply defined, the process is planned, and is followed through according to a plan. It will inevitably take more time and money, but I feel that especially for a person like myself (who loves to dig deeply into things and understand thoroughly) it's probably the most suitable format. I tend to be a good planner and a strategical person in my life and quite independent, so I don't mind that there aren't strict plans and expectations imposed on me externally and I'm also free to create how I use my therapy experience.

I think the lightbulb has to want to change. Otherwise the plan is moot.

Eta - just occurred to me - the new mercury lightbulbs go a verrrrrry long time before changing

Neither of mine take insurance, yet they state there will be a plan...so that is not the reason for the lack of a plan. Therapists in my state can be disciplined for not having a treatment plan, perhaps it's also in the APA regulations.

I am a light bulb that wants to change, believe me, but if I could have done it without therapy, I would have. But I'm also not in good enough shape physically or emotionally these days to correct the increasing lack of focus (which is much as Xynesthesia describes, just adding topics and angles that are distracting) on my own; they're going to need to help me out.

Oh, and this whole conversation just reminded me of a line from "Ninotchka" (Greta Garbo as a humorless loyal Soviet who visits Paris and attracts a decadent Parisian):

Besmitten Parisian: Oh, a Russian! I love Russians! Comrade...I've been fascinated by your five-year plan for the last fifteen years!

No plan that I know of. I'd hate it if there were one.

The only official treatment plan I was ever aware of was in the hospital with my pdoc which was an insurance requirement.

With my current therapist yes a treatment plan was made at the start. Though naturally said treatment plan has had to be modified as my therapist and myself have gotten to know each other better, and to fit my life circumstances now which were rather different when I started my work with her back in March.

However, most of the therapists I've seen before with the exception of one did not create a treatment plan, or do any goal setting, or anything. I am the type of person who likes having a plan in place even though it'll inevitably need modifying later on, I require the structure as a person with Schizophrenia. I think I just had a bad run of therapists. Finding my current therapist has been a huge gift that I am quite grateful for.

Never had a plan with any of my therapists. I was required to sign a plan when in PHP but it was so vague it was useless really.

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Our couples counselor suggested she had an 'outline' in the first session. I'm not sure what's happened to that. We've had some big issues pop up since then and maybe we all realized it was going to be a lot more work than we first thought.

Treatment plans in hospitals are pretty worthless. At least they are where I live now. The practically kick you out the door before the inks dry. They certainly don't keep people long enough to see if the meds are working or what averse side effects might happen. Years ago they had treatment plans like; you will go to one group today. You will get dressed everyday, you will take a shower at least once in 48 hours, you will go to bed and try to sleep,,,,, etc....

Now days they never know if a group will happen or not, they don't have the staff to care if someone showers unless it's really bad. They just hold their noises and avoid anyone they don't want to interact with. Unless of course they decide to handle it with a take down , which they seem to get a lot of pleasure and excitement from!

Yeah I don't much care for hospitals.

A better place to start would be to think about what your goals are vs. The therapist determining what your treatment should look like. You pay them for a service. It's about what you want to get out of it.

Honestly, I think it might be required by some insurance companies, so the therapist sort of says it because of that, even if it's not required by every person's insurance. I pay privately, but my therapist has some wording like that on her website and maybe even in the intake papers I filled out. She never brought it up and I never asked. The one before her had actual steps, but she didn't even follow those, so it was a meandering mess.

I do think there is an ever-evolving informal plan with my therapist that helps me know where things are going, but it develops as things happen with me and it's not something either of us feel a need to stick to. Underneath it all, though, there's definitely a trajectory that's been constant, so whatever she does, it works for me. I don't feel it's aimless or without intention, but it is definitely flexible and has lots of detours.

Oh, I have goals. Have since the beginning. They know what they are and I reiterate them frequently. I am not asking them to determine anything, but I want them to FOCUS.

I ask about the plan only because I'm trying to think of how best to talk to them about it. Although I'm also surprised by the poll results.

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my therapist did a treatment plan when I started counseling w her then she did two different treatment plans after she did a psychological evaluation on me . my old therapist didn't do a treatment plan for me to sign off from like my therapist now .she and I signed on the treatment plans for me after she read it to me and she made me look and read the treatment plans that she wrote up for me .






Diagnosis: Anxiety and depression
meds : Cymbalta 90mgs at night
Vistrail 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia

Here are some sample templates for treatment plans. I have never seen one from a private therapist - I see them all the time for my clients who are hospitalized. If this is what is meant for private therapy - I cannot at all see how such a thing would have ever been useful for me.
http://www.healthandwelfare.idaho.go...20Template.pdf

www.pent.ca.gov/frm/mentalhealthplan2.doc

How to Write a Treatment Plan for Mental Health | eHow