15 -Treatment Planning Using the CASSP
Addiction Counselor Exam Review

 
 
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WRITING EFFECTIVE TREATMENT PLANS:
The Pennsylvania CASSP Model
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP
Executive Director: AllCEUs.com
Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery and Addiction Counselor Exam Review
Objectives
• Learn the principles of the CASSP model
• Review the difference between goals, objectives and interventions
• Identify qualities of good goals, objectives and interventions

• Services are planned to meet the individual needs of the child, rather than to fit the child into an existing service.
• Services
• Consider the child’s family and community contexts
• What resources are available
• What are their capabilities and needs
• Are developmentally appropriate and child- specific (not little adults)
• Build on the strengths of the child and family to meet the mental health, social, and physical needs of the child.

• Services recognize that family is the child’s primary support system
• The family is a full partner in all stages of the decision-making and treatment planning process, including implementation, monitoring, and evaluation.
• A family may include biological, adoptive, and foster parents, siblings, grandparents and other relatives, and other adults committed to the child.
• Examine the people with whom the youth spends the most time. (runaways/homeless youth; youth in boarding school)
• What is the family’s perception of:
• Functioning
• Strengths
• Priorities
• Cultural values

• Whenever possible, services are delivered in the child’s home community, drawing on formal and informal resources to promote the child’s successful participation in the community.
• Community resources include not only mental health professionals and provider agencies, but also social, religious, and cultural organization and other natural community support networks

• Services are planned in collaboration with all the child-serving systems involved in the child’s life.
• Representatives from all these systems and the family collaborate to
• Define the goals with the child
• Develop a service plan
• Develop the necessary resources to implement the plan
• Provide appropriate support to the child and family
• Evaluate progress.

• Culture determines our world view and provides a general design for living and patterns for interpreting reality that are reflected in our behavior.
• Services that are culturally competent are provided by individuals who have the skills to recognize and respect the behavior, ideas, attitudes, values, beliefs, customs, language, rituals, ceremonies, and practices characteristic of a particular group of people.
• Questions that must be answered
• What is the view of the child in this culture?
• What are cultural expectations for functioning in this area?
• What is the cultural perception for need for help and who from?
• What are cultural strengths that can be capitalized on?
• What does the culture perceive as the child and family’s strengths?

• Services take place in settings that are the
• most appropriate and natural for the child
• and family and are the least restrictive and
• intrusive available to meet the needs of the
• child and family.

Treatment Plan Characteristics
• An effective treatment plan should be both informative and practical.
• A person reading a treatment plan should be able to grasp the major concerns and how they are being addressed.
• The initial treatment plan identifies the work to be done.
• Subsequent treatment plans identify
• what is currently being done
• what has recently been achieved,
• work and services planned for the future.
• By defining goals and objectives which can be monitored, the treatment plan becomes an instrument of accountability.
• Identified goals, objectives and outcomes can be actively tracked by the team, and modifications in treatment made as needed.

Components
• Brief Description of the Child
• Tony is a thirteen-year-old Caucasian male living with his mother and four sisters in a three bedroom mobile home. Tony is currently in the seventh grade and attends special classes for reading. Tony has been referred to counseling on multiple occasions for behavioral issues at school but has yet to keep an appointment; he says, “Counseling is dumb, and school is useless.”

Components cont…
• Needs, Concerns and Problems
• Identifies why the child was referred to the service and includes reasons for intervention.
• Likelihood of failure as evidenced by…
• *Major depression as evidenced by…
• Incorporates the child’s and family’s perception of the needs and concerns.
• Specific targets for intervention are clearly stated and prioritized.
• Forms the basis for the specific intervention
• Problems not related to the reason for referral should be omitted
• Tony was referred to treatment to help increase his chances of school success. Tony is frequently truant and in danger of failing. Tony’s mother is also concerned that Tony doesn’t come home in the evenings until after midnight. Tony expresses no interest in school and feels school activities aren’t relevant to him

Components cont…
• Child and Family Strengths
• Areas of strength might include
• Interests (e.g., sports, music, extended family)
• Abilities (art, listening skills, making new friends)
• Activities (hunting, church, family reunions)
• Capacities (empathy, pride)
• Note: Avoid including “disguised weaknesses” such as “performs well if highly supervised.”
• Tony is interested in rap music ( Snoop Doggy Dog), motorcycles (Harleys) and social injustice. He relates to older adult males, and participates in activities with his sisters. He writes rap lyrics, makes friends easily (both male and female), and knows how to relate to the opposite gender. Tony’s family members look out for each other and defend each other in public. Tony’s mother is interested in her children graduating from high school.

Components cont…
• Statement of Goals and Objectives
• A goal is a global statement that (SMART)
• Reflects a positive resolution to the identified need or problem
• Indicates the specific area of functioning to be addressed
• Includes an outcome measure or expectation

Goals
• What the person wants to achieve stated in positive, observable, measurable, achievable terms
• Will be nicotine free and have identified 3 other strategies for dealing with stress and boredom within 3 months
• Not: Will quit smoking
• Will be happier as evidenced by a rating of a 3 or better on a 5 point scale of happiness at least 80% of the time (use an anchored Likert Scale) within 2 months.
• Not will stop being depressed
• Will be calmer and more self confident as evidenced by getting at least 7 hours of quality sleep at least 6 nights/week, a rating of a 3 or better on a 5 point scale of contentment at least 70% of the time from both client and significant other within 1 month.
Components cont…
• Statement of Goals and Objectives
• An objective (short-term goal) is directly related to a specified goal but highly specific and reflecting small attainable steps toward a goal. (Like a recipe)
• Critical components of goals and objectives are that both the child and family want the goal/objective attained
• Goals and objectives must clearly relate to the needs and priorities agreed upon by the team and identified in the treatment plan.

Objectives
• Identifies steps toward achieving the goals in positive, observable, measurable, achievable terms
• Only one outcome per objective (Hint: Use Excel)
• Uses client’s current strengths to help achieve goals (Mind-map on a whiteboard)
• Nicotine free
• Remove nicotine products from house
• Identify a triggers for use
• Identify 3 alternative behaviors for each trigger
• Identify ways to deal with cravings

Components cont…
• Statement of Goals and Objectives cont.…
• A goal might be the completion of seventh grade.
• The objectives could include:
• Attendance in class at least 95% of the time
• Completion of homework at least 95% of the time
• Appropriate classroom behavior 98% of the time
• Passing tests with a C or better 90% of the time
• Measurable objectives ensure that each child has an individualized treatment plan.
• Measurable objectives convey to all persons on the team the same expectation and approach to the behavior being changed.
• Measurable objectives determine what approaches are used and their effectiveness i.e. the success of the interventions.

Components cont…
• Methods and Interventions
• Descriptive statements of treatment that specify
• Who
• What in observable terms.
• Where
• When
• How often
• Staff, child, and family responsibilities and activities are clearly stated and the identified strengths are used to obtain the objectives.

Example 1
• A goal might be the completion of seventh grade.
• The objective is:
• Passing tests with a C or better 90% of the time
• Interventions
• Tony will keep a log of his homework assignments daily beginning Monday.
• Tony will bring home all relevant materials for study daily beginning Monday
• Tony will begin his homework by 6pm daily beginning Monday.
• Tony’s mother will prompt him to start and encourage him to stay focused
• Tony will write (or find) rap lyrics to help him learn his material (maybe even teach the class a song)
• Tony will mark with a yellow highlighter areas he is struggling with
• Tony will meet with his teachers after school to get questions answered beginning Monday and teachers will initial next to the highlighted areas when Tony has developed an understanding of the concept (Tony can ride the late bus home)

Example
• Nicotine free (Goal)
• Remove all nicotine from house (Objective)
• Sally will go through the house and car and discard all nicotine products within 3 days
• Sally will clean the car and house cleaning everything that smells like smoke within 14 days
• Identify a 35 triggers for use
• Sally will make a list of the top 5 sights, sounds, smells, tastes, feelings, activities and times that trigger her to want to use within 7 days and will add to it as necessary
• Identify 3 ways of coping with each trigger
• Sally will make a list of 3 ways of coping with each trigger within 7 days
• Sally will keep an emergency card in her wallet with those 3 strategies within 7 days
• Identify 3 ways to deal with cravings/urges
• Sally will make an appointment to get smoking cessation meds from her doctor within 14 days
• Sally’s therapist will give her a handout on distress tolerance skills today
• Sally will make a list of distress tolerance skills she can use to urge surf within 14 days
• Identify at least 2 vulnerabilities that make her more likely to be triggered
• Sally will keep a mindfulness journal for 30 days, noting her mood, diet, sleep, exercise and the weather to identify things that make her more vulnerable to stress beginning today
Example 3
• To Feel Calmer
• Identify 10 sources of stress/anxiety
• June will make a list of the top 10 things that cause her anxiety by 3/2
• June will identify what parts of each of those things she can control and which parts she cannot. By 3/2
• Identify at least 6 ways to deal with anxiety
• To feel calmer, June will process that list with her therapist on 3/2
• June’s therapist will help her identify unhelpful thoughts that keep her stuck using the Challenging Questions Worksheet on 3/2
• June will identify at least 5 ways she has successfully dealt with anxiety in the past by 3/2
• June will create an emergency card to keep in her wallet with 3 coping strategies by 3/2

Summary
• Treatment plans are like recipes
• Goals must be stated in positive terms (what are you going to achieve (make)
• Objectives are like the steps in a recipe.
• Objectives identify what each step is (combine all wet ingredients)
• Interventions identify who, what, when, where, why, how and how often something is to be done (1/2 t. vanilla, 3 eggs, ½ c. milk, ¼ c. coconut oil and blend on medium for 1 minute)
• Goals, objectives and interventions must be specific, observable, measurable, achievable, time limited and clearly related to the overall goal for treatment