What Is a Treatment Plan in Therapy?

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In therapy, a treatment plan refers to the specific goals you have for therapy and interventions your therapist might use to help you reach these goals. Typically, a treatment plan is created early on in the therapeutic process, and it serves as a guideline to drive your sessions in a way that fits with what you hope to achieve.

Treatment plans are usually updated on a regular basis, often every six months or so, to allow for changes in your priorities and to reflect on the progress you have made.

If something in your life shifts, you and your therapist do not have to wait. Your treatment plan can change as needed in order to continue serving your needs.

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How Is a Treatment Plan Developed?

A treatment plan is often discussed in the first therapy session or a session early in therapy. A common question your therapist will ask you is some variation of, “What do you hope to get out of coming to therapy?” They might also ask something like, “What are your goals for treatment?” or “How would you know things have improved?”

Often, people go to therapy because they have a sense that something is wrong with them even if they do not have the ability to articulate what it is or how to fix it.

Remember that a therapist is an expert on their specific treatment approach, but you are the expert on yourself. Your therapist relies on you to tell them your history, symptoms, and needs, and you can share what your priorities are in treatment.

Sometimes people are so used to their depression, anxiety, or intrusive thoughts that they do not realize that these symptoms are impacting their well-being, relationships, or daily functioning.

Your therapist might make connections that you did not see and have ideas about your treatment plan based on these observations. This collaborative approach to developing the treatment plan can ensure that you make progress in therapy.

If your therapist suggests something that feels uncomfortable to you, it is OK to let them know. Your therapist can either address your concerns by answering questions that you have, or they can choose an intervention that is a better fit for you.

Therapy is sometimes uncomfortable, and so your therapist might encourage you to try something even if you feel uncertain. If you have good rapport and trust with your therapist, you can work through your discomfort together. However, it is also OK to say “No” to something your therapist suggests if you are not ready or do not feel that it is right for you.

Types of Treatment Plans

Each treatment plan is unique and based on the individual’s symptoms, needs, and goals. However, your therapist might choose interventions informed by their theoretical orientation. When finding a therapist, you can ask about their approach to treatment and what kinds of things they prioritize in the treatment plan.

Typically, a treatment plan will include goals you want to achieve through therapy as well as specific interventions that your therapist might utilize to help you achieve those goals. Some examples of how a therapist might approach selecting interventions for your treatment plan include:

• Cognitive Behavioral Therapy: A therapist using this approach wants to help you discover how your thoughts, emotions, and behaviors interact. They might suggest goals related to identifying harmful or false thoughts and replacing them with helpful, true thoughts.
• Psychodynamic Therapy: A psychodynamic therapist explores the patterns in your life and helps you find the root emotional causes of these patterns. They might ask you to explore connections between various events.
• Narrative Therapy: Therapists with a narrative approach conceptualize people’s stories to help clients become their own experts and develop a deeper sense of self-understanding.
• Strengths-Based Therapy: A strengths-based therapist wants to teach you to identify your own strengths and maximize their impact on your life. They believe you already have strengths within yourself and want to help you recognize them.

Treatment Goals

Treatment goals can be just about anything that you want to achieve through therapy. They must be things that a therapist can help you with, and they can evolve over time. Many therapists use the SMART goal model, creating therapy goals that are:

• Specific: What exactly are you trying to gain from treatment? What does “better” look like for you?
• Measurable: How can you track that you are making progress toward this goal?
• Attainable: Is this a reasonable, doable goal?
• Relevant: Is this goal relevant to your reasons for coming to treatment?
• Time-limited: What is your timeline for achieving this goal?

Some examples of treatment goals might be:

• A teen whose parents are concerned about their mental health might be unsure about participating in therapy, so the therapist may make it a goal to build rapport and develop trust with the client.
• Someone struggling to feel safe leaving their home might have a goal to be able to visit a friend who lives in the next town.
• A couple might want to develop healthy communication skills.
• Someone engaging in self-harm behavior might want to learn how to stop or address the underlying problems contributing to the behavior.
• Someone with a trauma history might want to be better able to tolerate triggers or experience fewer flashbacks of what happened to them.

There is no one “right” goal to have when you enter therapy, and your therapist can help you decide what goals will benefit you and improve your life.

When to Update a Treatment Plan

Many therapists update clients’ treatment plans about once every six months. This allows enough time for the client to make progress in their goals and gain insight into what changes they want to see in their lives.

However, you do not have to wait, and you and your therapist can update your treatment plan at other times as well.

If you experience a relapse, or your symptoms worsen, you might need to shift your goals to reflect how your needs have changed. If you experience a traumatic event or personal crisis, it might require a more immediate focus in your therapy than previous goals.

You might also notice that you have achieved one or more of your treatment goals, and you might want to talk to your therapist about focusing on another area of your mental health. Similarly, if your therapist notices that you have made significant progress in one area, they might ask if you are ready to adjust your treatment plan.

Treatment plans are an important part of the therapeutic process. They inform your treatment and allow you and your therapist to work together and help you reach your mental health goals.

By Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

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