MASTER TREATMENT PLAN #This is NOT the form you use to type into. #This is a crib sheet of instructions for filling out the report. #The form you actually fill out is called type_restraint.txt. #You can find it at: www.abrloggingandmining.com/forms/ #or maybe on your desktop. # If you are new to this process, you will find # lots of useful information to help you get your head # around it on the crib_aa.txt in the forms dir. # This version maps the governing # DFPS Rules 40 TAC 720.528 # to the MTP outline. # Note: The AA may be attached and included _by_reference_ # as part of the required diagnostic assessment. # Additional assessment data may be usefully included in # sections II, III and VI. # The 'assessment statement' for each domain in section V # may specifically reference that information -- eg see AA section IV. # Also, the section in this report MTP section VI.a. may contain # important assessment info that can be referenced for various # domains as appropriate. Using all the data available, # esp sections II and III here, various domains may need to # be reassessed. # - However, the main feature of section V. is to # list: # strengths # needs # actions (strategies and instructions). # - 'needs' may be better specified as long and short term goals. # - 'actions' consisting of 'strategies and instructions' may meet the Rules # You will have better management and accountability if # each short term goal and maybe some logterm goals (or 'needs') # have an 'action' with an indication of _byWho_ and _byWhen_. # # ####### # **NOTE!!: Section V Domains are strictly reserved # for information, needs, # interventions/actions _SPECIFIC_ to this child!! # Any needs or interventions _common_ to most ABR kids # should appear in Section VII. # - Section VII is strictly reserved for information that # would apply to most ABR kids. You may add any such generic # information to your Section VII as you wish. # If you have generic information you would like to see # permanently added to Section VII, please contact Doc or Wade. # ##### # # NOTE!!: You may copy the section V # from the PTP (or AA) as a starting point. # (On the PTP it is called section III). # HOWEVER: Do not think a simple copy will be satisfactory. # This MTP document will flow over for the Treatement Plan Reviews # and will be the major framework for managing and monitoring # this child's treatment at ABR. This document can be a tool for managing treatment # and for you to learn how to manage treatment. # It's function as paperwork to meet standards is purely coincidental. # What you do here can make a difference in a child's life. # Try not to think of the time you spend on this plan # as time "taken away" from your work with the kids; # instead realize that this can be time _dedicated_ # as a gift to a child. I. Vital Information: Name: DOB: Age: Sex: Race: SS#: Medicaid#: Parents: Rights: Date of admission: LOC: Date of Report: On ________ the ____________ cottage treatment team met to review and update this treatment plan. I.Y. Issues requested to be addressed in this meeting: Kid: PD: Others: # If other's have items to be addressed # say who requested which item. # Ideally when preparing the kid for the conference, and # it's good to prepare a kid for his first one, # you'll ask him what issues/questions he wants the meeting to be sure to cover. II. Progress to Date and Current Status a.) Resident's View (Subjective): b.) Staff View (Objective) - Course - Incidents - Restraints - Point Scores III. Additional History # If you don't know any additional history, say 'n/a' *IVa. Diagnoses (by Dr. Bates) *IVb. Current Medications V. Assessment and Interventions for Special Needs by Domain 528-2.a-f # !! This section is _strictly_ reserved for # individualized needs and interventions/actions # _specific_ to this child. # The wording in the DFPS Rule is: "special needs". # Needs and interventions/actions that would apply # to most ABR kids go in Section VII. # If you assessment of any domain does not identify # any _special_ needs for this individual in that domain, # that is perfectly legal. Not all kids have special # needs in all domains. # If you have a special need for which the appropriate action/intervention # is something that would apply to all ABR kids # (ie is described in the Section VII domain) # then just reference that here. # For instance, for a boy who has # good recreational skills but occasional asthma on exertion # you would say: # Need: Occasional shortness of breath on exertion, uses inhaler # Action:"All staff should be alert encouraging # this boy to use his inhaler if needed when exercising # Note: For now you can use: Action, Strategy, or Instruction as you wish # maybe later you'll improve accountability # by using just "Action"s each of # which will specify a "by who" and "by when". *a. Physical: # 'Physical' is for health issues residing in the the kid's body. # If it's in his mind (between his ears) it goes in Emotional Psychological # For instance, if he has a very small nose, it goes here. # If he worries about his small nose, it goes in Emotional,Psychological. Height: Weight: # Say where you got the Ht/Wt and when it was _measured_. Next Physical:_______ Next Dental:_________ Physical Stage of Adolescence: Pre Early Early/Middle Middle Late Assessment: Strengths: Special Needs: Actions: *b. Familial: # This section is for information about _people_ # in his family and the relationship between them and the kid. # How he _feels_ about them goes in Emotional, Psychological ... *c. Educational - IQ info - Grade Level - Academic testing levels (Reading, Math, Spelling) - Learning strengths or disabilities. - School history # You can usually find the above info in the # admission (or later) psychological evaluation. - Special Cottage Team interventions (if any): See Section VII. d. Educational. *d. Social/Behavioral # The DFPS Rules say that treatment plans must _include_ # an evaluation of the child in the social and behavioral "areas" # We include that evaluation here in one place under 'd' # because in order to assess 'social' one has to describe social _behavior_, # and because when describing 'behavior', one has to deal with the fact that # all human behavior occurs in the context of a relationship between # at least two people only one of whom need not be imaginary. # For instance, if we are talking about angry/aggressive _behavior_, # that belongs here and we want to know "aggressive toward who?" # and "aggressive in what kinds of situations?" # If you want to talk about 'feels angry', that goes in # the Psychological/Emotional domain below. *e. Psychological/Emotional # If it's between the kid's ears, it goes here. # Except: IQ, Academic Acheivement Level, Learning Disabilities # go in the Educational Domain. # Most kids have an admission psychological evaluation; # read it! Some of them are very useful. # To some extent this Psychological/Emotional domain # is where you can put it all together. # But you put it together from the point of # view of what ends up between the kids ears. # That is, you can talk about how his # family situation or health situation # affects his attitudes and you can talk about # how his attitudes affect how he gets along with people -- # but the family situation, health issues, and # how he gets along with people would all have been # described in their appropriate domains. # The key thing here is his attitudes and # how he puts together dealing # with those circumstances. f. Self-harm considerations (if applicable) g. Informational # This is where you assess the amount and quality # of the information you have # what important information is missing # and the plan to obtain it. # This section can be very helpful # in rescuing you from having to pretend # you know things you don't know and # from coming to bogus conclusions not # based on facts. # Thus on the next line we mean 'Assessement' of the _information_ # you have or don't. VI. Overview of Special Issues: *a. Assessment: # This is where you put it all together. # You may have done a lot of that in the Psychological/Emotional section # above. If so, you can reference that here and add anything else # you have to say about the overall treatment situation. *b. Goals for Treatment: # This item b. is reserved for goals special to this boy. # You can reference Section VII. Other Goals for Treatment # The Goals here may be more global and abstract than # the specific Section VIII Summary goals # that are culled out for folks to focus on. *c. Discharge Plan: *- Current Permancy Plan: - Recommended: - Predicted: *d. Estimated Length of Stay: - Recommended - Predicted e. Prognosis: *VII. Detailed Plan to address Other Needs: # This section is _strictly_ reserved for # information that except for a few variable dettails # would apply to most ABR kids. # For example, the statement: # "This child will received individual therapy every week # from Dr. Belagosi," would belong here # on the principle that statement would # apply to all ABR kids with minor variations in the details # 'once a week' and 'Dr. Belagosi'. # On the outline, variable details are denoted by '_____' which you must replace. # For your convenience, this section may be extracted from the PTP # and used as is with minor modifications of the variable details. i. Domains 0. Informational Need: Other than specified above, no additional information is required at this time. Plan: Additional information will be sought as required. a. Physical Needs & Goals 1. Continue to take all medications as prescribed 2. Learn and practice good hygiene 3. Eat healthy portions of a balanced diet Strategies & Staff Instructions The cottage counselors should provide this client with a healthy diet and the opportunity for daily physical exercise. Counselors should follow the normal routine for his medical and dental needs. The staff will assist this client in developing good hygiene practices and ensure that he has everything needed to care for himself. b. Family Section Familial Needs & Goals 1. Learn to respect authority in a family setting 2.Work through emotional issues regarding his experiences with his biological family 3.Learn to compromise and cooperate with others around him Strategies & Staff Instructions This client should be subjected to a family atmosphere with clear structure and rules. Positive role models in the cottage and individual therapy sessions with his therapists will help this client identify and address the areas in which he struggles. The client will have an opportunity at the cottage to learn his role in a family setting and develop coping skills to use when he is frustrated with his family. c. Educational/Vocational This client is being recommended for Charter school. He attends special education classes. 1School personnel will encourage an interest in school and assist this client in planning his educational future, Monitoring and assessment will be done by consulting professionals in order to ensure this client's success. He will also be presented with options for post-graduation plans and alternatives for continued education. Educational/Vocational Needs & Goals 1. Practice challenging himself to increase confidence in school. 2. Resist negative attention that pulls him off task in the classroom. 3. Take advantage of teachers assistance when presented with areas that he does not understand Strategies & Staff Instructions School personnel will encourage an interest in school and assist this client in planning his educational future, Monitoring and assessment will be done by consulting professionals in order to ensure this client's success. This client will also be presented with options for post-graduation plans and alternatives for continued education. d.) Social/Behavioral - Social Needs & Goals 1. Develop positive social skills. 2. learn to be tolerant of others 3. Develop ways to manage anger that are socially acceptable. Strategies & Staff Instructions This client needs to be included in all age-appropriate recreational groups and therapeutic activities. Consistent rules and respect for authority figures should be reinforced. Recreation 1. Increase motor skills/hand eye coordination 2. Build self-esteem/self confidence 3. Educational/increase knowledge 4. Increase communication skills 5. Outlet for displayed anger & aggression 6. Build trust in others/integrity 7. Specific Recreation Target Goal 8. Promote teamwork/cooperation/sharing 9. Positive peer interaction/social skills 10. Promote development of interpersonal skills 11 Promote physical fitness/maintain health 12. Relationship builder/allows bonding 13. Decrease anxiety/anxious feelings - Recreational / Leisure Needs & Goals 1. Show age appropriate behaviors. 2. Demonstrate respect for staff and peers. 3. Improve social interaction with peers. Recreational/Leisure Strategies & Staff Instructions this client needs to be included in all age-appropriate recreational groups and therapeutic activities. Consistent rules and respect for authority figures should be reinforced. this client will be encouraged to engage in group and individual activities and therapeutic games. Staff will monitor this client for delinquent behavior and allow him opportunities to participate in experiential trips when his behavior warrants. Spiritual/Moral Section - Spiritual/Moral Needs and Goals 1. Begin to recognize the spiritual aspects of life. 2. Understand the connection between spirituality and moral issues. 3. Begin to address the most basic spiritual issues. Spiritual / Moral Strategies and Staff Instructions Staff should be available to answer any questions that this client may have regarding spiritual matters or be able to direct him to someone that can. Staff should encourage this client to live a life that has high moral character. - Behavioral Section Staff will utilize behavior modification in the cottage along with consistent structure in order to assist this client in learning more positive behaviors and reactions. The PAPH certified physical restraint will be used if this client becomes a danger to himself or others. Identify and address depression, low self-esteem, verbal aggression, low frustration tolerance, and defiant attitude. Address as needed in counseling appropriate anger management skills and appropriate peer relations, as well as assisting him with learning advanced social skills. Behavioral Needs & Goals 1. Improve responses to authority figures. 2. Increase coping skills by communicating thoughts and feelings before they overwhelm him. 3. Utilize opportunities for time outs to think about his response before acting. Behavioral Strategies & Staff Instructions This client will require behavior modification, applied by the counselors, to reduce his maladaptive behaviors. Individual therapy sessions with on reality techniques and consequences. this client should be monitored for depression, low self-esteem, verbal aggression, low frustration tolerance, and defiant attitude, suicidal ideation, physical aggression, affect, property destruction, and anger outbursts. If this client is considered to be a danger to himself or others, a PAPH certified physical restraint will be necessary. Staff will model appropriate behavior for Brandon. The staff will take Brandon to all scheduled appointments. The staff will help Brandon use his coping skills to help him reach the goals that he help set for himself during the Treatment team review. The staff will encourage Brandon to want to work on his goals and help him understand the purpose of setting and achieving goals. e.) Emotional/Psychological This client will be seen on an individual basis with ______ frequency by his therapist, _______,, because of his LOC being _________. He will also participate in the Azleway substance abuse program(ASAP) if indicated. Staff will provide a structured, supportive environment which will allow time to deal with his problems in a safe, healthy manner. Justin will utilize the coping skills he came up with during the treatment team meeting. Emotional / Psychological Needs & Goals 1. Provide a consistent daily structure to allow this client to gain greater success meeting his daily goals 2. Develop positive pro social skills. 3. Increase communication skills to help this client reduce anger and anxiety. Strategies & Staff Instructions This client will receive counseling regarding the problems related to his biological family, his maladaptive behaviors and his emotions. This client should be included in cottage group therapy, conducted by his therapist and counselors, as well as, individual therapy dealing with his other problems. Positive role models and consistent authority in the cottage and school will help this client develop trust and facilitate his bonding with others. He should be monitored by all staff for any depression, low self-esteem, verbal aggression, low frustration tolerance, and defiant attitude, suicidal ideation, physical aggression, flat affect, property destruction, and anger outbursts. ii. Other Goals for Treatment Short Range: The staff will assist this client in adjusting to cottage life and will formulate a treatment plan describing the child's initial needs and the plan of action that will be utilized in order to care for the child. This client will also engage in counseling, and will undergo an assessment by consulting professionals. Staff will encourage involvement in recreational activities, and will evaluate the child's behavior for the continued necessity of psychotropic medication. Contact will be made with TDFPS, and an ARD assessment will be needed to determine placement in school. The school administrator will also acquire the child's last IEP to assist with educational assessment and placement in the appropriate classes. this client will be offered the chance to become stable in the RTC placement so that he can begin to make plans for a transition to moving toward and appropriate permancy plan. Long Range: This Client will be encouraged and assisted in completing the prescribed goals in school. Staff will provide a structured, supportive environment which will allow his intellectual abilities to flourish, allowing time for him to learn new skills so This Client will have an opportunity to deal with his problems in a safe, healthy manner. This Client will also be encouraged to address, in therapy, the breakdown of his biological home, as well as, his issues with his biological parents. Staff will also assist the child in addressing, in therapy, any issues with poor coping skills, problems with authority, impulse control issues, assaultive behaviors, and anger outbursts including any history of physical aggression, fighting, defiant behavior, suicidal ideations, and lack of insight. Upon successful completion of the RtC program, arrangements will be made to effect the appropriate discharge plan. VIII. Summary # You may omit this section if # tpr conference has not established # specific goals and coping mechanisms # as per Dr. Bates a.) Goals of Special Interest # These are not the Goals of Treatment as in Sections V. or VII. # Instead they are specifically assigned child-centered goals of special interest. b.) Coping-Skills