Sample Individual Treatment Plan Page 4
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Time Frame
Type of Service
Frequency
Persons
Goals, Objectives and Strategies
Nec
Responsible
Y/N
Goal #3A: Making friends who don’t use (Use of drugs
Yes
Goal #3A By
Resource
Goal #3A:
Goal #3A: Tony
and alcohol, social functioning and leisure)
Or
1/3/05
acquisition
Weekly 1 to 1’s
and Best
Objective: I will make a new acquaintance who I can
Best
(where to go to meet
and weekly
ARMHS
call
ARM
people)
groups with Best
Staff
A friend and will tell his/her name and social contact to
my ARMHS worker.
HS
ARMHS staff
Strategies: I will make a list of places to go where I can
specializing in
XYZ CSP
have fun without using. I can ask other members of
socialization and
XYZ CSP. I can call AA. I can attend “African
interpersonal
African American Perspectives on Mental Health
Group” and talk about it with other young guys,
communication
I can go to the drop in center. I can volunteer. I can
ask people at church what they do.
Yes for
Goal 3B: 180 days
MI/CD group at
Goal #3B: Weekly
Tony and
Goal #3B: Standing up for myself and not let others take
Best
with no use or
Best ARMHS
MI/CD groups at
ARMHS staff,
Advantage of me. (Use of drugs and alcohol, social
functioning)
ARM
approximately
Best ARMHS
Objective: I will not use any drugs or alcohol for the
HS
through 1/3/05.
XYZ assertiveness
Weekly 1 to 1’s
next six months reported weekly by me, my family,
group
with ARMHS
XYZ CSP staff weekly to my ARMHS worker.
Reported weekly
staff.
Strategies: I sill say “no” to others who use drugs or ask
me to do things I feel are wrong. I will role play with
to ARMHS staff.
AA group
staff. I will talk about difficult situations with
participation
XYZ CSP
XYZ CSP staff
with staff. I will try AA and go to the MI/CD class at
program group
and my family
Best ARMHS. I will participate in Assertiveness
Community
weekly
Group at XYZ CSP.
intervention with
brother and as
needed
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