Every three months Sadie and I have to update my treatment plan. The first page reviews progress made since the previous treatment plan was created, and addresses strengths, needs, abilities, and preferences (SNAP). It lists the members of my treatment team and any “natural supports” – people in my life who are helpful to my recovery. The rest of the plan consists of overall goals and any smaller objectives within those goals. Each goal is tied to a problem identified on the Adult Needs and Strengths Assessment (ANSA) which is updated every 6 months. Each objective within a goal contains criteria for identifying when it is completed, a target date, and any interventions that will be provided by the therapist or other staff.
My treatment plans have varied widely. They used to be crammed full of objectives that we sometimes never worked on, but they were there in case I wanted to work on them. The benefit to this is that Sadie’s paperwork for each appointment (a Service Activity Record or SAR) requires that she choose a goal or goals from my treatment plan that we addressed during that appointment. I’ve experienced firsthand the struggle to choose something relevant to the actual work, so I like to ensure that she has several choices and/or sufficiently vague goals that can apply to anything we do.
My last treatment plan had only one goal, pertaining to interpersonal problems. It was about setting healthy boundaries. We kept that as an objective, and incorporated another objective, with the goal of “have more realistic interpretations of other people’s comments”. One of my major struggles in relationships is that I get disproportionately upset by things people say (particularly with my mother), so I am aiming to tone down my reactions. The completion criterion here is to complete at least one thought diary per week. We made it a small goal because sometimes I struggle with the longer thought diaries, but there are also forms that do a quick mini version where you can log several different thoughts on the same form. I plan to keep one of those handy and fill it in as often as possible.
The next goal, pertaining to depression, is to “work on accepting imperfection”. The material from which the thought diary form comes also contains a series of modules on Perfectionism in Perspective, so Sadie and I plan to work through these modules together. The final goal, pertaining to self-care, is to “explore Buddhism”. I have committed to reading at least one book per month on the subject, although knowing me it will be a lot more. I’m starting with Buddhism for Dummies, which is probably not the most enlightening book option, but gives a thorough overview and suggestions for additional reading, which I can use to help me figure out where I want to look next.
I feel better about this treatment plan than the last one, as the things I’m trying to accomplish are more concretely measurable. I like to be able to check things off a list, and these are all things I can check off if I work hard.