Client Service Plan – Noah and his Family
Problems Goals Objectives Intervention/Model/ Theory Clinical Skill/Practice Strategy Outcomes


Client Service Plan – Noah and his Family
Problems Goals Objectives Intervention/Model/ Theory Clinical Skill/Practice Strategy Outcomes
Depression, grief, stress-related symptoms resuting from the death of his cousin Provide a normative degree of resolutin for grief, resolve acute symptoms related to deth, cognitive appraisal of the death and further sense of danger Carefully review child’s understanding of circumstances of cousin’s death and exaggerated fears of his own danger, review time with Damon and develop a scrapbook together Cognitive therapy focused on resolving fears related to death and facilitiating grief: Introduce emotion identification and scaling, explore cognitive distortions Behavioral activation Mindful listening Engagement Decrease score on index of suicidal ideation and index of hopelessness
Shyness, social anxiety with kids at school Increase comfort level and improve socializiation skills to play after school for at least one hour Graduated objectives: measured from a few minutes up to 60 minutes in after school program; instructors record number of minutes Coping Skills to enhance relaxation through imagery and muscle relaxation, modeling and role playing of conversation and play; graduated exposure, contingency management with rewards for more playtime in afterschool program Explore core beliefs that trigger avoidant behavior Therapeutic alliance Mutual agreement Systems collaboration (school) Reframing Increase number of minutes playing with others in after school program from 0 to 10 to 20 to 40 then 60. Increase number of times he initiates conversation druing play from 0 to 4 Decrease SUDS (subjective units of distress scale) to below 5 when approaching other children
Moderate OCD symptoms, perfectionism, excessive organizing to get things just right, feelings of responsibility for external events Reduce expectations to be perfect: tolerate messiness with reduced anxiety and compulsive behaviors Graduated objectives: to reduce level of perfectionism with regard to tidying up room, homework, prayer by reducing amount of organizing to 1-2 mintues daily at the end of each task. In addition to coping skills, EXRP (exposure with response prevention) exercised early on until he can leave it alone, dailiy rewards for reducing organizing time Mindfulness – relabeling, reattributing, refocusing, revaluing Exploration Feedback Reinforcement Decrease number of minutes organizing at home and school from current rate to 5 then to 1-2 Level of subjective anxiety experienced if things are not perfect to under 5

Sample Skills

holding space
tolerating silence
tolerating strong emotion
expressing empathy
reflecting back/active listening
inspiring hope
being genuine
inspiring trust
expressing acceptance

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