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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: PracticePlanners
- Sprache: Englisch
Guide to develop formal treatment plans for third-party payers and state and federal review agencies
Pressure from accrediting agencies and other outside parties has increased the need for clinicians to produce effective, high-quality treatment plans; Treatment Planners provide all the elements necessary to quickly and easily develop formal treatment plans that satisfy the needs of most third-party payers and state and federal review agencies. This second edition has been updated with new chapters and appendices, and enables readers to stimulate clinical thought to improve the quality and comprehensiveness of treatment plans, and to reduce the time involved in recordkeeping.
In this new edition, readers will find:
- New chapters on Anxiety, Attention-Deficit/Hyperactivity Disorder, Bipolar Disorder, Low Self-Esteem, Obsessive-Compulsive and related Disorders, Opioid Use Disorder, Panic Disorder/Agoraphobia, Sexual Promiscuity, Sleep Disturbance, Social Anxiety, and Specific Phobia
- New Objectives and Interventions consistent with identified evidence-based practices
- Integrated DSM-5 diagnostic labels and codes into the Diagnostic Suggestions section of each chapter
- More suggested homework assignments integrated into the Interventions
Treatment Planners help practitioners clarify, simplify, and accelerate the treatment planning process, so they spend less time on paperwork and more time with their clients.
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Veröffentlichungsjahr: 2025
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Table of Contents
COVER
TABLE OF CONTENTS
SERIES PAGE
TITLE PAGE
COPYRIGHT PAGE
DEDICATION PAGE
PREFACE
ACKNOWLEDGMENTS
ABOUT THE COMPANION WEBSITE
INTRODUCTION
ABOUT PRACTICE
PLANNERS
®
TREATMENT PLANNERS
ABOUT THIS SECOND EDITION OF
THE COLLEGE STUDENT COUNSELING TREATMENT PLANNER
HOW TO USE THIS TREATMENT PLANNER
A FINAL NOTE ON TAILORING THE TREATMENT PLAN TO THE CLIENT
REFERENCES AND FURTHER READING
SAMPLE TREATMENT PLAN
ANXIETY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSIS
ABUSIVE RELATIONSHIPS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ACADEMIC MAJOR SELECTION
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ACADEMIC UNDERACHIEVEMENT
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ANTISOCIAL BEHAVIOR
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ANXIETY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ATTENTION‐DEFICIT/HYPERACTIVITY DISORDER (ADHD) – ADULT
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
BIPOLAR DISORDER – DEPRESSION
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
BIPOLAR DISORDER – MANIA
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
CAREER CHOICE CONFUSION
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
CHILDHOOD TRAUMA
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
DEPRESSION – UNIPOLAR
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
DIVERSITY ACCEPTANCE
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
EATING DISORDERS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
FAMILY CONFLICT
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
FINANCIAL STRESS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
GRADUATION ANXIETY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
GRIEF/LOSS – UNRESOLVED
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
HOMESICKNESS/EMANCIPATION ISSUES
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
INTIMACY/COMMITMENT ISSUES
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
LEARNING/PHYSICAL DISABILITIES
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
LONELINESS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
LOW SELF‐ESTEEM
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
OBSESSIVE‐COMPULSIVE AND RELATED DISORDERS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
OPIOID USE DISORDER
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
PANIC DISORDER/AGORAPHOBIA
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
PREGNANCY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
PSYCHOTICISM
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
ROOMMATE CONFLICTS
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SELF‐HARM
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SEXUAL ABUSE VICTIM
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SEXUAL ASSAULT VICTIM
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SEXUAL ORIENTATION CONFUSION
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SEXUAL PROMISCUITY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SLEEP DISTURBANCE
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SOCIAL ANXIETY
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SPECIFIC PHOBIA
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SUBSTANCE USE
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
SUICIDAL IDEATION
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
TIME MANAGEMENT
BEHAVIORAL DEFINITIONS
LONG‐TERM GOALS
DIAGNOSTIC SUGGESTIONS
APPENDIX A: BIBLIOTHERAPY SUGGESTIONS
GENERAL
ABUSIVE RELATIONSHIPS
ACADEMIC MAJOR SELECTION
ACADEMIC UNDERACHIEVEMENT
ANTISOCIAL BEHAVIOR
ANXIETY
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) – ADULT
BIPOLAR DISORDER – DEPRESSION
BIPOLAR DISORDER – MANIA
CAREER CHOICE CONFUSION
CHILDHOOD TRAUMA
DEPRESSION – UNIPOLAR
DIVERSITY ACCEPTANCE
EATING DISORDERS
FAMILY CONFLICT
FINANCIAL STRESS
GRADUATION ANXIETY
GRIEF/LOSS – UNRESOLVED
HOMESICKNESS/EMANCIPATION ISSUES
INTIMACY/COMMITMENT ISSUES
LEARNING/PHYSICAL DISABILITIES
LONELINESS
LOW SELF‐ESTEEM
OBSESSIVE‐COMPULSIVE AND RELATED DISORDERS
OPIOID USE DISORDER
PANIC DISORDER/AGORAPHOBIA
PREGNANCY
PSYCHOTICISM
ROOMMATE CONFLICTS
SELF‐HARM
SEXUAL ABUSE VICTIM
SEXUAL ASSAULT VICTIM
SEXUAL ORIENTATION CONFUSION
SEXUAL PROMISCUITY
SLEEP DISTURBANCE
SOCIAL ANXIETY
SPECIFIC PHOBIA
SUBSTANCE USE
SUICIDAL IDEATION
TIME MANAGEMENT
APPENDIX B: PROFESSIONAL RESOURCES
THERAPEUTIC RELATIONSHIP
HOMEWORK PLANNERS
ABUSIVE RELATIONSHIPS
ACADEMIC MAJOR SELECTION
ACADEMIC UNDERACHIEVEMENT
ANTISOCIAL BEHAVIOR
ANXIETY
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) – ADULT
BIPOLAR DISORDER – DEPRESSION
BIPOLAR DISORDER – MANIA
CAREER CHOICE CONFUSION
CHILDHOOD TRAUMA
DEPRESSION – UNIPOLAR
DIVERSITY ACCEPTANCE
EATING DISORDERS
FAMILY CONFLICT
FINANCIAL STRESS
GRADUATION ANXIETY
GRIEF/LOSS – UNRESOLVED
HOMESICKNESS/EMANCIPATION ISSUES
INTIMACY/COMMITMENT ISSUES
LEARNING/PHYSICAL DISABILITIES
LONELINESS
LOW SELF‐ESTEEM
OBSESSIVE‐COMPULSIVE AND RELATED DISORDERS
OPIOID USE DISORDER
PANIC DISORDER/AGORAPHOBIA
PREGNANCY
PSYCHOTICISM
ROOMMATE CONFLICTS
SELF‐HARM
SEXUAL ABUSE VICTIM
SEXUAL ASSAULT VICTIM
SEXUAL ORIENTATION CONFUSION
SEXUAL PROMISCUITY
SLEEP DISTURBANCE
SOCIAL ANXIETY
SPECIFIC PHOBIA
SUBSTANCE USE
SUICIDAL IDEATION
TIME MANAGEMENT
APPENDIX C: RECOVERY MODEL OBJECTIVES AND INTERVENTIONS
LONG‐TERM GOALS
APPENDIX D: CITED AND COMMONLY USED ASSESSMENT INSTRUMENTS AND THEIR SOURCES
Additional Sources of Commonly Used Scales and Measures
END USER LICENSE AGREEMENT
Guide
COVER PAGE
TABLE OF CONTENTS
SERIES PAGE
TITLE PAGE
COPYRIGHT PAGE
DEDICATION PAGE
PREFACE
ACKNOWLEDGMENTS
ABOUT THE COMPANION WEBSITE
BEGIN READING
APPENDIX A: BIBLIOTHERAPY SUGGESTIONS
APPENDIX B: PROFESSIONAL RESOURCES
APPENDIX C: RECOVERY MODEL OBJECTIVES AND INTERVENTIONS
APPENDIX D: CITED AND COMMONLY USED ASSESSMENT INSTRUMENTS AND THEIR SOURCES
WILEY END USER LICENSE AGREEMENT
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WILEY PRACTICEPLANNERS® SERIES
Treatment Planners
The Complete Adult Psychotherapy Treatment Planner, Sixth EditionThe Child Psychotherapy Treatment Planner, Sixth EditionThe Adolescent Psychotherapy Treatment Planner, Sixth EditionThe Addiction Treatment Planner, Sixth EditionThe Continuum of Care Treatment Planner, Second EditionThe Couples Psychotherapy Treatment Planner, with DSM‐5 Updates, Second EditionThe Employee Assistance Treatment PlannerThe Pastoral Counseling Treatment Planner, Second EditionThe Older Adult Psychotherapy Treatment Planner with DSM‐5 Updates, Second EditionThe Behavioral Medicine Treatment PlannerThe Group Therapy Treatment PlannerThe Gay and Lesbian Psychotherapy Treatment PlannerThe Family Therapy Treatment Planner, with DSM‐5 Updates, Second EditionThe Severe and Persistent Mental Illness Treatment Planner, with DSM‐5 Updates, Second EditionThe Mental Retardation and Developmental Disability Treatment PlannerThe Social Work and Human Services Treatment PlannerThe Crisis Counseling and Traumatic Events Treatments Planner, with DSM‐5 Updates, Second EditionThe Personality Disorders Treatments PlannerThe Rehabilitation Psychology Treatment PlannerThe Special Education Treatment PlannerThe Juvenile Justice and Residential Care Treatment PlannerThe School Counseling and School Social Work Treatment Planner, with DSM‐5 Updates, Second EditionThe Sexual Abuse Victim and Sexual Offender Treatment PlannerThe Probation and Parole Treatment PlannerThe Psychopharmacology Treatment PlannerThe Speech‐Language Pathology Treatment PlannerThe Suicide and Homicide Treatment PlannerThe College Student Counseling Treatment Planner, Second EditionThe Parenting Skills Treatment PlannerThe Early Childhood Intervention Treatment PlannerThe Co‐Occurring Disorders Treatment PlannerThe Complete Women's Psychotherapy Treatment PlannerThe Veterans and Active Duty Military Psychotherapy Treatment Planner, with DSM‐5 Updates
Progress Notes Planners
The Child Psychotherapy Progress Notes Planner, Sixth EditionThe Adolescent Psychotherapy Progress Notes Planner, Sixth EditionThe Adult Psychotherapy Progress Notes Planner, Sixth EditionThe Addiction Progress Notes Planner, Sixth EditionThe Severe and Persistent Mental Illness Progress Notes Planner, Second EditionThe Couples Psychotherapy Progress Notes Planner, Second EditionThe Family Therapy Progress Notes Planner, Second EditionThe Veterans and Active Duty Military Psychotherapy Progress Notes Planner
Homework Planners
Couples Therapy Homework Planner, Second EditionFamily Therapy Homework Planner, Second EditionGrief Counseling Homework PlannerGroup Therapy Homework PlannerDivorce Counseling Homework PlannerSchool Counseling and School Social Work Homework Planner, Second EditionChild Therapy Activity and Homework PlannerAddiction Treatment Homework Planner, Sixth EditionAdolescent Psychotherapy Homework Planner, Sixth EditionAdult Psychotherapy Homework Planner, Sixth EditionChild Psychotherapy Homework Planner, Sixth EditionParenting Skills Homework PlannerVeterans and Active Duty Military Psychotherapy Homework Planner
Client Education Handout Planners
Adult Client Education Handout PlannerChild and Adolescent Client Education Handout PlannerCouples and Family Client Education Handout Planner
Complete Planners
The Complete Depression Treatment and Homework PlannerThe Complete Anxiety Treatment and Homework Planner
Wiley PracticePlanners®
The College Student Counseling Treatment Planner
Second Edition
Chris E. Stout
Timothy J. Bruce
Arthur E. Jongsma, Jr
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies.
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Library of Congress Cataloging‐in‐Publication Data
Names: Stout, Chris E. author | Bruce, Timothy J. author | Jongsma, Arthur E., Jr., 1943– authorTitle: The college student counseling treatment planner / Chris E. Stout, Timothy J. Bruce, Arthur E. Jongsma.Description: Second edition. | Hoboken, New Jersey : Wiley, [2025] | Series: Practice plannersIdentifiers: LCCN 2025025179 (print) | LCCN 2025025180 (ebook) | ISBN 9781394296590 paperback | ISBN 9781394296637 adobe pdf | ISBN 9781394296613 epubSubjects: LCSH: College students–Mental health services | Counseling in higher education | Counseling in higher education–Planning | PsychotherapyClassification: LCC RC451.4.S7 H455 2025 (print) | LCC RC451.4.S7 (ebook) | DDC 378.1/9713–dc23/eng/20250522LC record available at https://lccn.loc.gov/2025025179LC ebook record available at https://lccn.loc.gov/2025025180
Cover design and image: Wiley
In the first edition of this book, I wrote a dedication to my ever‐understanding mother‐in‐law, Mary Louise (Wentz) Beckstrand, whose Door County, Wisconsin home became a wonderful retreat for my writing projects. For this second edition, it is in memory and honor of my former coauthor, Camile (Cam) Helkowski, MA, LCPC. She was a rockstar to an innumerable number of lives: her children's, her grandchildren's, her students', her clients', and mine. Cam, I miss you my friend, please know your impact lives on.
—CES
I would like to dedicate this contribution to the PracticePlanners Series to my mother, Judith Eileen Tyler, whose love and support have been a constant in my life and something for which I am eternally grateful. Thank you, Mom. I love you.
—TJB
In memory of my mother, Harmina Doot, whose sacrificial love and joyful spirit continue to glow in the hearts of her family.
—AEJ
PREFACE
This second edition of The College Student Counseling Treatment Planner updates and expands its first edition, including new chapters, appendices, and the inclusion of objectives and interventions consistent with identified evidence‐based practices, details of which can be read in the Introduction of this Planner. We hope you find this new edition informative, up to date, and, above all, useful.
College student counseling is an important and integral contribution to overall student health. And the range of issues that arise in counseling college students is growing and evolving as society does. This book is intended to facilitate and support practitioners in this setting in developing and executing counseling/psychotherapy treatment plans to address the issues they meet in an efficient and effective manner.
Although the components of this book have been tailored to meet the practical needs of counselors in these settings, other goals of this second edition remain the same as its predecessor: to stimulate clinical thought, to improve the quality and comprehensiveness of treatment plans, and to reduce the time involved in recordkeeping.
Working on this book required taking time and energy away from our professional responsibilities and our personal lives. So we would like to express immense gratitude to our coworkers—and particularly, to our spouses and children—for managing without us and providing unflagging encouragement and support.
Chris E. Stout, PsyD., MBA
Timothy J. Bruce, Ph.D
Arthur E. Jongsma, Jr., Ph.D
ACKNOWLEDGMENTS
First, I am forever indebted to Kelly Franklin, my first publisher/editor with Wiley; we did more books together than I can remember. Thank you for taking the chance on me, and 38 books later here we are. Next, Peggy Alexander introduced me to Art Jongsma, PhD, and it was kismet. Art has coach‐quarterbacked an amazing ensemble of professionals over the past 30 years and is a kindred spirit, sharing a passion to help others by teaching clinicians scientifically verified, research‐based ways to provide care and help change lives. While I was serving as the Chief of Psychology for the State of Illinois, I met another powerhouse psychologist and academic, Tim Bruce, PhD, whom I immediately introduced to Wiley and to Art, and who has taken up the mantle for a project of which I am fortunate, and proud, to be a part of.
CES
I would like to acknowledge the outstanding support we received from the editorial and production teams at and affiliated with Wiley, including Darren Lalonde, Katherine Wong, Sandra Kerka, and Christina Weyrauch. Thank you all. I would like to thank lead author Dr. Chris Stout for his timely, highly informed, and thoughtful contributions to the second edition of this important treatment planner. It was a pleasure, Chris. I would like to thank Dr. Art Jongsma for his collegial support and friendship through my transition into the series editor role of the PracticePlanners Series, which has been based on his brainchild and led by him for going on nearly 30 years. I have been trying to let Art actually retire but have not yet been successful due to my dependence on his consultation. I am working on it. Lastly, I would like to acknowledge the love and support of our families through this process, which was and has always been steadfast.
TJB
ABOUT THE COMPANION WEBSITE
This book is accompanied by a companion website.
www.wiley.com/go/stout/collegeTP2e
This website includes:
Appendix E: References to Empirical Support for Evidence‐Based Content
INTRODUCTION
ABOUT PRACTICEPLANNERS® TREATMENT PLANNERS
Pressure from third‐party payers, accrediting agencies, and other outside parties has increased the need for clinicians to quickly produce effective, high‐quality treatment plans. Treatment Planners provide all the elements necessary to quickly and easily develop formal treatment plans that satisfy the needs of most third‐party payers and state and federal review agencies.
Each Treatment Planner:
Saves you hours of time‐consuming paperwork.
Offers the freedom to develop customized treatment plans.
Includes thousands of definitions of behavioral manifestations of each relational problem, long‐term goals, short‐term objectives, and clinically tested treatment options.
Has an easy‐to‐use reference format that helps locate treatment plan components by behavioral problem or
Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5™)
diagnosis.
As with the rest of the books in the PracticePlanners® series, our aim is to clarify, simplify, and accelerate the treatment planning process, so you spend less time on paperwork and more time with your clients.
ABOUT THIS SECOND EDITION OF THE COLLEGE STUDENT COUNSELING TREATMENT PLANNER
This second edition of the College Student Counseling Treatment Planner has been improved in many ways:
Updated with new Objectives and Interventions consistent with identified evidence‐based practices
An expanded and updated list of self‐help books in the Bibliotherapy Suggestions (
Appendix A
)
A new appendix of Professional Resources including recommended books, chapters, manuals, and other “how‐to” clinical resources (
Appendix B
)
A new appendix with Objectives and Interventions reflecting principles of the Recovery Model of mental health care (
Appendix C
)
A new alphabetical appendix of sources for assessment instruments, measures, and inventories used in mental health care (
Appendix D
)
An online appendix of references to empirical work supporting the evidence‐based content found in this
Planner
More suggested homework assignments integrated into the Interventions
Addition of new chapters on Anxiety, Attention‐Deficit/Hyperactivity Disorder, Bipolar Disorder, Low Self‐Esteem, Obsessive‐Compulsive and Related Disorders, Opioid Use Disorder, Panic Disorder/Agoraphobia, Sexual Promiscuity, Sleep Disturbance, Social Anxiety, and Specific Phobia
Integrated
DSM‐5
diagnostic labels and codes into the Diagnostic Suggestions section of each chapter
Evidence‐based practice (EBP) is steadily becoming the standard of care in mental health care as it has in medical health care. Professional organizations such as the American Psychological Association, National Association of Social Workers, and the American Psychiatric Association, as well as consumer organizations such the National Alliance on Mental Illness have all endorsed the use of EBP. In some practice settings, EBP is becoming mandated. Some third‐party payers require the use of EBP for reimbursement. The call for evidence and accountability is being increasingly sounded. So, what is EBP and how is its use facilitated by this Planner?
Borrowing from the Institute of Medicine's definition (Institute of Medicine, 2001), the American Psychological Association (APA) has defined EBP as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (APA Presidential Task Force on Evidence‐Based Practice, 2006). Consistent with this definition, we have identified those psychological treatments with the best available supporting evidence, added Objectives and Interventions consistent with them in the pertinent chapters, and identified these with this symbol: . As most practitioners know, research has shown that although these treatment methods may have demonstrated efficacy, factors such as the individual psychologist (e.g., Wampold, 2001), the treatment relationship (e.g., Norcross, 2019), and the client (e.g., Bohart & Tallman, 1999) are also vital contributors to optimizing a client's response to psychotherapy. As noted by the APA, “Comprehensive EBP will consider all of these determinants and their optimal combinations” (APA Presidential Task Force on Evidence‐Based Practice, 2006, p. 275). For more information and instruction on constructing evidence‐based psychotherapy treatment plans, see our 12 DVD‐based training videos titled Evidence‐Based Psychotherapy Treatment Planning (Jongsma & Bruce, 2010–2012).
The sources we used to identify the evidence‐based treatments integrated into this Planner are multiple and, we believe, high quality. They include rigorous meta‐analyses, current critical, expert reviews, as well as EBP guideline recommendations. Examples of specific sources include the Cochrane Collaboration reviews; the work of the Society of Clinical Psychology identifying research‐supported psychological treatments; evidence‐based treatment reviews (e.g., David et al. 2018; Nathan & Gorman, 2015), as well as critical analyses of the process through which EBP is defined (e.g., Dimidjian, 2019; Norcross et al. 2017). EBP guidelines informing the selection process include those from the American Psychological Association, American Psychiatric Association, the National Institute for Health and Clinical Excellence in the United Kingdom, and the National Institute on Drug Abuse to name a few.
Although sources may vary slightly in the criteria they use for judging levels of empirical support, we favored those that use more rigorous criteria, typically requiring demonstration of efficacy through randomized controlled trials or clinical replication series, good experimental methodology, and independent replication. Our approach was to evaluate these various sources and include those treatments supported by the highest level of evidence and for which there was consensus across most of these sources. For any chapter in which EBP is indicated, references to the sources used to identify them can be found online at www.wiley.com/go/stout/collegeTP2e. In addition to these references to empirical support, we have also included a Professional Resources appendix. Clinical resources are books, manuals, and other resources for clinicians that describe the details of the application, or the “how to,” of the treatment approaches described in a chapter. To maintain the consistency and integrity of the evidence‐based content in the PracticePlanners Series, some of the evidence‐based content in this Planner is adapted from other Planners in the series, including the sixth editions of the Adult and Adolescent Treatment Planners. Although this does build some redundancy across treatment planners in the series that provide this content, we felt that the convenience of having it readily available in each planner supersedes other, more resource‐consuming, options for accessing it.
We recognize that there is debate regarding EBP among mental health professionals who are not always in agreement regarding the best treatment, what factors contribute to good outcomes, or even what constitutes “evidence.” We also recognize that some practitioners are skeptical about changing their practice based on psychotherapy research. Our intent in this book is to accommodate these differences by providing a range of treatment plan options, including those consistent with the “best available research” (APA Presidential Task Force on Evidence‐Based Practice, 2006), those reflecting common clinical practices of experienced clinicians (that may not have been subjected to study), and some that reflect promising emerging approaches. Our intent is to allow users of this planner an array of options so they can construct what they believe to be the best plan for their particular client.
More recently, psychotherapy research is moving toward trying to identify evidence‐based principles of psychotherapeutic change that cut across the various individual psychotherapies that have largely been the focus of outcome research. An example of this call to identify these principles is seen in Goldfried (2019), in which he advances the following principles:
Promoting client expectation and motivation that therapy can help
Establishing an optimal therapeutic alliance
Facilitating client awareness of the factors associated with their difficulties
Encouraging the client to engage in corrective experiences
Emphasizing ongoing reality testing in the client's life
Although many endorse this effort, at the time of this writing it is still in progress. Consequently, our approach to identifying objectives and interventions consistent with EBPs reflects what has been done from the “principles” approach as well as the previous and continuing research examining and demonstrating the efficacy and effectiveness of individual models. Perhaps the field will advance enough by the next edition of this planner to include only evidence‐based principles of psychotherapeutic change. Until then, we believe that the approach we have taken reflects the current state of the science.
Each of the chapters in this edition provides options to integrate homework exercises into the Interventions. Many (but not all) of the client homework exercise suggestions were taken from and can be found in the Adult Psychotherapy Homework Planner (Jongsma & Bruce, 2021) and the Adolescent Psychotherapy Homework Planner (Jongsma et al., 2024). You will find more homework assignments suggested in this second edition of the College Student Counseling Treatment Planner than in its first edition.
The Bibliotherapy Suggestions (Appendix A of this Planner) have been expanded and updated from previous editions. They include classics, recently published offerings, and more recent editions of books cited in our earlier editions. All the self‐help books and client workbooks cited in the chapter Interventions are listed in this appendix. There are also many additional books listed that are supportive of the treatment approaches described in the respective chapters. Each chapter has a list of self‐help books consistent with the chapter's content listed in this appendix.
In its final report titled Achieving the Promise: Transforming Mental Health Care in America, The President's New Freedom Commission on Mental Health called for recovery to be the “common, recognized outcome of mental health services” (New Freedom Commission on Mental Health, 2003). To define recovery, the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services and the Interagency Committee on Disability Research in partnership with six other federal agencies convened the National Consensus Conference on Mental Health Recovery and Mental Health Systems Transformation (SAMHSA, 2004). Over 110 expert panelists participated, including mental health consumers, family members, providers, advocates, researchers, academicians, managed care representatives, accreditation bodies, state and local public officials, and others. From these deliberations, the following consensus statement was derived:
Mental health recovery is a journey of healing and transformation for a person with a mental health problem to be able to live a meaningful life in a community of their choice while striving to achieve maximum human potential. Recovery is a multifaceted concept based on the following 10 fundamental elements and guiding principles:
Self‐direction
Individualized and person centered
Empowerment
Holistic
Nonlinear
Strengths based
Peer support
Respect
Responsibility
Hope (SAMHSA,
2004
, p. 13)
These principles are defined in Appendix C. We have also created a set of Goal, Objective, and Intervention statements that reflect these 10 principles. The clinician who desires to insert into the client treatment plan specific statements reflecting a Recovery Model orientation may choose from this list.
In addition to this list, we believe that many of the Goal, Objective, and Intervention statements found in the chapters reflect a recovery orientation. For example, our assessment interventions are meant to identify how the problem affects this unique client and the strengths that the client brings to the treatment. Additionally, an intervention statement such as, “Assist the client in finding positive, hopeful things in their life at the present time” from the Suicidal Ideation chapter is evidence that recovery model content permeates items listed throughout our chapters. However, if the clinician desires a more focused set of statements directly related to each principle guiding the recovery model, they can be found in Appendix C.
We have organized chapters on mood disorders in a way that may benefit from explanation. We have titled the chapter on unipolar depression as “Depression – Unipolar”. This chapter is distinct from the chapter written for Bipolar Disorder – Depression. Bipolar Disorder – Mania is the companion to the Bipolar Disorder – Depression chapter. You will note that some of the content from the Bipolar Disorder – Depression chapter is repeated in the Bipolar Disorder – Mania chapter, but that the evidence‐based treatment (EBT) symbol may or may not be present for the same content. This is done to indicate that the EBT currently has support for its efficacy on that chapter’s problem (e.g., symptoms of mania) but not necessarily on other aspects of the disorder (e.g., symptoms of bipolar depression). If more information is desired regarding the specific effects of any evidence‐based treatment, one can find them by consulting the references to empirical support for that chapter online at www.wiley.com/go/stout/collegeTP2e.
We want to make a few points about this Planner to avoid misunderstandings about its intended use, especially in relation to seeking third‐party reimbursement. First, some interventions contain citations to books, manuals, and the like intended to provide therapists more information on the “how‐to” of applying the intervention described. References to these citations are found in Appendix B, Professional Resources. These citations are intended as examples of how the intervention could be done. They are not intended to be a requirement for the proper application of the intervention. Accordingly, we begin each of these citations with “e.g.,” to indicate that the suggested reading is an example of how the intervention could be done but not the only way. Second, some interventions are longer than what is typically required in a treatment plan submitted for reimbursement. When this is the case, it is often because we have added additional information on the major steps of an intervention or provided examples of intervention options intended to be helpful. We do this occasionally because in addition to reducing the time it takes to document a treatment plan, another aim of this series is educational. As with all our interventions, we advise users of these Planners to edit them as needed to fit your needs. In the case of these longer interventions, the user could simply delete the additional educational content and keep only the primary description of the intervention.
Lastly, some clinicians have asked that the Objective statements in this Planner be written such that the client's attainment of the Objective can be measured. We have written our objectives in behavioral terms, and many are measurable as written. For example, this Objective from the Anxiety chapter is one that is measurable as written because it either can be done or it cannot: “Verbalize an understanding of the role that cognitive biases play in excessive irrational worry and persistent anxiety symptoms.” But at times the statements are too broad to be considered measurable. Consider, for example, this Objective from the Anxiety chapter: “Identify, challenge, and replace biased, fearful self‐talk with positive, realistic, and empowering self‐talk.” To make it quantifiable a clinician might modify it to read, “Give two examples of identifying, challenging, and replacing biased, fearful self‐talk with positive, realistic, and empowering self‐talk.” Clearly, the use of two examples is arbitrary, but it does allow for a quantifiable measurement of the attainment of the Objective. Similarly, consider this example from the Depression chapter: “Identify and engage in pleasant activities on a daily basis.” To make it more measurable the clinician might simply add a desired target number of pleasant activities, thus: “Identify and report engagement in two pleasant activities on a daily basis.” The exact target number that the client is to attain is subjective and should be selected by the individual clinician in consultation with the client. Once the exact target number is determined, then our content can be very easily modified to fit the specific treatment situation. For more information on psychotherapy treatment plan writing, see Jongsma (2005).
We hope you find these improvements to this second edition of the College Student Counseling Treatment Planner useful to your treatment planning needs.
HOW TO USE THIS TREATMENT PLANNER
Use this Treatment Planner to write treatment plans according to the following progression of six steps:
Problem Selection.
Although the client may discuss a variety of issues during the assessment, the clinician must determine the most significant problems on which to focus the treatment process. Usually a primary problem will surface, and secondary problems may also be evident. Some other problems may have to be set aside as not urgent enough to require treatment at this time. An effective treatment plan can deal with only a few selected problems or treatment will lose its direction. Choose the problem within this
Planner
that most accurately represents your client's presenting issues.
Problem Definition.
Each client presents with unique nuances as to how a problem behaviorally reveals itself in their life. Therefore, each problem that is selected for treatment focus requires a specific definition about how it is evidenced in the particular client. The symptom pattern should be associated with diagnostic criteria and codes such as those found in the
DSM‐5
or the
International Classification of Diseases
. This
Planner
offers such behaviorally specific definition statements to choose from or to serve as a model for your own personally crafted statements.
Goal Development.
The next step in developing your treatment plan is to set broad goals for the resolution of the target problem. These statements need not be crafted in measurable terms but can be global descriptive statements that indicate a desired positive outcome to the treatment procedures. This
Planner
provides several possible goal statements for each problem, but one statement is all that is required in a treatment plan.
Objective Construction.
In contrast to long‐term goals, objectives must be stated in behaviorally measurable language so that it is clear to review agencies, health maintenance organizations, and managed care organizations when the client has achieved the established objectives. The objectives presented in this
Planner
are designed to meet this demand for accountability. Numerous alternatives are presented to allow construction of a variety of treatment plan possibilities for the same presenting problem.
Intervention Creation.
Interventions are the actions of the clinician designed to help the client complete the objectives. There should be at least one intervention for every objective. If the client does not accomplish the objective after the initial intervention, new interventions should be added to the plan. Interventions should be selected on the basis of the client's needs and strengths and the treatment provider's full therapeutic repertoire. This
Planner
contains interventions from a broad range of therapeutic approaches, and we encourage providers to write other interventions reflecting their own training and experience. Some suggested interventions listed in the
Planner
refer to specific books that can be assigned to the client for adjunctive bibliotherapy.
Appendix A
contains a full bibliographic reference list of these materials, including these two popular choices:
Read Two Books and Let's Talk Next Week: Using Bibliotherapy in Clinical Practice
by Joshua and DiMenna and
Rent Two Films and Let's Talk in the Morning: Using Popular Movies in Psychotherapy, Second Edition
by Hesley and Hesley (both books are published by Wiley). For further information about self‐help books, mental health professionals may wish to consult
Authoritative Guide to Self‐Help Resources in Mental Health, Revised Edition
(Norcross et al.,
2003
).
Diagnosis Determination.
The determination of an appropriate diagnosis is based on an evaluation of the client's complete clinical presentation. The clinician must compare the behavioral, cognitive, emotional, and interpersonal symptoms that the client presents with the criteria for diagnosis of a mental illness condition as described in
DSM‐5
. Despite arguments made against diagnosing clients in this manner, diagnosis is a reality that exists in the world of mental health care, and it is a necessity for third‐party reimbursement. It is the clinician's thorough knowledge of
DSM‐5
criteria and a complete understanding of the client assessment data that contribute to the most reliable, valid diagnosis.
Congratulations! After completing these six steps, you should have a comprehensive and individualized treatment plan ready for immediate implementation and presentation to the client. A sample treatment plan for Anxiety is provided at the end of this introduction.
A FINAL NOTE ON TAILORING THE TREATMENT PLAN TO THE CLIENT
One important aspect of effective treatment planning is that each plan should be tailored to the individual client's problems and needs. Treatment plans should not be mass produced, even if clients have similar problems. Factors such as the individual's demographic and sociocultural considerations, strengths and weaknesses, insight, unique stressors, social network, family circumstances, symptom patterns, and severity of impairment must be considered in developing a treatment strategy. Drawing upon our own years of clinical experience and the best available research, we have put together a variety of treatment choices. These statements can be combined in thousands of permutations to develop detailed treatment plans. Relying on their own good judgment, clinicians can easily select the statements that are appropriate for the individuals whom they are treating. In addition, we encourage readers to add their own definitions, goals, objectives, and interventions to the existing samples. As with all the books in the Treatment Planner series, it is our hope that this book will help promote effective, creative treatment planning—a process that will ultimately benefit the client, clinician, and mental health community.
REFERENCES AND FURTHER READING
American Psychiatric Association (n.d.).
American Psychiatric Association practice guidelines
. American Psychiatric Association
http://psychiatryonline.org/guidelines.aspx
.
American Psychiatric Association (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). American Psychiatric Association.
American Psychological Association (n.d.).
APA clinical practice guidelines
. American Psychological Association
https://www.apa.org/about/offices/directorates/guidelines/clinical‐practice
.
American Psychological Association Division 12: Society of Clinical Psychology. (n.d.) American Psychological Association division 12 website on research‐supported psychological treatments.
https://www.div12.org/treatments
.
APA Presidential Task Force on Evidence‐Based Practice (2006). Evidence‐based practice in psychology.
American Psychologist
,
61
, 271–285.
Bohart, A., and Tallman, K. (1999).
How clients make therapy work: The process of active self‐healing
. American Psychological Association.
Cochrane Collaboration Reviews. (n.d.)
www.cochrane.org/
.
David, D., Lynn, S. J., and Montgomery, G. H. (Eds.) (2018).
Evidence‐based psychotherapy: The state of the science and practice
. Wiley.
Dimidjian, S. (2019).
Evidence‐based practice in action
. Guilford Press.
Goldfried, M. R. (2019). Obtaining consensus in psychotherapy: What holds us back?
American Psychologist
,
74
(4), 484–496.
Institute of Medicine (2001).
Crossing the quality chasm: A new health system for the 21st century
. National Academy Press
https://www.nap.edu/catalog/10027/crossing‐the‐quality‐chasm‐a‐new‐health‐system‐for‐the
.
Jongsma, A. (2005). “Psychotherapy treatment plan writing.” In Koocher, G. P., Norcross, J. C., Hill, S. S. (Eds.),
Psychologists' desk reference
(2nd ed., pp. 232–236). Oxford University Press.
Jongsma, A. E. (2013).
Adult psychotherapy homework planner
(3rd ed.). John Wiley and Sons.
Jongsma, A. E., and Bruce, T. J. (2010–2012).
The evidence‐based psychotherapy treatment planning [DVD‐based series]
. John Wiley & Sons
http://www.Wiley.com/go/ebtdvds
.
Jongsma, A. E., and Bruce, T. J. (2021).
Adult psychotherapy homework planner
(6th ed.). John Wiley & Sons.
Jongsma, A. E., Peterson, L. M., McInnis, W. P., and Bruce, T. J. (2024).
Adolescent psychotherapy homework planner
(6th ed.). John Wiley & Sons.
Moore, B. A., and Jongsma, A. E. (2015).
The veterans and active duty military psychotherapy treatment planner
. John Wiley and Sons.
Nathan, P. E., and Gorman, J. M. (Eds.) (2015).
A guide to treatments that work
(4th ed.). Oxford University Press.
National Institute on Drug Abuse. (n.d.)
https://www.drugabuse.gov
.
National Institute for Health and Clinical Excellence (NICE). (n.d.)
http://www.nice.org.uk
.
New Freedom Commission on Mental Health (2003).
Achieving the promise: Transforming mental health care in America (Final report. DHHS Publication No. SMA‐03‐3832)
. New Freedom Commission on Mental Health
https://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/downloads/downloads.html
.
Norcross, J. C. (2019).
Psychotherapy relationships that work
((3rd ed.). Oxford University Press.
Norcross, J. C., Hogan, T. P., Koocher, G. P., and Maggio, L. A. (2017).
Clinicians guide to evidence‐based practices: Behavioral health and the addictions
. Oxford University Press.
Norcross, J. C., Santrock, J. W., Campbell, L. F., Smith, T. P., Sommer, R., and Zuckerman, E. L. (2003).
Authoritative guide to self‐help resources in mental health
(rev. ed.). Guilford Press.
Substance Abuse and Mental Health Services Administration's (SAMHSA) National Mental Health Information Center, Center for Mental Health Services (2004).
National consensus statement on mental health recovery
. SAMHSA.
Wampold, B. E. (2001).
The great psychotherapy debate: Models, methods, and findings
. Lawrence Erlbaum.
SAMPLE TREATMENT PLAN
ANXIETY
BEHAVIORAL DEFINITIONS
Excessive and/or unrealistic worry that is difficult to control occurring more days than not for at least six months about two or more events or activities.
Motor tension (e.g., restlessness, tiredness, shakiness, muscle tension).
Autonomic hyperactivity (e.g., palpitations, shortness of breath, dry mouth, trouble swallowing, nausea, diarrhea).
Hypervigilance (e.g., feeling constantly on edge, experiencing concentration difficulties, having trouble falling or staying asleep, exhibiting a general state of irritability).
LONG‐TERM GOALS
Reduce overall frequency, intensity, and duration of the anxiety so that daily functioning is not impaired.
Learn and implement coping skills that result in a reduction of anxiety and worry, and improved daily functioning.
OBJECTIVES
INTERVENTIONS
1. Work cooperatively with the therapist toward agreed‐upon therapeutic goals while being as open and honest as comfort and trust allow. (1, 2)
Establish rapport with the student and parents (if participating) toward building a strong therapeutic alliance; convey caring, support, warmth, and empathy; provide nonjudgmental support and develop a level of trust with the student toward feeling safe to discuss academic, social, psychological, emotional, and behavioral aspects of college life, and the fear, anxiety, and distress related to it, and its impact on their life.
Strengthen powerful relationship factors within the therapy process and foster the therapy alliance through paying special attention to these empirically supported factors: work
collaboratively
with the student in the treatment process; reach agreement on the
goals
and
expectations
of therapy; demonstrate
consistent empathy
toward the student’s feelings and struggles; verbalize
positive regard
toward and
affirmation
of the student; and collect and deliver
student
feedback
as to the student’s perception of their progress in therapy (see, e.g.,
Psychotherapy Relationships That Work: Vol. 1
by Norcross & Lambert and
Vol. 2
by Norcross & Wampold).
2. Describe situations, thoughts, feelings, and actions associated with anxieties and worries, their impact on functioning, and attempts to resolve them. (3)
Ask the student to describe past experiences of anxiety and their impact on functioning; assess the focus, excessiveness, and uncontrollability of the worry and the type, frequency, intensity, and duration of anxiety symptoms (consider using a structured interview, e.g.,
Anxiety and Related Disorders Interview Schedule for the DSM‐5
by Brown & Barlow).
3. Verbalize an understanding of the cognitive, physiological, and behavioral components of anxiety and its treatment. (4, 5, 6)
Discuss how anxiety typically involves excessive worry about unrealistically appraised threats, various bodily expressions of overarousal, hypervigilance, and avoidance of what is threatening that interact to maintain the problem (see, e.g.,
Mastery of Your Anxiety and Worry: Therapist Guide
by Zinbarg, Craske, & Barlow;
Treating Generalized Anxiety Disorder
by Rygh & Sanderson).
Discuss how treatment targets worry, anxiety symptoms, and avoidance to help the student manage worry effectively, reduce overarousal, eliminate unnecessary avoidance, and reengage in rewarding activities.
Assign the student to read psychoeducational materials as a bibliotherapy adjunct to in‐session work (see, e.g.,
Mastery of Your Anxiety and Worry: Workbook
by Craske & Barlow;
The Anxiety and Worry Workbook
by Clark & Beck).
4. Learn and implement calming skills to reduce overall anxiety and manage anxiety. (7, 8)
Teach the student calming/relaxation/mindfulness skills (e.g., applied relaxation, progressive muscle relaxation, cue‐controlled relaxation; mindful breathing; biofeedback) and how to discriminate better between relaxation and tension; teach the student how to apply these skills to daily life (see, e.g.,
New Directions in Progressive Muscle Relaxation
by Bernstein, Borkovec, & Hazlett‐Stevens; or supplement with
The Relaxation and Stress Reduction Workbook
by Davis et al.).
Assign the student homework in which they practice calming/relaxation/mindfulness skills daily, gradually applying them progressively from non‐anxiety‐provoking to anxiety‐provoking situations; review and reinforce success; resolve obstacles toward sustained implementation (or supplement with “Deep Breathing Exercise” in the
Adult Psychotherapy Homework Planner
by Jongsma & Bruce).
5. Learn and implement a strategy to limit the association between various environmental settings and worry, delaying the worry until a designated “worry time.” (9, 10)
Explain the rationale and teach a worry time intervention in which the student postpones interacting with worries until a designated time and place; use worry time for exposure (repeating worry toward extinction) and/or the application of problem‐solving skills to address worries; agree upon and implement a worry time with the student.
Teach the student how to recognize, stop, and postpone worry to the agreed‐upon worry time using skills such as thought‐stopping, relaxation, and redirecting attention (or supplement with “Making Use of the Thought‐Stopping Technique” and/or “Worry Time” in the
Adult Psychotherapy Homework Planner
by Jongsma & Bruce to assist skill development); encourage use in daily life; review and reinforce success; resolve obstacles toward sustained implementation.
6. Verbalize an understanding of the role that thinking plays in worry, anxiety, and avoidance. (11)
Assist the student in analyzing worries by examining potential biases such as the probability of the negative expectation occurring, the real consequences of it occurring, ability to control the outcome, the worst possible outcome, and ability to accept it (or supplement with “Analyze the Probability of a Feared Event” in the
Adult Psychotherapy Homework Planner
by Jongsma & Bruce;
Cognitive Therapy of Anxiety Disorders
by Clark & Beck).
7. Identify, challenge, and replace biased, fearful self‐talk with positive, realistic, and empowering self‐talk. (12, 13)
Using techniques from cognitive behavioral therapies, including intolerance of uncertainty and metacognitive therapies, explore the student’s self‐talk, underlying assumptions, schema, or metacognition that mediate anxiety; assist the student in challenging and changing biases; conduct behavioral experiments to test biased versus unbiased predictions toward dispelling unproductive worry and increasing self‐confidence in addressing the subject of worry (see, e.g.,
Cognitive Therapy of Anxiety Disorders
by Clark & Beck;
Metacognitive Therapy for Anxiety and Depression
by Wells).
Assign the student a homework exercise to identify fearful self‐talk, identify biases in the self‐talk, generate alternatives, and test them through behavioral experiments (or supplement with “Negative Thoughts Trigger Negative Feelings” in the
Adult Psychotherapy Homework Planner
by Jongsma & Bruce); review and reinforce success, providing corrective feedback toward improvement.
DIAGNOSIS
F41.1
Generalized anxiety disorder
indicates that the Objective/Intervention is consistent with those found in evidence‐based treatments.
ABUSIVE RELATIONSHIPS
BEHAVIORAL DEFINITIONS
Avoids displeasing or angering the partner at all costs (e.g., misses classes or work, stops socializing with friends, or yields control of personal time and money to partner).
Feels intimidated by interactions with partner leading to pervasive worry, anxiety, and/or fear.
Attempts to control others and the environment to prevent anything that could serve as a catalyst for the partner's anger/violence.
Experiences feelings of inadequacy, guilt, and shame in reaction to the partner's constant criticism, belittling comments, and/or demeaning demands.
Feels invisible and/or unworthy because ideas, interests, and needs are ignored or dismissed by the partner.
Excuses the partner's abusive physical and sexual behavior and blames self for creating a situation in which the partner could not control rage and violent impulses.
Sustains physical injuries at the hands of the partner and lies to medical personnel and friends about the origin of the injuries.
Isolates self from family, friends, and campus personnel due to feelings of embarrassment and fear.
Believes that it is impossible to leave the relationship due to financial, emotional, and/or social dependence on the partner.
Believes that it is impossible to leave the relationship due to the partner's threats of physical violence, death, and/or suicide.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
LONG‐TERM GOALS
Terminate the abusive relationship and accept that no one deserves to be victimized by abuse.
Reclaim a personal vision of self as deserving kindness and respect.
Articulate their own views and perspectives independent of the partner's dictums.
Understand the impact of an abusive relationship on identity development and engage in behaviors that are emotionally and physically nurturing and strengthening.
Renew relationships with family, friends, and other sources of support, affirmation, and comfort.
Create and maintain healthy boundaries in intimate relationships.
Recommit to academic goals and create a plan of action.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
SHORT‐TERM OBJECTIVES
THERAPEUTIC INTERVENTIONS
1. Work cooperatively with the therapist toward agreed‐upon therapeutic goals while being as open and honest as comfort and trust allow. (1, 2)
Establish rapport with the student and parents (if participating) toward building a strong therapeutic alliance; convey caring, support, warmth, and empathy; provide nonjudgmental support and develop a level of trust with the student toward feeling safe to discuss academic, social, psychological, emotional, and behavioral aspects of college life, and the fear, anxiety, and distress related to it and its impact on their life.
Strengthen powerful relationship factors within the therapy process and foster the therapy alliance through paying special attention to these empirically supported factors: work
collaboratively
with the student in the treatment process; reach agreement on the
goals and expectations
of therapy; demonstrate
consistent empathy
toward the student's feelings and struggles; verbalize
positive regard
toward and
affirmation
of the student; and collect and deliver
student feedback
as to the student's perception of their progress in therapy (see, e.g.,
Psychotherapy Relationships That Work: Vol. 1
by Norcross & Lambert and
Vol. 2
by Norcross & Wampold).
2. Describe the immediate abusive situation that precipitated seeking assistance. (3, 4, 5)
Explore the particular abusive incident or current situation that led the student to seek counseling.
Assess the level of danger to the student (e.g., is the partner violent; has the abuse been increasing lately; has the partner threatened to harm or kill the student, someone in the student's family, or themself; or does the partner have a weapon); contact campus safety and security, the police, and/or other crisis intervention personnel to ensure their immediate safety.
Encourage the student to use the student health center, campus legal clinic, or other campus/community services to ensure their safety and well‐being.
3. Provide behavioral, emotional, and attitudinal information toward an assessment of specifiers relevant to a
DSM 5‐TR
diagnosis, motivation for change, sociocultural considerations, the efficacy of treatment, and the nature of the therapy relationship. (6, 7)
Assess the student's cognitive, behavioral, and emotional status related to insight, motivation, and comorbid disorders: (1) level of insight toward the presenting problems (e.g., from demonstrating good insight into the problem to demonstrating resistance to acknowledging the problem); (2) level or stage of motivation to change (e.g., from voicing strong motivation and demonstrating action toward change to voicing and/or demonstrating resistance to change); and (3) evidence of relevant comorbidities (e.g., depression secondary to an anxiety disorder) including vulnerability to suicide, if appropriate (e.g., increased suicide risk when comorbid depression is evident).
Assess relevant sociocultural factors and degree of impairment: (1) issues of age, gender, culture, resources, and preferences that could help explain the presenting problem(s), affect treatment selection and outcome, and provide a better understanding of the student's behavior; and (2) severity of distress and disability to determine appropriate level of care as well as the efficacy of treatment (e.g., no longer demonstrates severe impairment but the problem now is causing mild or moderate distress/disability).
4. Describe the history and current status of the abusive relationship. (8, 9, 10)
Explore the history of and feelings about the student's relationship with their abusive partner.
Encourage the student to describe the initial incidents that were indicative of the partner's potential for abuse.
Explore the student's abusive incidents in depth and assist them in identifying relationship patterns that led to or resulted from the abuse and the effects of the abuse on their self‐esteem.
5. Sort out and identify the feelings generated by this abusive relationship. (11, 12, 13)
Clarify the types of feelings that are typically generated by an abusive relationship (e.g., anxiety, self‐blame, fear, embarrassment, or shame) for the student.
Assist the student in identifying, as specifically as possible, their feelings about the abuse; validate and normalize them.
Encourage the student to use a journal to record their feelings and thoughts about this relationship; ask them to recall in the journal any previous relationships that have generated similar emotions and thinking.
6. Verbalize an understanding of the facts about abusive relationships. (14)
