Treatment Planning in Psychotherapy

Sheila R. Woody, PhD, is Associate Professor of Psychology at the University of British Columbia and a registered psychologist in British Columbia, Canada.Jerusha Detweiler-Bedell, PhD, is Assistant Professor of Psychology at Lewis and Clark College in Portland, Oregon.Bethany A. Teachman, PhD, is Assistant Professor of Psychology at the University of Virginia.Todd O'Hearn, PhD, was previously Director of the Yale Psychological Services Clinic and served on the teaching faculty in Yale's Department of Psychology. Currently he is developing a private practice in the Santa Barbara area.

• 1. The PACC Approach to Treatment Planning PACC: Going beyond Randomized Clinical Trials PACC: Enhancing Accountability Guiding Principles of Our ApproachOverview of the ModelWhat Are the Benefits of the PACC Approach?What the PACC Approach Is NotTime and Cost2. Developing a Problem ListWhy Formalize the Problem List?Domains of Functioning: A Biopsychosocial PerspectiveAn Outline for Biopsychosocial AssessmentCase Formulation and the Problem ListPrioritizing ProblemsReexamining the Problem ListShortcuts for the Busy Clinician3. Treatment Planning Using a Phase Approach From Problem Identification to Problem Solving Treatment Planning as the Therapist's MapTreatment PhasesEffectiveness of Phase Models of PsychotherapyPhases in the PACC ApproachOutlining Expectations for Progress within PhasesTreatment AimsTreatment StrategiesChoosing Aims and Strategies: Case ExampleChallenges in Implementing the Treatment PlanShortcuts for the Busy Clinician4. Ongoing MeasurementBenefits of Ongoing MeasurementObstacles to Routine MeasurementCompleting the Measures Section of the Treatment Phase FormEstablishing a Measurement PlanCase Study: Group Treatment for Social PhobiaShortcuts for the Busy Clinician5. Illustrating Progress through GraphingWhy Graph?: Rationale for Visual Inspection of the DataCreating GraphsGraphing Progress with Microsoft ExcelReviewing Progress and Moving across PhasesCase ExampleResearch ImplicationsShortcuts for the Busy Clinician6. Review of ProgressStrategies for Implementing a Progress ReviewCultural Considerations in Conducting the Progress ReviewConducting Progress Reviews with Clients with Personality DisordersReadiness to Change and the Progress ReviewReasons to Move to a New Treatment PhaseSeeking Consultation to Improve Treatment DeliveryWhen a Lapse Has OccurredCase ExampleTroubleshooting: Anticipating Barriers to Conducting Progress ReviewsConclusionShortcuts for the Busy Clinician7. Iterative Treatment Planning and Its ApplicationsThe Decision TreeCase Study: Using the Decision TreeEthical Implications of Using PACCApplications of PACCFinal CommentsAppendix: Measures for Tracking Clients' ProgressOverviewDescription of the MeasuresBrief Psychiatric Rating ScaleBulimia Test-RevisedCenter for Epidemiological Studies-Depression Scale (CES-D)Daily Spiritual Experiences ScaleKansas Marital Satisfaction ScalePsychotic Symptoms Rating ScalesRosenberg Self-Esteem ScaleYale-Brown Obsessive Compulsive Scale (Y-BOCS)Sources for Other Measures

This book is a marvelous contribution to the evidence-based practice movement in mental health. The authors' Planning and Assessment in Clinical Care (PACC) system helps the empirically oriented practitioner operationalize the steps necessary to identify and prioritize client problems, establish mutually agreed-upon treatment goals, and measure the outcomes of psychotherapy. PACC breathes new life into the long-advocated but little-implemented practice of integrating single-client evaluation designs into routine clinical practice. The case studies exemplify the best of evidence-based care in psychotherapy. This will make a superb primary practice textbook for graduate students in professional psychology, social work, psychiatry, counseling, and nursing.--Bruce A. Thyer, PhD, LCSW, School of Social Work, Florida State UniversityThis book is a boon for the practicing clinician as well as the graduate student beginning psychotherapy training or taking a course in behavioral assessment. Step by step, Woody et al. coach the reader in the use of an empirically oriented but idiographic approach to psychotherapy. Readers interested in problem-oriented psychotherapy, regardless of their specific theoretical orientation, will find much of value in this user-friendly work replete with examples of the complex cases encountered in real practice.--Dianne L. Chambless, PhD, Department of Psychology, University of North Carolina at Chapel HillWoody et al. have provided a highly useful guide for clinicians of all levels of experience, regardless of theoretical orientation. The PACC model provides general strategies and concrete plans for tailoring treatment to each patient. Clinicians will find specific ideas on planning the different phases of treatment, harnessing client motivation, and overcoming pitfalls, as well as tools for assessment and progress evaluation. The Appendix includes a full range of widely studied self-report instruments that will prove invaluable.--Robert L. Leahy, PhD, Department of Psychiatry, Weill-Cornell University Medical College; Director, American Institute for Cognitive Therapy- ...a significant addition to the treatment planning resources that are available to today's clinicians....its focus on the importance of ongoing patient assessment and treatment plan review and revision during an episode of care makes it a unique and important contribution to the field and an excellent supplement to other works on the topic. --Contemporary Psychology, 8/13/2004ƒƒ Woody and coauthors have produced an excellent book that offers a scientifically rigorous and clinically sensitive assessment system. Adoption of their system by any clinician would go a long way toward ensuring that clients receive optimal psychological services. --The Clinical Psychologist, 8/13/2004ƒƒ The authors' system helps the empirically oriented practitioner implement the steps necessary to identify and prioritize clients' problems, establish mutually agreed-upon treatment goals, and measure the outcomes of psychotherapy. Clinicians will find specific ideas on planning the different phases of treatment, harnessing client motivation, and overcoming pitfalls, as well as tools for assessment and progress evaluation. A superb primary practice textbook for graduate students. --Canadian Association of Social Work Bulletin, 8/13/2004ƒƒ The book is particularly well-suited to graduate students, possibly as an introductory textbook for a course in psychotherapy planning and evaluation. It will also be a valuable guide for clinicians working in training settings or for more experienced therapists who would like to incorporate these strategies in their work....Will not only likely help therapists manage their cases more effectively and subsequently provide clients and patients with explicit knowledge about the progress and outcome of their therapy, but is also likely, with minimal effort, to produce a great deal of valuable data for case studies, case series, and other clinically useful and publishable evaluations of both progress and outcome in clinical care. --Canadian Psychology, 8/13/2004