Chapter 4 of 69% of exam

Treatment Planning

Treatment planning turns assessment into a course of action the client helped write. The domain covers goals and objectives, level of care, referral and coordination, progress review, and ending counseling well.

Collaborative, measurable plans

Plans are written with the client, not for the client, and are revised as things change. Goals set direction; objectives make progress measurable.

Joint planning

Counselors and clients jointly devise plans that fit the client's abilities, developmental level and circumstances, and review them regularly.

ACA Code of Ethics (2014), A.1.c

SMART objectives

NBCC spells SMART out as Specific, Measurable, Attainable, Realistic and Timely.

NBCC NCE Content Outline (Summer 2027 edition)

Written approval of changes

NBCC requires the record to be updated when goals, techniques or diagnoses change, with the client's written approval.

NBCC Code of Ethics (2023), directive 36

Goals versus objectives

Goals are broad outcomes; objectives are the specific, measurable steps toward them.

NBCC NCE Content Outline (2023), Domain 4B

Readiness and level of care

The right plan depends on where the client is. An ambivalent client needs help resolving ambivalence before an action plan; a client at imminent risk needs a higher level of care now.

Match the stage

In contemplation, normalize and resolve ambivalence and evoke change talk before detailed action planning.

SAMHSA TIP 35

Setbacks

Most people cycle through the stages with setbacks and do not return to precontemplation; a lapse is a reason to revisit the plan.

SAMHSA TIP 35

Imminent risk

Direct warning signs are the highest priority; no-suicide contracts are not recommended as a safety measure.

SAMHSA TIP 50

Coordination, referral and termination

Counselors coordinate with other providers only with consent, refer when a case is outside their competence, and plan for interruptions and endings so no client is abandoned.

Other providers

When a client sees another mental health professional, request a release to inform them and collaborate.

ACA Code of Ethics (2014), A.3

Competence and referral

If the counselor lacks competence, suggest referrals; if the client declines them, discontinue the relationship.

ACA Code of Ethics (2014), A.11.a

Termination

End counseling when the client no longer needs it, is not benefiting or is being harmed, with pretermination counseling and referrals as needed.

ACA Code of Ethics (2014), A.11.c

Interruptions

Arrange coverage by a qualified professional or emergency service for vacations and illness.

NBCC Code of Ethics (2023), directive 26; ACA Code of Ethics (2014), A.12

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