2.1: Treatment Plan Document

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Master Textbook & Whatcom Community College
Whatcom Community College via WCC Library Press

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My Treatment Plan

Name:

Date:

Problem #:

My counselor and I agree that the problem/goal I need to work on is:

We have identified the following as a strength I have that can help me work on this problem/goal.

Strength:

Goal:

Date Added	Steps to Complete Goal	Completion Target Date	Date Completed
	1.
	2.
	3.
	4.
	5.

Intervention(s):

Participant’s Signature: _______________________________________________ Date: ___________________

Counselor Signature: __________________________________________________ Date: ____________________

Reviewed:______________ Date:______________ Reviewed:______________ Date: ______________