The Treatment Plan

Jack Phelan

The third in a series of attempts to present an articulate description of the process of doing Child and Youth Care Work.

This essay, the third in my series of thoughts on “what we do" as Child and Youth Care workers, is focused on treatment planning. The development of a treatment plan can be the best place to articulate the complexity of our work, yet it often does just the opposite.

I often picture a youth on a distant hill, standing all alone and “stuck", while on another hill, quite separate and far away, cluster a group of “helpers" all shouting in unison toward the general direction of the youth, “get over here".

Many of the treatment plans I have seen follow a predictable scenario; they describe the self-destructive behavior of a youth, the goal (which is often merely stated as the absence of the self-destructive behavior), the punishment to be imposed when the behavior rears its ugly head, and the evaluation statement that the youth will be cured when the behavior changes to the goal behavior.

A metaphor that is useful for me: a person is lost in the wilderness and a search plane finally locates him. The search plane drops a message saying “you are in trouble, you need to get out of there".

The Child and Youth Care Worker is added to this and a person is dropped from the plane who enthusiastically joins the stranded soul. When the relieved traveler asks what supplies and equipment the rescuer has brought, he gets a blank stare.

To continue this metaphor, we are expected to meet people in dangerous and difficult places and to be able to support them to move in a useful direction by convincing them that we have the tools they need to get unstuck. Our treatment plans have to describe what we are going to do to support the other person, not describe what the other person needs to do to get out of their predicament.

Every treatment plan should describe the ways that the Child and Youth Care Worker will create a safe relationship as a first step. Then the change work has to be detailed, not what changes the helpee needs to create, but what behaviors the helper will engage in to do the job required.

Good change work is developmentally accurate, requires emotional courage on the part of the helper and eventually the helpee, and expects that there will be ups and downs encountered in the process. A treatment plan is a map of the journey required, not a description of the destination.

There is a good treatment plan example on CYC-Net written by Glenys Acorn about a girl who is pulling her eyelashes out. You can read it here.

I have two cautions about treatment plans which I advise my students to watch for: if you can do the plan while sitting in a chair, or if the youth's mother could just as easily have written it, then I’m not interested in reading it.