PLAN Actions Identified issues/problems Goals Treatments & interventions Referrals Any role of carer/support Consider: Consider: Consider: Consider: person(s) Consider: As presented by patient Goals made in collaboration psychological interventions Practitioner, service or with patient agency—referred to Identified role or task(s), Developed during face to face whom and what for e.g. monitoring, consultation What does the patient want internet based intervention, support to see as an outcome from Specific referral request Formulated by GP Program this plan? Discussed, agreed, (anxiety only) referral to internet mental negotiated with carer? Behavioural or symptomatic Websites health programs for goals education and/or specific Any necessary supports psychotherapy for carer Wellbeing, function, Program occupation, relationships Time frame Mobile Applications (anxiety only) Any reference to special Websites outcome measures Time frame pharmacological Mobile Applications interventions Key actions to be taken by patient and by guardians Support services to achieve patient goals Opinion, planning, Parent Management treatment Training Case conferences Role of GP Time frame Psycho-education Time frame Issue 1: Issue 2:
PLAN Actions Identified issues/problems Consider: As presented by patient Developed during consultation Formulated by GP Goals Consider: Goals made in collaboration with patient What does the patient want to see as an outcome from this plan? Behavioural or symptomatic goals Wellbeing, function, occupation, relationships Any reference to special outcome measures Time frame Treatments & interventions Consider: psychological interventions face to face internet based Program (anxiety only) Websites Mobile Applications pharmacological interventions Key actions to be taken by patient and by guardians Support services to achieve patient goals Parent Management Training Role of GP Psycho-education Time frame Referrals Consider: Practitioner, service or agency—referred to whom and what for Specific referral request referral to internet mental health programs for education and/or specific psychotherapy Program (anxiety only) Websites Mobile Applications Opinion, planning, treatment Case conferences Time frame Any role of carer/support person(s) Consider: Identified role or task(s), e.g. monitoring, intervention, support Discussed, agreed, negotiated with carer? Any necessary supports for carer Time frame Issue 1: Issue 2:
gp-mental-health-treatment-plan-template-child-adolescent.docx