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When to review and revise your treatment plans

Because clients’ needs change over time, your treatment plan will eventually change, too.

To effectively support your clients’ mental health, you need a plan in place. That’s why, after an initial assessment, you’ll create a comprehensive treatment plan that outlines the client’s presenting problems, goals and objectives, and the interventions you’ll use to meet them. This plan can help provide a helpful framework for your sessions while ensuring you stay on track in treating your client’s concerns over time. 

Because clients’ needs change over time—and you want to track progress in treatment—your treatment plan will eventually change, too. But when is the best time to review and revise a treatment plan, and what do you need to include in it? Keep reading to learn more.

How often should you review your treatment plan?

Regular reviews of your treatment plans can help you track your clients’ progress and update their plans as needed. When you review them can vary based on insurance company treatment plan update requirements, your practice’s guidelines, and beyond. But it’s best practice to closely look at them once a month, says Michael Heckendorn, Headway’s manager of clinician education.

Of course, if your client’s needs change, you can review and update the plan even sooner. And when you include a measurable goal in a treatment plan — like practicing five coping skills in the next five weeks — you should also review it accordingly. 

While it can take time to update your treatment plans, you’ll ultimately be able to provide more effective, efficient treatment to your clients when you stay on track.

How to revise a treatment plan

The goal of updating treatment plans is to ensure you’re properly supporting your clients according to their needs — and these needs can change over time. “A treatment plan isn’t meant to be a static document,” says Heckendorn. “Anything and everything within it can change.”

How you revise a client’s treatment plan depends on the individual case. Many times, therapists update the treatment plans when the presenting problem has changed. For example, maybe a client’s anxiety symptoms have improved or worsened since you started therapy, or maybe they developed an altogether new symptom you didn’t include in the original treatment plan. 

As you update the presenting problem(s), you’ll likely also update the client’s goals and objectives. From there, you’ll list new interventions to help the client meet their goals and objectives in a pre-determined amount of time. 

If the presenting problems are the same, the client isn’t responding to treatment as well as you’d hoped, or the client has voiced they don’t like the treatment modality you’re currently using, you may keep the goals and objectives the same but update the intervention you use to meet them.

In any case, the Wiley Treatment Planner provides a helpful list of evidence-based therapeutic modalities that can be used to treat your client’s presenting problems. 

Treatment plan review example

A treatment plan review template can be helpful for updating your own treatment plans and ensuring you’re providing the best possible care to your clients over time. 

The treatment plan below outlines a hypothetical client’s presenting problems, goals and objectives, and interventions. Then, following a review of the treatment plan is a refreshed plan that accurately reflects the clients concerns and needs after six months of therapy.

Original Treatment Plan


Client Name: John Public

DOB: 1/1/1991

Age: 32

Date: 1/11/2023

Exact start time and end time: 1:03 pm–1:55 pm: 52 mins

Session location: Serenity Behavioral Health Center, 123 Serenity Street, Hopeville, TX 56789

Diagnosis: (F41.1) Generalized anxiety disorder


Problem 1: Anxiety in Work Settings: John experiences significant anxiety that manifests as racing thoughts, restlessness, and difficulty sleeping. This anxiety has escalated post-COVID pandemic and affects his ability to maintain consistent employment. He describes being "high strung" and suffers from "Sunday Scaries" that can lead to anxiety attacks, impacting his job stability and ability to enjoy free time.

Goal: Within 120 days or 15 therapy sessions, the client will develop skills to manage anxiety effectively, allowing him to maintain employment and enjoy leisure without the need for withdrawal due to anxiety.


Objective 1: Client will demonstrate an increased understanding of ACT principles and apply them to reduce work-related anxiety within 60 days.

  • Intervention 1-1: Psychoeducation on ACT principles will be provided, explaining how acceptance, cognitive defusion, being present, self as context, values, and committed action can help manage anxiety. This will include discussing the nature of psychological distress and the role of psychological flexibility in improving mental health.
  • Intervention 1-2: Psychological Flexibility Exercises will be conducted to enhance the client's ability to remain adaptable in the face of changing work environments and persist in actions aligned with personal values, even when experiencing anxiety.


Objective 2: Client will learn cognitive restructuring techniques to identify and reframe unhelpful thought patterns related to work within 120 days.

  • Intervention 2-1: Cognitive Restructuring will be taught to help the client recognize irrational or unhelpful thoughts that contribute to anxiety. The client will learn to challenge these thoughts and replace them with more realistic and helpful ones, thereby reducing the intensity of anxious feelings.
  • Intervention 2-2: Relapse Prevention Planning will be implemented to prepare the client for potential setbacks. Together, we will identify triggers and high-risk situations that may lead to increased anxiety and develop a plan that includes coping strategies and ACT skills to maintain progress.


Client Signature and Date

John Public electronically signed 1/11/23

Clinician Signature and Date

Susan Q. Practitioner, LCSW, 1/10/2023


Treatment Plan Review

John Public has made notable progress in managing his generalized anxiety disorder (F41.1) after six months of treatment, though some challenges persist. He reports an increased ability to identify and reframe unhelpful thought patterns related to work stress, and he successfully applies cognitive restructuring techniques to prevent escalation of anxiety in certain situations. This has led to improved focus during work hours and a reduction in the frequency of anxiety attacks.

John has also shown meaningful progress with Acceptance and Commitment Therapy (ACT) principles, particularly in using values-based committed actions. He reports feeling more connected to his personal values, which has helped him make decisions aligned with his long-term goals. For example, he has been able to stay at his current job for the past four months, marking his longest period of stable employment in several years.

However, John continues to struggle with anticipatory anxiety, especially on Sundays and the night before important meetings. While the "Sunday Scaries" have diminished in intensity, they remain a disruptive influence on his weekends and sleep patterns. He notes that his restlessness at night has led to fatigue and difficulty maintaining productivity during the workweek.

Additionally, John has begun avoiding certain high-stress situations at work, such as taking on new projects or speaking up in meetings, for fear of failure or judgment. This avoidance behavior contrasts with his earlier willingness to face challenges directly and will be a focus of upcoming sessions.


Updated Clinical Impressions:

John has made considerable strides in reducing the intensity of his anxiety and improving emotional regulation in predictable, lower-stakes situations. His ability to apply cognitive and behavioral strategies is encouraging, but anticipatory anxiety and avoidance behaviors in high-stakes scenarios require further attention. Sleep disruptions and residual restlessness will also be addressed to support his continued progress.


Next Steps:

  • Reinforce ACT principles to address avoidance behaviors, focusing on increasing psychological flexibility in high-stress situations.
  • Introduce exposure-based techniques to help John gradually face feared scenarios at work, reducing avoidance.
  • Explore sleep hygiene strategies to alleviate restlessness and improve overall energy and functioning.
  • Revisit relapse prevention planning, incorporating new triggers (e.g., fatigue, avoidance patterns) into John's coping strategies.


John remains motivated and optimistic about his ability to continue building on the progress he has achieved thus far.

Updated Treatment Plan

Client Name: John Public

DOB: 1/1/1991

Age: 32

Date: 7/11/2023

Exact start time and end time: 2:10 pm–3:02 pm: 52 mins

Session location: Serenity Behavioral Health Center, 123 Serenity Street, Hopeville, TX 56789

Diagnosis: (F41.1) Generalized anxiety disorder


Problem 1: Residual Anxiety in Work Settings and Sleep Disturbances. John continues to experience anticipatory anxiety, avoidance behaviors in high-stakes situations, and sleep disturbances. These symptoms interfere with his productivity, ability to fully engage in his job, and overall energy levels.

Goal: Within 6 months or 15 therapy sessions, John will refine and expand his anxiety management skills to reduce anticipatory anxiety, decrease avoidance in high-stakes work scenarios, and establish a consistent sleep routine to support daily functioning.


Objective 1: Client will reduce avoidance behaviors in high-stakes work situations within 12 weeks.

  • Intervention 1-1: Graded Exposure Therapy will be implemented to help John gradually confront and navigate feared work scenarios, such as taking on new projects or contributing ideas in meetings.
  • Intervention 1-2: Values-Based Goal Setting will be used to guide John in identifying actions aligned with his personal values, encouraging engagement in challenging but meaningful work activities.


Objective 2: Client will manage anticipatory anxiety effectively, particularly during "Sunday Scaries" and before significant work events, within 3 months.

  • Intervention 2-1: Behavioral Activation techniques will be applied to structure John’s Sundays with meaningful, engaging activities that reduce time spent ruminating on work stress.
  • Intervention 2-2: Mindfulness-Based Stress Reduction (MBSR) practices will be introduced, such as guided breathing exercises and body scans, to help John regulate his anxiety and physiological responses in anticipation of high-stress situations.


Objective 3: Establish a consistent sleep routine to address restlessness and fatigue within 8 weeks.

  • Intervention 3-1: Psychoeducation on Sleep Hygiene will be provided, covering effective strategies for improving sleep quality, including setting a consistent bedtime, limiting screen time, and reducing caffeine intake in the evening.
  • Intervention 3-2: Progressive Muscle Relaxation (PMR) exercises will be incorporated into John’s nightly routine to reduce physical tension and promote relaxation.
  • Intervention 3-3: If sleep issues persist, Cognitive Behavioral Therapy for Insomnia (CBT-I) will be used to address unhelpful thoughts or behaviors contributing to sleep disturbances.

Headway is a free service that makes it easier and more profitable for therapists and psychiatrists to accept insurance.

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