Title
ABC/123 Version X
1
Behavior Plan Template
CJHS/400 Version 2
1
University of Phoenix Material
Behavior Plan Template
Use this template to create behavioral plans for assignments in Weeks Two and Three. Fill in each section and provide additional information as needed.
Client Identifying Information
List all pertinent and known identifying information.
Name
Age
Gender
Religion
History
Describe all pertinent and known history.
Medical
Family
Substance Abuse
Developmental and Social
Course of Treatment
List two target behaviors and two interventions.
Target Behaviors
Frequency and Duration of Target Behaviors
Severity and Number of Relapses
Interventions
Goals and Objectives
List two long-term goals, two short-term goals, and one objective to work towards each goal.
Long-Term Goal
Short-Term Goal
Objectives
Discharge and Termination Plans
Describe the discharge and termination plan for the client.
Discharge Plan
Termination Plan
Copyright © XXXX by University of Phoenix. All rights reserved.
Copyright © 2016 by University of Phoenix. All rights reserved.
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