week2behavior_plan_template.doc

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

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Copyright © 2016 by University of Phoenix. All rights reserved.

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