MENTAL HEALTH (PSYCHOLOGY): TREATMENT PLAN NOTES Introduction This Mental Health (Psychology): Treatment Plan is to be completed by a fully registered psychologist seeing a person whose treatment is funded by the Transport Accident Commission (TAC). It should be forwarded to TAC as the basis for requesting funding beyond an initial five hours of treatment. This treatment plan is principally for the purposes of TAC assuring its liability and that reasonable and effective treatment is funded. The treatment plan is therefore not designed to be comprehensive or to be a substitute for a practitioner’s own assessment, planning or intervention practices. All incomplete forms will be returned, so please give reasons if you are unable to complete a section. Liability The TAC only funds mental health treatment for mental health problems for which it has liability under the Transport Accident Act 1986. The person must have a current TAC claim and the mental health condition must have been caused by the transport accident. This treatment plan is for mental health problems that in the professional opinion of the psychologist arise from a transport accident. The TAC does not fund mental health treatment that is not related to the transport accident. Quality, effectiveness and coordination The treatment plan enables practitioners to clearly document goals, measures and outcomes. The treatment is expected to be of a high quality, effective, directed at positive outcomes in social, family and work functioning and closely coordinated with the work of other health practitioners and treatments. Mental health treatment Mental health treatment refers to a sequenced set of interventions, services, and resources that are delivered to improve a person’s state of mental health and well being and enhance the person’s ability to cope effectively with key environmental demands. These interventions must be evaluated for effectiveness by the psychologist. This will include evidence-based interventions and may also include education, advice, practical assistance and service coordination required to meet agreed goals. Variations or additional treatment to this plan require approval by TAC Upon completion of the mental health treatment plan the psychologist will need to contact the TAC for approval of funding for any subsequent mental health services. Where significant variations to the type and amount of treatment to be provided are anticipated these should be promptly advised and explained to the TAC. Important notes The following notes each refer to the sections of the Mental Health (Psychology): Treatment Plan. The plan should be completed by a psychologist with full registration, preferably with knowledge and skills in the assessment and treatment of people with problems of post traumatic mental health. 1. Person details A person is someone who has a current claim with the TAC and who is seeking psychological treatment for their transport accident injuries. 2. Referral The Transport Accident Act 1986, requires the person to be referred to the psychologist by a registered medical practitioner. 3. Current practical problems List in order of priority the practical problems that are preventing this person returning to valued roles in their family eg. anger; social eg. depression; and productive work or related activities eg. travel anxiety. These may also include problems of intelligence, thinking, perception, judgement, mood, behaviour, and relationships. Valued roles are those that are appropriate to the person’s post-accident interests and abilities and are available in the person’s environment. 4. Current diagnoses (DSM-IV multiaxial) On the basis of the assessment give the DSM-IV multiaxial diagnoses assigned to this person on the five axes shown. Diagnoses, including medical conditions such as head injury that are directly related to the transport accident should be indicated. 5. Identify risk factors for recovery Risk factors refer to barriers to improvements in mental health arising from the person’s physical eg. physical disability, brain injury or disfigurement; cultural eg. non-English speaking; or behavioural characteristics eg. substance use, avoidance behaviours; or those of the environment eg. unemployment, workplace conflict or legal problems. 6. Past mental health problems The person’s mental health problems that existed prior to and after the accident should be separately listed with the health treatment that has been received. 7. Agreed treatment plan and measures In this section the psychologist should list in priority order the practical goals of this treatment plan required to be achieved to carry out valued social and occupational roles eg. 1. To drive own car one hour across the city; 2. To participate in a hobby at least two days each week; 3. To practice dream imagery to reduce intensity of nightmare panics. Along with each goal should be listed the interventions or strategies for facilitating the achievement or goal eg. 1. Exposure therapy; 2. Activity scheduling; 3. Dream imagery rehearsal, and the measure of progress to be used eg. 1. Subjective units of discomfort; 2. Activity diary; 3. Frequency and intensity of nightmares, and the anticipated date of achievement or review eg. April, 2006. To promote practical outcomes, the use of standardised outcome measures is required against which progress can be measured. A psychologist may customise measures for individuals but only if there is no appropriate standardised measurement tool available. This is because the reliability, validity and responsiveness of customised outcome measures is generally not known. © Transport Accident Commission 2006 MHF1n 0406 60 Brougham Street GEELONG VIC 3220 Telephone 1300 654 329 STD Toll Free 1800 332 556 GPO Box 2751 MELBOURNE VIC 3001 www.tac.vic.gov.au ABN 22 033 947 623 Ausdoc DX 216079 Geelong Page 1 of 2 MENTAL HEALTH (PSYCHOLOGY): TREATMENT PLAN NOTES 8. Treatment requested for approval In this section the psychologist should give the duration and number of hours of treatment that TAC is being requested to fund. Within the approved dates and number of hours of treatment the psychologist and the person may determine the frequency of contacts. This may include periods during which treatment is not provided. Please note that both the commencement and completion dates are required in order for the plan to be considered. 9. Multidisciplinary coordination and medications Treatment coordination refers to health practitioners, professional and lay carers being most effective by ensuring that their treatment is consistent, mutually reinforcing and directed at common goals. In this section list other providers of treatment to this person, their interventions, including especially psychotropic medications, and how you will be communicating with them. Enter the date of last contact that you have had with the providers listed. 10. Other comments and issues Please note any other needs that this person has and your recommendations for additional treatment. This may include occupational, physical or social/family needs beyond those that you can address in this treatment plan. The TAC may be able to fund accident related vocational assessment and support and services for other needs where they are reasonable and form part of an overall plan of interventions for the person. 11. Agreement by the psychologist and the person This plan should be signed jointly by the psychologist and the person to whom they are providing treatment. © Transport Accident Commission 2006 MHF1n 0406 Page 2 of 2