Number Problem Altered Thoughts Related to: history of mental illness biochemical imbalance medication noncompliance sensory overload overwhelming situational stressors recent traumatic event or loss As evidenced by: disturbed affect auditory hallucinations visual hallucinations tactile hallucinations paranoid delusions grandiose delusions somatic delusions religious preoccupation ideas of reference disorganized speech decreased concentration social withdrawal psychomotor abnormalities other: ______________ ___________________ other: ______________ ______________________ Date ID Goals and Objectives Projected Achieved Date Date Actually Achieved Clinical Interventions Approaches, Modality, Provider, & Frequency Long-Term Goals: 1. Patient will decrease acute, reactive, psychotic symptoms and return to normal functioning in affect, thinking, and relating. 2. Other: ________________________________ ___________________________________________ ___________________________________________ 1. Group Psychotherapy ____x/day, ___ days/week, for one hour each. Therapist 2. Educational Group ____x/day, ____ days/week, for one hour each. Nurse/ Therapist 3. Prescribe and adjust psychotropic meds. MD Short-Term Goals/Objectives: a. Patient will accept and understand that distressing symptoms are due to mental illness. b. Patient will interact socially without fear or suspicion being reported for 5consecutive days. c. Patient will think more clearly as demonstrated by logical, coherent speech. d. Patient will report a diminished or absence of hallucinations/delusions for 5 consecutive days. e. Patient will verbalize strategies to decrease anxiety associated with psychosis. f. Patient will participate in therapeutic groups to the best of his/her ability _______% of the time. g. Patient will verbalize need for medication compliance and adhere to medication regime. h. Other: ______________________________ __________________________________ __________________________________ 4. Monitor patient’s response to psychotropic medications ongoing. MD, Nurse 5. Educate patient about mental illness, the disease process, symptom management & psychotropic medications. Nurse 6. Build trust and establish therapeutic rapport with patient. All staff 7. Monitor and record patients mood, behavior, appetite, sleeping patterns, and medication compliance. All staff 8. Other: ___________________________________________ ___________________________________________ ___________________________________________ Revised Goals/Objectives ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ MULTIDISCIPLINARY INTEGRATED TREATMENT PLAN *Status Key Denotes: A=Achieved, D=Deferred, E=Extended, and R=Revised. June 2006