INTRODUCTION

ABOUT PRACTICEPLANNERS® TREATMENT PLANNERS

Pressure from third‐party payers, accrediting agencies, and other outside parties has increased the need for clinicians to quickly produce effective, high‐quality treatment plans. Treatment Planners provide all the elements necessary to quickly and easily develop formal treatment plans that satisfy the needs of most third‐party payers and state and federal review agencies.

Each Treatment Planner:

• Saves you hours of time‐consuming paperwork.
• Offers the freedom to develop customized treatment plans.
• Includes over 1,000 clear statements describing the behavioral manifestations of each relational problem and provides long‐term goals, short‐term objectives, and clinically tested treatment options.
• Has an easy‐to‐use reference format that helps locate treatment plan components by behavioral problem or Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5™) diagnosis.

As with the rest of the books in the PracticePlanners® series, our aim is to clarify, simplify, and accelerate the treatment planning process, so you spend less time on paperwork and more time with your clients.

ABOUT THIS SIXTH EDITION COMPLETE ADULT PSYCHOTHERAPY TREATMENT PLANNER

This Sixth Edition of the Complete Adult Psychotherapy Treatment Planner has been improved in many ways:

• Updated with new and revised evidence‐based Objectives and Interventions from the research literature
• Revised, expanded, and updated References to Clinical Resources for Evidence‐Based Chapters appendix
• Moved a Revised Appendix for References to Empirical Support online as found at: www.wiley.com/go/jongsma/adulttp6e
• More suggested homework assignments integrated into the Interventions
• Expanded and updated self‐help book list in the Bibliotherapy appendix
• Addition of new chapters on Loneliness and on Opioid Use Disorder
• Unipolar Depression chapter has been renamed Depression—Unipolar and Sexual Identity Confusion chapter has been renamed Sexual Orientation Confusion
• Suicidal Ideation has been added to the list of evidence‐based chapters with new research content inserted
• Integrated DSM‐5 diagnostic labels and codes into the Diagnostic Suggestions section of each chapter and all transition references to DSM‐IV have been removed

Evidence‐based practice (EBP) is steadily becoming the standard of care in mental health care as it has in medical health care. Professional organizations such as the American Psychological Association, National Association of Social Workers, and the American Psychiatric Association, as well as consumer organizations such the National Alliance for the Mentally Ill (NAMI) have all endorsed the use of EBP. In some practice settings, EBP is becoming mandated. Some third‐party payers are requiring use of EBP for reimbursement. It is clear that the call for evidence and accountability is being increasingly sounded. So, what is EBP and how is its use facilitated by this Planner?

Borrowing from the Institute of Medicine's definition (Institute of Medicine, 2001), the American Psychological Association (APA) has defined EBP as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (APA Presidential Task Force on Evidence‐Based Practice, 2006). Consistent with this definition, we have identified those psychological treatments with the best available supporting evidence, added Objectives and Interventions consistent with them in the pertinent chapters, and identified these with this symbol: . As most practitioners know, research has shown that although these treatment methods may have demonstrated efficacy, factors such as the individual psychologist (e.g., Wampold, 2001), the treatment relationship (e.g., Norcross, 2019), and the client (e.g., Bohart & Tallman, 1999) are also vital contributors to optimizing a client's response to psychotherapy. As noted by the APA, “Comprehensive evidence‐based practice will consider all of these determinants and their optimal combinations.” (APA, 2006, p. 275). For more information and instruction on constructing evidence‐based psychotherapy treatment plans, see our 12 DVD‐based training videos titled Evidence‐Based Psychotherapy Treatment Planning (Jongsma & Bruce, 2010–2012).

The sources we used to identify the evidence‐based treatments integrated into this Planner are multiple and, we believe, high quality. They include rigorous meta‐analyses, current critical, expert reviews, as well as evidence‐based practice guideline recommendations. Examples of specific sources include the Cochrane Collaboration reviews; the work of the Society of Clinical Psychology identifying research‐supported psychological treatments; evidence‐based treatment reviews (e.g., David, Lynn, & Montgomery, 2018; Nathan & Gorman, 2015), as well as critical analyses of the process through which evidence‐based practice is defined (e.g., Dimidjian, 2019; Norcross, Hogan, Koocher, & Maggio, 2017). Evidence‐based practice guidelines informing the selection process include those from the American Psychological Association, American Psychiatric Association, the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom, and the National Institute on Drug Abuse (NIDA) to name a few.

Although sources may vary slightly in the criteria they use for judging levels of empirical support, we favored those that use more rigorous criteria, typically requiring demonstration of efficacy through randomized controlled trials or clinical replication series, good experimental methodology, and independent replication. Our approach was to evaluate these various sources and include those treatments supported by the highest level of evidence and for which there was consensus across most of these sources. For any chapter in which EBP is indicated, references to the sources used to identify them can be found online at www.wiley.com/go/jongsma/adulttp6e. In addition to these references to empirical support, we have also included a References to Clinical Resources appendix. Clinical resources are books, manuals, and other resources for clinicians that describe the details of the application, or the “how to,” of the treatment approaches described in a chapter.

We recognize that there is debate regarding evidence‐based practice among mental health professionals, who are not always in agreement regarding the best treatment, what factors contribute to good outcomes, or even what constitutes “evidence.” We also recognize that some practitioners are skeptical about changing their practice based on psychotherapy research. Our intent in this book is to accommodate these differences by providing a range of treatment plan options, including those consistent with the “best available research” (APA, 2006), those reflecting common clinical practices of experienced clinicians (that may not have been subjected to study), and some that reflect promising emerging approaches. Our intent is to allow users of this planner an array of options so they can construct what they believe to be the best plan for their particular client.

More recently, psychotherapy research is moving toward trying to identify evidence‐based principles of psychotherapeutic change that cut across the various individual psychotherapies that have largely been the focus of outcome research. An example of this call is seen in Goldfried (2019), in which he advances the following principles:

• Promoting client expectation and motivation that therapy can help
• Establishing an optimal therapeutic alliance
• Facilitating client awareness of the factors associated with his or her difficulties
• Encouraging the client to engage in corrective experiences
• Emphasizing ongoing reality testing in the client's life

Although many endorse this effort, at the time of this writing it is still in progress. Consequently, our approach to identifying objectives and interventions consistent with evidence‐based practices reflects what has been done from the “principles” approach as well as the research demonstrating the efficacy and effectiveness of individual models. Perhaps the field will advance enough by the next edition of this planner to include only evidence‐based principles of psychotherapeutic change. Until then, we believe that the approach we have taken reflects the current state of the science.

Each of the chapters in this edition provides options to integrate homework exercises into the Interventions. Many (but not all) of the client homework exercise suggestions were taken from and can be found in the Adult Psychotherapy Homework Planner (Jongsma, 2013). You will find more homework assignments suggested in this sixth edition of the Adult Psychotherapy Treatment Planner than in previous editions.

The Bibliotherapy Suggestions appendix of this Planner has been expanded and updated from previous editions. It includes classics, recently published offerings, as well as more recent editions of books cited in our earlier editions. All the self‐help books...