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Self Directed Treatment Plan

Client Name:_________________________________

In your own words, write down what you think are your problems, what you would like to change (goals), and how you think you can accomplish that change (intervention).

Identified Problem(s) Your Treatment Goal(s) Interventions
     
     
     
     
     
     
     
     
     
     
     
     
     
     

Therapist Signature:_____________________________________

Client Signature:________________________________________

Date:________________________________

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