1
Client & Clinical Information
2
Diagnosis & Medical Necessity
Medical necessity documentation links the diagnosis to the presenting impairment and justifies treatment.
Presenting Concerns — Duration, Frequency, Intensity (required for diagnosis)
3
Case Conceptualization — CCPT Framework
Write the CCPT conceptualization of the child. This is the clinical lens through which the treatment plan is framed.
Contextual Considerations (check all that apply — these inform SMART goals)
4
Long-Term Goals — SMART Format
Each goal must be Specific, Measurable, Achievable, Realistic, and Timely. Link each goal directly to a presenting concern above.
5
CCPT Interventions & Objectives
Select all interventions planned for this treatment. CCPT interventions are primarily nondirective; directive elements noted where applicable.
Core CCPT Therapist Skills
Parent / Caregiver Interventions
Collateral / Adjunctive Interventions
6
Other Professionals Involved & Referrals
7
Parent Consultation Plan
8
Signatures & Agreement
Parents must review, agree to, and sign the treatment plan. Document that this occurred.