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Exhibit 12: Treatment Plan Form
| Problem area |
Priority Ranking |
Goal |
Intervention |
Objective Measure |
| Cocaine |
(1) |
|
|
|
| Alcohol (score= ) |
|
|
|
|
| Other Drugs (score= ) |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Employ/Educ (score= ) |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Family Relat (score= ) |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Social Network |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Recreation |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Psychiatric (score= ) |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Legal (score= ) |
|
|
|
|
| |
|
|
|
|
| Medical (score= ) |
|
|
|
|
| |
|
|
|
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Therapy Manuals for Drug Abuse: Manual 2
Contents
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