Student name, student no.
Template for the proposed management plan
Demographic information – not included in word limit , age, gender,
Description of the case - , must be one of the following a person diagnosed with an eating disorder,
personality disorder, somatoform disorder, dual diagnosis (alcohol and other drug and mental illness), or dual
disability (learning or developmental disability)
Setting of treatment – inpatient, community
(students need to indicate whether the treatment will be provided in an inpatient setting or a community
setting)
*the yellow indicates what can be changed in the case study
Over the next 3 months Biological, psychological, social Expected outcome and
intervention proposed and evaluation approach
rationale
Consumer identified goals This part does not have to be filled What tools might assist the
out – it would be completed with consumer to evaluate their own
The person would complete this the person goals
section you don’t need to
You do need to identify a self-
evaluation tool in this section that
can support the person to evaluate
their own progress with the
treatment provided Two examples
of self-report tools where provided
in week 1. The BASIS 32, and the
INSPIRE tool
Some clinical practice guidelines
will recommend specific self-
report tools to use
Nursing diagnoses identified and Biological Expected outcome and
goals evaluation tools
The nursing diagnosis can be taken The evaluation tools might the
from the Fortinash text book Refer to the text book, Evans et al. same as assessment tools so you
recommended for this subject. (2017), clinical practice guidelines might have to identify how often
Alternatively a key issue identified and research articles that are an assessment is undertaken and
in the other text Evans et al. specific to the person’s diagnosis what precautions are around that.
(2017), clinical practice guidelines provided in the case study.
or research literature can be used.
Nursing goals should align with You might like to use a recovery
the diagnosis or issue identified, if specific evaluation of the treatment
you have taken them from a text
you need to reference them
Assessment tools utilised
Refer to the text book, Evans et al.
(2017), clinical practice guidelines
The assessment should objectively and research articles that are
confirm the nursing diagnosis or specific to the person’s diagnosis
issue you have identified provided in the case study.
Referencing – you need to use in
text citations in the table
Assessment tools utilised Psychological Expected outcome and evaluation
tools
Example - If we used an diagnosis Initiate a daily schedule for regular
like major depression time for waking, having breakfast That the person achieve some
and showering – record in a mood return of self-care routine over a 2
poor self-care (reference) diary – (reference) week period
Assessment tools utilised – K10
(reference)
A record self-care in the mood
Goal for treatment would to diary,
increase self-care
Hamilton anxiety and depression
rating scale (reference)
Assessment tools utlised Social interventions Expected outcome and
evaluation tools
Rationale for interventions chosen
In this section written in paragraph format you explain why you have chosen the
approach – assessment, interventions and evaluations and aligns with recovery-
oriented trauma informed care and practice.
Paragraph format
References