Create a draft of the assessment and treatment plan that you and your client completed together, using the
form below.
Client Name:
Purpose of Service: (Example: Assist the client to find secure housing. Note: the Purpose of Service should fall
within the mission of the agency)
Client Goal/Outcome: (Example: Mr. Brown’s goal is to find affordable, secure housing within six weeks)
Activities/Services to Reach Goal/Outcome
• State what the client will do to reach the goal/outcome
• State what the worker will do to reach the goal/outcome
• Describe how the activities/services are intended to reach the goal/outcome
Services Provided by Agency Staff – Underline the services provided
• Direct service – consultation
• Referral (describe)
Resources to Help Client Reach Goal/Outcome
Strengths that Will Help Client to Reach Goal/Outcome
Describe what it will look like for the client when the goal/outcome is reached. What will be different in the
client’s life?
Agency Mission: The Wallace Stevens Community Center (WSCC) seeks to support, strengthen, and empower
adults in the north country by providing them with access to a wide variety of services including medical,
mental health, continuing education, housing, career counseling, and temporary financial assistance.
Agency Outcome Goals: The adults who are served by the Wallace Stevens Community Center will achieve
ongoing stability as evidenced by:
Completing client education goals within 2 years from the initiation of service
Obtaining stable employment within 1 year from the initiation of service
Obtaining stable housing within 3 months from the initiation of service
Sample Solution