DV Treatment Plan Review #3

DVMRT Updated TPR #3
Name*

First NameLast Name
Date*

MonthDayYear
Date
Email*
example@example.com
1. What are your continued goals to work on after completion of treatment?*
2. What therapist or agency (including medication management, if applicable) will you contact when you need support in the future? Who in your personal life will support you in the future? *
3. How are you demonstrating financial responsibility and why is this important?*
4. How will you take responsibility for ensuring safety for your children and family when there is a conflict? *
5. What are you currently doing to have productive arguments/conflicts? How will you make sure your partner feels safe in future conflicts? *
6. What are indicators of successful/unsuccessful stress management? Explain why it is important to know what your personal needs are.
7. How have you committed to eliminating the behavior that led you to the system? What tools/concepts do you use?
Therapist Comments (to be completed by clinician):
Treatment Changes/Recommendations (to be completed by clinician):
Client Signature*

Clear
Therapist Signature:

Clear
Should be Empty:

DVMRT Updated TPR #3