PSYCHOTHERAPY TREATMENT PLAN

Case No. 35925 Client Name: Muhammad Muzamil Age: 13 Gender: Male

Symptoms Frequent aggression, emotional outbursts, defiance, lack of

cooperation during tasks, low independence in routines, poor
expressive communication, and limited impulse control.
Diagnosis Intellectual Developmental Disorder, Mild.
Target Symptoms 1.​ Physical aggression
2.​ Tantrums
3.​ Noncompliance
4.​ Poor task engagement
5.​ Inability to follow routines
Treatment Approach Applied Behavior Analysis (ABA)
Frequency of sessions/week 1-2 Total No. of sessions 30 - 35
Major Treatment Goals 1.​ Increase adaptive behaviors and reduce maladaptive
behaviors.
2.​ Enhance ability to communicate needs and follow simple
instructions.
3.​ Increase tolerance for tasks and transitions.
4.​ Develop age-appropriate self-help and social skills.
5.​ Foster independence within structured routines.

Problem 1 Build Therapeutic Alliance

Objective To build trust and a sense of safety to encourage participation in therapy.
Intervention 1.​ Initially engaging the child in play and enjoyable, no-pressure activities
(e.g., bubbles, coloring, building blocks). The goal is to let the child
associate the therapy setting with comfort, fun, and predictability.
2.​ Consistently use the child’s favorite toys during sessions to make the
therapist’s presence a source of positive feelings.
3.​ Gently follow the child’s lead in activities to show that you are listening,
attentive, and accepting. This helps the child feel in control and safe.
4.​ Gradually start incorporating structured tasks into fun activities, bridging
trust into task participation. (i.e. Tracing, Object identification etc).
Duration 3–5 sessions (initial phase, then ongoing maintenance)

Problem 2 Physical Aggression

Objective Reduce frequency and intensity of physical aggression.
Intervention 1.​ Use of extinction procedures for aggression (e.g., no attention if
attention-maintained).
a.​ When the child attempts to hit or push, calmly and consistently
respond by preventing the behavior from being reinforced (e.g., no
extra attention, redirecting quietly). Keep your energy low to avoid
escalation.
2.​ Teach alternative behaviors that serve the same function (Functional
 Communication Training – FCT).
a.​ During calm moments, teach the child to use a simple phrase or
gesture (like “help” or handing over a “break” card) to express
frustration or request assistance.
3.​ Implement Differential Reinforcement of Alternative Behavior (DRA).
a.​ When the child uses the new communication behavior, immediately
reinforce it with something desirable (e.g., a favorite snack, toy, or
praise). This helps the child understand that expressing needs
appropriately gets quicker, better results.
b.​ Offer regular praise, tokens, or rewards for using hands gently,
playing cooperatively, or asking for help instead of lashing out.
4.​ Anticipate situations that lead to aggression and intervene early with
calming activities or distraction.

Duration 3-5 Sessions

Problem 3 Noncompliance and Task Avoidance

Objective Increase task compliance and reduce avoidance behavior.
Intervention 1.​ Using Premack Principle (“First-Then”) for increasing compliance. Make
the reward immediate and highly motivating.
2.​ Task Analysis: Breaking tasks into small, manageable steps.
a.​ Use consistent visual cues and schedule boards to show what’s
coming next, which reduces uncertainty and refusal.
3.​ Token Economy: Every time the child complies with a request, give
enthusiastic praise or a token, and let them access something they enjoy, for
positive reinforcement.
4.​ High-Probability Request Sequence: Begin each session with easy,
enjoyable instructions (e.g., “High five,” “Touch your nose”) to build
momentum before asking for less preferred behaviors.
Duration 5-6 Sessions

Problem 4 Tantrums and Emotional Dysregulation

Objective To reduce tantrums by improving the client’s ability to express emotions in healthy
ways.
1.​ Teach the child a simple relaxation routine using deep breaths, squeezing a
stress ball, or blowing a balloon.
2.​ Emotion Labeling and Regulation:
a.​ Introduce an emotion chart with expressive faces and help the child
point to or touch how they feel throughout the day.
b.​ Prepare a “calm corner” in the therapy space with soothing toys or
sensory items where the child can go to relax during emotional
episodes.
c.​ After the episode ends, gently talk about what the child could try
next time.
d.​ Reward and praise the child when they use emotional regulation
strategies instead of tantrums—even partially.
Duration 4-5 Sessions

Problem 5 Limited Communication Skills

Objective To strengthen expressive communication so the child can ask for help, make
choices, and express needs without frustration.
Intervention 1.​ Mand Training to increase requests.
a.​ During activities, pause before giving a preferred item and gently
prompt the child to use a word, gesture, or picture to make a
request. For example, point to “want toy” or encourage them to say
“please.”
2.​ Picture Exchange Communication (PECS) for alternative communication.
a.​ Use visual communication cards throughout the session. For
example, cards for “break,” “more,” “stop,” “help,” etc., and teach
the child to use them by modeling and prompting.
3.​ Praise even small attempts to communicate and reinforce them by quickly
meeting the child’s request.
4.​ Use natural daily routines (snack time, play time) to embed communication
opportunities so the child learns to request in different settings.
5.​ Pair verbal models with pictures to build vocabulary and understanding
over time.
Duration 3–4 sessions (introductory), continued use throughout

Problem 6 Poor Daily Living Skills

Objective To improve independence in daily routines like hygiene, eating, and dressing.
Intervention 1.​ Using Task Analysis and Chaining (forward/backward)
a.​ Choose one routine task (e.g., washing hands) and teach it in
small steps, providing prompts.
b.​ Praise at each stage—like “turn on tap,” “put soap,” “rub
hands,” and so on.
c.​ Visual Support: If the child struggles with multi-step actions,
use a visual sequence chart showing each part of the task with
pictures.
d.​ Backward chaining: complete most of the task yourself, and
let the child finish the last step. Then slowly work backward,
letting them do more.
e.​ Keep reinforcement immediate after each correct step. Use
tokens, stickers, or brief access to something fun.
f.​ Repeat routines consistently in the same way each day to
promote mastery.

Duration 5-6 sessions.

Problem 7 Termination and Generalization

Objective To maintain progress, support carryover across environments, and prevent
regression.
Intervention 1.​ Generalization and Maintenance
a.​ Begin introducing skills in other settings (e.g., home, school) with
support from caregivers.
2.​ Caregiver Training to ensure consistency
a.​ Role-play with family members so they can help reinforce.
b.​ Train caregivers to use the same cues and reinforcers so the child
experiences consistency across environments.
c.​ Create a visual “Coping Toolbox” or behavior book with reminders
of strategies the child can use.
3.​ Fading Reinforcement to promote natural environment.
a.​ Fade out tokens or rewards slowly while increasing praise and
real-life reinforcers (like extra playtime).
4.​ Booster Sessions: Schedule a monthly booster session to track progress and
tweak interventions if needed.
Duration 4-5 sessions at the end, then spaced follow-up.

__________________ ________________
Supervisor Therapist
Ms. Anita Hasan Rubab Agha
Teaching Assistant Mphil Trainee