A Treatment Plan should include the demographic and personal information of the individual in the assessment
write-up. In the conclusion of the assessment write-up, the Recreational Therapist is to include the score from the
assessment conducted (FACTR-R, GRST and/or Mini-Mental State Examination). For example, “CTRS
administered the MMSE (Mini-Mental State Exam) and scored 26/30 (No Cognitive Impairment). CTRS
administered the FACTR-R (4/11 Physical, 8/11 Cognitive, & 3/11 Social/Emotional), identifying that all three
functional domains can be improved through RT.” This should be followed by the goals and objectives. And lastly
include the two evidence-based practices chosen to reach the selected goals.

The Last Revision date is the date you completed the Treatment Plan.
The Review Date is the date one year out from the completion date of the Treatment Plan.

Here is a completed Treatment Plan Example.

The finalized RT Treatment Plan Template must be updated a minimum once per year and uploaded to Bureau of Disabilities Services (BDS) online portal, where each member of the Individualized Support Team (IST) may review any and all documentations pertaining to the individual supported.

Please download the documents above and save to your computer!