L. Strength Based Client Wellness Plan Template
Strength Based Client Wellness Plan
Plan Date Staff Member Client No.
Date of Birth: Age:
Cultural Preference:
Strengths:
Mental:
Emotional:
Physical:
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Plan Date Staff Member Client No.
Resiliency Factors
Spiritual: connection, prosperity
Family: attachment, communication, family structure, parent relations, parenting style, sibling
relationships, parents’ health and support outside the family relationships, connections, support
Friends: relationships, connections, support, involvement
Community: relationships, connections, support, involvement
Nation: relationships, connections, support, involvement
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Plan Date Staff Member Client No.
Intervention Areas
Current stressors: homeless, poverty, education, unemployment, abuse, dependency, legal, stress, disease, illness, age, disability, loss, grief, spirituality, love, gender identity, rage, access,
Emotional status :temperament, guilt, shame, hopelessness, despair, failure, rejection, anxiety, humiliation, trauma, loneliness, tolerance, intergenerational, residential school, fear, negativity, abandonment, resentment
Social network: children, family attachment, community, nation, peer pressure, family behaviours
Physical health need: intoxication, withdrawal, eating disorder, weight, flexibility, exercise, genetics
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Plan Date Staff Member Client No.
Coping skills need: respect, kindness, caring, honesty, humility, tolerance, visibility, denial, secrecy, craving, thief, sex trade, gang, obsession
Interpersonal conflicts need: angry, rage, blame, pity, violence, intimacy
Self-esteem need: spirit name, voice, assertiveness, pride, clan/colours, wisdom, compassion, vision, inner critic, forgiveness, generosity
Other relevant factors: adaptive behaviours, level of risk= self harm, suicidal behaviours, gifts, talents, hobbies, character, adversity, values, listening, judgment, support
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Plan Date Staff Member Client No.
Wellness Plan:
Physical / Mental / Emotional / SpiritualStep 3-Problem Identification:
Step 4-Goals:
Step 5-Objectives:
Level of Risk
(Low, Moderate, High, Uncertain)
Intoxication/
Withdrawal/
Harm reduction
Plan changes/
modifications
Follow up dates
1,
2.
3.
4.
Evaluation Plan
Physical / Mental / Emotional / SpiritualHarm Reduction/ Sobriety
Conclusions
I have read this plan. I understand its contents and agree to abide by the content.
Client: Date:
Counsellor: Date: