SOP 508.44-att-3: Summary of Monthly Progress in the ITF (Attachment 3)

Division:
Unknown
Topic Area:
508 Policy-MH Evaluations/Screenings/Treatment
PowerDMS:
View on PowerDMS
Length:
138 words

Summary

This is a monthly progress report form used to document an inmate's progress while enrolled in an Intensive Treatment Facility (ITF) program. The form captures the inmate's program phase, level of progress, participation quality in treatment activities, any learning experiences or disciplinary issues, and staff observations. The completed form is signed by ITF counselors, the Mental Health Unit Manager, and Clinical Director, then retained in the inmate's mental health record.

Key Topics

  • ITF progress report
  • intensive treatment facility
  • monthly progress note
  • mental health program phases
  • treatment participation
  • program evaluation
  • inmate mental health record
  • therapeutic progress tracking
  • behavioral observation
  • discharge planning

Full Text

508.44
Attachment 3

10/19/2023

PROGRESS NOTE
Summary Report of Monthly Progress in the ITF

Facility:____________________________ Date of Summary:_______________
Name:______________________________ GDC#:________________________
DOB:______________________________ Race:_________________________

Judge:_____________________________ Chief PO: _____________________

|Month|Col2|
|---|---|
|
|Program Phase: I II III IV
|
|















|Level of Progress: __Above Standard Level ___ Standard Level ___ Below Standard Level|
|















|Participation Quality: __ Appropriate ___ Attentive ___Sharing ___ Gave Feedback
___ Received Feedback __ Supportive ___ Monopolizing ___ Resistant
___ Argumentative __ Other: ____________________________________________
|
|















|Learning Experiences:__ Yes __ NoDisciplinary Reports: __Yes __ No|
|















|Summary of Progress:




|
|















|Staff Issues/Concerns:
|
|















|Discharge Needs:


|
|















|Plan:
|

ITF Counselor: ______________________________________ Signature: _________________________________
(print name)

Mental Health Unit Manager: __________________________ Signature: _________________________________
(print name)

Clinical Director: _____________________________________ Signature: _________________________________
(print name)

Revised 6/2020

Retention: Attachment 3 will be placed in the offender’s mental health record, section one (1). At the end of the offender’s need for mental health
services and/or sentence, the mental health record will be placed within the offender’s health record and retained for 10 years.

Attachments (3)

  1. Addiction Severity Index Summary Assessment (212 words)
  2. Integrated Treatment Programs 4 Quadrant Assignment (Attachment 2) (299 words)
  3. Summary of Monthly Progress in the ITF (Attachment 3) (138 words)
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