• How to Write the SOAP Treatment Plan Section

    A therapist types out the Plan section in their SOAP note on their laptop. Here’s how to write the Plan section, or SOAP treatment plan, along with examples of what to include.

    Wondering what goes into the SOAP Plan section in a SOAP note? This article explains how to write the SOAP treatment plan section, along with examples of what to include.

    The SOAP format has helped standardize healthcare documentation—improving client record-keeping, facilitating clear communication with other providers, increasing insurance reimbursement rates, and ensuring liability protection in case of an audit.

    SOAP notes are organized into four sections, which are each titled according to the SOAP acronym: Subjective, Objective, Assessment, and Plan. 

    It’s important for clinicians to be familiar with how to write a SOAP note and how to create a SOAP treatment plan in order to properly track and document the efficacy of client care. 

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    What is the Plan part of a SOAP note?

    The final section in a SOAP note—Plan—is designated for creating a SOAP treatment plan

    The SOAP Plan serves as a general course of action for upcoming appointments. It contains the next steps of treatment that are intended to move the client closer to their goals. 

    When writing the SOAP treatment plan, clinicians should focus on the treatment targets, usually noted in the client’s overall treatment plan. It should also include how the therapist will work with the client in the near future to meet these targets.  

    Think of this section as a snippet of the client’s overall treatment plan, which applies to upcoming appointments. 

    This section can serve as a communication tool for collaborating with other clinicians, noting what is planned for the client’s treatment. It also serves as a reminder to the primary clinician about what they will be working on with the client in the next session.

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    What is included in the Plan section of the SOAP note?

    Additional assessments

    If the clinician intends on conducting additional assessments or measures in the near future, they should note this in the SOAP Plan section.  

    The therapist may determine that further investigation or comparative data is needed to assess the client on an ongoing basis. For example, the therapist may use the PHQ-9 and GAD-7 measurements to monitor anxiety and depression as treatment progresses.   

    Consultation and referrals

    When therapists know they need to consult with collaborating clinicians or make referrals to other providers, they should add it to the Plan section.. This could include a consultation with the client’s former therapist or a referral to a psychiatrist for medication assessment.  

    Frequency of sessions

    Therapists should also include how often the client will be attending therapy in the Plan section (i.e., weekly or biweekly sessions).  

    In some cases, the client’s insurance may place limitations or require pre-authorization, and the clinician can determine the number of remaining therapy sessions. 

    The clinician may also be able to estimate treatment time based on an intervention protocol or goal completion.  This too can be indicated in the Plan section of the SOAP note. . For example, if a therapist is completing a 12-session protocol with a client, they can document the number of remaining sessions..

    Specific interventions and steps

    A clinician should have a sense of where they will take the course of treatment next, in response to the client’s progression and the direction of the overall treatment plan. The specific, tangible interventions and steps required to achieve the desired progress should be listed in the SOAP Plan section for each session’s progress note. 

    Client homework

    Clinicians should document activities or steps the client has agreed to work on between sessions in this section as well. 

    Any homework added to the SOAP treatment plan of a session can remind clinicians to follow-up with the completion of any assignments in future sessions.   

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    What to avoid in the Plan section

    When writing the SOAP Plan, clinicians should avoid making the following mistakes.  

    The first is repeating information listed in the SOAP Assessment section. The SOAP note has four distinct sections to keep documentation concise and reduce unnecessary redundancy—so it’s important to understand what goes in each section to maintain the integrity and purpose of the note. 

    Second, the clinician shouldn’t  include steps or interventions that do not align with the overall treatment plan. It’s particularly important that all SOAP notes are in alignment with the overall treatment plan for clients using their insurance—since payers may require strict adherence to the overall treatment plan and goals set to pay for services..  

    Finally, the therapist should avoid descriptions that are too vague. Statements such as, “provide ongoing treatment” or “continue working toward treatment plan goal” are too vague to add value to the note.  

    How to write the SOAP Plan section

    When writing a SOAP note, it can be helpful for the clinician to think about taking on different roles.  

    For the Subjective section, the clinician can take on the role of an interviewer or reporter who is trying to accurately represent the client’s point of view. 

    For the Objective section, they can shift into scientist-mode, reporting their impartial discoveries about the client. 

    While charting the Assessment section, the therapist can really put on their clinician hat and apply their clinical knowledge to understand and analyze their subjective and objective findings. 

    Finally, when thinking about how to write the Plan section, the clinician acts as a project manager who is trying to keep the bigger targets in mind and working towards achieving those end goals. 

    The focus of the Plan is to determine the best next steps according to the client’s current progress and where they want to go. This determination comes from analyzing information in other SOAP sections for the current note, previous SOAP session notes, and the overall treatment plan. 

    When writing the Plan in SOAP notes, it can be helpful to answer these 4 questions:

    1. What specific steps has the client committed to work on as homework before the next session?
    2. What specific interventions will the clinician be focused on in the upcoming sessions?
    3. Will any referrals or additional recommendations be provided to the client?
    4. How often will the client and clinician meet? 

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    Plan section of SOAP note vs. the overall treatment plan

    It is important to clarify the distinction between the SOAP Plan and the overall treatment plan.  

    The treatment plan is created in collaboration with the client at the beginning of sessions together and is a guiding document that outlines the overall trajectory of treatment. It encompasses all of the specific goals, objectives, and interventions that will be pursued throughout the therapeutic process.

    The SOAP Plan is the final portion of the SOAP note that gives a more narrow and focused view of the plans for upcoming therapy sessions, which is why it’s also referred to as the SOAP treatment plan

    While this section can include long-term goals, it is typically focused more on near-term goals. This section of the note should include information that is directly related to the treatment plan, but it should never be a full rewriting of the entire treatment plan.  

    Another way to think of this is that the treatment plan is the overarching, parent-plan, while the Plan in SOAP notes is a smaller, typically shorter-term, sub-plan that gets rewritten in each session’s SOAP note.  

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    SOAP note Plan examples

    SOAP Plan example #1

    Client agreed to contact the psychiatrist recommended by Therapist in order to set up a medication assessment. Client will continue to attend weekly therapy sessions in order to address their major depressive disorder through cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT). Therapist will teach the three-minute breathing space MBCT technique to help with Client’s goal of preventing any future relapse of depressive episodes. Therapist will introduce CBT thought disputation methods to help Client create alternative thoughts and continue to improve their mood. 

    SOAP Plan example #2

    Writer will provide psychoeducation and informed consent on interoceptive exposure techniques and their impact on panic disorder symptoms. Assuming Client’s consent, Writer will begin interoceptive exposure techniques focused on meeting Client’s overall treatment plan objective to increase their tolerance of experiencing panic symptoms of muscle tension and rapid breathing. Writer will assign interoceptive exercises for the Client to begin working on between weekly therapy sessions. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire will be conducted to measure progress against Client’s original DASS-21 scores. 

    Hopefully this article and these examples helped you to gain a better understanding of the SOAP treatment plan.

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