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treatment plan traffic sign blue sky background diagnosis medical assessment patient evaluation care management options therapeutic approach individualized goal setting intervention strategies medication regimen behavioral therapy rehabilitation recovery goals follow-up monitoring progress objectives targeted interventions evidence-based practices multidisciplinary team collaborative guidelines symptom psychoeducation supportive counseling services engagement adherence referral process continuum case timeline crisis risk relapse prevention self-care peer support coping skills family involvement coordinated effectiveness coordination psychotherapy training holistic nutritional discharge planning long-term