REPS MODEL

REPS MODEL
Please be as specific as possible regarding the offense and patterns of behavior leading up to the offense. The therapist has the right to share your completed document with your diversion/probation/case worker for feedback and approval before satisfactory completion of treatment.
Responsibility: “I take responsibility for…” *
Empathy: “I believe __________________ felt________________.”Please include your thoughts about the impact that your actions had on your partner, ex, children, family, neighbors, etc. Please be as detailed as possible below.*
Plan: “My plan for maintaining personal change is:Include tools you will use and concepts you will use. List your options. Be as specific as possible. Include any supports/mentors or other figures that will help you stay on track. If your incident included drugs or alcohol, include your sobriety plan. How have your perceptions changed? What have you learned? *
Sustainability and Safety: What behaviors and thought patterns will I be on the lookout for which show that I might be sliding back into old ways? Be specific. *
Name*

First NameLast Name
Email
example@example.com
Should be Empty:

Please be as specific as possible regarding the offense and patterns of behavior leading up to the offense. The therapist has the right to share your completed document with your diversion/probation/case worker for feedback and approval before satisfactory completion of treatment.