A Clinician's Guide to Therapy Planning that Works (and doesn't take forever!)

If you find yourself planning therapy sessions one at a time, scrambling to come up with activities on the fly, or feeling like you’re constantly in survival mode—you’re not alone.

Between writing reports, updating files, and squeezing in emails, session-by-session planning often feels like the only option. But this approach can leave therapy feeling reactive instead of proactive, making progress slower and leading to last-minute stress (and let’s be honest- burnout).

So how do you turn your goals into effective, engaging sessions without spending hours planning?

Great question!

Here’s the key: Rethink how you plan.

Instead of planning session by session, start planning with the goal in mind.

Think about:

• The bigger picture—how does this goal fit into the child’s developmental journey?
• The next step—what’s the next small, achievable step that will move them closer?

By shifting your focus from “What activity should I do this session?” to “What’s the next step to help build this skill and move us closer to the goal?" you create therapy that feels more intentional, more efficient, and ultimately, more effective.

And this is where two key frameworks come in handy:

1. Developmental milestones help you identify what skills to target based on ‘typical’ developmental pathways. Want to learn more? Check out my article:

2. Teaching hierarchies show you how to break those skills into manageable steps and ensure they’re taught in a way that builds success.

Used together, these tools create a structured (but flexible!) plan that not only keeps therapy moving forward but also makes planning quicker, easier, and less overwhelming for you.

Teaching Hierarchies: A smarter approach to planning

A teaching hierarchy is a roadmap for learning, breaking down complex skills into sequential steps—from foundational abilities to more advanced ones. It helps guide when and how to introduce skills while ensuring the right level of support is provided at each stage.

Here’s why they’re so useful:

• They help estimate how many sessions it might take to reach a goal.
• They make it easier to adjust therapy on the fly—you can scale activities up or down depending on how the child is responding.
• They provide a clear structure while still allowing for individualised, child-led learning.

And that's the key- They aren’t a rigid rulebook!

While teaching hierarchies provide a helpful framework, they’re designed to be adapted—not followed step-by-step without question. The real power of teaching hierarchies lies in their flexibility—you can adjust them to fit the unique needs of each child, ensuring therapy remains effective and engaging.

Every child learns differently, and this is especially true for neurodivergent learners, where a one-size-fits-all approach simply doesn’t work. For some children, you might need to skip steps, revisit earlier skills, or introduce concepts out of the typical sequence.

That’s not a sign you’re “off track”—it’s a sign you’re tailoring therapy in the way that’s most effective for that child.

Ultimately, flexibility is what makes teaching hierarchies work. They guide your clinical thinking while leaving plenty of room for creativity, responsiveness, and child-led learning—ensuring therapy is not just effective, but also meaningful and engaging for every individual you work with.

Building your Teaching Hierarchy Toolbox (Without the overwhelm)

If learning new hierarchies on top of everything else sounds daunting, don’t stress! You don’t need to master everything at once.

Instead, build your clinical toolbox one step at a time:

• Pick one hierarchy to focus on each week—whether it’s teaching concepts, developing vocabulary, or another skill.
• Look for patterns across your caseload—you’ll often find common goals where you can apply the same framework.
• Over time, you’ll naturally get faster, more confident, and more efficient at planning therapy in a way that flows.

The key is to start! The skills you develop now will save you time, reduce planning stress, and improve therapy outcomes in the long run.

Quick Tips for Smarter, Faster Planning

To make therapy planning even smoother, try these strategies:

? Batch your planning—setting aside time to plan for multiple clients at once is far more efficient than doing it session by session.

? Group similar goals—if multiple clients are working on similar skills, reuse strategies to save time.

? Set planning challenges—try shaving five minutes off your planning time each week to build efficiency.

? Work smarter, not harder—lean into your frameworks and tools rather than reinventing the wheel for every session.

Bringing It All Together

Just like goal setting, therapy planning works best when you step back and see the bigger picture.

By using developmental milestones to identify what goals to work on and teaching hierarchies to guide how to teach them, you create a framework that: saves time, reduces overwhelm, and improves therapy outcomes.

So, what’s your approach to session planning?

Are you a session-by-session planner, or have you found ways to streamline your process? I’d love to hear your strategies—drop a comment below!

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