diminished; this progress was reinforced.The client has not learned the self-control strategies and was provided with remedial feedback in this area.
48 Select Situations to Apply Skills (48)The client was directed to identify situations in which they will be challenged to apply new strategies for managing ADHD.The client was urged to start the application of new strategies with a situation that was highly likely to be successful.The client was assisted in identifying a hierarchy of gradually more challenging situations to apply new techniques.
49 Consolidate New Skills (49)The client was assisted in consolidating the use of new ADHD management skills.Techniques such as imagery were used to help the client consolidate new ADHD management skills.Techniques such as behavioral rehearsal, modeling, role-playing, and in vivo exposure/ behavioral experiments were introduced to help the client consolidate the use of new ADHD management skills.
50 Build Communication Skills (50)Instruction, modeling, and role-playing techniques were used to help build the client's general social and communication skills.The client was assisted in practicing general social and communication skills.The client was reinforced for increasing social and communication skills.The client was redirected in areas in which they continue to struggle with communication and social skills.
51 Assign Books/Manuals on Building Social Skills (51)The client was assigned to read about general social and/or communication skills in books or treatment manuals on building social skills.The client was assigned to read Your Perfect Right (Alberti & Emmons).The client was assigned to read Conversationally Speaking (Garner).Key points from the client's reading material were reviewed and processed.The client has not read the assigned information on social and communication skills and was redirected to do so.
52 Review Incidents of Intrusive Comments (52)The client was assisted in reviewing social situations in which they were intrusive or talked excessively without thoughtfulness.The client was redirected toward greater social success through modeling, role-playing, and instruction.The client was reinforced for the ability to change from intrusive thoughtless comments to better social functioning.
53 Teach Problem-Solving Techniques Requiring Thought Before Action (53)The client was taught about problem-solving techniques that require thought before taking action and how they can apply these to interpersonal conflict situations.The client was assigned “Applying Problem-Solving to Interpersonal Conflicts” from the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client was assigned “Staying Attentive and Other Negotiating Skills” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).The client was reinforced for use of problem-solving skills.The client has not used problem-solving skills and was redirected to do so.
54 Teach Relaxation Techniques (54)The client was taught various relaxation techniques, including deep muscle relaxation, rhythmic breathing, meditation, and guided imagery to be used when stress levels increase.The client was assigned “Self-Soothing: Calm Down, Slow Down” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).It was noted that the client has implemented relaxation procedures to reduce tension and physical restlessness and reported that this technique is beneficial.The client has not followed through on implementation of relaxation techniques to reduce restlessness and tension and was encouraged to do so.
55 Review Symptoms and Fixes (55)The client was assisted in reviewing the symptoms that have been problematic and the newly learned coping skills that they will use to manage the symptoms.The client was assigned “Symptoms and Fixes for ADD (now ADHD)” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).
56 Teach Mindful Meditation (56)The client was provided with a rational for mindful meditation to enhance attentional regulation.The client was taught mindful meditation skills.The client was encouraged to apply mindful meditation skills in other tasks requiring attentional focus.The client engaged accurately in mindful meditation and was reinforced for using this skill.The client struggled to use mindful meditation skills and was provided with remedial feedback.
57 Develop an Aftercare Program (57)The client was assisted in developing an aftercare plan that will support recovery from ADHD and addictive behavior problems, including regular attendance at 12-step meetings, getting a sponsor, and continuing necessary therapy.The client has listed several components of an aftercare plan that will support sobriety (e.g., self-help groups, sponsors), as well as specific techniques to assist with ADHD concerns; the client was encouraged to use these skills.The client was reinforced while describing active pursuit of the elements of the aftercare program.The client has not followed through on an aftercare plan and was redirected to do so.
58 Assess Satisfaction (58)A treatment satisfaction survey was administered to the client.The client's survey responses indicated a high level of satisfaction with treatment services; these results were processed.The client's survey responses indicated a medium level of satisfaction with treatment services; these results were processed.The client's survey responses indicated a low level of satisfaction with treatment services; these results were processed.Although the client was encouraged to complete a treatment satisfaction survey, it was refused.
NOTES
1 * The numbers in parentheses correlate to the number of the Behavioral Definition statement in the companion chapter with the same title in The Addiction Treatment Planner, Sixth Edition, by Perkinson, Jongsma, & Bruce (Wiley, 2022).
2 * The numbers in parentheses correlate to the number of the Therapeutic Intervention statement in the companion chapter with the same title in The Addiction Treatment Planner, Sixth Edition, by Perkinson, Jongsma, & Bruce (Wiley, 2022).
BIPOLAR DISORDER
CLIENT PRESENTATION
1 Mood Dysfunction (1)*The client exhibits an abnormally and persistently elevated, expansive, or irritable mood.The client displays multiple symptoms of mania.The client displays inflated self-esteem or grandiosity.The client displays decreased need for sleep.The client displays pressured speech, flight of ideas, and distractibility.The client displays excessive goal-directed activity or psychomotor agitation and excessive involvement in pleasurable, high-risk behavior.The client's mood has returned to normal limits.
2 History of Mood Episode (2)The client has a history of a hypomanic mood episode.The client has a history of a full-blown manic episode.The client has experienced mixed mood episodes in the past.
3 Inflated Sense of Self (3)The client gave evidence of an inflated sense of self-esteem, unrealistic self-capacities, or grandiosity.The client appears oblivious to their inflated sense of self-esteem, unrealistic self-capacities, or grandiosity.The client's inflated sense of self-esteem, unrealistic self-capacities, and grandiosity have persisted, in spite of attempts to get them to be more realistic.The client's sense of self-esteem and beliefs in their capabilities have become more reality based.The client has presented no recent evidence of inflated self-esteem or exaggerated, euphoric beliefs.
4 Increased, Pressured Speech (4)The client gave evidence of increased, excessive, and pressured speech within the session.The client reported that their speech rate increases as they feel stressed.The client's pressured speech has shown evidence of a decrease in intensity.The client showed no evidence of pressured speech in today's session.
5 Racing Thoughts (5)The client demonstrated a pattern of racing thoughts, moving from one subject to another without maintaining focus.The client reported experiencing racing thoughts, including difficulty concentrating on one thought because other thoughts interfere.The client reported that at times of quiet reflection, they are disturbed by thoughts racing through their mind.The client's thoughts are not racing as they had been, and the client is able to stay focused.
6 Poor Attention Span/Distraction (6)The client gave evidence of a short attention span and a high level of distractibility.The client reported being unable to focus thoughts on one topic.The