need such a family to recover (or assign the client to complete the Step 12 exercise in
The Alcoholism and Drug Abuse Client Workbook by Perkinson).
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Educate the client about the family atmosphere in a home ACA/AA/NA recovery group, and how helping others can aid in recovery and reestablish a feeling of worth.
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List five ways in which belief in, and interaction with, a higher power can reduce fear and increase self-worth in recovery. (38, 39)
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Teach the client how faith in a higher power can aid in recovery and arrest ACA traits and addiction (or assign the client to complete the Step 2 exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
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Assign the client to read the Adult Children of Alcoholics Red Book and the Alcoholics Anonymous Big Book on the topic of spirituality and the role of a higher power; process the material in an individual or group therapy session.
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Verbalize the feeling of serenity that results from turning out-of-control problems over to a higher power. (40)
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Review problematic circumstances in the client's life that could be turned over to a higher power to increase serenity (or supplement with “Understanding Spirituality” or “Finding a Higher Power That Makes Sense” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma).
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Practice assertiveness skills and share how these skills were used in interpersonal conflict. (41, 42)
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Use modeling, behavior rehearsal, and role-playing to teach the client healthy, assertive skills (or assign “Becoming Assertive” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce); apply these skills to several current problem situations, and then ask the client to journal his/her/their assertiveness experiences.
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Teach the client the assertive formula of “I feel ____ when you ____. I would prefer it if ____”; role-play several applications in his/her/their life and then assign him/her/them to use this formula three times per day.
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Share the personal experiences of each day with one person that day. (43, 44)
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Teach the client the share check method of building trust, in which the degree of shared information is related to a proven level of trustworthiness; use behavior rehearsal of several situations in which the client shares feelings.
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Review and reinforce instances when the client has shared honestly and openly with a trustworthy person.
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Cooperate with a physician's evaluation for psychopharmacological intervention. (45)
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Refer the client to a physician to evaluate whether psychopharmacological interventions are warranted.
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Take medications as prescribed, and report on their effectiveness and side effects. (46, 47)
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Medical staff administers medications to the client as prescribed.
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Monitor the client's medications for effectiveness and side effects.
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Develop a five-year plan to recover from substance abuse and ACA traits. (48)
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Assist in the client developing a five-year plan to recover from substance abuse and ACA traits (or assign the client to complete the Personal Recovery Plan exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
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Complete a survey to assess the degree of satisfaction with treatment. (49)
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Administer a survey to assess the client's degree of satisfaction with treatment.
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DIAGNOSTIC SUGGESTIONS
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ICD-10-CM
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DSM-5 Disorder, Condition, or Problem
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F34.1
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Persistent depressive disorder
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F41.1
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Generalized anxiety disorder
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F41.9
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Unspecified anxiety disorder
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F43.10
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Posttraumatic stress disorder
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Z62.820
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Parent–child relational problem
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F60.6
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Avoidant personality disorder
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F60.7
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Dependent personality disorder
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F60.9
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Unspecified personality disorder
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Note
1 Indicates that the Objective/Intervention is consistent with those found in evidence-based treatments.
ANGER
BEHAVIORAL DEFINITIONS
1 Has a history of explosive, aggressive outbursts, particularly when intoxicated, that lead to assaultive acts or destruction of property.
2 Abuses substances to cope with angry feelings and to relinquish responsibility for aggression.
3 Shows cognitive biases associated with anger (e.g. demanding expectations of others, overly generalized labeling of the targets of anger, anger in response to perceived slights).
4 Shows direct or indirect evidence of physiological arousal related to anger.
5 Reports a history of explosive, aggressive outbursts out of proportion with any precipitating stressors, leading to verbal attacks, assaultive acts, or destruction of property.
6 Displays overreactive verbal hostility to insignificant irritants.
7 Engages in verbal, physical, and/or emotional abuse against significant other.
8 Makes swift and harsh judgmental statements to or about others.
9 Displays body language suggesting anger, including tense muscles (e.g. clenched fist or jaw), glaring looks, or refusal to make eye contact.
10 Shows passive-aggressive patterns (e.g. social withdrawal, lack of complete or timely compliance in following directions or rules, complaining about authority figures behind their backs, uncooperative in meeting expected behavioral norms) due to anger.
11 Passively withholds feelings and then explodes in a rage.
12 Demonstrates an angry overreaction to perceived disapproval, rejection, or criticism.
13 Uses abusive language meant to intimidate others.
14 Rationalizes
