Название | The Addiction Progress Notes Planner |
---|---|
Автор произведения | Группа авторов |
Жанр | Медицина |
Серия | |
Издательство | Медицина |
Год выпуска | 0 |
isbn | 9781119793076 |
49 Assign Step 4 Exercise (49)The client was taught about a 12-step program's Step 4, focusing on detailing the exact nature of their wrongs and forgiveness.The client was directed to write an autobiography detailing the exact nature of their wrongs.The client was assigned the Step 4 exercise from The Alcoholism and Drug Abuse Client Workbook (Perkinson).Active listening skills were provided as the client has completed an autobiography and has detailed the exact nature of their wrongs.The client endorsed the need to forgive self and others and has begun to process this; this insight was reinforced.The client described struggles regarding how to forgive self and others; these barriers were processed.The client has not completed the Step 4 exercise and was redirected to do so.
50 Develop Recovery Group Involvement (50)The client was taught about how active involvement in a recovery group is a way to build trust in others and confidence in self.The client was assigned “Aftercare Plan Components” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client was referred to an appropriate recovery group.The client described involvement in an active recovery group, and the benefits they have experienced were reviewed.The client acknowledged that they have not followed through with involvement in a recovery group, and the client was redirected to do so.
51 Educate the Family About Anxiety Disorders (51)A family session was held to educate the client's family and significant others regarding anxiety disorder, treatment, and prognosis. Active listening was modeled.Family members expressed their positive support of the client and a more accurate understanding of anxiety and substance-abuse concerns.Family members were neither understanding nor willing to provide support to the client, in spite of diagnosis of an anxiety disorder; they were urged to reconsider this refusal.
52 Direct Family Members to List Support for Recovery (52)Family members were assisted in identifying ways in which they could be supportive of the client's sobriety.A family session was held to facilitate communication of techniques that the family can use to assist in the client's recovery.The client reported family members assisting significantly in encouragement and other techniques to help them recover from anxious behavior and addiction; the client was urged to express gratitude.The client's significant others were strongly encouraged to attend Al-Anon meetings on a regular basis to help support the client's recovery.
53 Assess Satisfaction (53)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).
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADOLESCENT
CLIENT PRESENTATION
1 Lack of Attention to Detail (1)*The client reported failure to give close attention to detail or makes mistakes with things of low interest, even though they may be important to the client's life.The client's lack of ability to give close attention has resulted in missing out on the comprehension of important details.The client's ability to give close attention seems to be increasing as they reported increased attention skills.
2 Fidgety (2)The client reported being unable to sit still for any length of time but often feels fidgety.The client gave evidence of being fidgety within the session, often moving about in the chair.The client's ability to fidget less has increased.
3 Difficulty Sustaining Attention (3)The client reported difficulty sustaining attention to tasks or activities.The client gave evidence of difficulty sustaining attention within today's session.The client's difficult sustaining attention is diminishing and focused concentration is increasing.
4 Fails to Listen (4)The client does not seem to listen to others even when spoken to directly.The client reports problems with day-to-day functioning because of failure to listen to others.The client reports greater control over listening when others are speaking to them.
5 Restless (5)The client reported being unable to sit still for a significant length of time and often feels restless.The client gave evidence of being restless within the session, often moving about in a chair.The client's ability to rest comfortably for a longer period of time has increased.
6 Lack of Follow-Through (6)The client reported struggling to follow through on instructions and fails to finish duties.Family members reported frustration at the client's pattern of failing to finish duties.The client has shown progress in follow-through and completing duties.
7 Inability to Engage Quietly (7)The client reports an inability to engage in leisure activities quietly.The client has identified problems with others because of inability to engage in leisure activities quietly.The client has improved in ability to engage in leisure activities at an appropriate noise level.
8 Disorganization (8)The client has a history of disorganization in many areas of their life.The client's disorganization is evident in areas related to home and work, leading them to be less efficient and less effective than they could be.The client has made significant progress in increasing organization and is using that organization to become more efficient.The client uses lists and reminders to increase organizational ability.
9 On the Go (9)The client is often described as “on the go” or acting as if “driven by a motor.”The client has identified problems with overall functioning because of their “on the go” behaviors.The client has been able to improve in functioning as they have reduced their “on the go” behaviors.
10 Avoidance (10)The client often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.The client has struggled to maintain employment or struggles in school because of avoidance of tasks that require sustained mental effort.The client has reduced their avoidance of difficult tasks and reports improved functioning in a variety of areas.
11 Excessive Talking (11)The client talks excessively.The client's family and friends have reported frustrations because of excessive talking.The client has improved in the ability to talk an appropriate amount.
12 Losing Items (12)The client often loses items necessary for tasks or activities.The client identified problematic functioning because of losing items necessary for day-to-day tasks.The client has done better self-management in order to reduce loss of necessary items.
13 Interrupting (13)The client often interrupts, doesn't wait for their turn, or blurts out answers before a question has been completed.The client's friends and family have identified problems related to the client's inability to function appropriately in social situations.The client's work relationships have suffered owing to an inability to function appropriately.The client has reduced the need to interrupt others, now waits for others, blurts out answers less, and has identified positive results from this improvement.
14 Distractibility (14)The client reported being easily distracted and their attention is drawn away from the task at hand.The client gave evidence of distractibility within today's session.The client's distractibility is