The Adult Psychotherapy Progress Notes Planner. David J. Berghuis

ACT Approach (43)The use of acceptance and commitment therapy (ACT) was applied.The client was assisted in accepting and openly experiencing angry thoughts and feelings, without being overly impacted by them.The client was assisted in committing his/her/their time and efforts to activities that are consistent with identified personally meaningful values.The client has engaged well in the ACT approach and applied these concepts to his/her/their symptoms and lifestyle.The client has not engaged well in the ACT approach, and remedial efforts were applied.

      44 Assign ACT Homework (44)The client was assigned homework situations in which he/she/they practice lessons from mindfulness meditation and ACT.The client was assisted in consolidating his/her/their mindfulness meditation and ACT approaches into his/her/their everyday life.

      45 Assign Reading on Mindfulness and ACT (45)The client was assigned reading material consistent with mindfulness and the ACT approach to supplement work done in session.The client was assigned Get out of Your Mind and into Your Life (Hayes).The client has read assigned material and key concepts were processed.The client has not read assigned material and was redirected to do so.

      46 Teach Mindfulness Meditation (46)The client was taught mindfulness meditation techniques to help recognize negative thought processes associated with anger.The client was taught to focus on changing his/her relationship with the anger-related thoughts by accepting the thoughts, images, and impulses that are reality-based while noticing, but not reacting to, non-reality-based mental phenomenon.The client was assisted in differentiating between reality-based thoughts and non-reality-based thoughts.The client has used mindfulness meditation to help overcome negative thought processes that trigger anger and was reinforced for this.The client has struggled to apply mindfulness meditation and was provided with remedial assistance in this area.

      47 Identify Anger Expression Models (47)The client was assisted in identifying key figures in his/her/their life who have provided examples to him/her/them of how to positively or negatively express anger.The client was reinforced as he/she/they identified several key figures who have been negative role models in expressing anger explosively and destructively.The client was supported and reinforced as he/she/they acknowledged that he/she/they manage his/her/their anger in the same way that an explosive parent figure had done when he/she/they were growing up.The client was encouraged to identify positive role models throughout his/her/their life whom he/she/they could respect for their management of angry feelings.The client was supported as he/she/they acknowledged that others have been influential in teaching him/her/them destructive patterns of anger management.The client failed to identify key figures in his/her/their life who have provided examples to him/her/them as to how to positively express his/her/their anger and was questioned more specifically in this area.

      48 Encourage Disclosure (48)The client was encouraged to discuss his/her/their anger management goals with trusted persons who are likely to support his/her/their change.The client was assisted in identifying individuals who are likely to support his/her/their change.The client has reviewed his/her/their anger management goals with trusted persons and their responses were processed.The client has not discussed his/her/their anger management goals and was redirected to do so.

NOTES

      1 1 The numbers in parentheses correlate to the number of the Behavioral Definition statement in the companion chapter with the same title in The Complete Adult Psychotherapy Treatment Planner, Sixth Edition, by Jongsma, Peterson, and Bruce (Hoboken, NJ: Wiley, 2020).

      2 2 The numbers in parentheses correlate to the number of the Therapeutic Intervention statement in the companion chapter with the same title in The Complete Adult Psychotherapy Treatment Planner, Sixth Edition, by Jongsma, Peterson, and Bruce (Hoboken, NJ: Wiley, 2020).

ANTISOCIAL BEHAVIOR

      CLIENT PRESENTATION

      1 Adolescent Antisocial History (1)¹The client confirmed that his/her/their history of rule breaking, lying, physical aggression, and/or disrespect for others and the law began when he/she/they were a teenager.The client reported that he/she/they were often incarcerated within the juvenile justice system for illegal activities.The client acknowledged that his/her/their substance abuse paralleled his/her/their antisocial behavior dating back to adolescence.

      2 Dysfunctional Childhood History (1)The client described instances from his/her/their childhood in which severe and abusive punishment resulted whenever a parent laid blame on him/her/them for some perceived negative behavior.The client described a history of experiences in which he/she/they were unfairly blamed for others' behavior, leading to feelings of resentment of authority and a pattern of lying to avoid punishment.The client provided examples from his/her/their own childhood of instances when parental figures consistently projected blame for their behavior onto others, causing the client to learn and practice this same behavior.The client began to verbalize some insight into how previous instances of pain in child- hood are causing current attitudes of detachment from the concerns of others and a focus on self-protection and self-interest.The client began to understand how his/her/their attitudes of aggression are the result of having learned to accept and normalize aggression during childhood abusive experiences.

      3 Legal Conflicts (2)The client maintained a disregard for laws, rules, and authority figures.The client reported engaging in illegal activities in his/her/their current situation.The client has repeatedly engaged in illegal activities in the past.The client often minimized the seriousness of his/her/their offenses against the law and other people's rights.The client acknowledged that his/her/their disregard for the law has resulted in serious problems and has pledged to live within the rules of society.

      4 Aggressive/Argumentative (3)The client presented in a hostile, angry, and uncooperative manner.The client was intimidating in his/her/their style of interaction.The client is trying to interact in a more cooperative manner within social and employment settings.The client is showing less irritability and argumentativeness within therapy sessions.

      5 Authority Conflicts (3)The client acknowledged a history of irritability, aggression, and argumentativeness when interacting with authority figures.The client's history of conflict with acceptance of authority has led to employment instability and legal problems.The client is beginning to accept direction from authority figures, recognizing his/her/their need to resist challenging such directives.

      6 Consistent Use of Substances (4)The client described a history of alcohol and other mood-altering drug use on a frequent basis and, often, until intoxicated or passed out.Family members confirmed a pattern of chronic substance abuse by the client.The client acknowledged that his/her/their substance abuse began in adolescence and continued into adulthood.The client has committed self to a plan of abstinence from substance abuse and participation in a recovery program.The client has maintained total abstinence, which was confirmed by his/her/their family.

      7 Lack of Remorse (5)The client, after describing his/her/their pattern of aggression or disrespect for others' feelings, showed no remorse for his/her/their behavior.The client projected blame for his/her/their hurtful behavior onto others, saying there was no alternative.The client is beginning to develop some sensitivity to the feelings of others and to recognize that he/she/they have hurt others.The client reported feelings of remorse and guilt over previous behaviors that were hurtful to others.

      8 Blaming/Projecting (6)The client showed an attitude of blaming others for his/her/their problems.The client refused to take responsibility for his/her/their own behavior and decisions; instead, he/she/they pointed at the behavior of others as the cause for his/her/their decisions and actions.Interpersonal conflicts were blamed on others without taking any responsibility for the problem.The client is beginning to accept responsibility for his/her/their own behavior and to make fewer statements of projection of responsibility for his/her/their actions onto others.The client is gradually accepting more responsibility for his/her/their behavior and increasing the frequency of such statements.

      9 Lying