The Adult Psychotherapy Progress Notes Planner. David J. Berghuis

Kind Actions (26)The client was required, in an attempt to get him/her/them to focus on the needs and feelings of others, to list three actions that would be performed as acts of kindness toward someone else.The client and therapist signed a contract in which he/she/they committed to performing three acts of service toward the community or others that would not result in direct benefit to self.The client was assigned “Three Acts of Kindness” in the Adult Psychotherapy Homework Planner (Jongsma).The client's acts of kindness were reviewed and the feelings associated with performing this assignment were processed.The client has not completed acts of kindness and was redirected to do so.

      27 Solicit an Apology (27)The client was asked to make a list of those people who deserve an apology because they were injured by the client's insensitive, impulsive, aggressive, or dishonest behavior.The client was assigned the homework exercise “How I Have Hurt Others” from the Adult Psychotherapy Homework Planner (Jongsma).The client was confronted when he/she/they attempted to project the blame for his/her/their aggressive or dishonest actions onto others.The client was supported as he/she/they identified those people who deserve an apology because they were injured by his/her/their insensitive, impulsive, aggressive, or dishonest behavior.Positive feedback was provided as the client reported that he/she/they have given an apology to those who were injured by his/her/their insensitive, impulsive, aggressive, or dishonest behavior.The client has not made an apology to those identified as being injured by his/her/their insensitive, impulsive, aggressive, or dishonest behavior and was redirected to do so.

      28 Teach Acceptance of Responsibility (28)The value of taking full responsibility for one's own behavior and then apologizing for the pain caused to others because of that behavior was reviewed and emphasized.Role-playing and modeling were used to teach how to apologize.Positive feedback was provided to the client for his/her/their understanding and use of apologies.

      29 Review Elements of Apology (29)The specific steps were laid out that would be necessary to begin to make amends to others who have been hurt by the client's behavior.The client was assigned the homework exercise “Letter of Apology” from the Adult Psychotherapy Homework Planner (Jongsma).The client was asked to make a commitment to carry out those necessary steps that would make restitution for the hurt caused to others.Behavioral rehearsal was used to teach how to make amends or give an apology to those who have been hurt by the client's behavior.The client's implementation of apologizing to others was reviewed and the feelings associated with this action were processed.The client was strongly reinforced for taking responsibility for causing pain to others and apologizing for this behavior.The client has not taken responsibility for the pain he/she/they have caused others, or apologized for this behavior, and was redirected to do so.

      30 Review Work Authority Conflicts (30)The client was asked to list the most important rules that should govern his/her/their behavior within the work setting.The client was assisted in developing a specific list of rules and duties related to the client's employment behavior.The client reviewed the expectations regarding how he/she/they should respond to authority figures within the employment setting; his/her/their appropriate expectations were reinforced.Role-playing was used to teach respectful responses to directives from authority figures.

      31 Reinforce Employment Attendance (31)The client's attendance at work and his/her/their respect for authority were reviewed and reinforced.The client was asked to keep a journal of work attendance and instances of acceptance of directives from authority figures.The client's work records and journal material were reviewed and successful prosocial behavior was reinforced.The client has not kept a record or journal of work attendance and acceptance of directives from authority figures and was redirected to do so.

      32 Teach Prosocial Work Behavior (32)The client was asked to list those negative behaviors that have led to conflicts within the work setting with both coworkers and authority figures.The client was assisted in developing prosocial responses toward resolving conflicts with coworkers and acceptance of directives from authority figures.The client has implemented more prosocial responses at work, and the positive results of this attitude were reviewed.

      33 Confront Irresponsible Parenting (33)The client was asked to acknowledge and accept responsibility for a history of avoiding the obligations of parenthood.The client was confronted with a pattern of his/her/their behavior that demonstrates a lack of acceptance of responsibility for being a nurturant parent.The client was asked to list incidences from his/her/their past that are examples of avoidance of the responsibilities of parenting.

      34 Reinforce Responsible Parenting (34)The client was asked to list specific behaviors that would indicate that he/she/they were taking on the responsibilities of being a reliable, responsible, and nurturant parent.The client was asked to list potential consequences to self and the child(ren) of avoiding the responsibilities of parenting.The client's list of behaviors and consequences related to taking responsibility for parenting were reviewed and processed.The client has not made a list of behaviors and consequences of being a responsible versus irresponsible parent and was redirected to do so.

      35 Solicit a Commitment to Responsible Parenting (35)The client was assisted in developing a list of concrete steps that could be taken to demonstrate reliable, responsible parenting behavior.The client was asked to make a commitment to implementation of specific steps that would demonstrate responsible parenting.The client has begun to implement specific steps toward demonstrating responsible parenting and he/she/they were reinforced for this change in behavior.The positive impact of the client's implementation of positive parenting behavior was reviewed.The client has not implemented steps to responsible parenting and was redirected to do so.

      36 Confront Projection (36)The client was consistently confronted whenever he/she/they failed to take responsibility for his/her/their own actions and instead placed blame for them onto others.The client was assigned the homework exercise “Accept Responsibility for Illegal Behavior” from the Adult Psychotherapy Homework Planner (Jongsma).As the client's pattern of projecting blame for his/her/their actions onto others began to weaken, he/she/they were reinforced for taking personal responsibility.The importance of taking responsibility for one's own behavior and the positive implications of this for motivating change were reviewed.

      37 Explore Reasons for Blaming (37)The client's history was explored with a focus on causes for the avoidance of acceptance of responsibility for behavior.The client's history of physical and emotional abuse was explored.The client's early history of lying was explored for causes and consequences.Parental modeling of projection of responsibility for their behavior was examined.The client was gently offered examples of reasons why he/she/they tend to blame others for his/her/their actions (e.g. history of physically abusive punishment, parental modeling, fear of rejection, shame, low self-esteem, avoidance of facing consequences).

      38 Reinforce Taking Personal Responsibility (38)The client was verbally reinforced in a strong and consistent manner when he/she/they took responsibility for his/her/their own behavior.The client was taught how others develop respect for someone who takes responsibility for his/her/their actions and admits to mistakes.

      39 Explore Childhood Abuse and Neglect (39)Active-listening skills were used as the client described instances from his/her/their own childhood of emotional, verbal, and physical abuse.The client was assigned the homework exercise “Describe the Trauma” from the Adult Psychotherapy Homework Planner (Jongsma).Support and empathy were provided as the client described feelings of hurt, depression, abandonment, and fear related to parental abuse or neglect.It was reflected to the client that he/she/they were rather matter-of-fact in his/her/their description and showed little affect while describing a history of violence within the family during his/her/their childhood.It was reflected to the client that he/she/they have tended to minimize the negative impact of physical abuse that he/she/they suffered and, at times, even excused the behavior as something that he/she/they deserved.The client was shown the cycle of abuse or neglect is repeating itself in his/her/their behavior.

      40 Review Emotional Detachment (40)The client's pattern of emotional detachment from others was reviewed.It was pointed out to the client that his/her/their childhood history of abuse and neglect has led to a pattern of emotional detachment in current relationships.The client accepted that his/her/their emotional detachment is related to his/her/their childhood history of abuse and neglect and was supported for this insight.The client denied connection