The Addiction Progress Notes Planner E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: PracticePlanners
• Sprache: Englisch

Seitenzahl: 1300

Veröffentlichungsjahr: 2022

Beschreibung

An invaluable practice resource for practitioners engaged in addictions treatment

In The Addiction Progress Notes Planner, Sixth Edition, a team of distinguished mental health professionals delivers complete, pre-written session and patient presentation descriptions for every behavioral problem in the Addictions Treatment Planner, Sixth Edition. Each note can be simply and quickly adapted to fit a real-world client need or treatment situation while remaining completely unified with the client’s treatment plan.

This new edition offers new and revised evidence-based objectives and interventions organized around 46 behavior-based presentations, including alcoholism, nicotine dependence, substance abuse, problem gambling, eating disorders, and sexual addictions. The resource also offers:

• A wide array of treatment approaches that correspond to the behavioral problems and DSM-V diagnostic categories included in the Addiction Treatment Planner, Sixth Edition
• Sample progress notes conforming to the requirements of most third-party payors and accrediting agencies, including CARF, TJC, COA, and the NCQA
• Brand-new chapters on Opioid Use Disorder, Panic/Agoraphobia, and Vocational Stress

The Addiction Progress Notes Planner is an indispensable practice aid for addictions counselors, mental health counselors, social workers, psychologists, psychiatrists, and anyone else treating clients suffering from addictions.

Leseprobe

Table of Contents

COVER

TITLE PAGE

COPYRIGHT

DEDICATION

PRACTICE

PLANNERS

®

SERIES PREFACE

PROGRESS NOTES

INTRODUCTION

ABOUT PRACTICE

PLANNERS

®

PROGRESS NOTES

HOW TO USE THIS

PROGRESS NOTES PLANNER

A FINAL NOTE ABOUT PROGRESS NOTES AND HIPAA

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

ANGER

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

ANTISOCIAL BEHAVIOR

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED*

NOTES

ANXIETY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADOLESCENT

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADULT

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

BIPOLAR DISORDER

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

BORDERLINE TRAITS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

CHILDHOOD TRAUMA

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

CHRONIC PAIN

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

CONDUCT DISORDER/DELINQUENCY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

DANGEROUSNESS/LETHALITY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

DEPENDENT TRAITS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

DEPRESSION—UNIPOLAR

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

EATING DISORDERS AND OBESITY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

FAMILY CONFLICTS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

GAMBLING

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

GRIEF/LOSS UNRESOLVED

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

IMPULSIVITY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

LEGAL PROBLEMS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

LIVING ENVIRONMENT DEFICIENCY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

MEDICAL ISSUES

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

NARCISSISTIC TRAITS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

NICOTINE ABUSE/DEPENDENCE

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

OBSESSIVE COMPULSIVE DISORDER (OCD)

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

OCCUPATIONAL PROBLEMS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

OPIOID USE DISORDER

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

OPPOSITIONAL DEFIANT BEHAVIOR

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

PANIC DISORDER/AGORAPHOBIA

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

PARENT–CHILD RELATIONAL PROBLEM

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

PARTNER RELATIONAL CONFLICTS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

PEER GROUP NEGATIVITY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

POSTTRAUMATIC STRESS DISORDER (PTSD)

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

PSYCHOSIS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

READINESS TO CHANGE

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

RELAPSE PRONENESS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SELF-HARM

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SELF-CARE DEFICITS—PRIMARY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SELF-CARE DEFICITS—SECONDARY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SEXUAL ABUSE

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SEXUAL PROMISCUITY

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SLEEP DISTURBANCE

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SOCIAL ANXIETY/SKILLS DEFICIT

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SPIRITUAL CONFUSION

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SUBSTANCE-INDUCED DISORDERS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SUBSTANCE INTOXICATION/WITHDRAWAL

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SUBSTANCE USE DISORDERS

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

SUICIDAL IDEATION

CLIENT PRESENTATION

INTERVENTIONS IMPLEMENTED

NOTES

END USER LICENSE AGREEMENT

Guide

Cover

Table of Contents

Title Page

Copyright

Dedication

Practice Planners

®

Series Preface

Progress Notes Introduction

Begin Reading

End User License Agreement

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Wiley PracticePlanners® Series

Treatment Planners

The Complete Adult Psychotherapy Treatment Planner, with DSM-5 Updates, Sixth Edition

The Addiction Treatment Planner, with DSM-5 Updates, Sixth Edition

The Child Psychotherapy Treatment Planner, with DSM-5 Updates, Sixth Edition

The Adolescent Psychotherapy Treatment Planner, with DSM-5 Updates, Sixth Edition

The Continuum of Care Treatment Planner

The Couples Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition

The Employee Assistance Treatment Planner

The Pastoral Counseling Treatment Planner

The Older Adult Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition

The Behavioral Medicine Treatment Planner

The Group Therapy Treatment Planner, with DSM-5 Updates, Third Edition

The Gay and Lesbian Psychotherapy Treatment Planner

The Family Therapy Treatment Planner, with DSM-5 Updates, Second Edition

The Severe and Persistent Mental Illness Treatment Planner, with DSM-5 Updates, Second Edition

The Intellectual and Developmental Disability Treatment Planner, with DSM-5 Updates, Second Edition

The Social Work and Human Services Treatment Planner, with DSM-5 Updates

The Crisis Counseling and Traumatic Events Treatments Planner, with DSM-5 Updates, Second Edition

The Personality Disorders Treatments Planner, with DSM-5 Updates, Second Edition

The Rehabilitation Psychology Treatment Planner

The Special Education Treatment Planner

The Juvenile Justice and Residential Care Treatment Planner, with DSM-5 Updates

The School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, Second Edition

The Sexual Abuse Victim and Sexual Offender Treatment Planner, with DSM-5 Updates

The Probation and Parole Treatment Planner, with DSM-5 Updates

The Psychopharmacology Treatment Planner

The Speech-Language Pathology Treatment Planner

The Suicide and Homicide Risk Assessment and Prevention Treatment Planner, with DSM-5 Updates

The Co-Occurring Disorders Treatment Planner, with DSM-5 Updates

The Parenting Skills Treatment Planner, with DSM-5 Updates

The Early Childhood Education Intervention Treatment Planner

The College Student Counseling Treatment Planner

The Complete Women's Psychotherapy Treatment Planner

The Veterans and Active Duty Military Psychotherapy Treatment Planner, with DSM-5 Updates

Progress Notes Planners

The Adult Psychotherapy Progress Notes Planner, Sixth Edition

The Addiction Progress Notes Planner, Sixth Edition

The Child Psychotherapy Progress Notes Planner, Sixth Edition

The Adolescent Psychotherapy Progress Notes Planner, Sixth Edition

The Severe and Persistent Mental Illness Progress Notes Planner, Second Edition

The Couples Psychotherapy Progress Notes Planner, Second Edition

The Family Therapy Progress Notes Planner, Second Edition

The Veterans and Active Duty Military Psychotherapy Progress Notes Planner

Homework Planners

Adult Psychotherapy Homework Planner, Sixth Edition

Addiction Treatment Homework Planner, Sixth Edition

Adolescent Psychotherapy Homework Planner, Sixth Edition

Couples Therapy Homework Planner, Second Edition Family Therapy Homework Planner, Second Edition Grief Counseling Homework Planner

Group Therapy Homework Planner Divorce Counseling Homework Planner

School Counseling and School Social Work Homework Planner, Second Edition

Child Therapy Activity and Homework Planner

Child Psychotherapy Homework Planner, Fifth Edition Parenting Skills Homework Planner

Veterans and Active Duty Military Psychotherapy Homework Planner

Client Education Handout Planners

Adult Client Education Handout Planner

Child and Adolescent Client Education Handout Planner Couples and Family Client Education Handout Planner

Complete Planners

The Complete Depression Treatment and Homework Planner

The Complete Anxiety Treatment and Homework Planner

PracticePlanners®

The Addiction Progress Notes Planner

Sixth Edition

David J. Berghuis

Katy Pastoor

Arthur E. Jongsma, Jr.

This edition first published 2022

© 2022 John Wiley & Sons, Inc.

Edition History

1e (2002); 2e (2005); 3e (2009); 5e (2014)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of David J. Berghuis, Katy Pastoor, and Arthur E. Jongsma, Jr. to be identified as the authors of this work has been asserted in accordance with law.

Registered Office

John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA

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Wiley also publishes its books in a variety of electronic formats and by print-on-demand. Some content that appears in standard print versions of this book may not be available in other formats.

Limit of Liability/Disclaimer of Warranty

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress Cataloging-in-Publication Data

Names: Berghuis, David J., author. | Pastoor, Katy, author. | Jongsma, Arthur E., Jr., 1943- author.

Title: The addiction progress notes planner / David J. Berghuis, Katy Pastoor, Arthur E. Jongsma, Jr.

Description: Sixth edition. | Hoboken, NJ : Wiley, 2022. | Series: Wiley PracticePlanners series | Includes bibliographical references.

Identifiers: LCCN 2021052435 (print) | LCCN 2021052436 (ebook) | ISBN 9781119793052 (paperback) | ISBN 9781119793069 (adobe pdf) | ISBN 9781119793076 (epub)

Subjects: LCSH: Substance abuse—Treatment—Handbooks, manuals, etc. | Substance abuse—Treatment—Planning—Handbooks, manuals, etc.

Classification: LCC RC564.15 .B47 2022 (print) | LCC RC564.15 (ebook) | DDC 362.29—dc23/eng/20211122

LC record available at https://lccn.loc.gov/2021052435

LC ebook record available at https://lccn.loc.gov/2021052436

Cover Design: Wiley

Cover Images: © Ryan McVay/Getty Images

To Dave and Jan Dykgraaf, who are models of compassion and sacrifice for the good of others.

Arthur E. Jongsma, Jr.

To my husband, Andy, for supporting me in all my work.

Katy Pastoor

PRACTICEPLANNERS® SERIES PREFACE

Accountability is an important dimension of the practice of psychotherapy. Treatment programs, public agencies, clinics, and practitioners must justify and document their treatment plans to outside review entities in order to be reimbursed for services. The books in the PracticePlanners® series are designed to help practitioners fulfill these documentation requirements efficiently and professionally. They have also proven very beneficial to graduate students as well as young or seasoned practitioners who are looking for suggestions for effective interventions, all of which are best practice or evidence based.

The PracticePlanners® series includes a wide array of treatment planning books including not only the original Complete Adult Psychotherapy Treatment Planner, Child Psychotherapy Treatment Planner, Adolescent Psychotherapy Treatment Planner, and Addictions Treatment Planner, all now being revised and updated for the sixth editions, but also many other Treatment Planners targeted to specialty areas of practice, including:

Co-occurring disorders

Integrated behavioral medicine

College students

Couples therapy

Crisis counseling

Early childhood education

Employee assistance

Family therapy

Group therapy

Intellectual and developmental disability

Juvenile justice and residential care

LGBTQ+

Neuro rehabilitation

Older adults

Parenting skills

Pastoral counseling

Personality disorders

Probation and parole

Psychopharmacology

School counseling and school social work

Severe and persistent mental illness

Sexual abuse victims and offenders

Social work and human services

Special education

Speech-language pathology

Suicide and homicide risk assessment

Veterans and active military duty

Women's issues

In addition, there are three branches of companion books that can be used in conjunction with the Treatment Planners or on their own:

Progress Notes Planners

provide a menu of progress statements that elaborate on the client's symptom presentation and the provider's therapeutic intervention. Each

Progress Notes Planner

statement is directly integrated with the behavioral definitions and therapeutic interventions from its companion

Treatment Planner

.

Homework Planners

include homework assignments designed around each presenting problem (such as anxiety, depression, substance use, anger management, eating disorders, or panic disorder) that is the focus of a chapter in its corresponding

Treatment Planner

.

Client Education Handout Planners

provide brochures and handouts to help educate and inform clients on presenting problems and mental health issues, as well as life skills techniques. The handouts are included on CD-ROMs for easy printing from your computer and are ideal for use in waiting rooms, at presentations, as newsletters, or as information for clients struggling with mental illness issues. The topics covered by these handouts correspond to the presenting problems in the

Treatment Planners

.

The series also includes:

Evidence-Based Psychotherapy Treatment Planning Video Series

, which offers 12 sixty-minute programs that provide step-by-step guidance on how to use empirically supported treatments to inform the entire treatment planning process. In a viewer-friendly manner, Drs. Art Jongsma and Tim Bruce discuss the steps involved in integrating evidence-based treatment (EBT) objectives and interventions into a treatment plan. The research support for the EBTs is summarized, and selected aspects of the EBTs are demonstrated in role-played counseling scenarios.

A companion Treatment Planning software product is also available:

TheraScribe

®

, the #1 selling treatment planning and clinical recordkeeping software system for mental health professionals.

TheraScribe

®

allows the user to import the data from any of the

Treatment Planner

,

Progress Notes Planner

, or

Homework Planner

books into the software's expandable database to simply point and click to create a detailed, organized, individualized, and customizable treatment plan along with optional integrated progress notes and homework assignments. TheraScribe is available by calling 616-776-1745. Also, see

TheraScribe.com

for more information.

Adjunctive books, such as The Psychotherapy Documentation Primer and The Clinical Documentation Sourcebook, contain forms and resources to aid the clinician in mental health practice management.

The goal of our series is to provide practitioners with the resources they need in order to provide high-quality care in the era of accountability. To put it simply: We seek to help you spend more time on patients and less time on paperwork.

ARTHUR E. JONGSMA, JR.

Grand Rapids, Michigan

PROGRESS NOTES INTRODUCTION

ABOUT PRACTICEPLANNERS® PROGRESS NOTES

Progress notes are not only the primary source for documenting the therapeutic process but also one of the main factors in determining the client's eligibility for reimbursable treatment. The purpose of the Progress Notes Planner series is to assist the practitioner in easily and quickly constructing progress notes that are thoroughly unified with the client's treatment plan.

Each Progress Notes Planner:

Saves you hours of time-consuming paperwork.

Offers the freedom to develop customized progress notes.

Features over 1,000 prewritten progress notes summarizing patient presentation and treatment delivered.

Provides an array of treatment approaches that correspond with the behavioral problems and

DSM-5

diagnostic categories in the corresponding companion

Treatment Planner

.

Offers sample progress notes that conform to the requirements of most third-party payors and accrediting agencies, including the Joint Commission, Council on Accreditation, Commission on Accreditation of Rehabilitation Facilities, and National Committee for Quality Assurance.

HOW TO USE THIS PROGRESS NOTES PLANNER

This Progress Notes Planner provides a menu of sentences that can be selected for constructing progress notes based on the behavioral definitions (or client's symptom presentation) and therapeutic interventions from its companion Treatment Planner. All progress notes must be tied to the patient's treatment plan—session notes should elaborate on the problems, symptoms, and interventions contained in the plan.

Each chapter title is a reflection of the client's potential presenting problem. The first section of the chapter, “Client Presentation,” provides a detailed menu of statements that may describe how that presenting problem manifested itself in behavioral signs and symptoms. The numbers in parentheses within the Client Presentation section correspond to the numbers of the Behavioral Definitions from the Treatment Planner.

The second section of each chapter, “Interventions Implemented,” provides a menu of statements related to the action that was taken within the session to assist the client in making progress. The numbering of the items in the Interventions Implemented section follows exactly the numbering of Therapeutic Intervention items in the corresponding Treatment Planner.

Each item list begins with a few keywords in bold type. These words are meant to convey the theme or content of the sentences that are contained in that listing. The clinician may peruse the list of keywords to find content that matches the client's presentation and the clinician's intervention. It is expected that the clinician may modify the prewritten statements contained in this book to fit the exact circumstances of the client's presentation and treatment. To maintain complete client records, in addition to progress note statements that may be selected and individualized from this book, the date, time, and length of a session; those present within the session; the provider; the provider's credentials; and a signature must be entered in the client's record.

A FINAL NOTE ABOUT PROGRESS NOTES AND HIPAA

Federal regulations under the Health Insurance Portability and Accountability Act (HIPAA) govern the privacy of a client's psychotherapy notes, as well as other protected health information (PHI). PHI and psychotherapy notes must be kept secure and the client must sign a specific authorization to release this confidential information to anyone beyond the client's therapist or treatment team. Further, psychotherapy notes receive other special treatment under HIPAA; for example, they may not be altered after they are initially drafted. Instead, the clinician must create and file formal amendments to the notes if he or she wishes to expand, delete, or otherwise change them.

Does the information contained in this book, when entered into a client's record as a progress note, qualify as a “psychotherapy note” and therefore merit confidential protection under HIPAA regulations? If the progress note that is created by selecting sentences from the database contained in this book is kept in a location separate from the client's PHI data, then the note could qualify as psychotherapy note data that are more protected than general PHI. However, because the sentences contained in this book convey generic information regarding the client's progress, the clinician may decide to keep the notes mixed in with the client's PHI and not consider it psychotherapy note data. In short, how you treat the information (separated from or integrated with PHI) can determine if this progress note planner data is psychotherapy note information. If you modify or edit these generic sentences to reflect more personal information about the client or if you add sentences that contain confidential information, the argument for keeping these notes separate from PHI and treating them as psychotherapy notes becomes stronger. For some therapists, our sentences alone reflect enough personal information to qualify as psychotherapy notes, and they will keep these notes separate from the client's PHI and require specific authorization from the client to share them with a clearly identified recipient for a clearly identified purpose.

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

CLIENT PRESENTATION

Raised in an Alcoholic Home (1)

*

The client described a history of being raised in an alcoholic home but denied any effects of such an upbringing.

The client described a history of being raised in an alcoholic home but was uncertain about how this affected their emotions.

The client described a history of being raised in an alcoholic home and identified effects, including emotional abandonment, role confusion, abuse, and a chaotic, unpredictable environment.

The client processed issues related to being raised in an alcoholic home, including emotional abandonment, role confusion, abuse, and a chaotic, unpredictable environment.

Unresolved Childhood Trauma (2)

The client described a history of childhood trauma caused by family addiction but denied any effects of this behavior.

The client described a history of childhood trauma caused by family addiction but was unsure of any effects of this behavior.

The client described a history of unresolved childhood trauma caused by family addiction.

The client resolved the feelings associated with the childhood trauma caused by family addiction.

Inability to Trust and Share Feelings (3)

The client revealed a pattern of extreme difficulty in trusting others, sharing feelings, or talking openly about self.

When sharing openly with others, the client experiences feelings of anxiety and uncertainty.

As the client has begun to work through adult-child-of-an-alcoholic (ACA) concerns, they have reported feeling less anxiety or uncertainty when sharing emotional concerns.

The client no longer experiences anxiety or uncertainty while sharing emotions.

Overconcern With Others (4)

The client described a pattern of consistently being overly concerned with taking care of others, resulting in failure to care for self.

The client identified a need to reduce focus on others’ functioning and to replace this with a focus on their own functioning.

The client has been able to balance the focus on others’ functioning with a focus on their own functioning.

Passive Submission (5)

The client described a history of being passively submissive to the wishes of others, in an effort to please them.

The client tries to ingratiate self to others by being submissive to their wishes.

The client acknowledged the need to become more assertive but has struggled to implement the assertiveness.

The client is being self-assertive and setting healthy limits.

Clings to Destructive Relationships (6)

The client described a pattern of clinging to destructive relationships in order to avoid interpersonal abandonment.

Hypersensitivity to abandonment has caused the client to maintain relationships that are destructive.

The client has acknowledged interpersonal abandonment as a significant issue.

The client accepts interpersonal conflict and is changing destructive relationships.

Tells Others What They Want to Hear (7)

The client described a pattern of disregarding reality in order to present information so that others will be pleased.

The client identifies situations in which the client has been able to be more truthful.

The client described the acceptance of others in response to the client's increased truthfulness.

Feels Worthless (8)

The client verbalized seeing self as being worthless and that disrespectful treatment by others was normal and expected.

The client has begun to develop a more positive image of self-worth and is more expectant of positive treatment from others.

The client clearly identifies improved self-image and insists on being treated in a respectful manner.

Experiences of Abandonment and Abuse (9)

The client described feeling unwanted, unimportant, and unloved because of experiences of abandonment and abuse.

The client has reduced feelings of being unwanted, unimportant, or unloved.

The client verbalized feeling wanted, important, and loved in relationships with others.

Panic When Relationships End (10)

The client described a pattern of strong feelings of panic and helplessness when faced with being alone as a close relationship ends.

The client described a chronic pattern of precipitating problems in a relationship because of feelings of panic and helplessness when faced with the possibility of friction in a close relationship.

The client has become more at peace with the natural process of relationships beginning and ending.

Sublimates Own Needs to Attempt to Fix Others (11)

The client described situations in which the client has attempted to “fix” other people.

The client identified that they often sublimate their own needs in attempts to “fix” others.

The client identified several examples of how they sublimate needs in order to try to “fix” others.

As the client has gained insight into the tendency to prioritize their own needs below fixing others, the client has decreased this pattern.

The client indicated a decreased need to “fix” others and is able to appropriately concentrate on their own needs.

Parental Role (12)

The client described a consistent pattern of selecting relationships with immature individuals.

The client described a strong tendency to take on a parental role in a relationship, allowing the partner to continue in a pattern of immaturity.

The client is beginning to accept responsibility for taking on a parental role in relationships.

The client describes a pattern of replacing the parental role with a more equal relationship with peers.

Feels Less Worthy (13)

The client described self as having less worth, especially when compared with individuals who did not grow up in an alcoholic family.

The client has begun to develop a more positive self-image and has terminated verbalizing negative comments about self.

The client has begun to make positive comments about self and the positive aspects of their family.

INTERVENTIONS IMPLEMENTED

Build Trust and Establish Rapport (1)

*

Caring was conveyed to the client through support, warmth, and empathy.

The client was provided with nonjudgmental support and a level of trust was developed.

The client was urged to feel safe in expressing experiences as an ACA.

The client began to express feelings more freely as rapport and trust level have increased.

The client has continued to experience difficulty being open and direct about the expression of painful feelings; the client was encouraged to use the safe haven of therapy to express these difficult issues.

Focus on Strengthening Therapeutic Relationship (2)

The relationship with the client was strengthened using empirically supported factors.

The relationship with client was strengthened through the implementation of a collaborative approach, agreement on goals, demonstration of empathy, verbalization of positive regard, and collection of client feedback.

The client reacted positively to the relationship-strengthening measures taken.

The client verbalized feeling supported and understood during therapy sessions.

Despite attempts to strengthen the therapeutic relationship the client reports feeling distant and misunderstood.

The client has indicated that sessions are not helpful and will be terminating therapy.

Explore Feelings of Powerlessness (3)

The client was probed for childhood experiences of powerlessness while growing up in an alcoholic home.

The client was asked to explore similarities between feelings of childhood powerlessness and feelings when abusing chemicals.

The client was assigned to complete the Step 1 exercise in

The Alcoholism and Drug Abuse Client Workbook

(Perkinson).

The client was assisted in comparing and contrasting adult feelings of powerlessness connected to substance abuse with historical feelings of powerlessness associated with growing up in an alcoholic home.

The client was probed for childhood experiences of powerlessness but denied any concerns in this area.

Teach Connection Between Childhood and Addiction (4)

The client was taught about the increased likelihood to repeat addictive behavior because of growing up in an addictive family.

The client was taught specific syndromes of thought and behavior that often repeat from one addictive generation to another.

The client was provided with specific examples of the repetition of addiction from one generation to another.

The client was encouraged to identify the connection between childhood experiences and the likelihood of repeating behavior.

The client denied any connection between childhood experiences and the likelihood of repeating those types of behaviors; the client was reminded to be aware of this connection.

Administer Assessment for ACA Traits (5)

The client was administered psychological instruments designed to objectively assess the strength of traits associated with being an adult child of an alcoholic.

The Children of Alcoholics Screening Test was administered to the client.

The client has completed the assessment of adult-child-of-an-alcoholic traits, but minimal traits were identified; these results were reported to the client.

The client has completed the assessment of adult-child-of-an-alcoholic traits, and significant traits were identified; these results were reported to the client.

The client refused to participate in psychological assessment of adult-child-of-an- alcoholic traits, and the focus of treatment was turned toward this defensiveness.

Explore Dysfunctional Family Rules (6)

The client explored the pattern of dysfunctional family rules from childhood.

The client was asked to explore how dysfunctional family rules lead to chronic fear and an escape into addiction.

The client was given support and affirmation regarding the chronic fear related to dysfunctional family rules.

It was reflected to the client that they are continuing to exhibit emotional distress and a desire to escape into addiction.

Educate About ACA Rules (5)

The client was taught the ACA rules for living (i.e., “don't talk, don't trust, don't feel”).

The client was taught the connection between dysfunctional ACA rules and the impossibility of healthy relationships occurring.

The client was reinforced for verbalizing an understanding of dysfunctional ACA rules and how these have affected relationships.

The client denied any pattern of ACA rules or dysfunctional current relationships and was urged to monitor these patterns.

Develop Connection Between ACA Traits and Addiction (8)

The client was directed to list five ways in which ACA traits have led to addiction.

The client was assigned “Addressing ACA Traits in Recovery” from the

Addiction Treatment Homework Planner

(Lenz, Finley, & Jongsma).

The client was assisted in identifying how their ACA traits have led to addiction.

The client has displayed greater insight into the connection between their ACA traits and addiction and was reinforced for this growth.

The client has not completed assignments regarding understanding codependent behaviors and was redirected to do so.

Identify ACA Traits (9)

The client was assisted in clarifying ACA traits and the relationship between ACA traits and addiction.

The client clearly understood the role that ACA traits have played within their functioning and how that has contributed to the dynamics of their addiction; this insight was reinforced.

The client verbalized an understanding of ACA traits and how they have an impact on current functioning in relationships; this insight was reinforced.

The client denied the connection between ACA traits and addictive behavior or relationship conflicts and was urged to monitor for this dynamic.

Assess Level of Insight (10)

The client's level of insight toward the presenting problems was assessed.

The client was assessed in regard to the syntonic vs. dystonic nature of their insight about the presenting problems.

The client was noted to demonstrate good insight into the problematic nature of the behavior and symptoms.

The client was noted to be in agreement with others’ concerns and is motivated to work on change.

The client was noted to be ambivalent regarding the problems described and is reluctant to address the issues as a concern.

The client was noted to be resistant regarding acknowledgment of the problem areas, is not concerned about them, and has no motivation to make changes.

Assess for Correlated Disorders (11)

The client was assessed for evidence of research-based correlated disorders.

The client was assessed in regard to the level of vulnerability to suicide.

The client was identified as having a comorbid disorder, and treatment was adjusted to account for these concerns.

The client has been assessed for any correlated disorders, but none were found.

Assess for Culturally Based Confounding Issues (12)

The client was assessed for age-related issues that could help to better understand their clinical presentation.

The client was assessed for gender-related issues that could help to better understand their clinical presentation.

The client was assessed for cultural syndromes, cultural idioms of distress, or culturally based perceived causes that could help to better understand their clinical presentation.

Alternative factors have been identified as contributing to the client's currently defined “problem behavior” and these were taken into account in regard to their treatment.

Culturally based factors that could help to account for the client's currently defined “problem behavior” were investigated, but no significant factors were identified.

Assess Severity of Impairment (13)

The severity of the client's impairment was assessed to determine the appropriate level of care.

The client was assessed in regard to impairment in social, relational, vocational, and occupational endeavors.

It was reflected to the client that their impairment appears to create mild to moderate effects on the client's functioning.

It was reflected to the client that their impairment appears to create severe to very severe effects on the client's functioning.

The client was continuously assessed for the severity of impairment, as well as the efficacy and appropriateness of treatment.

Explore Reaction to Parent's Chemical Abuse (14)

The client described experiences of parental chemical abuse and was assisted in relating how these experiences had a negative impact, including the fear of violence, abandonment, unpredictability, and embarrassment.

The client was supported while expressing increased insight into how parental chemical abuse has affected their emotional functioning.

The client was reinforced for beginning to identify the inappropriateness of parental abuse of chemicals.

The client was noted to be in denial regarding the negative impact of parental substance abuse.

Probe Abandonment/Rejection Fears (15)

The client was asked to identify specific childhood situations in which they experienced a fear of abandonment, mental or physical abuse, and/or feelings of rejection.

Active listening skills were used as the client explained what it was like to grow up in the alcoholic home environment, focusing on situations in which fear of abandonment, mental or physical abuse, and/or feelings of rejection occurred.

The client has begun to be more open about childhood experiences but was noted to remain rather guarded.

The client was supported while describing, in detail, the facts and feelings associated with painful childhood experiences.

The client denied any fears of abandonment, mental or physical abuse, and/or rejection, and this was accepted at face value.

Explore Childhood Experience's Effect on Intimate Relationships (16)

The client was assisted in becoming more aware of fears of abandonment, rejection, neglect, and the assumption of the caretaker role and how these fears are connected to past experiences of being raised in an alcoholic family.

The client was assisted in expressing insight into the historical and current sources of fears of abandonment, rejection, neglect, and the assumption of the caretaker role.

The client was helped to identify ways in which growing up in an alcoholic family have led to detrimental intimate relationships.

The client denied any connection between childhood experiences and problems in intimate relationships and was urged to monitor this area.

Identify Parental Role of Caretaker (17)

The client was assisted in identifying ways in which the client takes on the parental role of caretaker.

The client was assisted in developing a plan for meeting emotional needs without adopting the parental/caretaker role.

The client was noted to have begun to reduce the adoption of the parental/caretaker role and to increase healthy relationship skills.

The client denied taking on the parental role but has continued in the role of caretaker; additional feedback was provided.

Explore Feelings of Worthlessness and Shame (18)

The client was probed to describe feelings of worthlessness/shame and level of functioning when compared with others.

The client was supported while acknowledging feelings of worthlessness/shame and feeling less competent than others.

The client was assisted in identifying parental substance abuse as a factor in low self-esteem issues.

The client denied feelings of worthlessness or shame; this was accepted at face value.

Teach Low Self-Esteem Precursors (19)

The client was taught about the connection between low self-esteem and how the alcoholic home causes experiences of emotional rejection, broken promises, abuse, neglect, poverty, and loss of social status.

The client acknowledged a connection between low self-esteem and experiences of emotional rejection, broken promises, abuse, neglect, poverty, and loss of social status because of parental chemical dependence; this insight was reinforced.

The client reported beginning to increase self-esteem by moving beyond the effects of being raised in an alcoholic home; this progress was highlighted.

List Positive Traits (20)

The client was asked to list their positive traits and accomplishments.

The client has identified several positive traits and accomplishments; these were reinforced as a foundation for building self-esteem.

The client struggled to identify their own positive traits and accomplishments and was provided with tentative examples.

The client was assigned “Acknowledging My Strengths” in the

Adult Psychotherapy Homework Planner

(Jongsma & Bruce).

The client has not listed positive traits and accomplishments and was redirected to do so.

Emphasize Self-Worth (21)

An emphasis was placed on the client's inherent self-worth as a human being.

The connection between the client's inherent self-worth and acceptance of a higher power was emphasized.

The client was reinforced as they displayed an understanding of self-worth and how this is related to the acceptance of a higher power.

The client continues to display poor self-worth; positive self-worth was reemphasized.

Explore Family Response to Sharing Feelings (22)

The client was asked to identify how the family responded to expressions of feelings, wishes, and wants.

The client was assigned “Understanding Family History” from the

Addiction Treatment Homework Planner

(Lenz, Finley, & Jongsma).

It was noted that the client identified negative responses from family members during childhood regarding the expression of feelings.

It was noted that the client identified a connection between learning in childhood that it was dangerous to share feelings with others and current problems with sharing feelings with peers.

The client did not complete the assignment to help understand family history and was redirected to do so.

The client denied the family's history of negative responses to sharing feelings; this was accepted.

Identify Trustworthiness Traits (23)

The client was asked to list a set of character traits in others that qualify them as trustworthy.

The client was assisted in identifying several traits that they would expect from others that would identify them as trustworthy (e.g., honesty, sensitivity, open-mindedness, kindness).

The client was reinforced as they identified situations in which they saw others being trustworthy.

The client was unable to list a set of character traits in others that qualify them as trustworthy and was redirected to do so.

Teach Honest Communication Skills (24)

The client was taught that the tendency to tell others what we think they want to hear is based on fear of rejection, commonly learned in an alcoholic home.

The client was provided with modeling, role playing, and behavior rehearsal to teach more honest communication skills.

The client was reinforced for more honest communication in place of telling others what the client thinks they want to hear.

The client struggled to understand the techniques or usefulness for honest communication skills; remedial feedback was provided in this area.

Assign a Journal of Honest Communication (25)

The client was asked to keep a journal to record incidents in which they told the truth rather than saying only what others want to hear.

The client presented a journal of situations in which they told the truth rather than saying only what others want to hear; these situations were processed.

The client was reinforced in acknowledging a healthier pattern of communication through reviewing journal entries regarding honest communication rather than saying what others want to hear.

The client did not journal honest communication and was redirected to do so.

Teach Problem-Solving Skills (26)

The client was presented a specific problem-solving technique (i.e., identify the problem, brainstorm alternate solutions, examine the advantages and disadvantages of each solution, select an option, implement a course of action, evaluate the results).

The client was assigned “Applying Problem-Solving to Interpersonal Conflict” in the

Adult Psychotherapy Homework Planner

(Jongsma & Bruce).

The client and therapist role-played examples of implementing problem-solving techniques.

The client was helped to recount instances of using problem-solving techniques in day-to-day situations.

The client has completed the assignment regarding how to resolve interpersonal conflict, and the answers were reviewed.

The client has not completed the assignments regarding applying problem-solving to personal conflict, and this resistance was processed.

Explore Family Response to Sharing Feelings (27)

The client was asked to identify how the family responded to expressions of feelings, wishes, and wants.

It was noted that the client identified negative responses from family members during childhood regarding the expression of feelings.

It was noted that the client identified a connection between learning in childhood that it was dangerous to share feelings with others and current problems with sharing feelings with peers.

The client did not complete the assignment to help understand family history and was redirected to do so.

The client denied the family's history of negative responses to sharing feelings; this was accepted.

Educate About Healthy Relationships (28)

The client was presented with information about building healthy interpersonal relationships through openness, respect, and honesty, including the sharing of feelings to build trust and mutual understanding.

The client was assigned the honesty exercise in

The Alcoholism and Drug Abuse Client Workbook

(Perkinson).

The client has completed the honesty exercise and the responses were processed.

The client has not completed the honesty exercise from

The Alcoholism and Drug Abuse Client Workbook

(Perkinson) and was redirected to do so.

The client acknowledged situations in which they could increase sharing of feelings in order to build trust and mutual understanding; the client was directed to do so.

The client was supported while recounting situations in which they used openness and honesty in order to increase trust and mutual understanding.

Explore the Client's Focus on Others (29)

The client was assisted in comparing reluctance to share personal problems with their pattern of focusing on helping others with their problems.

Active listening skills were used as the client expressed an understanding of how childhood experiences have prompted the client to focus on helping others as a way to resist sharing personal problems.

The client struggled to identify a pattern of resistance to sharing personal problems and was provided with examples of this pattern.

Connect Overhelping Others With Low Self-Esteem (30)

The client was presented with the concept that overemphasis on helping others is based on low self-esteem and a need for acceptance, which was learned in the alcoholic family of origin.

The client was presented with the concept that caretaking behavior often results from choosing friends and partners who are chemically dependent or psychologically disturbed.

The client rejected the concept that helping others is based on low self-esteem and relates to choosing friends who are chemically dependent or psychologically disturbed; the client was urged to review this pattern.

The client was reinforced in accepting the concept that they have a strong need to help others because of low self-esteem.

The client was able to connect caretaking behavior to the choice of friends who are chemically dependent or psychologically disturbed; this insight was reinforced.

Teach Recovery Group Involvement (31)

The client was taught about how active involvement in a 12-step recovery group is a way to build trust in others and self-confidence.

The client was referred to an appropriate 12-step recovery group.

Active listening was provided as the client described involvement in an active 12-step recovery group.

The client reported that they had not followed through with involvement in a 12-step recovery group and was redirected to do so.

The client reported that they had not followed through with involvement in a 12-step recovery group and was instead assigned the Step 12 exercise in

The Alcoholism and Drug Abuse Client Workbook

(Perkinson).

Develop an Aftercare Plan (32)

The client was assisted in developing an aftercare plan that will support recovery from ACA issues, including regular attendance at Alcoholics Anonymous/Narcotics Anonymous (AA/NA) meetings.

The client's aftercare plan that will support sobriety (e.g., self-help groups and sponsors, family activities, counseling) was reviewed.

The client described active pursuit of the elements of the aftercare plan.

The client has not followed through on an aftercare plan and was redirected to do so.

List Reasons for Recovery Group Attendance (33)

The client was assigned to list 10 reasons why 12-step recovery group attendance is helpful in overcoming ACA traits.

The client was assisted in developing a list of 10 reasons why 12-step recovery group attendance is helpful in overcoming ACA traits.

The client has not followed through in developing a list of reasons why 12-step recovery group attendance is helpful and was redirected to do so.

Identify ACA Traits’ Effect on Recovery Groups (34)

The client was urged to identify the relationship between ACA traits and the fear of attending recovery group meetings.

The client was provided with feedback about common ways in which ACA traits cause fear of attending recovery group meetings.

The client was assisted in brainstorming ways to help cope with fear of attending recovery group meetings.

The client was assigned “Safe and Peaceful Place Meditation” from

Addiction Treatment Homework Planner

(Lenz, Finley, & Jongsma) or “Progressive Muscle Relaxation” from

Adolescent Psychotherapy Homework Planner

(Jongsma, Peterson, McInnis, & Bruce).

The client was taught about how to give self positive messages regarding self-worth in order to overcome the fear of attending recovery group meetings.

The client was taught how to use relaxation techniques to reduce tension when attending recovery group meetings.

The client was taught how to use meditation to induce calm and support from a higher power in order to be more comfortable attending recovery group meetings.

The client's fear of openness with others was noted to cause them to continue to avoid recovery group meetings.

Teach ACA/AA/NA Group as Trust Builder (35)

The client was presented with the idea that an ACA/AA/NA home recovery group can aid in building trust with others and self-confidence.

The client was assisted in understanding the need to gain trust and confidence.

The client was reinforced for accepting the idea that an ACA/AA/NA group can help build trust and confidence.

The client was resistant to acknowledging the need for gaining trust and confidence; additional support and encouragement were provided.

Emphasize Family Atmosphere in Home Recovery Group (36)

An emphasis was placed on the opportunity to engage in a home recovery group as a way to develop a healthy family atmosphere.

The client was urged to help others in the home recovery group.

The client was asked about how their self-concept is boosted through helping others in a healthy manner.

Teach ACA/AA/NA Group as a Promoter of Self-Worth (37)

The client was presented with the idea of an ACA/AA/NA home recovery group functioning as the healthy family they never had.

The client was advised about how helping others can aid in recovery and establish a feeling of worth.

The client was reinforced while verbalizing acceptance of the family atmosphere in ACA/AA/NA.

The client identified ways in which they specifically use the ACA/AA/NA group as a healthy family; these examples were processed.

The client was resistant to acknowledging the ACA/AA/NA group as a promoter of self-worth and was urged to review this on a daily basis.

Teach About a Higher Power (38)

The client was presented with information about how faith in a higher power can aid in recovery from ACA traits and addiction.

The client was assigned the Step 2 exercise in

The Alcoholism and Drug Abuse Client Workbook

(Perkinson).

The client has completed the Step 2 exercise and responses were reviewed and processed.

The client has not completed the Step 2 exercise from

The Alcoholism and Drug Abuse Client Workbook

(Perkinson) and was redirected to do so.

The client was assisted in processing and clarifying ideas and feelings regarding the existence of a higher power.

The client was encouraged to describe beliefs about the idea of a higher power.

The client rejected the concept of a higher power but was encouraged to review this at a later time.

Read About Spirituality in AA's

Big Book

(39)

The client was assigned to read about spirituality and the role of a higher power in portions of Adult Children of Alcoholics's

Red Book

and AA's

Big Book

.

The client reported reading Adult Children of Alcoholics's

Red Book

and AA's

Big Book

on the topic of spirituality and the role of a higher power, and this topic was discussed.

The client was helped to process the material related to spirituality from Adult Children of Alcoholics's

Red Book

and AA's

Big Book

and identified ways in which this related to their situation.

The client did not read the portions of Adult Children of Alcoholics's

Red Book

and AA's

Big Book

on the topic of spirituality, and this was reassigned.

Identify Issues for a Higher Power (40)

The client was asked to identify circumstances in their life that could benefit from being turned over to a higher power.

The client was assigned “Understanding Spirituality” or “Finding a Higher Power That Makes Sense” in the

Addiction Treatment Homework Planner

(Lenz, Finley, & Jongsma).

The client was assisted in identifying specific issues that need to be turned over to a higher power.

The client was reinforced in identifying specific steps that they are taking to turn specific issues over to a higher power.

The client denied any need for turning any issues over to a higher power and was urged to remain open to this concept.

Teach Assertiveness Skills (41)

The client was taught assertiveness skills through the use of modeling, behavior rehearsal, and role-playing.

The client was assigned the “Becoming Assertive” exercise from the

Adult Psychotherapy Homework Planner

(Jongsma & Bruce).

The client displayed an understanding of assertiveness skills that they have been taught.

The client's journal of assertiveness experiences was reviewed.

The client listed several different situations in which they have been able to be assertive; this success was celebrated.

The client reported finding it very difficult to implement assertiveness skills, and remedial assistance was provided.

Teach Assertiveness Formula (42)

The client was taught the “I feel … when you…. I would prefer it if…” assertiveness formula.

The client and the therapist role-played several applications of the assertiveness formula in the client's life.

The client was reinforced while displaying an understanding and mastery of assertiveness techniques.

The client was assigned to use the assertiveness formula three times per day.

The client struggled to understand the techniques and usefulness of the assertiveness formula and was provided with remedial assistance in this area.

Teach the

Share Check

Method (43)

The client was taught the share check method of building trust in relationships.

The therapist and client role-played several applications of the share check method in the client's life.

The client was noted to have indicated a desire to increase their level of trust in others and has implemented the share check method to do so.

The client continues to be distrustful of others and has not implemented the share check method to increase trust in others; the client was redirected to do so.

Reinforce Honest Sharing (44)

The client was encouraged and reinforced to share honestly and openly with a trusted person.

As the client identified situations in which they have shared honestly and openly with a trusted person, strong reinforcement was given.

It was reflected that the client continues to struggle with sharing openly and honestly with a trusted person.

Refer for Psychopharmacological Intervention (45)

A referral to a physician was made to evaluate the client for a prescription for psychotropic medication.

The client has followed through on the referral to a physician and has been assessed for a prescription of psychotropic medication, but none were prescribed.

The client has been prescribed psychotropic medications.

The client has refused a prescription of psychotropic medication provided by the physician.

Administer Medications (46)

The medical staff administered medications as prescribed.

The medical staff assisted the client in administering their own medications.

The client refused to accept medication as prescribed.

Monitor Medication Effectiveness and Side Effects (47)

As the client has taken psychotropic medication prescribed by a physician, the effectiveness and side effects of the medication were monitored.

It was noted that the client has reported that the psychotropic medication has been beneficial.

The client reported that the psychotropic medication has not been beneficial; this was relayed to the prescribing clinician.

The client identified side effects of the medications; this was relayed to the prescribing clinician.

The client has not consistently taken the prescribed medication and has been redirected to do so.

Develop 5-Year Plan (48)

The client was asked to set goals for recovery from ACA traits at 6 months, 12 months, and 5 years.

The identification of specific steps toward recovery was emphasized.

The client was assigned the “Personal Recovery Plan” exercise in

The Alcoholism and Drug Abuse Client Workbook

(Perkinson).

The client was unable to set goals for recovery, and roadblocks were assessed and managed.

Assess Satisfaction (49)

A treatment satisfaction survey was administered to the client.