The Adult Psychotherapy Progress Notes Planner. David J. Berghuis

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

      14 Assess Severity of Impairment (14)The severity of the client's impairment was assessed to determine the appropriate level of care.The client was assessed in regard to his/her/their impairment in social, relational, vocational, and occupational endeavors.It was reflected to the client that his/her/their impairment appears to create mild to moderate effects on the client's functioning.It was reflected to the client that his/her/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.

      15 Identify Difficult ADHD Behaviors (15)The client was assisted in identifying the specific ADHD behaviors that have caused him/her/them the most difficulty.The client was supported as he/she/they listed such things as distractibility, lack of concentration, impulsivity, restlessness, and disorganization as the most difficult for him/her/them.The client was assisted in identifying specific behaviors that will be treatment targets.The client was resistive to becoming specific about identifying ADHD behaviors that cause him/her/them the most difficulty; he/she/they were encouraged to do this as he/she/they feel capable.

      16 Review Evaluation Results (16)The results of the psychological testing and physician's evaluation were reviewed again with the client in order to assist him/her/them in the choice of his/her/their most difficult, problematic behaviors to address in counseling.The client was assisted in selecting those behaviors that are most difficult as focal points for treatment.The client was supported as he/she/they agreed to concentrate his/her/their efforts to change on these most difficult behavior areas.

      17 Direct Family to Rank Client's Behaviors (17)The client was asked to request family members to complete a ranking of the three behaviors that they perceive as those that interfere the most with the client's daily functioning.Family members have ranked the client's behavior and have identified those three behaviors that they perceive to be the most problematic for the client; these were processed with the client.It was noted that the client's family has refused to cooperate with ranking his/her/their behaviors and would not provide such a list for him/her/them.The client has failed to ask for the family's participation in his/her/their treatment and has not asked them to rank his/her/their problematic behaviors; he/she/they were asked to get this feedback.

      18 List Negative ADHD Consequences (18)The client was asked to make a list of the negative consequences that result from his/her/their problematic ADHD behaviors.The client was assigned “Impulsive Behavior Journal” in the Adult Psychotherapy Homework Planner (Jongsma).The list of the negative consequences that result from ADHD behaviors was processed to increase the client's awareness of the impact of his/her/their behavior on self and others.Coping strategies were reviewed that could be implemented as alternatives to the problematic ADHD behaviors that produce negative consequences.The client was guarded about making a list of the negative consequences that result from his/her/their problematic ADHD behaviors and was gently offered examples in this area.

      19 Engage Significant Other (19)The client was directed to invite a significant other to participate in the therapy.The significant other was trained to help support the change and reduce friction in the relationship introduced by the ADHD.It was reflected that the significant other has been helpful in supporting the client's changes and reducing friction in the relationship.The significant other has struggled to be helpful to the client's change process and was provided with remedial feedback in this area.

      20 Train the Coach in HOPE Technique (20)The person selected by the client to act as his/her/their coach was trained in the Help, Obligations, Plans, and Encouragement (HOPE) technique as described in the book Driven to Distraction (Hallowell and Ratey).The coach was trained in how to assist the client with Help, Obligations, Plans, and Encouragement as part of the HOPE procedure.The coach technique has been implemented and the client reported that it has been helpful in increasing his/her/their organization and task focus.The client and the coach have failed to implement the HOPE technique, and the client was encouraged to initiate this procedure.

      21 Educate About Symptoms of ADHD (21)The client was taught about the signs and symptoms of ADHD.Emphasis was placed on how symptoms of ADHD disrupt functioning through the influence of distractibility, poor planning and organization, maladaptive thinking, frustration, impulsivity, and procrastination.The client was reinforced for his/her/their clear understanding of the signs and symptoms of ADHD.The client has struggled with understanding the signs and symptoms of his/her/their ADHD and was provided with remedial feedback in this area.

      22 Discuss Rationale for Treatment (22)A rationale for treatment was discussed where the focus will be on improvement in organizational and planning skills, management of distractibility, cognitive restructuring, and overcoming procrastination.The client had a clear understanding of the rationale for treatment, and this was reinforced.The client seemed to struggle with understanding the rationale for treatment and was provided with additional information in this area.

      23 Assign Books on ADHD (23)The client was referred to specific reading material designed to increase his/her/their knowledge about ADHD.The client was assigned Mastery of Your Adult ADHD—Client Workbook (Safren et al.).The client was assigned The Attention-Deficit Disorder in Adults Workbook (Weis).The client has followed through on reading the recommended books, and key concepts were processed within the session.The client has not followed through on reading the assigned material on ADHD and was encouraged to do so.

      24 Assign Self-Help Readings on ADHD (24)The client was assigned self-help reading to facilitate his/her/their understanding of ADHD.The client was assigned Driven to Distraction (Hallowell and Ratey).The client was assigned Hyperactive Child, Adolescent, and Adult (Wonder).The client was assigned to read Putting on the Brakes (Quinn and Stern).The client was assigned to read You Mean I'm Not Lazy, Stupid, or Crazy!? (Kelly and Ramundo).The client was assisted in processing the material that he/she/they have read.The client was not read the assigned information on ADHD and was redirected to do so.

      25 Teach Organization and Planning Skills (25)The client was taught organizational and planning skills.The client was taught about tasks such as using a calendar and a daily task list.The client was reinforced for his/her/their regular use of organizational and planning tools.The client has not used the organizational planning techniques and was redirected to do so.

      26 Develop Document Management System (26)The client was assisted in developing a procedure for classifying and managing mail and other papers.The client was taught about taking care of mail and other important document tasks in the least amount of steps.The client was taught to organize his/her/their mail and documents in one place.

      27 Teach Problem-Solving Skills (27)The client was taught problem-solving skills that involve identifying the problem, brainstorming solutions, evaluating options, implementing action, and evaluating results.The client was reinforced as he/she/they verbalized an understanding of the problem-solving skill techniques.Role-playing was used to help the client apply problem-solving techniques to daily problems in his/her/their life.The client has not internalized the problem-solving skills and was provided with remedial assistance in this area.

      28 Assign Problem-Solving Homework (28)The client was assigned the homework of applying the problem-solving techniques previously learned to specific, identified ADHD behaviors.The client was assigned “Problem-Solving: An Alternative to Impulsive Action” in the Adult Psychotherapy Homework Planner (Jongsma).The client has followed through with the problem-solving homework and the results of that effort were processed.The client reported success at implementing the problem-solving techniques and he/she/they were reinforced for this success.The client has had difficulty applying problem-solving techniques and he/she/they were redirected regarding implementation of these techniques.

      29 Assess Typical Attention Span (29)The client's typical attention span was assessed by having him/her/them do a few “boring” СКАЧАТЬ