The Adult Psychotherapy Progress Notes Planner. David J. Berghuis

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СКАЧАТЬ task until the point that they report distraction.The client's level of attention during this task was used as an approximate measure of his/her/their typical attention span.

      30 Break Down Tasks (30)The client was taught about breaking down tasks into meaningful smaller units.An emphasis was placed on being able to complete small tasks without being distracted, based on his/her/their demonstrated attention span.The client was reinforced for breaking down tasks into meaningful smaller units.The client has struggled to apply the use of the smaller tasks technique and was pro- vided with additional examples in this area.

      31 Teach Use of Timers (31)The client was taught to use timers or other cues to remind him/her/them to stop a task before he/she/they get distracted.The client was taught about reducing the time that he/she/they may be distracted and off task through the use of timers.The client was taught the regular use of timers and other cues to remind him/her/them to stop a task before he/she/they get distracted.The client has failed to regularly use the timer technique, and was redirected to do so.

      32 Teach Stimulus Control Techniques (32)The client was taught techniques that use external structure such as lists, files, and daily rituals to improve on-task behavior.The client was taught to remove distracting stimuli from his environment when per- forming a task requiring focus.The client was urged to self-reward for successful focus and follow through with on-task behavior.The client followed through with implementing techniques to increase on-task behavior and he/she/they were reinforced for doing so.The client did not follow through with implementing on-task behavior and was encouraged to do so.

      33 Modify Maladaptive Self-Talk (33)The client was taught about using cognitive therapy techniques to help identify maladaptive self-talk.The client was assisted in challenging biases and generating alternatives to his/her/their maladaptive self-talk.The client struggled to identify maladaptive self-talk and was provided with specific examples (e.g. “I must do this perfectly,” “I can do this later,” “I can't organize all these things”).

      34 Discuss Metacognitive Therapy Approach (34)The client was taught about using a metacognitive approach to examine his/her thinking.The client was assisted in developing a more adaptive plan based on new, less-threatening metacognitive appraisals.The client was provided with positive reinforcement for his/her use of a metacognitive approach to examining his/her thinking.The client was provided with corrective feedback toward improving his/her ability to examine thinking.

      35 Assign New Cognitive Appraisal Homework (35)The client was assigned to implement new cognitive appraisal skills while doing tasks in which maladaptive thinking has occurred previously.The client was assisted in reviewing his/her/their use of new cognitive appraisal skills in his/her/their real-life situations.The client was provided with positive reinforcement for his/her/their use of cognitive appraisal skills.The client was provided with corrective feedback toward improving his/her/their cognitive appraisal skills.

      36 Discuss Procrastination (36)The client was assisted in identifying both the positive and negative effects of procrastinating.The client was assisted in moving toward the goal of being more engaged and staying focused.The client was reinforced for identifying the positives and negatives associated with procrastination.

      37 Apply Problem-Solving Skills to Procrastination (37)The client was taught about applying new problem-solving skills to planning as a first step in overcoming procrastination.The client was taught that for each plan, he/she/they must break it down into manageable, time-limited steps to reduce the influence of distractibility.

      38 Apply Cognitive Restructuring Skills to Procrastination (38)The client was taught to apply new cognitive restructuring to challenge thoughts that encourage the use of procrastination.The client was encouraged to embrace thoughts that encourage action.The client was provided with examples of cognitive restructuring to change thoughts from procrastination to action (e.g. “I can do this later” becomes “I am going to do this right away”).

      39 Assign Homework on Procrastination (39)The client was assigned homework to accomplish identified tasks without procrastination.The client was assigned “Self-Monitoring Self-Reward Program” in the Adult Psychotherapy Homework Planner (Jongsma) to assist in reducing procrastination.The client was urged to use techniques learned in therapy to address procrastination.The client's use of new techniques was reviewed, with encouragement for successes and corrective feedback toward improving the skill and decreasing procrastination.

      40 Teach Self-Control Strategies (40)The client was taught the self-control strategy of “stop, listen, think, and act” to assist him/her/them in curbing impulsive behavior.The client was taught problem-solving self-talk as a means of reducing impulsivity.Role-playing was used to help the client apply self-control strategies to daily life situations that are affected by his/her/their ADHD symptoms.The client reported success at applying self-control strategies and indicated that his/her/their impulsivity has been diminished; this progress was reinforced.The client has not learned the self-control strategies and was provided with remedial feedback in this area.

      41 Select Situations to Apply Skills (41)The client was directed to identify situations in which he/she/they will be challenged to apply his/her/their new strategies for managing ADHD.The client was urged to start the application of new strategies with a situation that was highly likely to be successful.The client was assisted in identifying a hierarchy of gradually more challenging situations to apply his/her/their new techniques.

      42 Consolidate New Skills (42)The client was assisted in consolidating the use of his/her/their new ADHD management skills.Techniques such as imagery were used to help the client consolidate his/her/their new ADHD management skills.Techniques such as behavioral rehearsal, modeling, role-playing, and in vivo expo- sure/behavioral experiments were introduced to help the client consolidate the use of his/her/their new ADHD management skills.

      43 Teach Relaxation Techniques (43)The client was taught various relaxation techniques including deep muscle relaxation, rhythmic breathing, meditation, and guided imagery to be used when stress levels increase.The client was advised to use techniques from The Relaxation and Stress Reduction Workbook (Davis et al.).The client was advised to use techniques from “Deep Breathing Exercise” in the Adult Psychotherapy Homework Planner (Jongsma).It was noted that the client has implemented relaxation procedures to reduce tension and physical restlessness and reported that this technique is beneficial.The client has not followed through on implementation of relaxation techniques to reduce restlessness and tension and was encouraged to do so.

      44 Review Symptoms and Fixes (44)The client was assisted in reviewing the symptoms that have been problematic and the newly learned coping skills that he/she/they will use to manage the symptoms.The client was assigned “Symptoms and Fixes for ADHD” in the Adult Psychotherapy Homework Planner (Jongsma).

      45 Teach Mindful Meditation (45)The client was explained the rational for mindful meditation to enhance attention regulation.The client was taught the skills of mindful meditation.The client was asked to apply mindful meditation to tasks that require attentional focus.Positive feedback was provided as the client reported that he/she was able to use mindful meditation during tasks.The client reported difficulties with applying mindful meditation with appropriate tasks and was provided with remedial feedback in this area.

      46 Refer to ADHD Group (46)The client was referred to group therapy for adults with ADHD to help increase his/her/their understanding of ADHD, boost self-esteem, and to receive feedback from others.It was noted that the client has followed through on attendance at the ADHD group therapy sessions and reported that they have been beneficial.The client has not followed through on consistent attendance at the ADHD group therapy sessions and was encouraged to do so.

      47 Teach Listening Skills (47)Role-playing and modeling were used to teach the client how to listen to others and to accept their feedback regarding his/her/their behavior.Positive feedback was provided as the client reported that, on several occasions, he/she/they were able to use the new listening skills СКАЧАТЬ