people for his/her/their own problems and behaviors.5 Uses aggressive behavior to manipulate, intimidate, or control others.
6 Demonstrates a chronic pattern of dishonesty.
7 Lives a hedonistic, self-centered lifestyle, with little regard for the needs and welfare of others.
8 Verbalizes a lack of empathy for the feelings of others, even if they are friends or family.
9 Presents a pattern of criminal activity and addiction, going back to the client's adolescent years.
10 Engages in dangerous, thrill-seeking behavior, without regard for the safety of self or others.
11 Makes decisions impulsively, without giving thought to the consequences for others.
LONG-TERM GOALS
1 Develop a program of recovery that is free from addiction and the negative influences of antisocial behavior.
2 Learn the importance of helping others in recovery.
3 Learn how antisocial behavior and substance use are related and self-defeating.
4 Understand criminal thinking and develop self-talk that respects the welfare and rights of others.
5 Understand the importance of a program of recovery that demands rigorous honesty.
6 Take responsibility for one's own behavior.
| SHORT-TERM OBJECTIVES | THERAPEUTIC INTERVENTIONS |
|---|---|
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Establish rapport with the client toward building a strong therapeutic alliance; convey caring, support, warmth, and empathy; provide nonjudgmental support and develop a level of trust with the client toward his/her/their feeling safe to discuss his/her/their antisocial behavior issues and their impact on his/her/their life. |
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Strengthen powerful relationship factors within the therapy process and foster the therapy alliance through paying special attention to thsese empirically supported factors: work collaboratively with the client in the treatment process; reach agreement on the goals and expectations of therapy; demonstrate consistent empathy toward the client's feelings and struggles; verbalize positive regard toward and affirmation of the client; and collect and deliver client feedback as to the client's perception of his/her/their progress in therapy (see Psychotherapy Relationships That Work: Vol. 1 by Norcross & Lambert and Psychotherapy Relationships That Work: Vol. 2 by Norcross & Wampold). |
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| Verbalize an acceptance of powerlessness and unmanageability over antisocial behavior and addiction. (3, 4) | Help the client to understand the self-defeating nature of antisocial behavior and addiction (or assign the Step 1 exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson). |
| Help the client to see the relationship between antisocial behavior and addiction. | |
| Complete psychological testing or objective questionnaires for assessing antisocial behavior. (5) | Administer to the client psychological instruments designed to objectively assess antisocial behavior, impulsivity, and/or aggression rating instruments (e.g. Psychopathy Checklist-Revised; Aggressive Acts Questionnaire; Barratt Impulsiveness Scale-11); give the client feedback regarding the results of the assessment and test again, if necessary, to assess treatment progress. |
| State how antisocial behavior and addiction are associated with irrational thinking (Alcoholics Anonymous's “insanity”). (6) | Help the client to understand how doing the same things over and over but expecting different results is irrational—what Alcoholics Anonymous calls “insanity.” |
| Provide behavioral, emotional, and attitudinal information toward an assessment of specifiers relevant to a DSM diagnosis, the efficacy of treatment, and the nature of the therapy relationship. (7, 8, 9, 10) | Assess the client's level of insight (syntonic versus dystonic) toward the presenting problems (e.g. demonstrates good insight into the problematic nature of the described behavior, agrees with others' concern, and is motivated to work on change; demonstrates ambivalence regarding the problem described and is reluctant to address the issue as a concern; or demonstrates resistance regarding acknowledgment of the problem described, is not concerned, and has no motivation to change). |
| Assess the client for evidence of research-based correlated disorders (e.g. oppositional defiant behavior with attention-deficit/hyperactivity disorder [ADHD], depression secondary to an anxiety disorder) including vulnerability to suicide, if appropriate (e.g. increased suicide risk when comorbid depression is evident). | |
| Assess for any issues of age, gender, or culture that could help explain the client's currently defined problem behavior and factors that could offer a better understanding of the client's behavior. | |
| Assess for the severity of the level of impairment to the client's functioning to determine appropriate level of care (e.g. the behavior noted creates mild, moderate, severe, or very severe impairment in social, relational, vocational, or occupational endeavors); continuously assess this severity of impairment as well as the efficacy of treatment (e.g. the client no longer demonstrates severe impairment but the presenting problem now is causing mild or moderate impairment). | |
| Consistently follow all rules. (11) | Assign appropriate consequences when the client fails to follow rules or expectations. |
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Identify and verbalize the negative consequences that failure
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