to solve or overcome a problem or stressor that they are currently facing.The client was given a directive to use problem-solving strategies at home or school on at least three occasions before the next therapy session.46 Assign Problem-Solving Exercises (46)The client and parents were taught problem-solving techniques for daily life through the use of role-playing and modeling.The parents were helped to identify exercises that could facilitate the client's use of problem-solving in various everyday situations.The client and parents reported using techniques and exercises for problem-solving with positive success.The client and parents reported minimal success using problem-solving techniques and exercises and were provided with support.
47 Relate Learning Problems, Negative Emotions, Addictive Behavior (47)The client was presented with the concept that negative experiences regarding learning have caused negative emotions, which have in turn led to addictive behaviors.The client accepted the concept presented, that they have experienced strong negative emotions related to learning problems, which have led to addiction problems.The client rejected the concept that negative learning experiences have led to strong negative emotions and addiction problems; the client was urged to be aware of this dynamic.
48 Use Alternative Behaviors for Negative Emotions (48)The client was presented with a variety of constructive coping behaviors that can be used to cope with negative emotions (e.g., focus cognitively, breathe deeply, make lists, reduce distractions, shorten learning sessions, repeat instructions verbally).Alternative coping behaviors were role-played and modeled with the client as alternatives for dealing with negative emotions.The client was reinforced while displaying an understanding of a variety of alternative coping behaviors to cope with negative emotions.The client identified that they have regularly used alternative coping behaviors to deal with negative emotions and thereby decreased addiction behavior; this progress was highlighted.The client has not used alternative coping behaviors for negative emotions and has continued to use addictive behaviors; the client was redirected to the alternative coping behaviors.
49 Teach Relaxation Techniques (49)The client was taught various relaxation techniques, including progressive relaxation, guided imagery, and/or biofeedback, to be used to help reduce tension.The client was assigned to relax twice a day for 10 to 20 minutes, using newly learned relaxation techniques.The client has implemented relaxation procedures to reduce tension and physical restlessness and has reported that this technique is beneficial; this progress was reinforced.The client has not followed through on implementation of relaxation techniques to reduce restlessness and tension and was encouraged to do so.
50 Relax When Frustrated by Learning Problems (50)The client was encouraged to incorporate relaxation skills as a coping and focusing mechanism when feeling tense and frustrated by a learning situation or an urge to use substances.The client reported regular use of relaxation skills as a coping and focusing mechanism; the experience was processed.The client was assisted in identifying benefits from the use of relaxation skills when frustrated by learning situations or urges to use substances.The client acknowledged that they have not used relaxation skills when frustrated by learning situations or urges to use substances and was redirected to do so.
51 Develop Physical Fitness Program (51)After the client obtained approval from their personal physician, they were assisted in developing an exercise program.The client has followed through on the exercise program and has gradually increased exercise level by 10% each week; the client was reinforced.The client reported now exercising at a training heart rate for at least 20 minutes, at least three times per week; the benefits of this activity were catalogued.The client has not followed through on establishing a daily exercise routine and was encouraged to do so.
52 Develop an Aftercare Program (52)The client was assisted in developing an aftercare plan that will support recovery from ADHD and addictive behavior problems, including regular attendance at 12-step meetings, getting a sponsor, and continuing necessary therapy.The client was assigned “Aftercare Plan Components” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client has listed several components of an aftercare plan that will support sobriety (e.g., self-help groups, sponsors) as well as specific techniques to assist with ADHD concerns; the client was encouraged to use these skills.The client was reinforced while describing active pursuit of the elements of the aftercare program.The client has not followed through on an aftercare plan and was redirected to do so.
53 Assess Satisfaction (53)A treatment satisfaction survey was administered to the client.The client's survey responses indicated a high level of satisfaction with treatment services; these results were processed.The client's survey responses indicated a medium level of satisfaction with treatment services; these results were processed.The client's survey responses indicated a low level of satisfaction with treatment services; these results were processed.Although the client was encouraged to complete a treatment satisfaction survey, it was refused.
NOTES
1 * The numbers in parentheses correlate to the number of the Behavioral Definition statement in the companion chapter with the same title in The Addiction Treatment Planner, Sixth Edition, by Perkinson, Jongsma, & Bruce (Wiley, 2022).
2 * The numbers in parentheses correlate to the number of the Therapeutic Intervention statement in the companion chapter with the same title in The Addiction Treatment Planner, Sixth Edition, by Perkinson, Jongsma, & Bruce (Wiley, 2022).
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADULT
CLIENT PRESENTATION
1 ADHD Childhood History (1)*The client confirmed that childhood history consisted of the following symptoms: behavioral problems at school, impulsivity, temper outbursts, and lack of concentration.The client had a diagnosed ADHD condition in childhood.Although the client's symptoms were not diagnosed as ADHD, it can be concluded from the childhood symptoms that the ADHD condition was present at that time.
2 Lack of Attention to Detail (2)The client reported failure to give close attention to detail or makes mistakes with things of low interest, even though they may be important to their life.The client's lack of ability to give close attention has resulted in missing out on the comprehension of important details.The client's ability to give close attention seems to be increasing as they reported increased attention skills.
3 Fidgety (3)The client reported being unable to sit still for any length of time but often feels fidgety.The client gave evidence of being fidgety within the session, often moving about in a chair.The client's ability to rest comfortably for a longer period of time has increased.
4 Difficulty Sustaining Attention (4)The client reported difficulty sustaining attention to tasks or activities.The client gave evidence of difficulty sustaining attention within today's session.The client's difficult sustaining attention is diminishing and focused concentration is increasing.
5 Fails to Listen (5)The client does not seem to listen to others even when spoken to directly.The client reports problems with day-to-day functioning because of failure to listen to others.The client reports greater control over listening when others are speaking to them.
6 Restless (6)The client reported being unable to sit still for a significant length of time and often feels restless.The client gave evidence of being restless within the session, often moving about in a chair.The client's ability to rest comfortably for a longer period of time has increased.
7 Lack of Follow-Through (7)The client reported struggling to follow through on instructions and failing to finish duties.Family members reported frustration
