client was scheduled for a “maintenance session” between 1 and 3 months after therapy ends.The client was advised to contact the therapist if they need to be seen before the “maintenance session.”The client's “maintenance session” was held and the client was reinforced for successful implementation of therapy techniques.The client's “maintenance session” was held and the client was coordinated for further treatment, as progress has not been sustained.52 Assign Reading on Bipolar Disorder (52)The client was assigned to read a book on bipolar disorder.The client was assigned to read The Bipolar Disorder Survival Guide (Miklowitz).The client was assigned to read The Bipolar Disorder Workbook (Forester & Gregory).The client was assigned to read Bipolar 101 (White & Preston).The client has read the assigned information on bipolar disorder and key concepts were reviewed.The client has not read the assigned information on bipolar disorder and was redirected to do so.
53 Outline Recovery Components (53)The client was assisted in outlining the essential components for managing manic/hypomanic states and addiction (i.e., taking medication, complying with medical monitoring, continuing therapy, attending therapy groups regularly, using a higher power, getting a sponsor, helping others in recovery).The client was assigned “Personal Recovery Planning” in the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).The client was reinforced in endorsing recovery plan components.The client has implemented recovery plan components to assist in managing manic/hypomanic states and addiction; this was reinforced.The client has not been using recovery plan components and was redirected to do so.
54 Discuss Discharge Plan/Environment (54)Today's session focused on discharge planning and on assisting the client in deciding what environment is needed in early recovery.Active listening was provided as the client endorsed a healthy discharge plan and identified the environment needed in early recovery.The client has been reluctant to endorse specific discharge plans and was urged to be more direct in this area.The client is uncertain about the recovery environment that they must use in order to have a successful early recovery; specific feedback was provided.
55 Assign Step 4 Exercise (55)The client was taught about a 12-step recovery program's Step 4, focusing on the detailing of the exact nature of their wrongs.The client was directed to write an autobiography detailing the exact nature of their wrongs.The client has completed the autobiography, has detailed the exact nature of their wrongs, and has shared this with someone in recovery; the reaction of the support person was processed.The client has not completed the Step 4 exercise and was redirected to do so.
56 Develop Recovery Plan (56)The client was taught about the importance of working a program of recovery that includes attending recovery group meetings regularly and helping others.The client was assisted in developing a recovery program.The client was reinforced in describing active pursuit of the elements of the recovery program.The client has not followed through on a recovery program and was redirected to do so.
57 Develop 12-Step Program Contact (57)A contact with a representative of a 12-step program was coordinated.The client was assigned to talk to the 12-step program contact person about manic/hypomanic states and addiction.The client reported a helpful conversation with a 12-step recovery program contact person, including insight into manic/hypomanic states and addiction; this progress was reinforced.The client has not made contact with a 12-step recovery program's representative and was encouraged to do so.
58 Assess Satisfaction (58)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).
BORDERLINE TRAITS
CLIENT PRESENTATION
1 Relationship Instability (1)*The client described a pervasive pattern of instability of interpersonal relationships, self-image, affect, and marked impulsivity.The client's unstable relationship, affect, and self-image patterns began in early adulthood and have been consistent since that time.The client's unstable relationship, affect, and self-image patterns are present in a variety of contexts throughout adulthood.The client's patterns of relationship, affect, and self-image instability have been reduced.
2 History of Childhood Trauma (2)The client reported having a history of childhood trauma, physical abuse, abandonment, or neglect.The client reported that painful memories of abusive childhood experiences are intrusive and unsettling.The client reported that nightmares and other disturbing thoughts related to childhood abuse interfere with sleep.The client reported that emotional reactions associated with the childhood abusive experiences have been resolved.The client was able to discuss childhood abusive experiences without being overwhelmed with negative emotions.
3 Abandonment Fears (3)The client described a history of becoming very anxious whenever there is any hint of abandonment present in an established relationship.The client's hypersensitivity to abandonment has caused them to place excessive demands of loyalty and proof of commitment on relationships.The client has begun to acknowledge fear of abandonment as being excessive and irrational.Conflicts within a relationship have been reported by the client, but they have not automatically assumed that abandonment will be the result.
4 Chaotic Interpersonal Relationships (4)The client has a pattern of intense, but chaotic, interpersonal relationships as the client puts high expectations on others and is easily threatened that the relationship might be in jeopardy.The client has had many relationships that have ended because of the intensity and demands that they placed on the relationship.The client reported incidents that have occurred recently with friends, whereby they continued placing inappropriately intense demands on the relationship.The client displays interpersonal relationships that are characterized as alternating between extremes of idealization and devaluation.The client has made progress in stabilizing relationships with others by diminishing the degree of demands that they place on the relationship and reducing the dependency on it.
5 Identity Disturbance (5)The client has a history of being confused as to who they are and what their goals in life are.The client has become very intense about questioning their identity.The client has become more assured about their identity and is less reactive to this issue.
6 Impulsivity (6)The client described a history of engaging in impulsive behaviors that have the potential for producing harmful consequences for the client.The client has engaged in impulsive behaviors that compromise their reputation with others.The client has established improved control over impulsivity and considers the consequences of actions more deliberately before engaging in behavior.
7 Suicidal/Self-Mutilating Behavior (7)The client reported a history of multiple suicidal gestures and/or threats.The client has engaged in self-mutilating behavior on several occasions.The client made a commitment to terminate suicidal gestures
