intense mood swings increase the probability of addictive behavior.The client was assigned “Analyzing Acting-Out Behavior” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).Active listening was used as the client identified specific incidences from their own life when their borderline traits have led to addictive behavior.The client has reported, as therapy has progressed, decreased incidences of borderline behaviors, with a commensurate decrease in addictive behavior.The client has struggled to identify how poor impulse control, poor anger management, fears of abandonment, and intense mood swings have led to an increase in addictive behavior; the client was provided with specific feedback in this area.46 Teach About a Higher Power (46)The client was presented with information about how faith in a higher power can aid in recovery from borderline traits and addiction.The client was assisted in processing and clarifying their own ideas and feelings regarding their higher power.The client was encouraged to describe beliefs about the idea of a higher power.The client rejected the concept of a higher power; the client was urged to consider this concept at a later time.
47 Develop an Aftercare Plan (47)The client was assisted in developing an aftercare plan that will support recovery when feeling angry, anxious, abandoned, or depressed.The client was assigned “Personal Recovery Planning” in the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).The client has listed several components of an aftercare plan that will support sobriety (e.g., self-help groups and sponsors, family activities, counseling); feedback was provided about the completeness of this plan.The client was reinforced in describing active pursuit of the elements of the aftercare plan.The client has not followed through on an aftercare plan and was redirected to do so.
48 Assist Family Members in Listing Support for Recovery (48)Family members were assisted in identifying ways in which they could be supportive of the client's sobriety.The client reported family members assisting significantly in encouragement and other techniques to help recover from borderline traits and addiction; this validation was emphasized.The client's significant others were strongly encouraged to attend Al-Anon meetings on a regular basis to support recovery.The client reported that family members have not been supportive of recovery; this rejection was processed.
49 Educate the Family About Borderline Syndrome (49)Family members were taught about the client's borderline syndrome and the steps that the client must take to recover successfully.Family members were reinforced as they have displayed an understanding of the client's borderline syndrome and the steps that the client must take to recover successfully.Family members refused to accept the information about the client's borderline syndrome, and they did not display an understanding of the steps that the client must take to recover successfully; remedial feedback was provided.
50 Develop a 5-Year Plan (50)The client was taught about the concept of a 5-year recovery plan.The client was assisted in developing a realistic 5-year personal recovery plan.The client was reinforced for a reasonable 5-year recovery plan.The client was provided with redirection in areas where the recovery plan seemed unrealistic.
51 Assess Satisfaction (51)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).
CHILDHOOD TRAUMA
CLIENT PRESENTATION
1 Physical/Sexual/Emotional Abuse (1)*The client reported having a history of physical/sexual/emotional abuse in childhood.The client reported that painful memories of childhood abusive experiences are intrusive and unsettling.The client reported that nightmares and other disturbing thoughts related to childhood abuse interfere with sleep.The client was able to discuss childhood abusive experiences without being overwhelmed with negative emotions.The client reported that emotional reactions associated with the childhood abusive experiences have been resolved.
2 Addiction Used to Escape Emotional Pain (2)The client reported a pattern of using mood-altering substances to escape emotional pain tied to childhood traumas.As the client has worked through emotional traumas, substance use has decreased.The client reported no longer engaging in any substance use.
3 Neglect Experiences (3)The client reported a history of parents who were neglectful of the client's emotional and physical needs.The client's feelings of low self-esteem, lack of confidence, and vulnerability to depression are related to childhood experiences of neglect.The client stated that their parents were involved with substance abuse and this led to neglect of their child-rearing responsibilities.The client was able to discuss childhood experience of neglect without becoming overwhelmed with negative emotions.
4 Unresolved Psychological Conflicts (4)The client described a pattern of emotional and psychological discord caused by childhood abuse or neglect.The client identified a pattern of interpersonal conflict related to unresolved psychological effects of childhood abuse or neglect.As the client has worked through the pattern of childhood abuse, there have been fewer psychological and relational conflicts.The client reports decreased psychological conflicts and an increased sense of serenity.
5 Irrational Fears (5)The client's early traumatic life experiences have led to continuing irrational fears in the present.As the client has developed insight into conflicts related to childhood, irrational fears have begun to diminish.The client reported a greater sense of security and serenity and an absence of previously held irrational fears.The client reports decreased addiction behavior as irrational fears have decreased.
6 Suppressed Rage (5)The client reported that early painful experiences have resulted in feelings of anger and unexpressed rage.The client has begun to express rage toward their parents for their treatment during childhood.The client's level of anger has diminished, and the client reported a greater sense of peace.As the client's level of anger has diminished, the client has decreased addictive behaviors.
7 Depression and Low Self-Esteem (5)The client reported feelings of low self-esteem and depression related to painful experiences of childhood.As the client has shared pain related to childhood experiences, the feelings of low self-esteem and depression have diminished.The client reported increased feelings of positive self-esteem and a lifting of depression.As the client has progressed in therapy, decreased symptoms of depression and increased self-esteem have resulted in a reduction in addictive behaviors.
8 Identity Conflicts/Anxious Insecurity (5)The client reported struggles with identity and feelings of insecurity because of painful childhood experiences.The client reported a clearer sense of identity and more self-confidence as painful childhood experiences were processed.As the client has processed painful childhood experiences, they have experienced a decrease in addictive behaviors.
9 Intrusive Memories (6)The client described experiencing
