as they affirmed self as not being responsible for the abuse and placed responsibility clearly on the perpetrator.The client was supported in confronting the nonperpetrating parent for not protecting the client from the abusive experiences in childhood.24 Reinforce Holding Perpetrator Responsible (24)Any and all statements that the client made that reflected placing blame on the perpetrators and nonprotective, nonnurturing adults for painful childhood experiences were reinforced.The client was consistently reminded that they were not responsible for the abuse and neglect that occurred in childhood but that it was the responsibility of childhood parents or caretakers.The client continues to struggle with self-blame for the abusive experiences of childhood; statements indicating self-blame were confronted and reframed.
25 Explore Victim Versus Survivor (25)The client was asked to consider the positive and negative consequences of considering self as a victim versus being a survivor of childhood trauma.The client's understanding of the advantages of self-perception as a survivor of abuse and neglect rather than a victim was processed.The client has continued to view self as a victim of painful childhood experiences and has not moved forward toward feeling empowered as a survivor; this stagnation was reflected to the client.
26 Reinforce Survivor Self-Perception (26)The client was encouraged and reinforced to perceive self as a survivor rather than a victim of childhood abuse or neglect.The client was assigned “Changing from Victim to Survivor” from the Adult Psychotherapy Homework Planner (Jongsma & Bruce).As the client increased statements that reflected a self-perception of survivorship rather than victimization, strong reinforcement was given.The client has continued to make statements of being a victim rather than statements of personal empowerment that reflect survivorship; the client was helped to reframe these statements into survivor statements.
27 Teach Share-Check Technique (27)The client was taught to build trust in relationships through the use of the share-check technique.The client reported beginning to share personal thoughts and feelings with others on a minimal basis in order to see if those feelings are dealt with respectfully and supportively; the results of this sharing were reviewed.The client expressed difficulty with building trust and intimacy with others; the client was reminded to do this in small steps.The client was reinforced in expressing insight into difficulty with building trust as related to childhood experiences of abuse and neglect.
28 Teach Trust in Others (28)The client was encouraged and taught the advantages of treating others as trustworthy while continuing to assess their character.Positive feedback was provided as the client reported beginning to increase trust and interaction with others.The client continues to struggle with issues of trust and to be withdrawn in social relationships; the client was reminded to increase trust in small steps.
29 Teach Healthy Problem-Solving and Communication (29)The client was taught healthy conflict resolution skills (e.g., active listening, using “I” messages, cooperation, compromise, mutual respect).The client reported an increase in using the healthy conflict resolution skills they have been taught.The client identified that they have regularly been using healthy conflict resolution skills (e.g., active listening, using “I” messages, cooperation, compromise, mutual respect); this experience was reviewed.The client has struggled to implement the use of healthy conflict resolution skills; barriers to this progress were brainstormed.
30 Teach Honest Communication Skills (30)The client was taught about healthy communication skills, including being honest, asking for wants, and sharing feelings.The client was provided with modeling, role-playing, and behavior rehearsal to teach more honest communication skills.The client was reinforced for more honest communication.The client continues to struggle in being straightforward with honesty, asking for wants, and sharing feelings; additional techniques were provided.
31 Teach Assertiveness Skills (31)The client was taught assertiveness skills through the use of modeling, behavior rehearsal, and role-playing.The client displayed an understanding of the assigned components of assertiveness.The client was assigned “Becoming Assertive” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, McInnis, & Bruce).The client used a journal to list assertive experiences; the journal was processed.The client listed several situations in which they have been able to be assertive; these were processed.The client reported finding it very difficult to implement assertiveness skills; small successes were encouraged.
32 Identify Unresolved Needs, Wishes, and Wants (32)The client was assisted in identifying, understanding, and verbalizing unresolved needs, wishes, and wants from childhood.The client was assigned “Corresponding With My Childhood Self” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma) to help a variety of needs, wishes, and wants from childhood.As the client has progressed in therapy, they have been helped to identify techniques for resolving childhood needs, wishes, and wants.The client was unable to consistently identify unmet needs, wishes, and wants from childhood; tentative examples were provided.The client was assisted with developing a written plan to meet each of their unmet needs, wishes, and wants.The client has implemented the plan to meet unmet needs, wishes, and wants; this was reviewed for successes and failures.The client has struggled to develop a written plan to meet each of their unmet needs, wishes, and wants and was redirected to do so.
33 Assign Books on Childhood Trauma (33)Reading materials relating to traumatic childhood experiences were recommended to the client to assist in developing insight.The client has followed through on reading the recommended childhood trauma material, and the insights related to that reading were processed.The client has been able to use the insights from the reading materials on childhood traumas in order to assist in identifying unresolved feelings, wishes, and wants; positive feedback was provided.The client has not followed through on reading the recommended childhood trauma material and was redirected to do so.
34 Assign Forgiveness Letter (34)The client was assigned to write a letter of forgiveness to the perpetrator of the childhood hurt.The client was assigned “Feelings and Forgiveness Letter” from the Adult Psycho- therapy Homework Planner (Jongsma).The client has followed through with writing a forgiveness letter to the perpetrator of the childhood hurt; as this letter was processed, the client reported experiencing a sense of putting the issue in the past.The client reported beginning the process of forgiving the perpetrator of childhood pain and others who may have been passive collaborators; the benefits of this progress were highlighted.The client has not followed through on writing the forgiveness letter to the perpetrator of childhood pain and was redirected to do so.
35 Assist With a Letter to the Parents (35)The client was assigned to write a letter to each parent or primary caregiver, detailing the childhood abuse and sharing what the client wants from each person in recovery.The client has followed through on writing a letter to each parent or primary caregiver and has processed this within the session.The client has shared the letter with the appropriate parent or primary caregiver, presenting information about the childhood abuse and sharing what they want from each person in recovery; this experience was processed.The client has not followed through with writing a letter to each parent or primary caregiver and was redirected to do so.The client has written the letter to each parent or primary caregiver but has declined to present this to the parent or caregiver; this decision was accepted.
36 Teach About a Higher Power (36)The client was presented with information about how faith in a higher power can aid in recovery from childhood trauma issues.The client was assisted in processing and clarifying ideas and feelings regarding the existence of a higher power.The client used faith in a higher power to assist in forgiving others and reestablishing self-esteem; the benefits were processed.The client rejected the concept of a higher power; the client was urged to be open to this concept.
37 View Perpetrators as Wounded Children (37)The client was presented with the concept that perpetrators were often wounded as children, too, and may need to be forgiven and turned over to a higher power.The client was noted to endorse the idea that the perpetrator(s) was/were also a wounded child.The client was noted to endorse the idea that the perpetrator needed to be forgiven and turned over to a higher
