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	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Arthur E. Jongsma, Jr., Series Editor Adult Psychotherapy Homework Planner Second Edition Arthur E. Jongsma, Jr. John Wiley & Sons, Inc. Practice Planners®	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Arthur E. Jongsma, Jr., Series Editor Over 500,000 Practice Planners Æsold... Practice Planners Æ Treatment Planners cover all the necessary elements for developing formal treatment plans, including detailed problem deìnitions, long-term goals, short-term objectives, therapeutic interventions, and DSM-IVí dia gnoses. ❑The Complete Adult Psychotherapy Treatment Planner, Fourth Edition................. 0-471-76346-2 / $49. 95 ❑The Child Psychotherapy Treatment Planner, Fourth Edition................................. 0-471-78535-0 / $49. 95 ❑The Adolescent Psychotherapy Treatment Planner, Fourth Edition....................... 0-471-78539-3 / $49. 95 ❑The Addiction Treatment Planner, Third Edition..................................................... 0-471-72544-7 / $49. 95 ❑The Couples Psychotherapy Treatment Planner.................................................. 0-471-24711-1 / $49. 95 ❑The Group Therapy Treatment Planner, Second Edition......................................... 0-471-66791-9 / $49. 95 ❑The Family Therapy Treatment Planner............................................................... 0-471-34768-X / $49. 95 ❑The Older Adult Psychotherapy Treatment Planner............................................. 0-471-29574-4 / $49. 95 ❑The Employee Assistance (EAP) Treatment Planner............................................ 0-471-24709-X / $49. 95 ❑The Gay and Lesbian Psychotherapy Treatment Planner.................................... 0-471-35080-X / $49. 95 ❑The Crisis Counseling and Traumatic Events Treatment Planner........................ 0-471-39587-0 / $49. 95 ❑The Social Work and Human Services Treatment Planner.................................. 0-471-37741-4 / $49. 95 ❑The Continuum of Care Treatment Planner......................................................... 0-471-19568-5 / $49. 95 ❑The Behavioral Medicine Treatment Planner....................................................... 0-471-31923-6 / $49. 95 ❑The Mental Retardation and Developmental Disability Treatment Planner............. 0-471-38253-1 / $49. 95 ❑The Special Education Treatment Planner........................................................... 0-471-38872-6 / $49. 95 ❑The Severe and Persistent Mental Illness Treatment Planner............................. 0-471-35945-9 / $49. 95 ❑The Personality Disorders Treatment Planner..................................................... 0-471-39403-3 / $49. 95 ❑The Rehabilitation Psychology Treatment Planner.............................................. 0-471-35178-4 / $49. 95 ❑The Pastoral Counseling Treatment Planner........................................................ 0-471-25416-9 / $49. 95 ❑The Juvenile Justice and Residential Care Treatment Planner........................... 0-471-43320-9 / $49. 95 ❑The School Counseling and School Social Work Treatment Planner................... 0-471-08496-4 / $49. 95 ❑The Psychopharmacology Treatment Planner..................................................... 0-471-43322-5 / $49. 95 ❑The Probation and Parole Treatment Planner...................................................... 0-471-20244-4 / $49. 95 ❑The Suicide and Homicide Risk Assessment and Prevention Treatment Planner...................................................................... 0-471-46631-X / $49. 95 ❑The Speech-Language Pathology Treatment Planner.......................................... 0-471-27504-2 / $49. 95 ❑The College Student Counseling Treatment Planner........................................... 0-471-46708-1 / $49. 95 ❑The Parenting Skills Treatment Planner.............................................................. 0-471-48183-1 / $49. 95 ❑The Early Childhood Education Intervention Treatment Planner......................... 0-471-65962-2 / $49. 95 ❑The Co-Occurring Disorders Treatment Planner.................................................. 0-471-73081-5 / $49. 95 The Complete Treatment and Homework Planners series of books combines our bestselling Treatment Planners and Homework Planners into one easy-to-use, all-in-one resource for mental health professionals treating clients suffering from the most commonly diagnosed disorders. ❑The Complete Depression Treatment and Homework Planner............................ 0-471-64515-X / $39. 95 ❑The Complete Anxiety Treatment and Homework Planner.................................. 0-471-64548-6 / $39. 95 Helping therapists help their clients...	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Practice Planners Æ Name ________________________________________________________________________ Afìliation ______________________________________________________________________ Address ______________________________________________________________________ City/State/Zip___________________________________________________________________ Phone/Fax _____________________________________________________________________E-mail________________________________________________________________________ ❑ Check enclosed ❑ Visa ❑ Master Card ❑ American Express Card # _______________________________________________________________________ Expiration Date__________________________________________________________________ Signature _____________________________________________________________________ *Add $5 shipping for ìrst book, $3 for each additional book. Please add your local sales tax to all orders. Prices subject to chan ge without notice. ■To order by phone in the US: Call toll free 1-877-762-2974 ■Online: www. practiceplanners. wiley. com ■Mail this order form to: John Wiley & Sons, Attn: J. Knott, 111 River Street, Hoboken, NJ 07030Homework Planners feature dozens of behaviorally based, ready-to-use assignments that are designed for use between sessions, as well as a disk (Microsoft Word) containing all of the assignments Ñallo wing you to customize them to suit your unique client needs. ❑Brief Therapy Homework Planner........................................................................ 0-471-24611-5 / $49. 95 ❑Brief Couples Therapy Homework Planner.......................................................... 0-471-29511-6 / $49. 95 ❑Child Therapy Homework Planner, Second Edition................................................ 0-471-78534-2 / $49. 95 ❑Child Therapy Activity and Homework Planner.................................................... 0-471-25684-6 / $49. 95 ❑Adolescent Therapy Homework Planner, Second Edition...................................... 0-471-78537-7 / $49. 95 ❑Addiction Treatment Homework Planner, Second Edition...................................... 0-471-27459-3 / $49. 95 ❑Brief Employee Assistance Homework Planner................................................... 0-471-38088-1 / $49. 95 ❑Brief Family Therapy Homework Planner............................................................ 0-471-38512-3 / $49. 95 ❑Grief Counseling Homework Planner................................................................... 0-471-43318-7 / $49. 95 ❑Divorce Counseling Homework Planner.............................................................. 0-471-43319-5 / $49. 95 ❑Group Therapy Homework Planner...................................................................... 0-471-41822-6 / $49. 95 ❑School Counseling and School Social Work Homework Planner......................... 0-471-09114-6 / $49. 95 ❑Adolescent Psychotherapy Homework Planner II................................................ 0-471-27493-3 / $49. 95 ❑Adult Psychotherapy Homework Planner, Second Edition..................................... 0-471-76343-8 / $49. 95 ❑Parenting Skills Homework Planner.................................................................... 0-471-48182-3 / $49. 95 uu Homework Planners include disk or CD-ROM! Progress Notes Planners contain complete prewritten progress notes for each presenting problem in the companion Treatment Planners. ❑The Adult Psychotherapy Progress Notes Planner.............................................. 0-471-76344-6 / $49. 95 ❑The Adolescent Psychotherapy Progress Notes Planner..................................... 0-471-78538-5 / $49. 95 ❑The Severe and Persistent Mental Illness Progress Notes Planner.................... 0-471-21986-X / $49. 95 ❑The Child Psychotherapy Progress Notes Planner.............................................. 0-471-78536-9 / $49. 95 ❑The Addiction Progress Notes Planner................................................................ 0-471-73253-2 / $49. 95 ❑The Couples Psychotherapy Progress Notes Planner.......................................... 0-471-27460-7 / $49. 95 ❑The Family Therapy Progress Notes Planner....................................................... 0-471-48443-1 / $49. 95 Client Education Handout Planners contain elegantly designed handouts that can be printed out from the enclosed CD-ROM and provide information on a wide range of psychological and emotional disorders and life skills issues. Use as patient literature, handouts at presentations, and aids for promoting your mental health practice. ❑Adult Client Education Handout Planner.............................................................. 0-471-20232-0 / $49. 95 ❑Child and Adolescent Client Education Handout Planner.................................... 0-471-20233-9 / $49. 95 ❑Couples and Family Client Education Handout Planner...................................... 0-471-20234-7 / $49. 95 uu Includes CD-ROM!	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
For more information about Thera Scribe,ìll in this coupon and mail it to: R. Crucitt, John Wiley & Sons, Inc., 10475 Crosspoint Boulevard, Indianapolis, IN 46256 or e-mail us at planners@wiley. com. ❑Please send me information on Thera Scribe Æ ❑Please send me information on the network version of Thera Scribe Æ For a free demo, visit us on the web at: www. wiley. com/therascribe Name _____________________________________________ Afìliation ___________________________________________ Address ____________________________________________ City/State/Zip ________________________________________ Phone _____________________________________________ E-mail _____________________________________________Thera Scribe 4. 0Æ Generates treatment plans in less than 15 minutes. Used in thousands of behavioral health care practices and treatment facilities, Thera Scribe 4. 0Æês user-friendly, Windows Æ-based design helps you generate complete and effective treatment plans quickly and easily. Rich content. Thera Scribe 4. 0Æoffers you the option to choose from over 20 different client populations and treatment settings. Each treatment planner library features over 1000 pre-written behaviorally based primary and secondary presenting deìnitions, DSM-IVídiagnoses, treatment goals, short-and long-term objectives, and interventions. Meets major accrediting agency standards. Thera Scribe 4. 0Æmeets the standards of all major accrediting agencies such as NCQA, JCAHO, and other federal and stateagencies as well as most major third party payors, HMOê s and managed care companies. Easy to learn. Clinically sound, standardized language allows you to quickly and easily create effective treatment plans. You just çpoint and clickéto choose from the built-in set of behavioral deìnitions, DSM-IVídiagnoses, goals, objectives, and therapeutic interventions. Web-like navigation combined with clean screen design makes inputting and retrieving client data faster and easier. ç Having been a Thera Scribe Æuser for the past six years, I assure you that it continues to be a great assistant inmy practice Ñno other resource cancompare in helping mental healthprofessionals deal with managed care. é ÑK. Todd Wagner, LCSW, MSW, LCDC Inland Counseling Network, Dayton, Washington Discover the #1 Selling Treatment Planning System Used by Over 5,000 Mental Health Professionals For more information or to order: ■Call our Thera Scribe Æspecialists, toll free, at: 1-866-888-5158 ■Visit us on the web at: www. wiley. com/therascribe The Treatment Planning and Clinical Record Management System for Mental Health Professionals	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
SHIP TO Name/Title ________________________________________________ Organization ______________________________________________Address ____________________________________________________City/State/Zip______________________________________________Telephone__________________________________________________METHOD OF PAYMENT ❑ Bill my institution, PO#_______ (please include purchase order) ❑ Payment Enclosed (make all checks payable to John Wiley & Sons) ❑ Visa ❑ Mastercard ❑ American Express Card Number ___________________ Exp. Date ________________ Signature __________________________________________________ Credit card orders invalid if not signed. Add $5 shipping for ì rst book, $3 for each additional book. Please add your local sales tax to all orders; be sureto add shipping and handling charges before calculating sales tax. MAIL TO: John Wiley & Sons, Inc., Attn: J. Knott, 111 River Street, Hoboken, NJ 07030 Getting Started in Personal and Executive Coaching offers a go-to reference designed to help build, manage, and sustain a thriving coaching practice. Packed with hundreds ofproven strategies and techniques, this nuts-and-bolts guide covers all aspects of thecoaching business with step-by-step instruc-tions and real-world illustrations that pre-pare you for every phase of starting your owncoaching business. This single, reliable book offers straightforward advice and tools for running a successfulpractice, including: ÄSeven secrets of highly successful coaches ÄFifteen strategies for landing paying clients ÄTen marketing mistakes to avoid ÄSample business and marketing plans ÄWorksheets for setting rates and managing revenue Getting Started in Personal and Executive Coaching Stephen G. Fairley and Chris E. Stout ISBN 0-471-42624-5 Paper Ä $24. 95 Ä 356pp Ä December 2003Getting Started in Private Practice provides all the information you need to conì dently start and grow your own mental health practice. This book breaks down the ingredients ofpractice into more manageable and achiev-able components and will teach you theskills you need to avoid making costly mis-takes. Containing dozens of tools that youcan use to achieve your goals, this book hasspeciìc infor mation that can be applied toyour business today, worksheets that willhelp you calculate the true costs of variousexpenditures and activities, checklists thatmight save you from disaster, and lists ofresources to investigate. Includes: ÄForms and examples of various practice aspects ÄStep-by-step advice on writing a businessplan and marketing your business ÄSuggestions and ideas intended to help you get your creative juices îowing ÄPractical and simple formulasto help calculate rates, revenues,and Return on Investment ÄComprehensive information on licensing procedures and risk management Getting Started in Private Practice Chris E. Stout and Laurie Cope Grand ISBN 0-471-42623-7 Paper Ä $24. 95 Ä 304 pp. Ä October 2004TO ORDER BY PHONE CALL TOLL FREE 1-877-762-2974❑Getting Started in Personal and Executive Coaching (ISBN 0-471-42624-5, $24. 95 US) ❑Getting Started in Private Practice (ISBN 0-471-42623-7, $24. 95 US) Need Help Getting Started?	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Adult Psychotherapy Homework Planner	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
PRACTICE PLANNERS® SERIES Treatment Planners The Adult Psychotherapy Treatment Planner, Fourth Edition The Child Psychotherapy Treatment Planner, Fourth Edition The Adolescent Psychotherapy Treatment Planner, Fourth Edition The Addiction Treatment Planner, Third Edition The Continuum of Care Treatment Planner The Couples Psychotherapy Treatment Planner The Employee Assistance Treatment Planner The Pastoral Counseling Treatment Planner The Older Adult Psychotherapy Treatment Planner The Behavioral Medicine Treatment Planner The Group Therapy Treatment Planner, Second Edition The Gay and Lesbian Psychotherapy Treatment Planner The Family Therapy Treatment Planner The Severe and Persistent Mental Illness Treatment Planner The Mental Retardation and Developmental Disability Treatment Planner The Social Work and Human Services Treatment Planner The Crisis Counseling and Traumatic Events Treatment Planner The Personality Disorders Treatment Planner The Rehabilitation Psychology Treatment Planner The Special Education Treatment Planner The Juvenile Justice and Residential Care Treatment Planner The School Counseling and School Social Work Treatment Planner The Sexual Abuse Victim and Sexual Offender Treatment Planner The Probation and Parole Treatment Planner The Psychopharmacology Treatment Planner The Speech-Language Pathology Treatment Planner The Suicide and Homicide Risk Assessment & Prevention Treatment Planner The College Student Counseling Treatment Planner The Parenting Skills Treatment Planner The Early Childhood Education Intervention Treatment Planner The Co-Occurring Disorders Treatment Planner Progress Notes Planners The Child Psychotherapy Progress Notes Planner, Third Edition The Adolescent Psychotherapy Progress Notes Planner, Third Edition The Adult Psychotherapy Progress Notes Planner, Third Edition The Addiction Progress Notes Planner, Second Edition The Severe and Persistent Mental Illness Progress Notes Planner The Couples Psychotherapy Progress Notes Planner The Family Therapy Progress Notes Planner Homework Planners Brief Therapy Homework Planner Brief Couples Therapy Homework Planner Brief Employee Assistance Homework Planner Brief Family Therapy Homework Planner Grief Counseling Homework Planner Group Therapy Homework Planner Divorce Counseling Homework Planner School Counseling and School Social Work Homework Planner Child Therapy Activity and Homework Planner Addiction Treatment Homework Planner, Third Edition Adolescent Psychotherapy Homework Planner, Second Edition Adult Psychotherapy Homework Planner, Second Edition Child Psychotherapy Homework Planner, Second Edition Parenting Skills Homework Planner Client Education Handout Planners Adult Client Education Handout Planner Child and Adolescent Client Education Handout Planner Couples and Family Client Education Handout Planner Complete Planners The Complete Depression Treatment and Homework Planner The Complete Anxiety Treatment and Homework Planner	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Arthur E. Jongsma, Jr., Series Editor Adult Psychotherapy Homework Planner Second Edition Arthur E. Jongsma, Jr. John Wiley & Sons, Inc. Practice Planners®	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
This book is printed on acid-free paper. o Copyright © 2006 by Arthur E. Jongsma, Jr. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under SECTION 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www. Copyright. Com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008 or online at http://www. wiley. com/go/permissions. Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and speciﬁ cally disclaim any implied warranties of merchantability or ﬁ tness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of proﬁ t or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological, or any other expert assistance is required, the services of a competent professional person should be sought. Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration. For general information on our other products and services please contact our Customer Care Department within the U. S. at (800) 762-2974, outside the U. S. at (317) 572-3993, or fax (317) 572-4002. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our website at www. wiley. com Note about Photocopy Rights The publisher grants purchasers permission to reproduce handouts from this book for professional use with their clients. ISBN-13: 978-0-471-76343-7 (pbk. ) ISBN-10: 0-471-76343-8 (pbk. ) Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
To Dave and Lorrie Vander Ark, whose friendship has enriched our lives and whose support is more reliable than a ﬁ ne timepiece.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
x CONTENTS Practice Planners® Series Preface xv Acknowledgments xvii Introduction xviii SECTION I: Anger Management 1 Exercise I. A Alternatives to Destructive Anger 2Exercise I. B Anger Journal 8 SECTION II: Antisocial Behavior 13 Exercise II. A How I Have Hurt Others 14Exercise II. B Letter of Apology 17 SECTION III: Anxiety 20 Exercise III. A Analyze the Probability of a Feared Event 21Exercise III. B Past Successful Anxiety Coping 25 SECTION IV: Attention Deﬁ cit Disorder (ADD)—Adult 27 Exercise IV. A Problem Solving: An Alternative to Impulsive Action 28Exercise IV. B Symptoms and Fixes for ADD 32 SECTION V: Borderline Personality 35 Exercise V. A Journal and Replace Self-Defeating Thoughts 36Exercise V. B Plan Before Acting 43 SECTION VI: Chemical Dependence 46 Exercise VI. A Aftercare Plan Components 47Exercise VI. B Relapse Triggers 51Exercise VI. C Substance Abuse Negative Impact Versus Sobriety's Positive Impact 55	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CONTENTS xi SECTION VII: Chemical Dependence—Relapse 60 Exercise VII. A Early Warning Signs of Relapse 61Exercise VII. B Identifying Relapse Triggers and Cues 65Exercise VII. C Relapse Prevention Planning 70Exercise VII. D Relapse Symptom Line 74 SECTION VIII: Childhood Trauma 77 Exercise VIII. A Changing from Victim to Survivor 78Exercise VIII. B Feelings and Forgiveness Letter 82 SECTION IX: Chronic Pain 85 Exercise IX. A Pain And Stress Journal 86 SECTION X: Cognitive Deﬁ cits 92 Exercise X. A Memory Aid—Personal Information Organizer 93Exercise X. B Memory Enhancement Techniques 98 SECTION XI: Dependency 100 Exercise XI. A Making Your Own Decisions 101Exercise XI. B Satisfying Unmet Emotional Needs 104Exercise XI. C Taking Steps Toward Independence 108 SECTION XII: Depression 110 Exercise XII. A Identify and Schedule Pleasant Activities 111Exercise XII. B Negative Thoughts Trigger Negative Feelings 114Exercise XII. C Positive Self-Talk 119 SECTION XIII: Dissociation 121 Exercise XIII. A Describe the Trauma 122Exercise XIII. B Staying Focused on the Present Reality 126 SECTION XIV: Eating Disorder 128 Exercise XIV. A A Reality Journal: Food, Weight, Thoughts, and Feelings 129 Exercise XIV. B How Fears Control My Eating 134 SECTION XV: Educational Deﬁ cits 137 Exercise XV. A My Academic and Vocational Strengths 138Exercise XV. B The Advantages of Education 141	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
xii CONTENTS SECTION XVI: Family Conﬂ ict 143 Exercise XVI. A Applying Problem-Solving to Interpersonal Conﬂ ict 144 Exercise XVI. B A Structured Parenting Plan 148 SECTION XVII: Female Sexual Dysfunction 152 Exercise XVII. A Factors Inﬂ uencing Negative Sexual Attitudes 153 Exercise XVII. B Study Your Body: Clothed and Unclothed 157 SECTION XVIII: Financial Stress 160 Exercise XVIII. A Plan A Budget 161 SECTION XIX: Grief / Loss Unresolved 164 Exercise XIX. A Creating a Memorial Collage 165Exercise XIX. B Dear _______________: A Letter to a Lost Loved One 168 SECTION XX: Impulse Control Disorder 171 Exercise XX. A Impulsive Behavior Journal 172 SECTION XXI: Intimate Relationship Conﬂ icts 178 Exercise XXI. A How Can We Meet Each Other's Needs and Desires? 179Exercise XXI. B Positive and Negative Contributions to the Relationship: Mine And Yours 184 SECTION XXII: Legal Conﬂ icts 187 Exercise XXII. A Accept Responsibility for Illegal Behavior 188Exercise XXII. B Crooked Thinking Leads to Crooked Behavior 191 SECTION XXIII: Low Self-Esteem 193 Exercise XXIII. A Acknowledging My Strengths 194Exercise XXIII. B Replacing Fears with Positive Messages 197 SECTION XXIV: Male Sexual Dysfunction 201 Exercise XXIV. A Journaling the Response to Nondemand, Sexual Pleasuring (Sensate Focus) 202 SECTION XXV: Mania or Hypomania 209 Exercise XXV. A Recognizing the Negative Consequences of Impulsive Behavior 210 Exercise XXV. B What Are My Good Qualities? 214Exercise XXV. C Why I Dislike Taking My Medication 218	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CONTENTS xiii SECTION XXVI: Medical Issues 220 Exercise XXVI. A How I Feel About My Medical Treatment 221Exercise XXVI. B The Impact of My Illness 224 SECTION XXVII: Obsessive-Compulsive Disorder (OCD) 227 Exercise XXVII. A Making Use of the Thought-Stopping Technique 228 Exercise XXVII. B Reducing The Strength of Compulsive Behaviors 232 SECTION XXVIII: Panic 235 Exercise XXVIII. A Monitoring My Panic Attack Experiences 236 SECTION XXIX: Paranoid Ideation 238 Exercise XXIX. A Check Suspicions Against Reality 239 SECTION XXX: Parenting 241 Exercise XXX. A Learning to Parent as a Team 242Exercise XXX. B Using Reinforcement Principles in Parenting 246 SECTION XXXI: Phase of Life Problems 250 Exercise XXXI. A What Needs to be Changed in My Life? 251Exercise XXXI. B What's Good About Me and My Life? 254 SECTION XXXII: Phobia 256 Exercise XXXII. A Four Ways to Reduce Fear 257Exercise XXXII. B Gradually Reducing Your Phobic Fear 261 SECTION XXXIII: Posttraumatic Stress Disorder (PTSD) 264 Exercise XXXIII. A How the Trauma Affects Me 265Exercise XXXIII. B Share the Painful Memory 267 SECTION XXXIV: Psychoticism 270 Exercise XXXIV. A What Do You Hear and See? 271 SECTION XXXV: Sexual Abuse 273 Exercise XXXV. A A Blaming Letter and a Forgiving Letter to Perpetrator 274 Exercise XXXV. B Picturing the Place of the Abuse 277	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
xiv CONTENTS SECTION XXXVI: Sexual Identity Confusion 279 Exercise XXXVI. A Journal of Sexual Thoughts, Fantasies, Conﬂ icts 280 Exercise XXXVI. B To Whom and How to Reveal My Homosexuality 286 SECTION XXXVII: Sleep Disturbance 290 Exercise XXXVII. A Sleep Pattern Record 291 SECTION XXXVIII: Social Discomfort 296 Exercise XXXVIII. A Restoring Socialization Comfort 297 SECTION XXXIX: Somatization 299 Exercise XXXIX. A Controlling the Focus on Physical Problems 300 SECTION XL: Spiritual Confusion 303 Exercise XL. A My History of Spirituality 304 SECTION XLI: Suicidal Ideation 307 Exercise XLI. A Journal of Distorted, Negative Thoughts 308Exercise XLI. B The Aftermath of Suicide 312 SECTION XLII: Type A Behavior 315 Exercise XLII. A Developing Noncompetitive Values 316 SECTION XLIII: Vocational Stress 318 Exercise XLIII. A A Vocational Action Plan 319 Appendix: Additional Assignments for Presenting Problems 321 About the CD-ROM 329	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
xv PRACTICE PLANNERS® SERIES PREFACE The practice of psychotherapy has a dimension that did not exist 30, 20, or even 15 years ago—accountability. Treatment programs, public agencies, clinics, and even group and solo practitioners must now justify the treatment of patients to outside review entities that control the payment of fees. This development has resulted in an explosion of paper-work. Clinicians must now document what has been done in treatment, what is planned for the future, and what the anticipated outcomes of the interventions are. The books and software in this Practice Planners ® series are designed to help practitioners fulﬁ ll these documentation requirements efﬁ ciently and professionally. The Practice Planners® series has grown rapidly. It now includes not only the orig-inal Complete Adult Psychotherapy Treatment Planner, Third Edition, The Child Psy-chotherapy Treatment Planner, Third Edition, and The Adolescent Psychotherapy Treat-ment Planner, Third Edition, but also Treatment Planners targeted to specialty areas of practice, including addictions, co-occurring disorders, juvenile justice / residential care, couples therapy, employee assistance, behavioral medicine, therapy with older adults, pastoral counseling, family therapy, group therapy, psychopharmacology, neuropsychol-ogy, therapy with gays and lesbians, special education, school counseling, probation and parole, therapy with sexual abuse victims and offenders, and more. Several of the Treatment Planner books now have companion Progress Notes Plan-ners (e. g., Adult, Adolescent, Child, Addictions, Severe and Persistent Mental Illness, Couples). These planners provide a menu of progress statements that elaborate on the client's symptom presentation and the provider's therapeutic intervention. Each Progress Notes Planner statement is directly integrated with Behavioral Deﬁ nitions and Thera-peutic Interventions items from the companion Treatment Planner. The list of therapeutic Homework Planners is also growing from the original Home-work Planner for Adults, to Adolescent, Child, Couples, Group, Family, Addictions, Di-vorce, Grief, Employee Assistance, and School Counseling / School Social Work Homework Planners. Each of these books can be used alone or in conjunction with their companion Treatment Planner. Homework assignments are designed around each presenting prob-lem (e. g., Anxiety, Depression, Chemical Dependence, Anger Management, Panic, Eating Disorders) that is the focus of a chapter in its corresponding Treatment Planner. Client Education Handout Planners, a new branch in the series, provide brochures and handouts to help educate and inform adult, child, adolescent, couples, and family clients on a myriad of presenting problems mental health issues, as well as life skills techniques. The list of presenting problems for which information is provided mirrors the list of presenting problems in the Treatment Planner of the title similar to that of the	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
Handout Planner. Thus, the problems for which educational material is provided in the Child and Adolescent Client Education Handout Planner reﬂ ect the presenting problems listed in The Child and The Adolescent Psychotherapy Treatment Planner books. The handouts are included on CD-ROMs for easy printing from your computer and are ideal for use in waiting rooms, at presentations, as newsletters, or as information for clients struggling with mental illness issues. In addition, the series also includes Thera Scribe ®, the latest version of the popular treatment planning, clinical record-keeping software. Thera Scribe® allows the user to im-port the data from any of the Treatment Planner, Progress Notes Planner, or Homework Planner books into the software's expandable database. Then the point-and-click method can create a detailed, neatly organized, individualized, and customized treatment plan along with optional integrated progress notes and homework assignments. Adjunctive books, such as The Psychotherapy Documentation Primer, and Clinical, Forensic, Child, Couples and Family, Continuum of Care, and Chemical Dependence Documentation Sourcebook contain forms and resources to aid the mental health prac-tice management. The goal of the series is to provide practitioners with the resources they need in order to provide high-quality care in the era of accountability—or, to put it simply, we seek to help you spend more time on patients, and less time on paperwork. A RTHUR E. J ONGSMA, JR. Grand Rapids, Michiganxvi PRACTICE PLANNERS ® SERIES PREFACE	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
xvii ACKNOWLEDGMENTS Although only my name appears as the author of this book, the product is the result of the combined efforts of many people. I ﬁ rst would like to acknowledge the contribu-tion of my coauthors on several other books, William Mc Innis and Mark Peterson. They both gave permission for me to borrow and adapt some of the homework exercises we had collaborated on in writing the Brief Adolescent Therapy Homework Planner and the Adolescent Psychotherapy Homework Planner II. Several of the assignments in this book have been adapted to the adult focus group from their original creation for the adolescent client. Thank you, Bill and Mark. I would also like to thank Jim Finley and Brenda Lenz for giving their permission to me to adapt three of their assignments from their Addiction Treatment Homework Plan-ner for placement in the Chemical Dependence—Relapse section of this book. I am grateful to Sue Rhoda, who was so efﬁ cient at transcribing this manuscript in a very timely and professional manner. My support staff at John Wiley & Sons, David Bernstein, Peggy Alexander, Ester Mal-lach, Judi Knott, Kevin Holm, and Lynne Marsala, continues to move the Practice Plan-ners ® project forward with enthusiasm and professional dedication. Thank you all. Finally, my personal support system is grounded in my wife, Judy, who makes me feel important even when I am not, and my children and grandchildren, who consistently show interest in my work. Thank you, family. —A. E. J.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
INTRODUCTION More and more therapists are assigning homework to their clients. Not only have short- term therapy models endorsed this practice, but the beneﬁ ts are being recognized by many traditional therapists as well. WHY HOMEWORK? Assigning homework to psychotherapy clients is beneﬁ cial for several reasons. With the advent of managed care, which often requires shorter and fewer treatment sessions, ther-apists assign between-session homework to help maximize the effectiveness of briefer treatment. Homework is an extension of the treatment process, provides continuity, and allows the client to work between sessions on issues that are the focus of therapy. Home-work is also a tool for more fully engaging the client in the treatment process. Assignments place more responsibility on the client to resolve his or her presenting problems, counter-acting the expectations that some clients may experience—that it is the therapist alone who can cure him or her. For some, it even may bring a sense of self-empowerment. Another added beneﬁ t of homework is that these assignments give the client the oppor-tunity to implement and evaluate insights or coping behaviors that have been discussed in therapy sessions. Practice often heightens awareness of various issues. Furthermore, homework increases the expectation for the client to follow through with making changes rather than just talking about change. Exercises require participation, which creates a sense that the client is taking active steps toward change. Homework allows the client to try new behaviors, bringing these experiences back to the next session for processing. Modiﬁ cations can then be made to the client's thoughts, feelings, or behaviors as the homework is processed in the therapy session. Occasionally treatment processes can become vague and abstract. By adding focus and structure, homework assignments can reenergize treatment. Moreover, homework can increase the client's motivation to change as it provides something speciﬁ c to work on. Additionally, homework increases the involvement of family members and signiﬁ cant others in the client's treatment by using assignments that call for their participation. It promotes more efﬁ cient treatment by encouraging the client to actively develop in-sights, positive self-talk, and coping behaviors between therapy sessions. Consequently, many clients express increased satisfaction with the treatment process when homework is given. They are empowered by doing something active that facilitates the change pro-cess, and it reinforces their sense of control over the problem. All of these advantages have made the assignment of therapeutic homework increasingly prevalent. xviii	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
INTRODUCTION xix HOW TO USE THIS HOMEWORK PLANNER Creating homework assignments and developing the printed forms for recording responses is a time-consuming process. This Adult Psychotherapy Homework Planner, Second Edi-tion, follows the lead of psychotherapeutic interventions suggested in The Complete Adult Psychotherapy Treatment Planner (Jongsma and Peterson, 2006) and provides a menu of homework assignments that can easily be photocopied. In addition to the printed format, the assignments in this Planner are provided on a CD-ROM to allow the therapist to ac-cess them on a word processor and print them out as is or easily customize them to suit the client's individual needs and / or the therapist's style. The assignments are grouped under presenting problems that are typical of those found in an adult population. These presenting problems are cross-referenced to every presenting problem found in The Complete Adult Psychotherapy Treatment Planner. Al-though these assignments were created with a speciﬁ c presenting problem in mind, don't feel locked in by a single problem-oriented chapter when searching for an appropriate assignment. Included with each exercise is a cross-referenced list of suggested present-ing problems for which the assignment may be appropriate and useful called Additional Problems for Which This Exercise May Be Most Useful. This cross-referenced list can assist you in applying the assignments to other situations that may be relevant to your client's particular presenting problem. A broader cross-referenced list of assignments is found in the appendix Alternate As-signments for Presenting Problems. Review this appendix to ﬁ nd relevant assignments beyond the one, two, three, or four exercises found in any speciﬁ c presenting problem chapter. For example, under the heading of Depression in the appendix you will ﬁ nd 18 alternative assignments originally created for other presenting problems but relevant and easily adapted for use with a client struggling with depression issues. In this ap-pendix, with every presenting problem are listed relevant additional assignments from throughout the book. Remember, each assignments is available on the CD-ROM at the back of the book and, therefore, can be quickly edited for use with a speciﬁ c client. This modiﬁ ed assignment can be saved on your computer's hard disk for repeated later use. ABOUT THE ASSIGNMENTS Therapists may introduce the homework assignment with varying degrees of detail and client preparation. Recommendations regarding this preparation and post-exercise dis-cussion are made on the title page of each assignment under the heading “Suggestions for Processing This Exercise with the Client. ” Clinical judgment must be used to choose the homework assignments that focus on relevant issues for the client. The title page of each assignment contains a section on “Goals of the Exercise” to guide you in your selection of relevant homework for your cli-ent.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
xx INTRODUCTION CARRYING OUT THE ASSIGNMENT It is recommended that you review the entire book to familiarize yourself with the broad nature of the type and focus of the various homework exercises. Select a speciﬁ c assign-ment from a chapter titled with your client's presenting problem or from the alterna-tive list in the appendix and then review the list of homework goals. Assigning therapy homework is just a beginning step in the therapy treatment process. Carrying out the as-signment requires a follow-up exploration of the impact of the assignment on the client's thoughts, feelings, and behavior. What are the results? Was this assignment useful to the client? Can it be redesigned or altered for better results? Examine and search for new and creative ways to actively engage your client in participating in this homework process. IMPORT HOMEWORK DATA INTO THERA SCRIBE Since the release of the newer versions of the software Thera Scribe, The Treatment Plan-ning and Clinical Record Management System for Mental Health Professionals, all as-signments from Homework Planner books in the Practice Planner ® series can be imported into this point-and-click clinical tool. An electronic version of the Homework Planner book must be purchased separately (the CD-ROM in the back of every Homework Plan-ner book can only be imported into a word processing program, not into Thera Scribe ). Once the Homework Planner data is installed into Thera Scribe, the assignment may be added to a client's treatment plan as an intervention. It can also be launched, viewed, edited, and printed out for distribution to the client and / or family members.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 1Therapist's Overview ALTERNATIVES TO DESTRUCTIVE ANGER GOALS OF THE EXERCISE 1. Identify and clarify alternatives to destructive expressions of anger. 2. Increase awareness of how anger is expressed destructively. 3. Apply constructive alternatives to destructive anger expression. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Antisocial Behavior Attention Deﬁ cit Disorder (ADD)—Adult Borderline Personality Family Conﬂ ict Posttraumatic Stress Disorder (PTSD) SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Clients often feel they responded to a frustrating situation in the only way possible. They fail to realize that they have choices and control over their behavior. You may want to re-view the alternatives to rage listed in the ﬁ rst section of the assignment to help the client understand the alternatives he / she could apply when dealing with frustration or anger. Review the client's journal material and suggest additional constructive ways to respond to frustrating or hurtful situations that prompt his / her mismanaged anger. SECTION I: ANGER MANAGEMENT	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
2 ANGER MANAGEMENTEXERCISE I. A ALTERNATIVES TO DESTRUCTIVE ANGER Destructive anger can take many forms. Anger can be expressed in rage that is out of con-trol, either verbally or physically. We also can express anger by snapping at someone or being unkindly critical. A third form that anger may take is that of cold, icy withdrawal that punishes the other person by shutting them out, shunning them, or refusing to ac-knowledge their attempts to relate to us. All of these reactions and many more can be destructive to the relationship and to our own feelings of self-esteem. Destructive expres-sions of anger often generate later feelings of guilt and shame. This exercise is designed to brieﬂ y identify some constructive alternatives to destruc-tive anger by giving a brief description of the positive alternative. The goal is for you to consider these alternatives as you seek to replace destructive anger with more construc-tive behaviors. You will be asked to keep a journal of situations in your daily life that provoked anger and then note how one or more of these constructive alternatives may have been applied to the situations. Constructive Alternatives A. Assertiveness: Speaking forthrightly in a manner that is very respectful of the other person's needs and rights and does not attack anyone so as to make them defen-sive. B. Tune Out / Cool Down: Recognize that the situation has become volatile and nonpro-ductive and suggest withdrawal from the situation to give each party a chance to cool down and collect his / her thoughts and regain personal control. C. Relaxation: Learn and implement relaxation skills to reduce stress and tension through the use of words that cue relaxation, deep breathing that releases tension, imagining relaxing scenes, or deep muscle relaxation procedures. D. Diversion: When anger is felt to be building, ﬁ nd diversionary activities that stop the build up and focus the mind on more enjoyable experiences. E. Physical Exercise: When anger and tension levels rise, physical exercise can be a wonderful way to release tension and expel energy as an alternative to losing control or exploding in rage. F. Problem-Solving Skills: Identify or clarify the problem, brainstorm possible solu-tions, review the pros and cons of each alternative solution, select the best alterna-	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 3tive for implementation, evaluate the outcome as to mutual satisfaction, and ﬁ nally, adjust the solution if necessary to increase mutual satisfaction. G. Self-Talk: Take time to talk to yourself in calming, reasoned, and constructive sen-tences that move you toward anger control and away from hurtful expressions of anger. H. “I” Messages: Speak to the target of your anger, describing your feelings and needs rather than attacking, labeling, or describing the other person's behavior, motiva-tions, or goals. Begin your sentences with “I feel... ” or “I need.... ” I. Other: Describe your own or your counselor's alternative to rage. Application to Daily Life In the columns that follow, describe the date and time, the situation that prompted the angry response, the destructive response, and the alternative constructive response that might have been used. In the ﬁ nal row, instead of writing a full description of the alter-native, you may simply enter the alphabetical indicator of the constructive alternative, A through I. Entry 1 Situation Day / Date and Time: Response Alternative Response EXERCISE I. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
4 ANGER MANAGEMENTEntry 2 Situation Day / Date and Time: Response Alternative Response Entry 3 Situation Day / Date and Time: Response Alternative Response EXERCISE I. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 5Entry 4 Situation Day / Date and Time: Response Alternative Response Entry 5 Situation Day / Date and Time: Response Alternative Response EXERCISE I. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
6 ANGER MANAGEMENTEntry 6 Situation Day / Date and Time: Response Alternative Response Entry 7 Situation Day / Date and Time: Response Alternative Response EXERCISE I. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 7Therapist's Overview ANGER JOURNAL GOALS OF THE EXERCISE 1. Increase awareness of the prevalence of angry feelings. 2. Identify the circumstances around, targets for, and causes of the angry feelings. 3. Identify alternative constructive reactions in the place of maladaptive anger re-sponses. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Antisocial Behavior Borderline Personality Family Conﬂ ict Posttraumatic Stress Disorder (PTSD) SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Some clients deny the degree of anger they feel and express. Other clients may be aware of feelings of anger, but need help in understanding the contributing factors and causes for their anger. As you process the journal entries with clients, help them clarify and pinpoint these contributing factors and the causes for their anger. Often the causes for the anger are not those that are initially identiﬁ ed, but lie beneath the surface and can be discovered with some patient processing. Finally, it is helpful to press the client to-ward describing positive alternative behaviors that could have replaced the maladaptive anger responses that were selected in the heat of the moment. Positive alternatives may include things like assertiveness, time-out, problem solving, “I” messages, or self-talk.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
8 ANGER MANAGEMENTEXERCISE I. B ANGER JOURNAL To make you more aware of your angry feelings, the circumstances surrounding them, the target of them, the causes for them, and how they were shown, you are being asked to keep an anger journal. This journal will help you record the when, what, who, why, and how of the angry feelings as well as allow you to give some thought to what alterna-tive emotional, behavioral, or cognitive reaction you might have had to the situation. Be as honest as you can be with yourself about your angry feelings, trying not to discount them, excuse them, or deny them. When you conclude that you have experienced anger, that is the time to make an entry into this journal. Your entries do not have to be lengthy; a sentence or two will sufﬁ ce. You should enter enough information to permit you to dis-cuss each incident with your therapist as you try to process and learn from your anger experiences. Do not forget to include experiences that have generated some anger within you even though you did not express it in words or behavior. The buildup of unexpressed anger can result in an inappropriate outburst at a later time. This journal may help you understand that phenomenon. It is also important for you to give some thought to the last entry; that is, what alternative positive reaction could you have given to the situation instead of burying or blurting out your feelings of anger. Often there is a more construc-tive response available that you are able to discover when you give the issue some calm consideration and analysis. The heat of the moment leads many of us to make mistakes. Try to make at least one entry per day into your anger journal. The anger journal that follows asks you to enter the date and time of the experience that generated anger. Second, you are asked to enter a description of the situation, such as where you were and what was happening. Third, you are asked to name the people who were present, and speciﬁ cally the people with whom you were angry. Next, you are asked to enter a sentence or two indicating your reason(s) for being so angry or the cause of your anger. Then you are asked to describe how your anger was or was not revealed. In the ﬁ nal column, enter your thoughts about how you could have responded to the experi-ence more constructively.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 9Entry 1 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction Entry 2 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction EXERCISE I. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
10 ANGER MANAGEMENTEntry 3 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction Entry 4 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction EXERCISE I. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANGER MANAGEMENT 11Entry 5 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction Entry 6 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction EXERCISE I. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
12 ANGER MANAGEMENTEntry 7 What Day / Date (Situation) and Time: Who (People) Why (Cause) How (Reaction) Alternative Positive Reaction EXERCISE I. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANTISOCIAL BEHAVIOR 13Therapist's Overview HOW I HAVE HURT OTHERS GOALS OF THE EXERCISE 1. Acknowledge hurtful behavior toward others. 2. Identify speciﬁ c behaviors that have been engaged in to hurt others. 3. Identify the consequences of hurtful behavior. 4. Describe ways to make amends for hurtful behavior. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Chemical Dependence Chemical Dependence—Relapse Legal Conﬂ icts SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Minimization and denial are traits that often accompany antisocial behavior patterns. This exercise is designed to increase sensitivity to antisocial behaviors that cause oth-ers pain. Confrontation may be necessary to bring the client to acknowledge behaviors that are not included in his / her checklist. Be alert to the antisocial personality trait of projection, that is, the client may try to place blame for his / her behavior on anyone but himself / herself. Role reversal may be necessary to help the client feel the pain of his / her behavior on others. SECTION II: ANTISOCIAL BEHAVIOR	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
14 ANTISOCIAL BEHAVIOREXERCISE II. A HOW I HAVE HURT OTHERS We are capable of hurting others in many different ways. This assignment will help you become more aware of various behaviors that have a hurtful impact on others. Some-times we are very aware that we are hurting someone with our behavior, while at other times, we do not even seem to notice it. Review the list of hurtful behaviors that follow and put a checkmark next to those that you have engaged in and that have resulted in pain for others. Hurtful Behaviors Dishonesty Sex abuse Disloyalty Unfaithfulness Physically assaultive Verbal attacks Stealing Irresponsibility Unkindness Insensitivity Blaming Threatening Illegal acts Weapon use Substance abuse Name calling Job loss Unkept promises 1. Describe three situations where you have hurt others through engaging in one of the behaviors listed. Situation A: Situation B: Situation C:	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANTISOCIAL BEHAVIOR 152. Describe how your behavior affected others. How were they hurt? Situation A: Situation B: Situation C: 3. What might you do to make amends for your hurtful behavior toward others in these three situations? Situation A: Situation B: Situation C: EXERCISE II. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
16 ANTISOCIAL BEHAVIORTherapist's Overview LETTER OF APOLOGY GOALS OF THE EXERCISE 1. Increase awareness of hurtful behavior toward others. 2. Increase sensitivity toward the impact of hurtful behavior on others. 3. Take steps toward making amends through a letter of apology for hurtful behavior toward others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Chemical Dependence Chemical Dependence—Relapse Family Conﬂ ict Intimate Relationship Conﬂ icts Legal Conﬂ icts SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Hurtful behavior toward others is easily minimized or denied in terms of who is respon-sible for it or the impact it has on others. This assignment increases sensitivity toward the impact that hurtful behavior has had on others. Processing the exercise, it is impor-tant that the client include all elements of a constructive apology and avoid projection or minimization. Review each letter of apology to make sure it contains all the necessary elements. Evaluate whether the client demonstrates genuine feelings of regret, shame, or guilt. Clearly confront denial and emphasize the negative impact of insensitive behav-iors.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANTISOCIAL BEHAVIOR 17EXERCISE II. B LETTER OF APOLOGY After we become aware of the pain we have caused someone else due to our own unkind behavior, we must try to ﬁ nd a way to heal the hurt and make amends. Many times just saying “I'm sorry” is not enough. It can be helpful if the apology is accompanied by a writ-ten note acknowledging causing the pain and suggesting how you could have done things differently. This assignment asks you to describe three incidents in which you have hurt others. It then asks you to construct a brief letter of apology for each of these incidents. Three Hurtful Incidents Describe for each of three incidents who was hurt, what you did to hurt them, how they felt about what you did, how you feel now about what you did, and how you could have acted more kindly. Incident #1: Incident #2: Incident #3: Apology Write a letter of apology to each of the people who were hurt in each of the three incidents described. Include in your letter of apology a description of what you did to hurt them, your perception of how your actions must have affected them, how you feel today about your ac-tions, and what you wished you would have done in the place of your hurtful behavior.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
18 ANTISOCIAL BEHAVIORIncident #1: Dear : Sincerely, Incident #2: Dear : Sincerely, EXERCISE II. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANTISOCIAL BEHAVIOR 19Incident #3: Dear : Sincerely, EXERCISE II. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
20 ANXIETYTherapist's Overview ANALYZE THE PROBABILITY OF A FEARED EVENT GOALS OF THE EXERCISE 1. Develop an awareness of the irrational nature of the fear and anxiety. 2. Examine the probability of the negative expectation occurring and its conse-quences. 3. Identify distorted self-talk that mediates the anxiety response. 4. Recognize that the feared outcome will not terminate the ability to function. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Dependency Depression Low Self-Esteem Obsessive-Compulsive Disorder (OCD) Phobia Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Support the client as he / she takes the risk of looking boldly and fairly at the basis for his / her anxiety. Help the client to acknowledge the irrational basis for his / her anxiety and reinforce rational outcomes of feared situations that will not devastate his / her life. Pay special attention to the distorted cognitions that feed the fear and suggest realistic positive self-talk to counteract this strong mediation effect. SECTION III: ANXIETY	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANXIETY 21EXERCISE III. A ANALYZE THE PROBABILITY OF A FEARED EVENT Many of our fears grow in their intensity without us ever stopping to analyze their exact nature, their causes, their probabilities of occurrence, the amount of control we might have over the situation, and the very real outcomes that are possible if our fears were realized. This exercise will help you thoroughly review your fears. As you rationally ana-lyze the nature and cause of your fear and its real outcome, the fear will dissipate and your ability to cope will increase. Take this step-by-step approach in looking at three of your greatest fears and then bring this analysis to your counselor for a thorough process-ing and reinforcement of coping skills. 1. My First Fear A. What is the fear or anxiety about? B. What is the possibility on a scale of 1 (very unlikely) to 10 (inevitable) that the feared outcome will actually happen? Circle one number. 1 2 3 4 5 6 7 8 9 10 C. What self-talk messages do you give yourself that make the fear grow? D. What are the very real consequences if the feared outcome did occur? E. What can you do to control the outcome of the situation that you fear?	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
22 ANXIETY F. What is the worst possible real outcome if your fear was realized? G. How would your life be affected if your feared outcome actually happened? How would you cope or continue to function? 2. My Second Fear A. What is the fear or anxiety about? B. What is the possibility on a scale of 1 (very unlikely) to 10 (inevitable) that the feared outcome will actually happen? Circle one number. 1 2 3 4 5 6 7 8 9 10 C. What self-talk messages do you give yourself that make the fear grow? D. What are the very real consequences if the feared outcome did occur? E. What can you do to control the outcome of the situation that you fear? F. What is the worst possible real outcome if your fear was realized? EXERCISE III. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANXIETY 23 G. How would your life be affected if your feared outcome actually happened? How would you cope or continue to function? 3. My Third Fear A. What is the fear or anxiety about? B. What is the possibility on a scale of 1 (very unlikely) to 10 (inevitable) that the feared outcome will actually happen? Circle one number. 1 2 3 4 5 6 7 8 9 10 C. What self-talk messages do you give yourself that make the fear grow? D. What are the very real consequences if the feared outcome did occur? E. What can you do to control the outcome of the situation that you fear? F. What is the worst possible real outcome if your fear was realized? G. How would your life be affected if your feared outcome actually happened? How would you cope or continue to function? EXERCISE III. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
24 ANXIETYTherapist's Overview PAST SUCCESSFUL ANXIETY COPING GOALS OF THE EXERCISE 1. Identify successful coping strategies used in the past. 2. View yourself as a capable, resourceful person who has been successful at overcom-ing fear. 3. Apply successful coping strategies from the past to current anxieties. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Impulse Control Disorder Obsessive-Compulsive Disorder (OCD) Panic Phase of Life Problems Phobia Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This solution-focused assignment attempts to get the client to recognize his / her resource-fulness in the past in dealing with anxiety. Helping the client clarify and reﬁ ne the coping skill that he / she used is the most difﬁ cult part of the assignment. Clients are often not aware of what coping mechanism they relied on to deal with their fear. After the success-ful coping skills have been identiﬁ ed and reﬁ ned, help the client to apply these success-ful skills from the past to his / her current anxieties. Monitor and modify the solution as required.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ANXIETY 25EXERCISE III. B PAST SUCCESSFUL ANXIETY COPING This assignment leads us to focus on resources and successes that we have demonstrated throughout our past. We tend to forget about our ability to cope when our anxieties and fears seem so real and debilitating. However, all of us have had fears that we have over-come or that we have functioned with in spite of their presence from childhood right into adulthood. We may have feared attending kindergarten, but learned ways to cope with that fear as a child and eventually the fear was eradicated. We may have feared talking to a teenager of the opposite sex, but eventually learned to speak to them in spite of our anxiety. We may have feared going on a job interview, but pressed forward and presented ourselves in the best manner possible. In other words, we learn to cope and to function and to overcome anxiety. We cannot allow our anxieties to cripple us or cause us to avoid circumstances. We must face our anxieties head-on. We may have coped by just “taking a deep breath” or by getting encouragement from our friends or by rehearsing what we were going to do or say so often that it became almost automatic. Whatever coping skill we used, we have been successful in the past and now we must rediscover those coping skills and apply them to the current anxieties. 1. Identify three fears or anxieties that you experienced in the past. Fear #1: Fear #2: Fear #3: 2. Identify what you did to cope with, or continue to function in spite of, the anxiety. Fear #1: Fear #2:	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
26 ANXIETYFear #3: 3. How do you know your coping mechanism identiﬁ ed in question 2 was successful? Fear #1: Fear #2: Fear #3: 4. What other coping skills have you relied on in the past to help you overcome fears? 5. How can you use each of the coping skills identiﬁ ed in question 2 to help you with your current fears? EXERCISE III. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ATTENTION DEFICIT DISORDER (ADD)—ADULT 27Therapist's Overview PROBLEM SOLVING: AN ALTERNATIVE TO IMPULSIVE ACTION GOALS OF THE EXERCISE 1. Develop coping strategy to inhibit the tendency toward impulse responding. 2. Increase awareness of how impulsive behaviors lead to negative consequences for self and others. 3. Identify impulsivity problem and explore alternative courses of action before making ﬁ nal decision to act. 4. Learn to evaluate own behavior and how it affects self and others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Impulse Control Disorder Mania or Hypomania SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Clients with Attention Deﬁ cit Disorder (ADD) are characterized by their tendency to exercise poor judgment and act without considering the consequences of their actions. The ADD client frequently ﬁ nds himself / herself in trouble without realizing what caused him / her to get there and fails to recognize the antecedents of his / her negative conse-quences. In this exercise, the client is taught a basic problem-solving strategy to help inhibit impulses. The client ﬁ rst identiﬁ es a problem with impulsivity and then works through the subsequent problem-solving stages. This exercise can be used with clients who do not have ADD, but do have problems with impulse control. SECTION IV: ATTENTION DEFICIT DISORDER (ADD)—ADULT	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
28 ATTENTION DEFICIT DISORDER (ADD)—ADULTEXERCISE IV. A PROBLEM SOLVING: AN ALTERNATIVE TO IMPULSIVE ACTION People with Attention Deﬁ cit Disorder (ADD) often ﬁ nd themselves in trouble without realizing what caused them to get there. It is not uncommon for the person with ADD to try to solve problems by quickly rushing into a situation without stopping and thinking about the possible consequences of his / her actions. The failure to stop and think causes negative consequences for both self and others. If this sounds all too familiar to you and you are tired of ﬁ nding yourself in trouble because of your failure to stop and think, then this exercise is designed for you. In this exercise, you are taught to use basic problem-solving steps to deal with a stressful situation. By following these steps, you will hope-fully ﬁ nd yourself in less trouble with others and feel better about yourself. 1. The ﬁ rst step in solving any problem is to realize that a problem exists. At this begin-ning stage, you are asked to identify either a major impulsivity problem that you are currently facing or a common reoccurring problem that troubles you and is caused by your impulsive actions. Identify the problem. 2. After identifying the problem, consider three different alternative possible courses of action to help you solve or deal with the impulsivity problem. List the pros and cons of each possible course of action. Record at least three different pros and cons for each course of action. First possible course of action to be taken. Pros Cons	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ATTENTION DEFICIT DISORDER (ADD)—ADULT 29Second possible course of action to be taken. Pros Cons Third possible course of action to be taken. Pros Cons 3. Next, review the pros and cons of each one of your possible courses of action. At this point, talk with your partner, a family member, friend, or peer to help you choose a ﬁ nal plan of action. 4. Identify the course of action that you plan to follow. 5. What factors inﬂ uenced you to choose this course of action? 6. What advice or input did you receive from others that inﬂ uenced your decision? EXERCISE IV. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
30 ATTENTION DEFICIT DISORDER (ADD)—ADULTNow, you are in the ﬁ nal stage of this exercise. You have identiﬁ ed the problem, consid-ered different possible courses of action, made a decision, and followed through on your plan of action. Your ﬁ nal task is to evaluate the results or success of your plan of action. Please respond to the following questions. 7. What were the results of your plan of action? 8. How do you feel about the results? 9. How did your plan affect both you and others? 10. What did you learn from this experience? 11. What, if anything, would you do differently if you were faced with the same or a similar problem in the future? EXERCISE IV. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ATTENTION DEFICIT DISORDER (ADD)—ADULT 31Therapist's Overview SYMPTOMS AND FIXES FOR ADD GOALS OF THE EXERCISE 1. Identify symptoms of ADD that have been experienced over the past 6 months. 2. Become familiar with the preliminary elements of some treatment techniques. 3. Understand that treatment involves more than just taking medication. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL None SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Adult ADD is a syndrome that is revealed in a myriad of different symptoms. Review the client's checklist of symptoms that he / she has experienced and allow them to discuss any of them in more detail. It is also important to focus the client's attention on the interven-tion strategies that are a part of successful treatment. Many clients have the notion that medication alone is the complete answer to their struggles. They may have questions that need to be answered about the coping skills that are brieﬂ y described in this homework assignment. Provide the client with as much detail as necessary for their understanding of these techniques. Reinforce those strategies that you believe will be beneﬁ cial to them and that will be the focus for future treatment sessions.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
32 ATTENTION DEFICIT DISORDER (ADD)—ADULTEXERCISE IV. B SYMPTOMS AND FIXES FOR ADD Attention Deﬁ cit Disorder (ADD) is characterized by a variety of symptoms or signs. Although you may have become aware of having ADD as an adult, the symptoms of distractibility, short attention span, impulsivity, and restlessness most likely began in childhood. This assignment encourages you to review your life and indicate what symp-toms are a part of your experience. We then take a brief look at a list of coping skills that commonly help ADD clients. Symptom Checklist 1. Check all the symptoms that you have experienced within the last 6 months. Loss of concentration Disorganized Easily distracted Rarely ﬁ nish projects Restless and ﬁ dgety Easily irritated (short fuse) Impulsive actions Easily frustrated Rapid mood swings Low self-esteem Tendency for addictive behaviors Interrupt or intrude on others Inconsistent work and effort Fail to listen Poor sense of time Make careless mistakes Easily overwhelmed Poor time management Difﬁ culty switching activities Enjoy high-risk behaviors Feel “driven by a motor” Chronic lateness Talk excessively Easily bored Frequently lose things Poor employment history Blurt out answers Feel anxious Impatient in awaiting turn Often depressed Forgetful in daily duties Poor eye contact 2. List the three most problematic symptoms. A. B. C.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
ATTENTION DEFICIT DISORDER (ADD)—ADULT 333. Why are these symptoms the most problematic? What are the consequences for you of each of these three symptoms? A. B. C. 4. Fixes Following is a list of coping techniques that are used to assist people who struggle with ADD. Review the list and place a checkmark next to those that you think might be most helpful for you to receive further guidance with as your treatment progresses. Medication: One of the most common treatments for ADD is the prescription of stimulant medication by a physician. There are various types of these medi-cations and they are prescribed in various dosages to ﬁ t individual needs. Problem-Solving Skills: The client is taught how to approach problems in a systematic way and analyze the pros and cons of various solutions before making a decision for action. This approach is a replacement for the impulsiv-ity that characterizes many ADD clients. Stop, Listen, Think, Act: This technique is also designed to curb impulsivity. The client is taught to listen carefully to the requirements of a situation and then to think about what action should be taken in response to the situation before engaging in a behavior. Positive Self-Talk: The client is taught to give himself / herself positive mes-sages to counteract feelings of low self-esteem, inadequacy, depression, and anxiety. Time Out: This procedure is commonly used to help clients reduce their irrita-bility and impulsivity by training them to remove themselves from stimulus situations for a short time before reacting. This allows for consideration of consequences and engaging actions in a more planful manner. Relaxation: Many clients with ADD are ﬁ dgety and restless, anxious, and on edge. Learning to implement relaxation techniques is a major help in reduc-ing stress and reactivity. Self-Reward: Self-reward procedures are implemented to assist ADD clients in completing tasks that are often left incomplete. This procedure is also helpful in motivating clients to be focused in their actions. Reminder Aids: Forgetfulness and lack of organization are common traits of ADD clients. Learning to use checklists, notes written to self, organization calendars, and day planners are useful techniques. Physical Exercise: To reduce the restless, ﬁ dgety energy that is common to ADD clients, physical exercise on a regular basis is often implemented. The exercise reduces stress and increases relaxation and the ability to focus atten-tion. EXERCISE IV. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
34 ATTENTION DEFICIT DISORDER (ADD)—ADULT Distraction Reduction: The client learns to arrange the environment such that sounds, sights, people, or objects that could lead to distraction are minimized or removed. Organizational Coach: Consulting with others is a very helpful technique for those who lack organization in their life. Accepting guidance and advice from others in terms of ways to organize the environment or approach the task can be very beneﬁ cial. Talk Time: It is important for many ADD clients to have the opportunity to sit and talk without distractions. This allows for structured time to be set aside where distractions are minimal and thoughts are followed through to comple-tion. Signiﬁ cant others also beneﬁ t from this communication opportunity. 5. After you have checked off the techniques that you believe would be helpful for you to learn and implement, explain why you think these would be helpful to you. EXERCISE IV. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 35Therapist's Overview JOURNAL AND REPLACE SELF-DEFEATING THOUGHTS GOALS OF THE EXERCISE 1. Identify negative, distorted cognitions that mediate intense negative emotions. 2. Learn new ways to think that are more adaptive. 3. Replace negative thoughts with more positive, realistic interpretations of situa-tions. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Depression Low Self-Esteem Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Borderline clients are the epitome of negative, pessimistic thinkers. This exercise helps them acknowledge this pattern and begin to replace these thought patterns with posi-tive, realistic assessments of life. You may want to review the six types of self-defeating thought patterns that are described in the assignment as well as the alternatives to these before the client begins to journal his / her daily life experiences. In reviewing the journal material, you may have to assist the client in ﬁ nding positive thoughts to replace his / her distorted pessimistic thinking. SECTION V: BORDERLINE PERSONALITY	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
36 BORDERLINE PERSONALITYEXERCISE V. A JOURNAL AND REPLACE SELF-DEFEATING THOUGHTS Feeling intense emotions is preceded by the cognitive processing of external situations. When you encounter a troubling situation, you ﬁ rst develop a series of thoughts about that situation as you analyze it. Your emotions evolve based on how you interpret the situation based on your evaluative thoughts. Stimulus situations lead to interpretative thoughts that lead to a variety of different emotions based on those thoughts. This assign-ment highlights six common self-defeating thoughts that almost always lead to feelings of frustration, sadness, anger, or other negative emotions. Each of these six self-defeating thought patterns can be reversed and you can engage in more realistic positive thinking to produce more calm, conﬁ dent, and afﬁ rming feelings. 1. Deﬁ nitions of Six Self-Defeating Thought Pattern. A. Black or White Thinking: Viewing situations, people, or self as entirely bad or entirely good—nothing in between. Such thoughts almost always lead to harsh judgments and alienation from others. Example: “My supervisor is never fair and he has always hated me. ” B. Hopelessness: Consistently viewing situations as having no possible positive or even neutral resolution in the future. This leads to despair and refusal to search for solutions to problems. Example: “I'll never make any new friends who accept me and enjoy me. ” C. Helplessness: Refusing to acknowledge that he / she has any ability to impact his / her world in a positive fashion, but consistently believes that bad things just happen to him / her. This results in discounting all positive traits, abilities, and successes and refusing to put forth effort to change his / her environment, becom-ing dependent on others to do it for him / her. Example: “There is nothing I can do to change the situation, so I might as well just give up and let what happens happen. ” D. Worthlessness: Viewing self as not worthy of other people's time, interest, or ac-ceptance. This leads to making self-critical remarks in anticipation of rejection from others. Example: “I don't blame them for not liking me because I'm not worth it anyway. ” E. Catastrophizing: Blowing expected consequences out of proportion in a very negative direction. This results in withdrawal of effort to change things for the	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 37better and reacting to a situation as if the negative consequence has already happened. Example: “I'll never be able to get another job. This layoff is the end of the line for me. ” F. Negative Forecasting: Predicting events will turn out badly without any basis in reality. This type of thinking results in pessimism, depression, and withdrawal of effort. Example: “I'll never get hired, so there's no sense in even going for the interview. ” 2. Each of the six self-defeating thought patterns listed can be reversed and replaced with a positive alternative. A. Alternative to Black or White Thinking: Recognizing that there are good and bad aspects to almost anything and everyone and refusing to reject someone quickly because of some small ﬂ aw or error. This leads to a greater degree of acceptance of other people and acceptance of self. Example: “My supervisor seems to be hav-ing a bad day today but I must admit he has been good to me at times. ” B. Alternative to Hopelessness: Viewing life more realistically and seeing the po-tential for possible resolution to negative circumstances given increased time and effort. This leads to a sense of empowerment and increased acceptance from others who view you as a “positive thinker. ” Example: “Everyone needs friends and appreciates kindness, so if I'm patient, friendly, and considerate, I will de-velop a social network. ” C. Alternative to Helplessness: Acknowledging personal resources and abilities that can have an impact on negative situations and seeing opportunities to make a difference rather than waiting on others to do it for him / her. This results in taking action and feeling in control of situations. Example: “I will change my approach to this situation and I'm sure that using a different tactic will produce a positive result. ” D. Alternative to Worthlessness: Seeing self as worthy of acceptance from others and recognizing his / her intrinsic value as a human being with strengths and weaknesses. This results in greater self-acceptance and the expectation of ac-ceptance from others. Example: “I am a good and capable person who deserves respect from others whom I treat with respect. ” E. Alternative to Catastrophizing: Viewing consequences in a realistic light and keeping negative aspects in a context that includes positive aspects. This type of thinking leads to the ability to build on the positive aspects of any outcome and nurtures a sense of hopefulness. Example: “This layoff is difﬁ cult to accept but I have skills and work habits that will allow me to ﬁ nd another job if I am diligent in my search. ” F. Alternative to Negative Forecasting: Considering that all possible outcomes may occur and recognizing that without effort no positive outcome is possible. This leads to the more optimistic view of the world and generates enthusiasm. Ex-ample: “I know there is competition for this job but I'll stay positive in the in-EXERCISE V. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
38 BORDERLINE PERSONALITYterview. If I'm not hired for this job, I know there is another job for me in the future. ” 3. After reviewing the material on self-defeating thoughts and the positive alternatives to these negative patterns, please record up to seven instances of your engaging in self-defeating thoughts and write down a positive alternative thought that could have / should have replaced it. Please ﬁ ll in the information requested: Describe the situation that triggered the self-defeating thought, list the self-defeating thought itself, describe the negative emotion that resulted from this thought, and ﬁ nally, list an alternative positive thought that could have been used to interpret the situation differently. Entry 1 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought EXERCISE V. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 39Entry 2 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought Entry 3 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought EXERCISE V. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
40 BORDERLINE PERSONALITYEntry 4 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought Entry 5 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought EXERCISE V. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 41Entry 6 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought Entry 7 Situation Date: Self- Defeating Thought Negative Emotional Results Alternative Positive Thought EXERCISE V. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
42 BORDERLINE PERSONALITY Therapist's Overview PLAN BEFORE ACTING GOALS OF THE EXERCISE 1. Develop a coping strategy to inhibit the tendency toward impulsive responding. 2. Increase awareness on how impulsive behaviors lead to negative consequences for self and others. 3. Identify problem and explore alternative courses of action before making a ﬁ nal deci-sion to act. 4. Learn to evaluate own behavior and how it affects self and others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Attention Deﬁ cit Disorder (ADD)—Adult Mania or Hypomania Type A Behavior SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Many clients are characterized by their tendency to exercise poor judgment and act without considering the consequences of their actions. The client ﬁ nds himself / herself in trouble without realizing what caused him / her to get there and fails to recognize the antecedents of his / her negative consequences. In this exercise, the client is taught a basic problem-solving strategy to help inhibit impulses. The client ﬁ rst identiﬁ es a problem and then works through the subsequent problem-solving stages. This is a long assignment, so the client will need considerable encouragement and perhaps support in completing the assignment within the therapy session.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 43EXERCISE V. B PLAN BEFORE ACTING People often ﬁ nd themselves in trouble without realizing what caused them to get there. This occurs when people try to solve problems by quickly rushing into a situation without stopping and thinking about the possible consequences of his / her actions. The failure to stop and think causes negative consequences for both self and others. In this exercise, you are taught to use basic problem-solving steps to deal with a stressful situation. By following these steps, you will ﬁ nd yourself in less trouble with others and feel better about yourself. 1. The ﬁ rst step in solving any problem is to realize that a problem exists. At this begin-ning stage, you are asked to identify either a major problem that you are currently facing or a common recurring problem that troubles you. Talk with your friends, spouse, or family if you have trouble selecting a problem that you would like to focus on solving. Identify the problem. 2. After identifying the problem, consider three different possible courses of action to help you solve or deal with the problem. List the pros and cons of each possible course of action. Record at least three different pros and cons for each course of ac-tion. First possible course of action to be taken. Pros Cons	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
44 BORDERLINE PERSONALITYSecond possible course of action to be taken. Pros Cons Third possible course of action to be taken. Pros Cons 3. Next, review the pros and cons of each one of your possible courses of action and se-lect the course of action you plan to follow. At this point, you are encouraged to talk with your spouse or a friend or family member to help you choose a ﬁ nal plan of ac-tion. 4. Identify the course of action that you plan to follow. 5. What factors inﬂ uenced you to choose this course of action? 6. What advice or input did you receive from others that inﬂ uenced your decision? EXERCISE V. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
BORDERLINE PERSONALITY 457. Now it is time to follow through on your plan of action. Describe the events that oc-curred when you followed through with your plan of action. What were the results? You are in the ﬁ nal stage of this exercise. You have identiﬁ ed the problem, consid-ered different possible course of action, made a decision, and followed through on your plan of action. Your ﬁ nal task is to evaluate the results or success of your plan of action. Please respond to the following questions: 8. How do you feel about the results of your action? 9. How did your plan affect both you and others? 10. What did you learn from this experience? 11. What, if anything, would you do differently if you were faced with the same or a similar problem in the future? EXERCISE V. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
46 CHEMICAL DEPENDENCETherapist's Overview AFTERCARE PLAN COMPONENTS GOALS OF THE EXERCISE 1. Acknowledge that the maintenance of sobriety requires many different life changes and support components. 2. Identify the speciﬁ c aftercare components that will support recovery. 3. Maintain long-term sobriety. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence—Relapse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Recovery from substance abuse requires a multifaceted approached. The client must be reminded often of the need for many different support systems to overcome his / her natu-ral tendency to relapse into substance abuse. A structured aftercare plan should be com-pleted by the client at the early to middle stage of treatment. Assist the client with ﬁ lling in any of the necessary information requested on the form. Add additional information that you believe will be necessary to support the client's recovery. SECTION VI: CHEMICAL DEPENDENCE	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 47EXERCISE VI. A AFTERCARE PLAN COMPONENTS Maintenance of long-term sobriety requires an aftercare plan with various components that support the recovery endeavor. This assignment allows you to stipulate what compo-nents you will rely on to help you maintain sobriety for the long term. Sobriety will never be maintained if the only component of recovery is “I'm going to stop using a speciﬁ c sub-stance. ” Pure willpower has never been, nor will it ever be, enough to maintain sobriety once substance abuse has been such a dominating force in a person's life. You need many different components to keep the plan strong and moving forward. Fill in all the blanks with the pertinent information regarding the resources that you will be making use of during your recovery. A. AA / NA Meetings Where? When? How many times per week? B. Sponsor Who? Phone number C. 1-to-1 Counseling With whom? How often? Phone number D. Family Counseling With whom? How often? E. Spiritual Support Group Where? How often?	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
48 CHEMICAL DEPENDENCEF. Employment Where? How many hours per week? G. Employment Search How conducted? How often will you search? H. Recreation What will it be? When will you do it? I. New Sober Friends Who are they? What will you do together? How will you make new friends? J. Exercise Program What will you do? When will you do it? How many times per week? K. Probation / Parole Contact With whom? How often? L. Child Visitation Where? When? M. Sleep Schedule Bed time? Arise time? N. Meal Schedule Breakfast time? Lunch time? Dinner time? O. Other Important Component: EXERCISE VI. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 49P. Another Important Component: List the three most important components of your aftercare recovery plan and tell how you will ensure that you will follow through on these things. EXERCISE VI. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
50 CHEMICAL DEPENDENCETherapist's Overview RELAPSE TRIGGERS GOALS OF THE EXERCISE 1. Increase awareness of potential relapse triggers. 2. Identify coping techniques for each relapse trigger. 3. Accept powerlessness over mood-altering substances and the need for a structured recovery program that includes the help of others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence—Relapse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Although the client may be able to identify the people, places, and things that are the strongest potential triggers for relapse, he / she may need signiﬁ cant guidance in listing coping techniques for each of these triggers. Let the client struggle on his / her own to identify these coping skills before providing support and additional guidance. More than one coping technique may be recommended for a particular trigger situation.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 51EXERCISE VI. B RELAPSE TRIGGERS Alcoholics Anonymous (AA) refers to people, places, and things that can initiate a relapse into substance abuse as relapse triggers. It is very important that you try to identify those people or situations that may increase your vulnerability to the temptation to re-turn to substance abuse. Identifying the triggers for substance abuse is a ﬁ rst step that must be followed by a plan for coping with each of these triggers if you are to minimize the power of their inﬂ uence over you in the future. 1. List at least 10 people, places, or things that your experience has taught you will tempt you to return to the use of mood-altering substances. Consider such things as friends or associates, family members, drug or alcohol-using locations, places to purchase drugs or alcohol, strong emotions that have been associated with drug or alcohol use, recreational activities associated with use, ﬁ nancial situations that pro-vide opportunities for use, and so on. A. B. C. D. E. F. G. H.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
52 CHEMICAL DEPENDENCE I. J. K. L. 2. Consider each of the triggers that you have listed and write down a positive way that you can cope with this situation, person, or emotion in order to not return to sub-stance abuse. You may need to consult with your counselor about coping techniques, but attempt to come up with some of these on your own. Consider such things as AA meetings, sponsor contact, higher-power meditation, positive support groups, posi-tive relationships, one-to-one counseling, avoidance of speciﬁ c friends or places, keep-ing money out of your hands, increasing recreation, and so on. A. B. C. D. E. F. G. H. I. J. EXERCISE VI. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 53 K. L. 3. What are the three most important triggers that you need to be alert for in order to avoid their powerful inﬂ uence? A. B. C. 4. What are the three most important coping skills that you believe will help you main-tain your sobriety? A. B. C. EXERCISE VI. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
54 CHEMICAL DEPENDENCETherapist's Overview SUBSTANCE ABUSE NEGATIVE IMPACT VERSUS SOBRIETY'S POSITIVE IMPACT GOALS OF THE EXERCISE 1. Break down denial and minimization by acknowledging the negative consequences of substance abuse. 2. Increase hope and motivation for sobriety by recognizing the potential positive con-sequences of recovery. 3. Commit to a recovery program that will promote sobriety. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence—Relapse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Breaking through denial for a chemically dependent client is a difﬁ cult task. This assign-ment provides an opportunity for the client to assess the devastating effects of substance abuse on his / her life and the lives of others. Confrontation may be used if minimization or denial prevents honest acknowledgment of the negative consequences surrounding the client's substance abuse pattern. Reinforcement and support should be given as honesty is demonstrated. Assistance may be necessary to provide the chemically dependent client with a vision of the positive impact of sobriety on his / her future since it is not unusual for hopelessness and helplessness to predominate.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 55EXERCISE VI. C SUBSTANCE ABUSE NEGATIVE IMPACT VERSUS SOBRIETY'S POSITIVE IMPACT To maintain a life of sobriety, you need to acknowledge without denial and minimization the negative impact that substance abuse has had on your life and the lives of others. In contrast to that, you accept that sobriety will have a positive impact on your life and the lives of others. This assignment gives you an opportunity to honestly evaluate the negative consequences of your history of substance abuse and project how sobriety will produce positive consequences for you and others. 1. List at least 10 ways that your substance abuse has negatively impacted your life. Consider such things as health, relationships, self-esteem, employment, legal en-tanglements, ﬁ nances, friendships, family relations, children, and so on. A. B. C. D. E. F. G. H. I.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
56 CHEMICAL DEPENDENCE J. K. L. 2. List at least 10 ways that your substance abuse has had a negative impact on the lives of others. Consider friends, family, employers, children, coworkers, neighbors, counselors, clergy, AA members, sponsors, and so on. (Be sure to indicate not just who was affected by your substance abuse, but how they were affected. ) A. B. C. D. E. F. G. H. I. J. K. L. EXERCISE VI. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 573. List at least 10 positive impacts that being sober will have on your life. Consider the same areas that you reviewed in number 1. A. B. C. D. E. F. G. H. I. J. K. L. 4. List at least 10 ways that being sober will have a positive impact on the lives of oth-ers. Consider those same people that you thought of for number 2. A. B. C. D. EXERCISE VI. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
58 CHEMICAL DEPENDENCE E. F. G. H. I. J. K. L. 5. List the three most important negative consequences of your substance abuse on your life. Select these from number 1. A. B. C. Why have you chosen these as the most important? 6. List the three most important negative consequences that your substance abuse has had on others. Select these from number 2. A. B. C. Why have you chosen these as the most important? EXERCISE VI. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE 597. List the three most important positive consequences of sobriety in your personal life. Select these from number 3. A. B. C. Why have you chosen these as the most important? 8. List the three most important positive consequences of sobriety on the lives of oth-ers. Select these from number 4. A. B. C. Why have you chosen these as the most important? 9. What changes can you make in your life to reduce the probability that substance abuse will continue along with its negative consequences and increase the probabil-ity that sobriety will be maintained along with its positive consequences? EXERCISE VI. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
60 CHEMICAL DEPENDENCE—RELAPSETherapist's Overview EARLY WARNING SIGNS OF RELAPSE* GOALS OF THE EXERCISE 1. Increase awareness of personal early warning signs of relapse. 2. Learn that relapse is a process and that a person can prevent that process from con-tinuing to its completion in his / her life. 3. Increase awareness of being an active participant in the recovery process. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This activity is intended to help clients in early recovery gain awareness of cognitive, emotional, and behavioral changes often seen in the early stages of the relapse process, before an actual return to active addiction, and plan strategies to counter these changes if and when he / she sees them. This exercise is intended as preparation for the “Relapse Prevention Planning” activity (also found in this book). In addition to that exercise, fol-low-up for this exercise might include sharing the information gathered in this activity with a program sponsor, keeping a journal speciﬁ cally to record red-ﬂ ag symptoms, and discussing this topic with recovery role models in a home group. SECTION VII: CHEMICAL DEPENDENCE—RELAPSE *This assignment has been adapted from J. R. Finley and B. S. Lenz, Addiction Treatment Homework Planner (Hoboken, NJ: John Wiley & Sons, 2003, Copyright  by John Wiley & Sons, Inc. ). Reprinted with permission.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 61EXERCISE VII. A EARLY WARNING SIGNS OF RELAPSE In addition to external pressures to return to addiction, our attitudes, thoughts, and be-havior also play a key role in relapse. Learning about early warning signs can help you avoid going back to drinking, using, or other addictive patterns. This exercise will help you identify your personal warning signs. If you can identify the early warning signs, you can stop a relapse and turn it around. Returning to our addictions is the completion of the process of relapse, not its begin-ning. Before a person picks up a drink or drug, walks into a casino, or otherwise returns to an addiction, there are many warning signs. Knowing these warning signs can help you cut the process short. 1. Relapse-related changes in thinking may include persuading yourself that some new method of being a controlled drinker, drug user, gambler, and so on, will work; re-membering the good times and overlooking the problems; thinking of addictive ac-tions as a reward for success or a way to celebrate; or believing that one cannot suc-ceed in recovery. Please list speciﬁ c examples of how your thinking changed before your last relapse, or similar changes that you've seen in others. 2. Attitudes also change as a recovering person drifts toward relapse. Determination, optimism, teamwork, and motivation may be replaced by negative attitudes, such as apathy, negativity, selﬁ shness, and a feeling that being unable to drink, use, gamble, or use other addictive behavior is an undeserved punishment. Please list speciﬁ c examples of how your attitudes changed before your last relapse, or similar changes that you've seen in others.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
62 CHEMICAL DEPENDENCE—RELAPSE3. Another area where there are clear differences between an actively addicted person's lifestyle and that of a recovering person is in how he/she relates to others. Before returning to active addiction, our behavior usually slips back into patterns, such as self-isolation, manipulation, dishonesty, secretiveness, being demanding and resent-ful, and putting what we want ahead of caring about other people. Please list speciﬁ c examples of how your ways of relating to other people changed before your last re-lapse, or similar changes that you've seen in others. 4. You have probably also seen common behavior patterns in yourself and others who were abusing alcohol or other drugs or practicing other addictions and seen very dif-ferent patterns in recovering people. When a person is sliding back toward addiction, his / her behaviors usually start looking more and more like they did before absti-nence. Some typical addictive behavior patterns include irregular eating and sleep habits, neglect of health, irresponsibility, reckless high-risk behaviors, procrastina-tion, impulsivity, and other patterns showing a loss of self-control and the growth of chaos in one's life. Please list speciﬁ c examples of how your behavior changed before your last relapse, or similar changes that you've seen in others. 5. Together with the other changes described previously, the feelings and moods of ac-tively addicted people tend to be different from those they experience in recovery. Common addictive patterns of feelings and mood include irritability, anxiety, depres-sion, hopelessness, indifference, self-pity, anger, and self-centeredness. Please list speciﬁ c examples of how your feelings and moods changed before your last relapse, or similar changes that you've seen in others. EXERCISE VII. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 636. Now think back, check with others if possible, and identify whatever warning signs from all of the previous areas that preceded your last relapse. If you have never tried to quit before and have no experience of relapse, list the patterns that were normal for you when you were drinking or using. Either way, please write these red ﬂ ags down in the order in which they happened. EXERCISE VII. A	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
64 CHEMICAL DEPENDENCE—RELAPSETherapist's Overview IDENTIFYING RELAPSE TRIGGERS AND CUES* GOALS OF THE EXERCISE 1. Increase awareness of personal situational triggers and cues to relapse. 2. Recognize high-risk situations involving increased risk of relapse. 3. Develop alternative coping strategies to manage relapse triggers, cues, and warning signs. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This activity is designed to help the newly recovering client identify both environmental and internal relapse triggers and plan strategies to identify them quickly and cope with them when they occur. Follow-up may include completing the “Relapse Prevention Plan-ning” activity (also found in this book), keeping a journal about work with the informa-tion gained in this exercise, and reporting to the therapist or group on outcomes of any strategies that are identiﬁ ed. *This assignment has been adapted from J. R. Finley and B. S. Lenz, Addiction Treatment Homework Planner (Hoboken, NJ: John Wiley & Sons, 2003, Copyright  by John Wiley & Sons, Inc. ). Reprinted with permission.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 65EXERCISE VII. B IDENTIFYING RELAPSE TRIGGERS AND CUES Relapse is common, but it is preventable. Preventing relapse requires awareness of things that can trigger us to behave addictively and willingness to do something about it when one of them happens. The purpose of this exercise is to ask yourself questions to increase your awareness of possible relapse triggers and make a plan to cope with them and pre-vent relapse. Risky Situations 1. Relapse is often triggered by sights, sounds, and situations that have often been associated with addictive behaviors in the past. Many recovering people ﬁ nd that, unless they are on guard, their thoughts automatically turn back to old behavior patterns when they are around the people with whom they drank, used, or gambled. Who are the people, or the kind of people, with whom you usually practiced addictive behaviors in the past? 2. Because addictive behaviors are sometimes social activities, you may know people who will expect you to continue to do the old things with them. They may not under-stand or care about your recovery, and may use persuasion, teasing, or argument to try to get you to relapse. In your life, who are the people most likely to exert social pressure on you to relapse? (This list may include all or some of the people you listed for question 1. ) 3. Many recovering people ﬁ nd that others—family members, friends, or coworkers— had been enabling their addictions (i. e., these people had helped them avoid the consequences or made it easier in other ways for them to keep using). Please list any people that have enabled your addiction.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
66 CHEMICAL DEPENDENCE—RELAPSE4. For each of the people listed previously—drinking / using / gambling companions, people pressuring you to relapse, and enablers—describe how you will avoid relapse triggered by their actions. 5. What are the social situations that you think will place you at the greatest risk to relapse? 6. Many people also use addictions to cope with stress, and sometimes relationship issues can be extremely stressful. When you think about your future, what relation-ship difﬁ culties might put you at risk for returning to addictive patterns? 7. We also ﬁ nd that for many of us our addictions had become part of our daily routine, something we did automatically at certain times, such as just after work. Reviewing your former daily routines, at what times of the day are you most likely to relapse? 8. Many people feel the desire to test their ability to maintain recovery in challenging situations, such as being with drinking friends, going to old hangouts, and so forth. This often leads to relapse and is an unnecessary risk. Describe any ways in which you've tested your ability to stay in recovery. 9. As another way to guard against stress-induced relapse, please think about both current situations and future life events that you need to be prepared to handle without escaping into addictions. What are they? EXERCISE VII. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 6710. What's your plan to handle these situations? What changes are you willing and able to make to handle the pressures and temptations to relapse in the situations you listed previously? Internal Triggers 11. When you experience urges or cravings to act out addictively, how does your body feel? 12. When you experience urges to act out addictively, what emotions do you usually feel? 13. As mentioned earlier, addictions are often tools for coping with stress (i. e., ways to change feelings that we dislike to ones with which we are more comfortable). What unpleasant feelings will place you at greatest risk for relapse? 14. Following are some common feelings for which people have used chemicals to cope. It's important not only to be determined not to drink or use to cope, but also to know what you will do—not having an alternative to replace substance abuse increases your risk of relapse. Next to each feeling, describe what you will do instead of using to cope with that feeling. EXERCISE VII. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
68 CHEMICAL DEPENDENCE—RELAPSEFeeling What You Will Do to Cope a. Anger b. Anxiety c. Boredom d. Sadness e. Fatigue f. Fear g. Frustration h. Loneliness i. Indifference j. Self-pity k. Shame l. Depression m. Other feelings EXERCISE VII. B	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 69Therapist's Overview RELAPSE PREVENTION PLANNING* GOALS OF THE EXERCISE 1. Develop a plan of action to deal with relapse triggers and warning signs. 2. Assess commitment to recovery. 3. Take greater responsibility for recovery and increase the chances of success through planning. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This activity provides clients (either those who are beginning in recovery or experiencing stresses that increase the risk of relapse) with a structured framework to create a person-alized plan to anticipate relapse triggers and cues; plan coping or avoidance strategies; spot early warning signs of the relapse process; and identify resources, strategies, and re-lationships to use to maintain recovery. For best results, have the client complete “Early Warning Signs of Relapse” and “Identifying Relapse Triggers and Cues” (also found in this book) before assigning this activity. Follow-up may include having the client pre-sent his / her plan to the therapist, treatment group, and program sponsor; keep a log or journal on plan compliance; and report on the outcomes of his / her uses of the strategies planned. *This assignment has been adapted from J. R. Finley and B. S. Lenz, Addiction Treatment Homework Planner (Hoboken, NJ: John Wiley & Sons, 2003, Copyright  by John Wiley & Sons, Inc. ). Reprinted with permission.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
70 CHEMICAL DEPENDENCE—RELAPSEEXERCISE VII. C RELAPSE PREVENTION PLANNING If you have identiﬁ ed your own personal relapse triggers and relapse warning signs, you have a good understanding of your relapse process and how to spot it early, before it leads you to an actual return to your addiction. Now it's time to take this information and plan speciﬁ c strategies to put it to use. The more work you do on this plan and the more speciﬁ c you are, the more prepared you will be to deal with day-to-day living and unexpected stressful events without reliance on alcohol, other drugs, or other addictive behavior patterns. 1. First, evaluate your thoughts and feelings about sobriety. Are you ready to take any action needed, to go to any lengths to live your life without using mind-altering chemicals or addictive behaviors to block painful feelings or seek pleasure? Describe your attitude about this. 2. What will the consequences be if you return to your addiction? 3. Refer to the exercises on relapse triggers and warning signs, or draw on whatever information you have about the process of relapse. List what you consider to be your 10 most important personal triggers and warning signs for relapse and what you will do to cope with those triggers and warning signs. Triggers / Warning Signs Speciﬁ c Plan to Avoid Drinking / Using / Addictive Behavior Ex: Feeling hopeless Review progress; ask others what growth they see Ex: Urge to use Attend meetings; contact sponsor; meditate	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 71 4. Recovery is not a solo process, which is why people who try to quit without help from others usually relapse. Whom will you contact for support and assistance? List six people. Name Phone Number 5. Emergency planning: Your relapse prevention plan should include what you will do if you encounter a sudden crisis, a stressful situation that triggers a strong urge to use or drink or return to addictive behavior. Write a plan that is simple and can be started immediately. 6. Changing your routine is important in managing addictive behavior. How will you begin and end each day to help you maintain sobriety? 7. Your relapse prevention plan should include attending support groups—Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous, and so forth. List meet-ings you will commit yourself to attend regularly. EXERCISE VII. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
72 CHEMICAL DEPENDENCE—RELAPSEName of Group Day and Time Location 8. Do you foresee any obstacles or barriers to implementing this plan? If so, what are they? 9. What will you do about these roadblocks to your recovery or any others you experi-ence? 10. If your plan isn't enough, and you relapse, what will you do to get back on track in your recovery? 11. Are there parts of this plan that you are already carrying out? What are they, and how well have they worked? 12. Now that you have your plan made, it's important to monitor your success in using it and correct it or add to it as needed. When and with whom will you make regular progress checks? Person When You Will Talk about Your Progress EXERCISE VII. C	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 73Therapist's Overview RELAPSE SYMPTOM LINE GOALS OF THE EXERCISE 1. Identify the speciﬁ c people, places, things, and feelings that trigger relapse. 2. Discover patterns that may exist for the repeated relapses into substance abuse. 3. Isolate the most powerful triggers that must be dealt with to maintain sobriety suc-cessfully in the future. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT When a client relapses repeatedly after periods of successful sobriety, it is important to attempt to discover any patterns of relapse triggers that need special coping techniques applied to them. Review the client's Relapse Symptom Line to try to discover these pat-terns of relapse triggers. Reassure the client that you can focus on developing coping skills for any relapse trigger that has special signiﬁ cance in his / her life. It will probably be helpful to engage the resources of signiﬁ cant others and self-help support groups as part of the aftercare plan in dealing with relapse triggers.	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
74 CHEMICAL DEPENDENCE—RELAPSEEXERCISE VII. D RELAPSE SYMPTOM LINE It is very important to identify the speciﬁ c behaviors, attitudes, and feelings that led up to the loss of sobriety and the relapse into substance abuse. When a pattern of relapse occurs after a period of sobriety followed by a recovery and then another relapse, it is crucial to identify the triggers for each of the relapses. This assignment provides you with the opportunity to look back over your pattern of relapses and evaluate the circumstances surrounding each relapse. You will discover some triggers that make you vulnerable to relapse so that coping skills can be developed to deal with them. 1. An example of a Relapse Symptom Line follows. Notice that the Relapse Symptom Line begins with the date that substance abuse started. Perhaps there will be more than one start date if the ﬁ rst date is involved with alcohol, but the second start date involves some other mood-altering substance. The next event on the Symptom Line would be the date associated with the ﬁ rst time you become clean and sober. The next date on the Symptom Line is that of the ﬁ rst relapse into substance abuse. Each date of relapse should record the following information: When (the time of day or special event that was occurring), where (at what location did you begin to use the substance), who (who were you with when you were using the substance), why (what special circumstances surrounded the relapse), and feelings (what emotions were you experiencing at the time of the relapse). Look over the example that follows to further understand how a Relapse Symptom Line should look when it is completed. The example contains four relapses; yours may contain more or less than this ex-ample. 2/80 Started Alcohol6/85 Started Cocaine4/92 Clean & Sober10/92 Relapse12/92 Clean & Sober12/93 Relapse When: My birthday Where: At bar Who: With friends Why: Celebrating/argued with wife Feelings: Angry, celebrating When: Christmas Eve party Where: At mom's house Who: With family members Why: Party time Feelings: Nervous, happy, celebrating	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHEMICAL DEPENDENCE—RELAPSE 751/94 Clean & Sober8/94 Relapse10/94 Clean & Sober10/02 Relapse When: After softball game Where: At bar Who: With teammates Why: Celebrating Feelings: Celebrating When: After work Where: In car Who: Alone Why: Laid off Feelings: Depressed, worried 2. Personal Relapse Symptom Line: Enter on the lines the dates for your beginning of substance abuse, times of clean and sober living, and times of relapse. Below each relapse date, enter information on when, where, who, why, and the feelings experi-enced at the time prior to relapse. EXERCISE VII. D	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
76 CHEMICAL DEPENDENCE—RELAPSE3. What pattern do you see regarding where the substance abuse occurred at times of relapse? 4. What pattern can you ﬁ nd regarding who was with you when you relapsed into sub-stance abuse? 5. What pattern is there for any special circumstances that occurred prior to relapse? 6. What feelings are commonly experienced prior to relapse? 7. What has this exercise taught you about your triggers for relapse? EXERCISE VII. D	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf
CHILDHOOD TRAUMA 77Therapist's Overview CHANGING FROM VICTIM TO SURVIVOR GOALS OF THE EXERCISE 1. Identify the traits of a victim versus those of a survivor. 2. Evaluate current status as either a victim or a survivor. 3. Increase conﬁ dence toward facing life with a sense of empowerment. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Posttraumatic Stress Disorder (PTSD) Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The client may be far down the road toward becoming a survivor instead of a victim. On the other hand, the client may be stuck in victim status and this assignment will help him / her sort through traits that keep him / her in that status. Review his / her list of descriptors to make sure that the positive, conﬁ dent, and healthy descriptors are under the label of “Survivor” while the more negative, self-defeating, depressive descriptors are under the column labeled “Victim. ” Reinforce motivation to move from victim to survivor and point out the many beneﬁ ts that accrue as he / she changes this status of perspec-tive. SECTION VIII: CHILDHOOD TRAUMA	Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf

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