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PRACTICEPLANNERS SERIESTreatment PlannersThe Adult Psychotherapy Treatment Planner, Fourth EditionThe Child Psychotherapy Treatment Planner, Fourth EditionThe Adolescent Psychotherapy Treatment Planner, Fourth EditionThe Addiction Treatment Planner, Third EditionThe Continuum of Care Treatment PlannerThe Couples Psychotherapy Treatment PlannerThe Employee Assistance Treatment PlannerThe Pastoral Counseling Treatment PlannerThe Older Adult Psychotherapy Treatment PlannerThe Behavioral Medicine Treatment PlannerThe Group Therapy Treatment Planner, Second EditionThe Gay and Lesbian Psychotherapy Treatment PlannerThe Family Therapy Treatment PlannerThe Severe and Persistent Mental Illness Treatment PlannerThe Mental Retardation and Developmental Disability Treatment PlannerThe Social Work and Human Services Treatment PlannerThe Crisis Counseling and Traumatic Events Treatment PlannerThe Personality Disorders Treatment PlannerThe Rehabilitation Psychology Treatment PlannerThe Special Education Treatment PlannerThe Juvenile Justice and Residential Care Treatment PlannerThe School Counseling and School Social Work Treatment PlannerThe Sexual Abuse Victim and Sexual Offender Treatment PlannerThe Probation and Parole Treatment PlannerThe Psychopharmacology Treatment PlannerThe Speech-Language Pathology Treatment PlannerThe Suicide and Homicide Risk Assessment & Prevention Treatment PlannerThe College Student Counseling Treatment PlannerThe Parenting Skills Treatment PlannerThe Early Childhood Education Intervention Treatment PlannerThe Co-Occurring Disorders Treatment PlannerProgress Notes PlannersThe Child Psychotherapy Progress Notes Planner, Third EditionThe Adolescent Psychotherapy Progress Notes Planner, Third EditionThe Adult Psychotherapy Progress Notes Planner, Third EditionThe Addiction Progress Notes Planner, Second EditionThe Severe and Persistent Mental Illness Progress Notes PlannerThe Couples Psychotherapy Progress Notes PlannerThe Family Therapy Progress Notes PlannerHomework PlannersBrief Therapy Homework PlannerBrief Couples Therapy Homework PlannerBrief Employee Assistance Homework PlannerBrief Family Therapy Homework PlannerGrief Counseling Homework PlannerGroup Therapy Homework PlannerDivorce Counseling Homework PlannerSchool Counseling and School Social Work Homework PlannerChild Therapy Activity and Homework PlannerAddiction Treatment Homework Planner, Third EditionAdolescent Psychotherapy Homework Planner, Second EditionAdult Psychotherapy Homework Planner, Second EditionChild Psychotherapy Homework Planner, Second EditionParenting Skills Homework PlannerClient Education Handout PlannersAdult Client Education Handout PlannerChild and Adolescent Client Education Handout PlannerCouples and Family Client Education Handout PlannerComplete PlannersThe Complete Depression Treatment and Homework PlannerThe Complete Anxiety Treatment and Homework Planner

PracticePlanners Arthur E. Jongsma, Jr., Series EditorAdult PsychotherapyHomework PlannerSecond EditionArthur E. Jongsma, Jr.John Wiley & Sons, Inc.

This book is printed on acid-free paper.oCopyright 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 byany means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted underSECTION 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission ofthe Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright ClearanceCenter, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web atwww.Copyright.Com. Requests to the Publisher for permission should be addressed to the PermissionsDepartment, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008or online at http://www.wiley.com/go/permissions.Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts inpreparing this book, they make no representations or warranties with respect to the accuracy or completenessof the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for aparticular 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 aprofessional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or anyother 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 mattercovered. It is sold with the understanding that the publisher is not engaged in rendering professional services. Iflegal, accounting, medical, psychological, or any other expert assistance is required, the services of a competentprofessional person should be sought.Designations used by companies to distinguish their products are often claimed as trademarks. In all instanceswhere John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capitalletters. Readers, however, should contact the appropriate companies for more complete information regardingtrademarks and registration.For general information on our other products and services please contact our Customer Care Departmentwithin 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 beavailable in electronic books. For more information about Wiley products, visit our website at www.wiley.comNote about Photocopy RightsThe publisher grants purchasers permission to reproduce handouts from this book for professional use withtheir 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

To Dave and Lorrie Vander Ark,whose friendship has enriched our lives andwhose support is more reliable than a fine timepiece.

CONTENTSPracticePlanners Series PrefaceAcknowledgmentsxviiIntroductionxviiiSECTION I: Anger Management1Exercise I.AAlternatives to Destructive Anger2Exercise I.BAnger Journal8SECTION II: Antisocial Behavior13Exercise II.AHow I Have Hurt Others14Exercise II.BLetter of Apology17SECTION III: Anxiety20Exercise III.AAnalyze the Probability of a Feared Event21Exercise III.BPast Successful Anxiety Coping25SECTION IV: Attention Deficit Disorder (ADD)—Adult27Exercise IV.AProblem Solving: An Alternative to Impulsive Action28Exercise IV.BSymptoms and Fixes for ADD32SECTION V: Borderline Personality35Exercise V.AJournal and Replace Self-Defeating Thoughts36Exercise V.BPlan Before Acting43SECTION VI: Chemical Dependencexxv46Exercise VI.AAftercare Plan Components47Exercise VI.BRelapse Triggers51Exercise VI.CSubstance Abuse Negative Impact VersusSobriety’s Positive Impact55

CONTENTSSECTION VII: Chemical Dependence—Relapsexi60Exercise VII.AEarly Warning Signs of Relapse61Exercise VII.BIdentifying Relapse Triggers and Cues65Exercise VII.CRelapse Prevention Planning70Exercise VII.DRelapse Symptom Line74SECTION VIII: Childhood Trauma77Exercise VIII.AChanging from Victim to Survivor78Exercise VIII.BFeelings and Forgiveness Letter82SECTION IX: Chronic PainExercise IX.A85Pain And Stress JournalSECTION X: Cognitive Deficits8692Exercise X.AMemory Aid—Personal Information Organizer93Exercise X.BMemory Enhancement Techniques98SECTION XI: Dependency100Exercise XI.AMaking Your Own Decisions101Exercise XI.BSatisfying Unmet Emotional Needs104Exercise XI.CTaking Steps Toward Independence108SECTION XII: Depression110Exercise XII.AIdentify and Schedule Pleasant Activities111Exercise XII.BNegative Thoughts Trigger Negative Feelings114Exercise XII.CPositive Self-Talk119SECTION XIII: Dissociation121Exercise XIII.ADescribe the Trauma122Exercise XIII.BStaying Focused on the Present Reality126SECTION XIV: Eating DisorderExercise XIV.AExercise XIV.B128A Reality Journal: Food, Weight, Thoughts,and Feelings129How Fears Control My Eating134SECTION XV: Educational Deficits137Exercise XV.AMy Academic and Vocational Strengths138Exercise XV.BThe Advantages of Education141

xiiCONTENTSSECTION XVI: Family Conflict143Exercise XVI.AApplying Problem-Solving to Interpersonal Conflict144Exercise XVI.BA Structured Parenting Plan148SECTION XVII: Female Sexual Dysfunction152Exercise XVII.AFactors Influencing Negative Sexual Attitudes153Exercise XVII.BStudy Your Body: Clothed and Unclothed157SECTION XVIII: Financial StressExercise XVIII.APlan A BudgetSECTION XIX: Grief / Loss Unresolved160161164Exercise XIX.ACreating a Memorial Collage165Exercise XIX.BDear : A Letter to a Lost Loved One168SECTION XX: Impulse Control DisorderExercise XX.AImpulsive Behavior JournalSECTION XXI: Intimate Relationship Conflicts171172178Exercise XXI.AHow Can We Meet Each Other’s Needs and Desires?179Exercise XXI.BPositive and Negative Contributions to theRelationship: Mine And Yours184SECTION XXII: Legal Conflicts187Exercise XXII.AAccept Responsibility for Illegal Behavior188Exercise XXII.BCrooked Thinking Leads to Crooked Behavior191SECTION XXIII: Low Self-Esteem193Exercise XXIII.AAcknowledging My Strengths194Exercise XXIII.BReplacing Fears with Positive Messages197SECTION XXIV: Male Sexual DysfunctionExercise XXIV.AJournaling the Response to Nondemand, SexualPleasuring (Sensate Focus)SECTION XXV: Mania or HypomaniaExercise XXV.A201202209Recognizing the Negative Consequences ofImpulsive Behavior210Exercise XXV.BWhat Are My Good Qualities?214Exercise XXV.CWhy I Dislike Taking My Medication218

CONTENTSSECTION XXVI: Medical Issuesxiii220Exercise XXVI.AHow I Feel About My Medical Treatment221Exercise XXVI.BThe Impact of My Illness224SECTION XXVII: Obsessive-Compulsive Disorder (OCD)227Exercise XXVII.AMaking Use of the Thought-Stopping Technique228Exercise XXVII.BReducing The Strength of Compulsive Behaviors232SECTION XXVIII: PanicExercise XXVIII.A235Monitoring My Panic Attack ExperiencesSECTION XXIX: Paranoid IdeationExercise XXIX.ACheck Suspicions Against RealitySECTION XXX: Parenting236238239241Exercise XXX.ALearning to Parent as a Team242Exercise XXX.BUsing Reinforcement Principles in Parenting246SECTION XXXI: Phase of Life Problems250Exercise XXXI.AWhat Needs to be Changed in My Life?251Exercise XXXI.BWhat’s Good About Me and My Life?254SECTION XXXII: Phobia256Exercise XXXII.AFour Ways to Reduce Fear257Exercise XXXII.BGradually Reducing Your Phobic Fear261SECTION XXXIII: Posttraumatic Stress Disorder (PTSD)264Exercise XXXIII.AHow the Trauma Affects Me265Exercise XXXIII.BShare the Painful Memory267SECTION XXXIV: PsychoticismExercise XXXIV.AWhat Do You Hear and See?SECTION XXXV: Sexual AbuseExercise XXXV.AExercise XXXV.B270271273A Blaming Letter and a Forgiving Letterto Perpetrator274Picturing the Place of the Abuse277

xivCONTENTSSECTION XXXVI: Sexual Identity Confusion279Exercise XXXVI.AJournal of Sexual Thoughts, Fantasies, Conflicts280Exercise XXXVI.BTo Whom and How to Reveal My Homosexuality286SECTION XXXVII: Sleep DisturbanceExercise XXXVII.ASleep Pattern RecordSECTION XXXVIII: Social DiscomfortExercise XXXVIII.ARestoring Socialization ComfortSECTION XXXIX: SomatizationExercise XXXIX.AControlling the Focus on Physical ProblemsSECTION XL: Spiritual ConfusionExercise XL.AMy History of SpiritualitySECTION XLI: Suicidal Ideation290291296297299300303304307Exercise XLI.AJournal of Distorted, Negative Thoughts308Exercise XLI.BThe Aftermath of Suicide312SECTION XLII: Type A BehaviorExercise XLII.ADeveloping Noncompetitive ValuesSECTION XLIII: Vocational StressExercise XLIII.AA Vocational Action Plan315316318319Appendix: Additional Assignments for Presenting Problems321About the CD-ROM329

PRACTICEPLANNERS SERIES PREFACEThe practice of psychotherapy has a dimension that did not exist 30, 20, or even 15 yearsago—accountability. Treatment programs, public agencies, clinics, and even group andsolo practitioners must now justify the treatment of patients to outside review entitiesthat control the payment of fees. This development has resulted in an explosion of paperwork. Clinicians must now document what has been done in treatment, what is plannedfor the future, and what the anticipated outcomes of the interventions are. The books andsoftware in this PracticePlanners series are designed to help practitioners fulfill thesedocumentation requirements efficiently and professionally.The PracticePlanners series has grown rapidly. It now includes not only the original Complete Adult Psychotherapy Treatment Planner, Third Edition, The Child Psychotherapy Treatment Planner, Third Edition, and The Adolescent Psychotherapy Treatment Planner, Third Edition, but also Treatment Planners targeted to specialty areas ofpractice, 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, neuropsychology, therapy with gays and lesbians, special education, school counseling, probation andparole, therapy with sexual abuse victims and offenders, and more.Several of the Treatment Planner books now have companion Progress Notes Planners (e.g., Adult, Adolescent, Child, Addictions, Severe and Persistent Mental Illness,Couples). These planners provide a menu of progress statements that elaborate on theclient’s symptom presentation and the provider’s therapeutic intervention. Each ProgressNotes Planner statement is directly integrated with Behavioral Definitions and Therapeutic Interventions items from the companion Treatment Planner.The list of therapeutic Homework Planners is also growing from the original Homework Planner for Adults, to Adolescent, Child, Couples, Group, Family, Addictions, Divorce, Grief, Employee Assistance, and School Counseling / School Social Work HomeworkPlanners. Each of these books can be used alone or in conjunction with their companionTreatment Planner. Homework assignments are designed around each presenting problem (e.g., Anxiety, Depression, Chemical Dependence, Anger Management, Panic, EatingDisorders) that is the focus of a chapter in its corresponding Treatment Planner.Client Education Handout Planners, a new branch in the series, provide brochuresand handouts to help educate and inform adult, child, adolescent, couples, and familyclients on a myriad of presenting problems mental health issues, as well as life skillstechniques. The list of presenting problems for which information is provided mirrorsthe list of presenting problems in the Treatment Planner of the title similar to that of thexv

xviPRACTICEPLANNERS SERIES PREFACEHandout Planner. Thus, the problems for which educational material is provided in theChild and Adolescent Client Education Handout Planner reflect the presenting problemslisted in The Child and The Adolescent Psychotherapy Treatment Planner books. Thehandouts are included on CD-ROMs for easy printing from your computer and are idealfor use in waiting rooms, at presentations, as newsletters, or as information for clientsstruggling with mental illness issues.In addition, the series also includes TheraScribe , the latest version of the populartreatment planning, clinical record-keeping software. TheraScribe allows the user to import the data from any of the Treatment Planner, Progress Notes Planner, or HomeworkPlanner books into the software’s expandable database. Then the point-and-click methodcan create a detailed, neatly organized, individualized, and customized treatment planalong with optional integrated progress notes and homework assignments.Adjunctive books, such as The

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