#### III. Individual/Conjoint Sessions

#### Introduction

#### 

#### *Goals of Individual/Conjoint Sessions*

-   Provide clients and their families with an opportunity to establish
    an individualized connection with the counselor and learn about
    treatment.

-   Provide a setting where clients and their families can, with the
    counselor's guidance, work out crises, discuss issues, and determine
    the continuing course of treatment.

-   Allow clients to discuss their addiction openly in a nonjudgmental
    context with the full attention of the counselor.

-   Provide clients with reinforcement and encouragement for positive
    changes.

#### 

#### *Session Guidelines*

Three individual sessions are scheduled in the Matrix Intensive
Outpatient Treatment for People With Stimulant Use Disorders (IOP)
model. These sessions are 50 minutes long. The initial session orients
the client to treatment, and the final session helps the client plan for
posttreatment recovery; these are the first and last sessions of the
client's Matrix IOP experience. The remaining session should be
scheduled 5 or 6 weeks into treatment or when a client has relapsed or
is experiencing a crisis. This session focuses on assessing the client's
progress, supporting successes, and providing resources to keep recovery
strong. Whenever possible, the counselor should involve the client's
family or other significant and supportive persons in the individual
sessions; these are called conjoint sessions. Substance abuse can place
a family in crisis. The counselor should be mindful that violence can
erupt in this kind of environment. A concern for the safety of the
client and the family members involved in treatment should be foremost
in the counselor's mind.

Starting individual sessions on time is important. The client should
feel that the visit is an important part of the counselor's day. The
counselor should try to accommodate the client by scheduling individual
sessions at convenient times.

Generally, the counselor sees each client alone for the first half of
the session and then invites family members to join the client for the
second half. This arrangement should be communicated to the client and
family members before they arrive for the sessions so that family
members can bring along something to occupy them for the first 25
minutes of the session.

***Session Format and Counseling Approach***

The connection between the client and counselor is the most important
bond that develops in treatment. The counselor should use common sense,
courtesy, compassion, and respect in interacting with the client and
family members.

# Session 1: Orientation 

The client's family members may be included for the orientation portion
of the first session. Family members are informed of how the Matrix IOP
approach works and what is expected of the client. The counselor also
explains how family members can support the client's recovery and
answers questions the client or family members have.

*Session 2: Client Progress/Crisis Intervention*

During the second session, the counselor ensures that the client and
family members have an opportunity to describe urgent issues and to
discuss emotionally charged topics. During the first portion of the
session, when the counselor meets alone with the client, the counselor
determines whether urgent issues, such as strong cravings or a relapse,
need to be addressed immediately. If a crisis needs to be addressed, the
counselor may want to bring the family members into the session earlier
than the halfway point.

If the client's recovery is going well, the counselor introduces the
scheduled material for the session. Any positive changes in the client's
behavior or attitude need to be strongly reinforced. For example, a
client who has done a good job of stopping drug and alcohol use,
scheduling, and attending group sessions, but who has not exercised,
needs to be given unqualified reinforcement for the accomplishments. The
counselor should mention that the client would benefit from exercise,
but the counselor should not engage in a struggle over one area of
resistance.

*Session 3: Continuing Treatment Planning*

The final Individual/Conjoint session is also one of the final sessions
of Matrix intensive outpatient treatment. The counselor reviews the
client's treatment experience and underscores the importance of recovery
activities (e.g., scheduling, exercise, regularly attending a 12-Step
program) that help prevent relapse. The counselor works through a
goal-setting exercise with the client and helps the client plan steps
that will make the goals attainable. The client is encouraged to work on
issues that may have been put on hold during treatment, such as couples
or family therapy.

#### Session 1: Orientation

## Goals of Session 

-   Help clients understand what is expected of them during treatment.

-   Orient clients and their family members to the Matrix IOP approach.

-   Help clients make a treatment schedule.

-   Enlist family members' help in supporting clients' recovery.

## 

## Handout

-   IC 1---Sample Service Agreement and Consent

## Session Content

This session is conducted before the first group session and gives the
client and family members an opportunity to meet the counselor and learn
about the program. The counselor also uses this session to ensure that
the client and family members are oriented properly to treatment. At
this session, the counselor gives each client a copy of the *Client's
Treatment Companion.* Programs should not distribute the *Client's
Handbook* during the orientation session. Clients receive the *Client's
Handbook* during the first group session. Clients have their own copies
and make personal use of them but should not take them home. Programs
collect and store the handbooks in a secure location until clients
return for the next group session. (Programs may choose to give clients
photocopies of the handouts from the *Client's Handbook,* rather than
provide an individual copy of the book to each client.)

After greeting the client and family members, the counselor gives them a
brief overview of the Matrix IOP model. This overview takes about 10
minutes and includes the following:

-   A general introduction to the principles on which the Matrix IOP
    model is based (see Section I)

-   A description of the various components of the Matrix IOP model

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-   Individual/Conjoint group sessions

-   Early Recovery Skills group sessions

-   Relapse Prevention group sessions

-   Social Support group sessions

-   Urine and breath tests

-   12-Step or mutual-help group attendance

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-   A program schedule that shows the client and family members what a
    typical week of the Matrix IOP intervention looks like and how
    sessions change as the client moves through treatment (see Figure
    I-1 in Section I)

The counselor brings to the session a list of the program's Matrix IOP
meetings and times. With the counselor's help, each client selects a
schedule. The counselor then provides a copy of this schedule to the
client. The goal is for the client to leave the session with a copy of
the schedule and a clear idea of what the next steps are.

The counselor gives the client a copy of the program's service agreement
and consent form. (Handout IC 1---Sample Service Agreement and Consent
is provided as an example of such a form; programs are free to use or
adapt this form if they do not have service agreement and consent forms
of their own.) The counselor reads aloud while the client and family
members follow along. It is important for the counselor to take time
going over this document; the counselor should pause after each numbered
item on the form to be sure the client understands what he or she is
initialing. The counselor should ensure that the client understands the
consequences for not abiding by the agreement.

The counselor allows ample time for questions during and at the end of
the session. It is imperative that the client and family members feel
knowledgeable about and comfortable with the Matrix IOP approach.

**Session 2: Client Progress/Crisis Intervention**

## Goals of Session

-   Help clients assess progress.

-   Help clients address any crises they may be experiencing.

-   Reinforce recovery principles clients have learned in treatment.

## 

## Handouts

-   IC 2A---Recovery Checklist

-   IC 2B---Relapse Analysis Chart

## Session Content

The second Individual/Conjoint session is conducted about 5 or 6 weeks
after a client enters treatment. The counselor begins the session by
briefly discussing with the client how the recovery is progressing. At
this point, the session can take one of two different directions,
depending on the client's response:

-   If the client's recovery is on track, this session is used to assess
    progress, review relapse prevention skills, give positive
    reinforcement for the client's successes, and identify areas in
    which the client can improve. The client completes handout IC
    2A---Recovery Checklist. The counselor either reads the handout with
    the client or gives the client a few minutes to complete it.

> The counselor reviews the client's answers with the client. It is
> important that the counselor praise the client's progress before
> moving on to the final two questions on the handout, which address
> relapse prevention activities the client may be struggling to
> implement. The counselor may wish to make reference to Early Recovery
> Skills and Relapse Prevention session descriptions or handouts when
> reviewing recovery skills with the client. Useful session descriptions
> and handouts include

-   Early Recovery Skills sessions 1, 2, 3, 6, and 7 (in Section IV)

-   Handout IC 2B (in this section)

-   Handouts ERS 3B, 5, 6A, 6B, and 7B (in Section IV)

-   Handout SCH 1 (in Section IV)

-   Relapse Prevention sessions 3, 7, 11, 13, 16, 18, and 21 (in Section
    V)

-   Handouts RP 3A, 3B, 4, 8, 12, 13, 17, 19, and 22 (in Section V)

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-   If the client has been struggling with recovery or is experiencing a
    personal crisis, the counselor spends the session addressing these
    issues, allowing time for the client to talk about what is going on
    and, when appropriate, developing a plan to help the client maintain
    or get back to recovery. If a client recently has had a relapse or
    feels that a relapse is imminent, the client completes handout IC
    2B---Relapse Analysis Chart. The counselor can read the handout with
    the client or give the client a few minutes to complete it. The goal
    of completing this sheet and discussing it is to sensitize the
    client to the events and feelings that precede a relapse. The
    counselor may wish to refer to the notion of "mooring lines" that
    keep recovery anchored, as discussed in Relapse Prevention session 3
    (Avoiding Relapse Drift) and its accompanying handouts, RP 3A and
    3B. The session descriptions and handouts listed above also may make
    the client aware of the subtle ways in which behavior can imperil
    recovery.

> Relapse does not occur suddenly or unpredictably, although it often
> feels that way to the client. The counselor needs to help the client
> understand the context of the relapse. Handout IC 2B---Relapse
> Analysis Chart helps the client see relapse as an event that both has
> antecedents and can be avoided. Many people who successfully complete
> outpatient treatment experience a relapse at some point in the
> process. The critical issue is whether the client continues the
> recovery process following the relapse. The counselor should stress to
> the client that relapse does not indicate failure; it should be viewed
> as an indication that the treatment plan needs adjusting.

**Session 3: Continuing Treatment Planning**

## Goals of Session

-   Help clients evaluate their progress in recovery.

-   Help clients set continuing treatment goals.

-   Help clients draft a continuing treatment plan.

***Handouts***

-   Handout IC 3A---Treatment Evaluation

-   Handout IC 3B---Continuing Treatment Plan

***Session Content***

The final Individual/Conjoint session is scheduled when the client is
about to complete or after he or she has completed 16 weeks of the
Matrix IOP intervention (i.e., after clients have completed Family
Education and Relapse Prevention sessions). The counselor begins the
discussion by asking the client general questions about the treatment
experience:

-   What aspects of treatment have been most helpful?

-   Were there parts of treatment that have not been helpful? What were
    they?

-   What would you change about treatment, if you could?

-   How are you a different person now than you were when you entered
    treatment?

-   Have you started attending Social Support group sessions? How have
    they helped you?

The counselor then works with the client to complete handout IC
3A---Treatment Evaluation, addressing the eight categories listed on the
left side of the handout and helping the client evaluate behavioral
changes, current status, and hoped-for progress. Examining the
discrepancy between the client's current situations and the goals often
generates motivation for the client to formulate steps to reach the
desired goals. The counselor encourages the client to make the goals
realistic and helps the client set realistic timetables for achieving
the goals.

After the client has identified goals and established timetables, the
counselor goes over handout IC 3B---Continuing Treatment Plan, stressing
the importance of ongoing therapy and attending Social Support group
sessions and 12-Step or mutual-help meetings. The counselor should think
of this session as the final opportunity for case management. Earlier
group sessions underscored the importance of continuing with 12-Step or
mutual-help meetings after the end of treatment. During those sessions,
the counselor provided the client with a list of local meetings and
discussed ways to facilitate the client's attendance. The counselor
should provide the client with another copy of the list of meetings and
discuss in detail the client's plans for attending meetings.

The client uses items from handout IC 3A---Treatment Evaluation to draft
a continuing recovery plan at the end of handout IC 3B---Continuing
Treatment Plan. The counselor assists the client in writing this plan.
The counselor helps the client finish treatment with a clear
understanding of how to maintain recovery, with short- and long-term
recovery goals and with a realistic plan for accomplishing those goals.

**Handouts for Individual/Conjoint Sessions**

The handouts that follow are to be used by the client and the counselor
to make the most of the three Individual/Conjoint sessions.

### **IC 1---Sample Service Agreement and Consent**

\[Each program uses an agreement and consent form that it has developed
to meet its particular needs. This form is provided as a sample.\]

It is important that you understand the kinds of services you will be
provided and the terms and conditions under which these services will be
offered.

I, , am requesting treatment from the staff of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
As a condition of that treatment, I acknowledge the following items and
agree to them. (Please initial each item.)

**I understand:**

1\. The staff believes that the outpatient treatment strategies the
program uses provide a useful intervention for chemical dependence
problems; however, no specific outcome can be guaranteed.

2\. Treatment participation requires some basic ground rules. These
conditions are essential for a successful treatment experience.
Violation of these rules can result in treatment termination.

**I agree to the following:**

> a\. It is necessary to arrive on time for appointments. At each visit
> I will be prepared to take urine and breath-alcohol tests.
>
> b\. Conditions of treatment require *abstinence from all drug and
> alcohol use for the entire duration of the treatment program*. If I am
> unable to make this commitment, I will discuss other treatment options
> with the program staff.
>
> c\. I will discuss any drug or alcohol use with the staff and group
> while in treatment.
>
> d\. Treatment consists of individual and group sessions. Individual
> appointments can be rescheduled, if necessary. *I understand that
> group appointments cannot be rescheduled and attendance is extremely
> important.* I will notify the counselor in advance if I am going to
> miss a group session. Telephone notification may be made for
> last-minute absence or lateness.
>
> e\. Treatment will be terminated if I attempt to sell drugs or
> encourage drug use by other clients.
>
> f\. I understand that graphic stories of drug or alcohol use will not
> be allowed.
>
> g\. I agree not to become involved romantically or sexually with other
> clients.
>
> > h\. I understand that it is not advisable to be involved in any
> > business transactions with other clients.
>
> i\. I understand that all matters discussed in group sessions and the
> identity of all group members are absolutely confidential. I will not
> share this information with nonmembers.
>
> j\. All treatment is voluntary. If I decide to terminate treatment, I
> will discuss this decision with the staff.

3\. Staff: Services are provided by psychologists, licensed marriage and
family counselors, master's-level counselors-in-training, or other
certified addiction staff people. All nonlicensed counselors are
supervised by a licensed counselor trained in the treatment of
addictions.

4\. Consent to Videotape/Audiotape: To help ensure the high quality of
services provided by the program, therapy sessions may be audiotaped or
videotaped for training purposes. The client and, if applicable, the
client's family consent to observation, audiotaping, and videotaping.

5\. Confidentiality: All information disclosed in these sessions is
strictly confidential and may not be revealed to anyone outside the
program staff without the written permission of the client or the
client's family. The only exceptions are when disclosures are required
or permitted by law. Those situations typically involve substantial risk
of physical harm to oneself or to others or suspected abuse of children
or the elderly.

6\. Accomplishing treatment goals requires the cooperation and active
participation of clients and their families. Very rarely, lack of
cooperation by a client may interfere substantially with the program's
ability to render services effectively to the client or to others. Under
such circumstances, the program may discontinue services to the client.

+-----------------------------------------------------------------------+
| I certify that I have read, understand, and accept this Service       |
| Agreement and Consent. This agreement and consent covers the length   |
| of time I am involved in treatment activities at this facility.       |
|                                                                       |
| Client's Signature: Date:                                             |
+-----------------------------------------------------------------------+

##   {#section-4 .unnumbered}

## IC 2A---Recovery Checklist

Outpatient treatment requires a great deal of motivation and commitment.
To get the most from treatment, it is necessary for you to replace many
old habits with new behaviors.

**Check all the things that you do regularly or have done since entering
treatment:**

\_\_\_\_\_ **Schedule activities daily**

\_\_\_\_\_ **Visit physician for checkup**

\_\_\_\_\_ **Destroy all drug paraphernalia**

\_\_\_\_\_ **Avoid people who use alcohol**

\_\_\_\_\_ **Avoid people who use drugs**

\_\_\_\_\_ **Avoid bars and clubs**

\_\_\_\_\_ **Stop using alcohol**

\_\_\_\_\_ **Stop using all drugs**

\_\_\_\_\_ **Pay financial obligations promptly**

\_\_\_\_\_ **Identify addictive behaviors**

\_\_\_\_\_ **Avoid triggers (when possible)**

\_\_\_\_\_ **Use thought stopping for cravings**

\_\_\_\_\_ **Attend Individual/Conjoint sessions**

\_\_\_\_\_ **Attend Early Recovery Skills and**

**Relapse Prevention sessions**

\_\_\_\_\_ **Attend 12-Step or mutual-help**

**meetings**

\_\_\_\_\_ **Get a sponsor**

\_\_\_\_\_ **Exercise daily**

\_\_\_\_\_ **Discuss thoughts, feelings,**

**and behaviors honestly with your**

**counselor**

**What other behaviors have you decided to start since you entered
treatment?**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Which behaviors have been easy for you to do?**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Which behaviors take the most effort for you to do?**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Which behavior have you not begun yet? What might need to change for
you to begin this behavior?**

**Behavior Not Begun Change Needed**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# **IC 2B---Relapse Analysis Chart**

Name:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date of
Relapse:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

A relapse episode does not begin when you take a drug. Often, things
that happen *before* you use indicate the beginning of a relapse.
Identifying your patterns of behavior will help you recognize and
interrupt the relapse. Using the chart below, note events that occurred
during the week immediately before the relapse.

+---------+---------+---------+---------+---------+---------+---------+
| ###     | ###     | **Tr    | **Drug- | **Beh   | **      | ###     |
|         |         | eatment | Related | avioral | Relapse |         |
| ### **C | ##      | E       | Beha    | Pat     | Tho     | #       |
| areer E | # **Per | vents** | viors** | terns** | ughts** | ## **He |
| vents** | sonal E |         |         |         |         | alth St |
|         | vents** |         |         |         |         | atus**  |
+---------+---------+---------+---------+---------+---------+---------+
|         |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+

+---------+---------+---------+---------+---------+---------+---------+
| ###     |         |         |         |         |         |         |
| **Feeli |         |         |         |         |         |         |
| ngs abo |         |         |         |         |         |         |
| ut the  |         |         |         |         |         |         |
| above e |         |         |         |         |         |         |
| vents** |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
|         |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+

**IC 3A---Treatment Evaluation**

Recovery requires specific actions and behavioral changes in many areas
of life. Before you end your treatment, it is important to set new goals
and plan for a different lifestyle. This guide will help you develop a
plan and identify the steps necessary for reaching your goals. Write
your current status and goals for the areas of life listed in the left
column.

+----------+------------+-----------------+--------------------+------+
| **S      | **Where    | **Where would   | **What steps do    | ##   |
| ubject** | are you    | you like to     | you need to        | ## W |
|          | now?**     | be?**           | take?**            | hen? |
+----------+------------+-----------------+--------------------+------+
| **       |            |                 |                    |      |
| Family** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| **Work/  |            |                 |                    |      |
| Career** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| **Frien  |            |                 |                    |      |
| dships** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| **Fi     |            |                 |                    |      |
| nancial, |            |                 |                    |      |
| Legal    |            |                 |                    |      |
| Oblig    |            |                 |                    |      |
| ations** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+

+----------+------------+-----------------+--------------------+------+
| **S      | **Where    | **Where would   | **What steps do    | *    |
| ubject** | are you    | you like to     | you need to        | *Whe |
|          | now?**     | be?**           | take?**            | n?** |
+----------+------------+-----------------+--------------------+------+
| **Edu    |            |                 |                    |      |
| cation** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| **Ex     |            |                 |                    |      |
| ercise** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| *        |            |                 |                    |      |
| *Leisure |            |                 |                    |      |
| Acti     |            |                 |                    |      |
| vities** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| *        |            |                 |                    |      |
| *12-Step |            |                 |                    |      |
| or       |            |                 |                    |      |
| Mut      |            |                 |                    |      |
| ual-Help |            |                 |                    |      |
| Me       |            |                 |                    |      |
| etings** |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+
| \_       |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_       |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_       |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_       |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
| \_\_\_\_ |            |                 |                    |      |
|          |            |                 |                    |      |
| Client's |            |                 |                    |      |
| S        |            |                 |                    |      |
| ignature |            |                 |                    |      |
| Date     |            |                 |                    |      |
| Cou      |            |                 |                    |      |
| nselor's |            |                 |                    |      |
| S        |            |                 |                    |      |
| ignature |            |                 |                    |      |
| Date     |            |                 |                    |      |
+----------+------------+-----------------+--------------------+------+

##### IC 3B---Continuing Treatment Plan

Recovery is a lifelong process. You can stop drug and alcohol use and
begin a new lifestyle during the first 4 months of treatment. Developing
an awareness of what anchors your recovery is an important part of that
process. But this is only the beginning of your recovery. As you move
forward with your recovery after treatment, you will need a lot of
support. And you may need different kinds of support than you did during
treatment. You and your counselor can use the information below to help
you decide how best to support your recovery.

**Group Work**

You should participate in at least one regular recovery group every week
after treatment. The program offers a Social Support group that meets
once a week. Other recovery groups are often available in the community.
Ask your counselor about local recovery groups.

**Individual Therapy**

Individual sessions with an addiction counselor might be helpful. When
your current treatment ends, you have choices about continuing with
therapy. You may choose this time to enter therapy with another
professional. You may want to return to therapy with the professional
who referred you for the Matrix IOP method. Or you may choose to
continue to see your current Matrix IOP counselor.

**Couples Therapy**

It is often a good idea at this point for couples to begin seeing a
marriage counselor together to work on relationship issues.

**12-Step or Mutual-Help Meetings**

Attendance at a 12-Step or mutual-help meeting is a critical part of the
recovery process. It is essential to find a meeting that you will attend
regularly.

**My plan for the months following treatment is:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

### 

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

### Client's Signature Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Counselor's Signature Date