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78 CHILDHOOD TRAUMAEXERCISE VIII. A CHANGING FROM VICTIM TO SURVIVOR It is natural to view yourself as a victim and to experience all of the feelings and attitudes that accompany that victim status when the abuse has only recently occurred or there has been no opportunity for working through the emotions and thoughts connected to the abuse. It takes time and effort to move from the status of being a victim to becoming a survivor. The feelings and thoughts associated with being a victim are overwhelmingly negative and self-defeating. The feelings and thoughts associated with being a survivor, on the other hand, are more positive, forward looking, and confi dent. While it is natural and expected that everyone who has been exposed to abuse starts with feeling like a vic-tim, realization of the potential of this person can only be achieved if their status changes to that of becoming a survivor. This exercise will help you understand the differences between victims and survivors and help you defi ne your own current status. 1. The following words or phrases describe either a victim or a survivor, but they are presented to you in a jumbled and mixed-up order. Your task is to look at each word or phrase and rewrite it under the column labeled “Victim” or the column labeled “Survivor. ” You will have to sort through the list to fi nally end up with a profi le of words that describe the victim and words that describe a survivor. List of Descriptors Depressed Preoccupied with trauma Has overcome pain Enjoys living Blames perpetrator Lives in the past Pessimistic Wants understanding Hopeless Enjoys people Empowered Letting go of anger Trauma is in perspective Growing in trust Defeated No energy Lives in the present and future Dominated by fear Helpless More smiles than tears Hopeful Distrustful Withdrawn socially Bitter Optimistic Confi dent Ashamed Renewed energy Needs sympathy Focused on the pain | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHILDHOOD TRAUMA 79Victim Survivor 2. As you look through your list of words and phrases that describe both the victim and the survivor, do you see yourself more as a victim or as a survivor? Why? 3. Which three of the descriptor words or phrases are the most accurate in describing you and your current status? 4. What three words or phrases were most accurate in describing you as a child after the trauma occurred? 5. What three words or phrases best described you a year ago before you began the journey toward becoming a survivor? EXERCISE VIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
80 CHILDHOOD TRAUMA6. On a scale of 1 to 5, rate your degree of feeling like a victim (1) or a survivor (5). 1 234 5 Victim Survivor 7. What has helped you the most in moving from being a victim to becoming a survi-vor? EXERCISE VIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHILDHOOD TRAUMA 81Therapist's Overview FEELINGS AND FORGIVENESS LETTER GOALS OF THE EXERCISE 1. Increase feelings of empowerment and self-worth. 2. Clarify feelings regarding the childhood traumatic experiences of abuse or neglect. 3. Clarify feelings toward the perpetrator of the childhood abuse or neglect. 4. Increase the level of forgiveness toward the perpetrator and others associated with the childhood trauma. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Low Self-Esteem Posttraumatic Stress Disorder (PTSD) Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise should be assigned in the later stages of therapy after the client has al-ready verbalized and worked through many of his / her feelings surrounding the child-hood experiences of abuse or neglect. The client must be ready to offer forgiveness to the perpetrator or signifi cant others and should not be forced into this stage of counseling prematurely. Encourage the client to honestly answer the questions that are meant to help organize his / her thoughts or feelings before writing the actual letter. Some of the questions may not be relevant to a particular client and he / she should exercise his / her judgment about answering them. Be sure to remind the client to return the letter to you for further processing before making any decision about sharing it with the perpetrator or any signifi cant others. The letter may also be used as a basis for a conjoint session with the perpetrator or other family members if that seems clinically appropriate. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
82 CHILDHOOD TRAUMAEXERCISE VIII. B FEELINGS AND FORGIVENESS LETTER In this exercise, you are asked to write a letter of feelings and forgiveness to the perpetra-tor or other important people connected with your childhood abuse or neglect. You have been given this assignment because you have already done much hard work. You have been able to identify, verbalize, and work through many of your thoughts and feelings surrounding the childhood abuse or neglect. At this point, you are now much stronger emotionally and are ready to offer forgiveness to the perpetrator or signifi cant others as-sociated with your experiences of childhood abuse or neglect. Before you begin to write the actual letter, please respond to the questions that follow. These questions will help you organize your thoughts and feelings before you write the letter to the perpetrator or signifi cant others. You may fi nd that some of the questions do not apply to you; therefore, leave these items blank. Space is also provided for you at the end of this assignment where you may express any additional thoughts or feelings you may want to include in your letter. Feel free to write down whatever thoughts or feelings come into your mind as you respond to these questions. 1. What impact has the experience of childhood trauma had on your life as an adult? 2. What feelings did you have as a child toward the perpetrator of the childhood abuse or neglect that you suffered? 3. How did the abuse or neglect make you feel about yourself as a child? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHILDHOOD TRAUMA 834. How do you feel about yourself as an adult now that you have worked through some of the pain associated with your childhood abuse or neglect? 5. What are your present feelings toward the perpetrator of your childhood abuse or neglect? 6. What are your feelings about other signifi cant people in the family who witnessed the abuse or neglect but did nothing to stop it? 7. What changes have occurred within you that make it possible for you to consider forgiving the perpetrator or other signifi cant persons? 8. What, if anything, has the perpetrator or other signifi cant persons said or done that has allowed you to consider forgiveness of them? 9. Why are you choosing to begin the process of forgiveness toward the perpetrator or other signifi cant others? EXERCISE VIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
84 CHILDHOOD TRAUMA10. How would you characterize your present relationship with the perpetrator? 11. How would you characterize your relationship with other family members? 12. Use the following space to express any other thoughts or feelings that you have about your childhood trauma, yourself, the perpetrator, family members, or the future. 13. Review your responses to the questions and then write your letter on a separate piece of paper. Be sure to include your recollection of the facts of the abuse or neglect, how the experience made you feel as a child, how you feel toward yourself as an adult as a result of the trauma, how you have felt toward the perpetrator, your current reason for wanting to begin the process of forgiveness, and what type of relationship (if any) you see in the future with the perpetrator and other family members. Even if the perpetrator is deceased or unavailable for any relationship in the future, writing this letter can still be very benefi cial in terms of your own growth and freedom from bitterness. Bring the completed letter to your next therapy session to review it with your therapist. You will have several options to consider about what you want to do with the letter: You may want to destroy it; you may want to save it; you may want to share the letter with the perpetrator or other signifi cant persons through sending it or reading to them in person. Your therapist can help you reach your decision about these options. EXERCISE VIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHRONIC PAIN 85Therapist's Overview PAIN AND STRESS JOURNAL GOALS OF THE EXERCISE 1. Discover the relationship between stress, muscle tension, and increased pain levels. 2. Identify any patterns of times, places, or activities that trigger increased pain. 3. Identify sources of stress that are associated with increased pain. 4. Identify patterns of relief activities that are commonly being used to reduce pain or stress. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Medical Issues Phase of Life Problems Somatization SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Review the form for collection of data when this assignment is given to the client. Answer any questions about the type of data that the form requests. Review the completed form with the client to discover any patterns of the place, activity, or time that is associated with increased pain experiences. Also note how stress levels may be associated with in-creased pain. Review the sources of stress that may be triggering pain and prepare the client for training in stress management techniques focused on these sources of stress. Be alert for any adaptive stress reduction techniques the client is currently using so that they can be reinforced. SECTION IX: CHRONIC PAIN | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
86 CHRONIC PAINEXERCISE IX. A PAIN AND STRESS JOURNAL Chronic pain is both a producer of stress and exacerbated by stress. It is important for people suffering from chronic pain to recognize this fact and attempt to minimize the amount of stress in their lives and to develop effective coping skills and techniques to re-duce stress that cannot be avoided. The reduction of stress and its accompanying muscle tension will bring about increased pain management and control. This exercise will help you and your therapist discover when chronic pain seems to be most severe and the na-ture of the stressors that accompany or trigger the increase in pain. Keeping a journal is a diffi cult task that requires consistent discipline to make entries on a daily basis. The journal outline form is designed to help you focus your attention on pain and stress management during the treatment process. You are asked to make an entry at least once a day, beginning with writing the date and time in the lefthand column. You may make more than one entry if there are several instances of severe pain during 1 day. After entering the date and time, record where you were when the pain was severe under the Place heading. Next, record the degree of the pain on a scale of 1 to 100, with 100 being the most severe possible, under the Pain Severity heading. Next, record what it is you were doing while the pain increased in severity under the Activity heading. Record the degree of stress you feel you were under on a scale of 1 to 10, with 10 being the most severe stress in the Stress Severity heading. Next, record the reason you believe you were feeling so much stress under the Stress Source heading. Finally, record any actions you took to relieve the pain or reduce the stress under the Relief Actions heading (include any nonmedication or behavioral actions). Repeat these entries on a consistent daily basis and then bring the data to your counselor for review and processing. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHRONIC PAIN 87Entry 1 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions Entry 2 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions EXERCISE IX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
88 CHRONIC PAINEntry 3 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions Entry 4 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions EXERCISE IX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHRONIC PAIN 89Entry 5 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions Entry 6 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions EXERCISE IX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
90 CHRONIC PAINEntry 7 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions Entry 8 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions EXERCISE IX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
CHRONIC PAIN 91Entry 9 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions Entry 10 Place Date and Time: Pain Severity (1-100) Activity Stress Severity (1-10) Stress Source Relief Actions EXERCISE IX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
92 COGNITIVE DEFICITSTherapist's Overview MEMORY AID—PERSONAL INFORMATION ORGANIZER GOALS OF THE EXERCISE 1. Develop the habit of using coping strategies for memory defi cits. 2. Write down important information that must be remembered to maintain orienta-tion to person, place, and time. 3. Maintain a schedule and keep a history of activities of daily living. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Attention Defi cit Disorder (ADD)—Adult Depression Dissociation Phase of Life Problems Psychoticism SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Clients who experience memory defi cits related to brain trauma or to psychological issues (e. g., depression, ADD, dissociation) must use coping strategies to help them recall im-portant information and to keep themselves on a productive, structured schedule. These forms can be useful to provide structure to the client and reinforce the habit of writing down important information. You may want to recommend a wristwatch with an alarm feature that will remind the client to check the daily scheduler for an important activity to be completed. After a habit is established, the client could consider purchasing a more complete daily organizer. SECTION X: COGNITIVE DEFICITS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
COGNITIVE DEFICITS 93EXERCISE X. A MEMORY AID—PERSONAL INFORMATION ORGANIZER It is important and reassuring when we are accurately oriented to person, place, and time. When memory loss occurs, you must use coping strategies to help you remember in-formation about who you are, where you live, who are your supportive friends and family, what events are scheduled and have already occurred, and what activities are important for you to accomplish. Use the following guide to help you stay organized. 1. Identifying Personal Information Name: Address: Phone: Birth Date: Age: 2. Names of Supportive People in My Life Parent(s): Phone: Spouse / Partner: Phone: Brother(s): 1) Phone: 1A) 2) 2A) 3) 3A) | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
94 COGNITIVE DEFICITSSister(s): 1) Phone: 1A) 2) 2A) 3) 3A) Neighbor(s): 1) Address: 1A) Phone: 1B) 2) 2A) 2B) Friend(s): 1) Address: 1A) Phone: 1B) 2) 2A) 2B) 3) 3A) 3B) Phone for Police: Phone for Fire: 3. Plans for the Month Make a copy of this calendar page and write down your appointments for the month. Save your monthly calendars so you can look back to check what you have done in the past. Sunday Monday Tuesday Wednesday Thursday Friday Saturday EXERCISE X. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
COGNITIVE DEFICITS 954. Daily Schedule Write down your routine and nonroutine activities that are planned for the day. Make a copy of this page for your reminder or purchase a scheduling book like this. A. M. 7:00 4:30 7:30 5:00 8:00 5:30 8:30 6:00 9:00 6:30 9:30 7:00 10:00 7:30 10:30 8:00 11:00 8:30 11:30 9:00 P. M. 12:00 9:30 12:30 10:00 1:00 10:30 1:30 11:00 2:00 11:30 2:30 3:00 3:30 4:00 Activities of daily living you may include in your schedule: Bathe / shower Go to doctor appt. Brush teeth Grooming Call friend / family member Make bed Do laundry Pay bills Dust house Pick up house Eat breakfast Read e-mail Eat lunch Read paper Eat supper Run errand Get dressed Take medication Get out of bed Vacuum house Go grocery shopping Wash dishes Go to bed Watch T. V. EXERCISE X. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
96 COGNITIVE DEFICITS5. Projects I Need to Do Whenever you think of something specifi c that you must do, write it down and then put it into your schedule later. TO DO LIST: 6. Important Things to Remember Whenever you read or hear about something important to remember, write it down. DON'T FORGET: EXERCISE X. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
COGNITIVE DEFICITS 97Therapist's Overview MEMORY ENHANCEMENT TECHNIQUES GOALS OF THE EXERCISE 1. Learn the cognitive processes that increase the recall of information. 2. Apply the memorization techniques to personal life. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Attention Defi cit Disorder (ADD)—Adult SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT You may want to review and process these commonly used memorization techniques in session before asking the client to apply them to his / her daily life. Make suggestions to the client as to when the technique might be implemented. Help the client keep a positive attitude and try to reduce discouragement with his / her memory loss effects. Reinforce instances of the use of techniques to enhance memory. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
98 COGNITIVE DEFICITSEXERCISE X. B MEMORY ENHANCEMENT TECHNIQUES When memory loss occurs, it can be helpful to implement the use of memorization tech-niques that have proven to be effective over many years. Practice the use of the tech-niques described to improve your memory. 1. Chunking: Grouping information into chunks can be useful when trying to remem-ber a list. The items can be grouped into meaningful pieces. For example, 474965327 is easier to remember if you break the list into smaller groups, such as 474-965-327; or, TWANBCCBSCPRCIA is easier to recall if grouped into familiar chunks, such as TWA NBC CBS CPR CIA. List some examples of instances you could use chunking to help you recall information. A. B. C. 2. Associations: It is easier to recall something new if you relate it to or pair it with something you already know. For example, if you are trying to remember a person who was just introduced to you as “Holly Weames,” you might associate her as “Hal-loween” and picture her in your mind as having a costume on. List some examples of instances you could use association to help you recall informa-tion. A. B. C. 3. Rhyming: Simple rhymes can help you remember easily forgotten information. For example, if the name of a new acquaintance is Bill Fowler, you could say something silly to yourself like, “Bill Fowler looks like he 'fi lls his collar. '” List some examples of instances you could use rhyming to help you recall information. A. B. C. 4. Pictures: It is often easier to remember something if you visualize it. For example, to remember the name of John Runyon, picture in your mind a marathon runner with the sign of “John” on his chest. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
COGNITIVE DEFICITS 99List some examples of instances you could use pictures to help you recall information. A. B. C. 5. Acronyms: If you make up a word with the fi rst letter of items that must be re-membered, it will make it easier to recall the items. For example, the names of the Great Lakes—Huron, Ontario, Michigan, Erie, and Superior—can be remember as HOMES. We commonly remember information by using the fi rst letters of the words even if the result does not spell a word. For example, WNBA = Women's National Basketball Association. List some examples of instances you could use acronyms to help you recall information. A. B. C. 6. Categorizing: When faced with a long list of items to recall, it is always helpful to group it into categories. This breaks a long list into smaller parts that are associated with each other and thus easier to recall. For example, consider a long list of sports such as basketball, long jump, tennis, baseball, 100-yard dash, high jump, golf, hur-dles, volleyball, and cricket. This list is more easily memorized if it is grouped into two categories—track and fi eld versus sports using a ball. List some examples of instances you could use categorizing to help you recall infor-mation. A. B. C. 7. Acrostics: An acrostic is a sentence that is made by taking the fi rst letter from each word that you want to remember and then inserting another word beginning with that letter. For example, to remember the nine planets, you could create this sen-tence: Man Very Early Made Jars Stand Up Nearly Perpendicular (Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune, Pluto). List some examples of instances you could use acrostics to help you recall information. A. B. C. NOTE: The seven techniques described in this homework assignment can be recalled using the acronym CARPACA ( Chunking, Association, Rhyming, Pictures, Acronyms, Categorizing, and Acrostics). EXERCISE X. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
100 DEPENDENCYTherapist's Overview MAKING YOUR OWN DECISIONS GOALS OF THE EXERCISE 1. Identify decisions that have been avoided. 2. Identify decisions that will be made independently in the future. 3. Implement positive self-talk to build confi dence in decision-making. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Grief / Loss Unresolved Low Self-Esteem SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Decision-making is anxiety-producing in people who have developed a pattern of depen-dency on others or have lost confi dence in their own abilities. This exercise is focused on assisting the client to acknowledge the pattern of avoidance of decisions, to commit to making specifi ed decisions, and to build confi dence through positive self-talk. Point out the client's distorted cognitive messages that contribute to low self-esteem and assist him / her in listing replacement messages that are more realistic and positive. Reinforce all steps toward independent functioning and decision-making. SECTION XI: DEPENDENCY | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPENDENCY 101EXERCISE XI. A MAKING YOUR OWN DECISIONS When you develop a habit of dependence on others, you commonly avoid making your own decisions. You postpone or project responsibility for decisions onto others. Often, this pattern extends to even the small decisions of daily living, such as what time to eat, what meal to prepare, what time to go to bed, whether to call a friend or family member, or whether to make a small purchase. 1. Decisions I Have Let Others Make: List 10 decisions that you have avoided mak-ing in the recent past. A. B. C. D. E. F. G. H. I. J. 2. Decisions I Will Make: List 10 decisions you will make in the near future without seeking out unnecessary reassurance and direction from others. A. B. C. D. E. F. G. H. I. J. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
102 DEPENDENCY3. Positive Self-Talk: List 5 positive messages you can give to yourself that will help you make decisions more confi dently (e. g., I am a capable person, I have the intel-ligence necessary to make reasonable decisions, I have researched this issue enough to make an informed and logical decision). A. B. C. D. E. EXERCISE XI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPENDENCY 103Therapist's Overview SATISFYING UNMET EMOTIONAL NEEDS GOALS OF THE EXERCISE 1. View self as more independent and capable rather than needy and dependent on others. 2. Identify and specify unmet emotional needs. 3. Identify self-help actions to meet emotional needs. 4. Make a commitment to begin self-help action to meet emotional needs. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Borderline Personality Depression Grief / Loss Unresolved Intimate Relationship Confl icts Low Self-Esteem Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise helps clients focus on their unmet emotional needs. Clients who struggle with dependency, depression, or feelings of inadequacy often develop a sense of helpless-ness for doing anything to improve their situation. This assignment challenges the client to think about ways that he / she can commit himself / herself to a self-help action plan. The therapist probably will have to guide the client in listing actions he / she could take to improve the probability of getting his / her needs met. But, it is recommended that the client be allowed to struggle with this issue alone before the therapist provides too much assistance. Actually, this assignment becomes a test of the client's dependency on the therapist to do the assignment for him / her. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
104 DEPENDENCYEXERCISE XI. B SATISFYING UNMET EMOTIONAL NEEDS All human beings have emotional needs that they want to be fulfi lled. When these needs are not satisfi ed, we feel sad, depressed, lonely, hurt, disappointed, or even worthless. This exercise will help you identify and specify what needs of yours are unmet as well as to help you design a plan of action to get your needs met by doing something constructive to help yourself take charge of the satisfaction of your own needs. Too often, people rely on others or life's circumstances to get their needs met and they are disappointed. It is a much healthier approach to do everything you can to assert yourself and arrange your world in such a way that your needs get met through the actions or requests that you make of other people. To be completely dependent on others to meet your needs makes you too vulnerable to hurt and disappointment, and it denies your own capabilities and resources to get your needs met. Unmet Emotional Needs 1. Review the list of common emotional needs and place an X next to the ones that you feel are not met in your life. There are three blank lines for you to write in any unmet needs of yours that were left off the list. 1. To feel loved unconditionally by at least a few people. 2. To get recognition for accomplishments. 3. To be touched, patted, and hugged affectionately. 4. To be encouraged to do your best. 5. To be listened to, understood, and heard. 6. To feel supported when feeling hurt, weak, or vulnerable. 7. To be praised and rewarded for your effort to do the right thing. 8. To be treated with respect even if you disagree with someone. 9. To be forgiven when you do something wrong. 10. To feel accepted even with your faults or shortcomings. 11. To be asked to join others in social gatherings. 12. To be trusted and believed when telling your side of a story. 13. To have friends you can trust. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPENDENCY 105 14. To have some talent or ability that gets you recognition and builds self- esteem. 15. To feel accepted and loved by God. 16. To be treated fairly, equally, and given an opportunity to succeed. 17. To feel capable of competing adequately against others. 18. To feel your physical appearance is reasonably attractive. 19. To have someone believe in your capabilities. 20. To feel you fi t in with a group of friends. 21. 22. 23. 2. You must not rely entirely on others to meet your needs. Next to each unmet need, write one or two things you could do to help yourself move closer to getting your needs met. Perhaps your therapist can help you identify things you can do to help yourself. Write target dates for completing the steps you can take. Unmet Need Steps You Can Take Target Dates A. A. B. B. A. A. B. B. A. A. B. B. A. A. B. B. A. A. B. B. EXERCISE XI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
106 DEPENDENCY A. A. B. B. A. A. B. B. 3. Write out the consequences of the actions that you have taken to help yourself satisfy your own needs. EXERCISE XI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPENDENCY 107Therapist's Overview TAKING STEPS TOWARD INDEPENDENCE GOALS OF THE EXERCISE 1. Identify and acknowledge fears that inhibit independent actions. 2. Identify events in the past that have taught fear rather than confi dence. 3. List steps that can be taken to begin to be more independent. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Low Self-Esteem SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The client will be asked to examine his / her history to identify circumstances that contrib-uted to living a life of fear and dependence on others. Give the client support for revealing painful events that have nurtured fear, but also encourage growth in taking steps toward learning to overcome fear and live more independently. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
108 DEPENDENCYEXERCISE XI. C TAKING STEPS TOWARD INDEPENDENCE Fear and lack of confi dence can thwart the normal development of independence. You may look to others to make decisions for you while you seek to please them in any pos-sible way, even if it means taking over activities that clearly belong as the responsibility of others. Explore your fears and ways to overcome those fears by increasing independent actions. 1. Fear of Disappointing Others: This is a common fear that inhibits the growth of independence. Describe circumstances in your past that could have taught you to expect that you will disappoint others when you make a decision to act. 2. Fear of Failure: Describe incidents in your past that contribute to your expectation of failure when you take independent action. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPENDENCY 1093. Fear of Abandonment: What family or social circumstances have caused you to fear that others will leave you alone if you do not constantly try to please them? 4. Independent Actions: List actions you can take that will help you overcome your fears and increase your independence. Give a date for implementation. Action Date 1) 2) 3) EXERCISE XI. C | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
110 DEPRESSIONTherapist's Overview IDENTIFY AND SCHEDULE PLEASANT ACTIVITIES GOALS OF THE EXERCISE 1. Identify, schedule, and participate in enjoyable activities. 2. Enjoy the pleasant feelings that social, leisure, and recreational activities can bring. 3. Report a lift in mood resulting from increased social and recreational activity. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Family Confl ict Intimate Relationship Confl icts Type A Behavior SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The client's depression may interfere with his / her ability to recall pleasant activities and he / she may censor many of these activities, feeling he / she does not have the energy for them. Encourage him / her to brainstorm freely. If it is necessary, this assignment can be done within the counseling session rather than relying on the reduced motivation of the depressed client to fulfi ll the requirements of the assignment. Perhaps the brain-storming and scheduling need to be done within the session and the homework is that of implementing the activity and recording its impact. It is recommended that the client monitor his / her mood before, during, and after the event to focus him / her on the positive effect that the event has on mood. Review and reinforce the client's success in improving his / her mood using the satisfying activities. SECTION XII: DEPRESSION | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPRESSION 111EXERCISE XII. A IDENTIFY AND SCHEDULE PLEASANT ACTIVITIES People who are depressed almost always withdraw from participation in activities that they once found satisfying, rewarding, pleasurable, or just plain fun. It is very important to break this cycle of withdrawal and to begin reinvesting in the activities of life, the relationships around you, and the things you do well. A starting point for this task of re-investment or reinvolvement is to create an inventory of all those things that you found to be pleasant events in the past. 1. On the lines that follow, write down a description in only a few words of those ac-tivities that you found pleasurable and pleasant in the past. These enjoyable activi-ties should include (1) positive social interactions (e. g., spending time with a good friend), (2) useful or productive activities (e. g., caring for your child, doing a job well), and (3) intrinsically pleasant activities (e. g., a meal at your favorite restaurant, lis-tening to favorite music, taking a warm bath). During this brainstorming session, allow yourself to freely recall any pleasant and enjoyable activities without censor-ing them based on whether you think you have the energy for them or whether they are feasible. You may want to ask signifi cant others to give input to your list, but please remember that this is your list of personal pleasant activities and must refl ect events that you fi nd enjoyable. Positive Social Intrinsically Pleasant Interactions Useful Activities Activities | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
112 DEPRESSION2. Now select from your list of pleasant events seven that you believe are most likely for you to engage in. In the seven lines, list those activities and then to the right of the activity, write a few words that describe what was positive about the activity or why you found it pleasant or enjoyable. Most Likely Activities Why Pleasant?1) 2) 3) 4) 5) 6) 7) 3. On the following lines, schedule one pleasant activity per day to which you are com-mitted. Include the time of the day and with whom you might share the activity. Activity When and With Whom Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 4. On the following lines, record the activity engaged in and the degree of satisfaction on a scale of 1 (low) to 10 (high) that was felt during and after the engagement with the pleasant event. Also record the effect that the pleasant event had on your mood using a scale of 1 (no positive effect) to 10 (strong uplifting effect on mood). Activity Satisfaction Effect on Mood Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 EXERCISE XII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPRESSION 113Therapist's Overview NEGATIVE THOUGHTS TRIGGER NEGATIVE FEELINGS GOALS OF THE EXERCISE 1. Verbalize an understanding of the relationship between distorted thinking and neg-ative emotions. 2. Learn key concepts regarding types of distorted thinking. 3. Apply key concepts regarding distorted thinking to own experience. 4. Replace negative, distorted thoughts with positive, realistic thoughts that mediate recovery from depression. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Eating Disorder Grief / Loss Unresolved Intimate Relationship Confl icts Low Self-Esteem Panic Paranoid Ideation Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The concepts of cognitive therapy can be diffi cult to explain to a client in the abstract. This assignment defi nes and gives life examples for each of the common types of distorted thinking. The content of this assignment leans heavily on the work of cognitive / behavior therapists such as Beck, Burns, and Lazurus. You may use this assignment as a stepping stone for educating the client on the importance of controlling and changing thoughts. Help him / her fi nd examples of distorted thinking from his / her own life experience as it has been revealed to you in previous or current sessions. Then assist in generating posi-tive replacement thoughts for the client's negative thoughts. After this tutoring, send the client home with the assignment again to try to identify and replace negative thoughts. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
114 DEPRESSIONEXERCISE XII. B NEGATIVE THOUGHTS TRIGGER NEGATIVE FEELINGS We used to believe that it was depression or anxiety that made people think negatively, but psychologists and psychiatrists have discovered that most people who struggle with anxious or depressed feelings fi rst had negative, pessimistic, distorted thoughts that produced those feelings. People often have completely different reactions to the same situation. For example, John and Jack both heard their supervisor say to their produc-tion group, “We have to work harder and be more productive. Too much time is being wasted on trivial matters and we need to get focused. ” John thinks, “The supervisor is trying to increase production and make us more effi cient. I'd better do my part. ” But Jack thinks, “The supervisor is blaming me for our low productivity numbers. I'm worried that I'm going to get fi red. He never did like me. ” Jack returns to work feeling depressed and anxious and his preoccupation with these negative feelings reduces his productiv-ity. John, after hearing the same statement from the supervisor, returns to work more focused and confi dent that the situation can improve. The thoughts and interpretations that you make regarding a circumstance have a very strong infl uence on the feelings that are generated. Psychologists have identifi ed several negative thinking patterns that are common to people who struggle with feelings of anxiety and depression. These distorted thinking patterns trigger the negative feelings and can lead to chronic states of depres-sion and anxiety. 1. Study the following list of the types of negative thinking patterns that have been identifi ed and defi ned. These distorted thinking patterns are common to people who suffer from depression, anxiety, and low self-esteem. DISTORTED THINKING Type Defi nition Example Black or white Viewing situations, people, or self as entirely bad or entirely good—nothing in between. When Mary brought her vegetable salad to the neighborhood potluck, a hostess commented, “That's our third salad. ” Mary immediately thought, “She's criticizing me. She doesn't like me. ” | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPRESSION 115Type Defi nition Example Exaggerating Making self-critical or other-critical statements that include terms like never, nothing, everything, or always. Jack was accidentally overlooked when coworkers joined to make plans for lunch together. Jack thought, “They never ask me to do anything. Nobody wants me around here. ” Filtering Ignoring the positive things that occur to and around self but focusing on and ac-centuating the negative. Kate had her hair cut short and styled differently. After receiving several compliments from friends and family, one person was mildly criti-cal. Kate thought, “I knew I shouldn't have gotten it cut short. I look like a freak. People are laughing at me. ” Discounting Rejecting positive experi-ences as not being impor-tant or meaningful. Tyler was complimented by his boss for his good work on a project. He thought, “Anybody could have done that. She doesn't know anything about this project and I didn't do any-thing special with it. ” Catastrophizing Blowing expected conse-quences out of proportion in a negative direction. The teacher told Mary that her son was struggling a bit with math. Mary thought, “This is awful. Johnny is going to fail. I knew I should have worked with him more. ” Judging Being critical of self or oth-ers with a heavy emphasis on the use of should have, ought to, must, have to, and should not have. Jill made a sales presentation to a client. The client was very attentive and made comments about being impressed with the product. Jill thought, “He knows I stumbled over my words. I should have been more prepared. I have to be more relaxed or no client will ever buy from me. ” Mind reading Making negative assump-tions regarding other people's thoughts and mo-tives. Aaron inquired about a transfer to a new department. When he was told the position was already fi lled, he thought, “This manager never did like me. He knew I wanted that posi-tion but he just ignored me. ”EXERCISE XII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
116 DEPRESSIONType Defi nition Example Forecasting Predicting events will turn out badly. Kelly just fi nished an important job interview. She immediately predicted that she would not get hired. “I'll never get this job. That interview was awful and I'm sure I blew it,” she thought. Feelings are facts Because you feel a certain way, reality is seen as fi t-ting that feeling. Jim did not have plans for activity with any friends for the weekend. He felt lonely and inferior. He thought, “No one likes me. I have a terrible personality. ” Labeling Calling self or others a bad name when displeased with a behavior. Joan had a disagreement with her friend about where to meet for lunch. Joan thought, “Betty is such a con-troller. She never listens to anyone and insists on always getting her own way. ” Self-blaming Holding self responsible for an outcome that was not completely under one's control. Paula's friend had a minor traffi c accident while she and Paula were riding to the mall. Paula thought, “This accident was my fault. I should not have been talking to Jackie while we were driving. Even though that other car hit us, I'm sure Jackie could have avoided it if I would have kept my mouth shut. ” 2. Apply these 11 common types of distorted thinking to your own way of thinking. List at least three examples of your own thoughts that lead you to feeling depressed and anxious. First, describe the event that prompted you to feel depressed and then de-scribe the thoughts that promoted the bad feelings. What Happened? Negative Thoughts You Had A. B. EXERCISE XII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPRESSION 117C. D. 3. It is important to try to replace negative, distorted thoughts with positive, more re-alistic thoughts that can help you feel more happy. Refer to each of your examples listed in 2 and write a positive thought that you could have used to make you feel better. What Happened? Replacement Positive Thoughts A. B. C. D. EXERCISE XII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
118 DEPRESSIONTherapist's Overview POSITIVE SELF-TALK GOALS OF THE EXERCISE 1. Increase the frequency of positive thinking and talking about self, the world, and the future. 2. Report a positive shift in mood based on the implementation of positive self-talk. 3. Break the cycle of distorted negative cognition and replace it with more a more real-istic positive view of life. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Grief / Loss Unresolved Low Self-Esteem Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Explain to the client that our thoughts greatly infl uence our mood. He / she will tend to think that his / her mood dictates his / her thoughts rather than the reverse that we know is true. Help the client fi nd positive statements to apply to his / her life if the client is unsuccessful at writing them himself / herself. Reinforce the client's daily review of the positive statements to counteract the distortions that feed the depression. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DEPRESSION 119EXERCISE XII. C POSITIVE SELF-TALK How soon we forget. This statement is especially true for people struggling with depres-sion. They forget how to think positively and they forget about their worth as individuals, their contribution to society in general, and friends and family in particular. The cloud of depression blocks out the positive and distorts their vision into seeing themselves, the world, and their future as negative. This assignment is designed to help you break out of that self-defeating, unrealistic negative thinking cycle. It will take effort and focused attention to break the bad habit of distorted thinking. 1. List fi ve positive mood-enhancing statements regarding yourself (e. g., “I am a com-petent person who has had successes”), the world (e. g., “Other people are basically kind and want to be helpful”), and the future (e. g., “As I increase my activity, the future looks brighter”). You must force yourself to focus in on your successes, positive traits, the goodness of people, and an optimistic view of the future. Your tendency will be to think of failures and discount or ignore successes as well as seeing the fu-ture as hopeless. In other words, you must think contrary to your natural depressive inclination and return to the realistic positive way of thinking that characterized you before bad habits got a stranglehold on your thoughts. Positive View of Me Positive View of the World | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
120 DEPRESSIONPositive View of the Future 2. Each day select one mood-enhancing thought from your lists and write it on a piece of paper to be posted somewhere in your house so that it will be easily visible (e. g., on the refrigerator, on a mirror). 3. Stand in front of a mirror each day for 3 minutes and look yourself in the eye while repeating the positive self-talk that you have written in item 1. 4. Explain the impact that the positive self-talk has had on your mood. 5. Rate the degree of improvement in your mood when you think positively versus when you think negatively. 1 234 5 No Impact Great Impact EXERCISE XII. C | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DISSOCIATION 121Therapist's Overview DESCRIBE THE TRAUMA GOALS OF THE EXERCISE 1. Break down the repression and avoidance of pain. 2. Document details of the traumatic event. 3. Describe the emotions triggered by the event. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Antisocial Behavior Borderline Personality Childhood Trauma Posttraumatic Stress Disorder (PTSD) Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This assignment must be given to the client only when you are confi dent that the client has the strength to face his / her demons from the past. You may want to complete this exercise within the session rather than asking the client to fi ll this out at home between sessions. The data gathered must be processed carefully and often must be processed repeatedly to remove the emotional sting. SECTION XIII: DISSOCIATION | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
122 DISSOCIATIONEXERCISE XIII. A DESCRIBE THE TRAUMA It is often diffi cult to face the painful events of the past. You may try to avoid pain by avoiding talking about, or even thinking about, such events. Some events may be diffi cult to recall because you have pushed them away from your conscious memory. But healing comes from facing pain in an atmosphere of acceptance. This exercise tries to lead you to face the past by detailing the events that have been painful. You may have to consult sig-nifi cant and trusted others to help you recall facts. But make sure that when you record any fact, it is a fact you can vouch for and not just one someone else has told you. 1. The people involved: A. Who was there when you suffered the pain? B. Who have you told about the facts of this incident? C. Who was supportive when he / she became aware of the incident or witnessed it? D. Who was not supportive? E. Who was the person who was responsible for your pain and suffering? F. Was there anyone that you believe could have helped you or protected you but did nothing? 2. Where did the pain occur? A. Describe the location of the incident. B. What time was it when the incident occurred? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DISSOCIATION 123 C. How long did the incident last? D. Did it recur? If so, how often? 3. Your reaction: A. How did you feel physically and emotionally before the incident occurred? B. How did you feel physically and emotionally during the incident? C. And how did you feel immediately after the incident? D. How do you feel now as you process this incident? E. How do you now feel toward the perpetrator of your pain? 4. Others' reactions: A. How has the perpetrator acted since the incident? B. Who has been supportive of you recently? C. Who has disappointed you recently because of his / her lack of understanding? 5. Write your description of the incident in as much detail as you can. EXERCISE XIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
124 DISSOCIATION EXERCISE XIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DISSOCIATION 125Therapist's Overview STAYING FOCUSED ON THE PRESENT REALITY GOALS OF THE EXERCISE 1. Reduce preoccupation with the painful past or confusion with identity. 2. Increase focus on present realities of life. 3. Keep identity focused on reality. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Cognitive Defi cits Posttraumatic Stress Disorder (PTSD) Psychoticism Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT When a client becomes lost in the issues of the past or loses focus on his / her real identity, this assignment simply reinforces that real identity and present responsibilities. Recog-nize and reward the client's instances of here-and-now focus to behavior and thoughts. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
126 DISSOCIATIONEXERCISE XIII. B STAYING FOCUSED ON THE PRESENT REALITY It is easy to become preoccupied with traumas suffered in the past. But after facing these painful events of the past with openness and sharing the feelings with trusted, support-ive people, it is important to not allow the feelings from the past to overwhelm you and cause you to be immobilized. You should have a present reality focus that should consume most of your energy as you take care of your day-to-day responsibilities. Just to clarify your focus on daily facets of reality for you, list the facts of your life. 1. Just the facts: Your name: Spouse's / Partner's name: City of residence: Type of work you do: Employer: Hours you work: Children's names and ages: Parents' names: Siblings' names: 2. Projects at home that need attention: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
DISSOCIATION 1273. Things you should do with or for the kids: 4. Things you should do with or for your partner: 5. Long-range plans or goals for the future: EXERCISE XIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
128 EATING DISORDERTherapist's Overview A REALITY JOURNAL: FOOD, WEIGHT, THOUGHTS, AND FEELINGS GOALS OF THE EXERCISE 1. Break down denial regarding actual food intake, weight gain, and body size. 2. Identify the distorted thoughts that are associated with eating and the feelings such negative thoughts generate. 3. Reduce the incidence of dysfunctional behaviors used to control weight. 4. Make a concrete pledge to take responsibility for a steady weight gain to be achieved through healthy eating behaviors. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL None SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The distorted perception and denial that characterize the client with an eating disorder make it diffi cult to establish a basis for recovery. This exercise is designed to get the client to face the facts of what and how much has been eaten and how eating sets off a cognitive chain reaction that leads to irrational fear and dysfunctional weight control behaviors (e. g., vomiting, binging, excessive exercise, laxative abuse). You will have to educate the client regarding the relationship between cognitive distortions, negative emotions, and dysfunctional coping behaviors associated with eating. For example, eating three crack-ers with cheese: “I am going to get fat. My tummy is bloated. I look like a fat pig. ” After awareness of the destructive pattern is established, the client must be confronted with the personal responsibility to break the cycle and begin to eat normally to gain weight. SECTION XIV: EATING DISORDER | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EATING DISORDER 129EXERCISE XIV. A A REALITY JOURNAL: FOOD, WEIGHT, THOUGHTS, AND FEELINGS When you are caught in the web of anorexia or bulimia, it is very easy to distort the reality of what and how much you have eaten, your actual body weight, and reasonable thoughts about food and body image. This journal form is designed to help you stay in touch with reality and not to exaggerate, promote denial, negatively forecast the future, or distort your thinking. 1. Keep a daily record of what foods you eat and the quantity. After each occasion of eating, write your thoughts about the food and yourself. Also, record your feelings connected to the food and yourself. Finally, in the last column, record the common, secret, dysfunctional coping behaviors you engaged in (such as overexercising, forced vomiting, food hoarding, laxative use, lying about eating). On a weekly basis record your weight. WEEKLY REALITY JOURNAL Starting Weight: _____ Food Consumed Thoughts Feelings Secret Behavior DAY 1 Breakfast: Lunch:Dinner:Snacks: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
130 EATING DISORDERFood Consumed Thoughts Feelings Secret Behavior DAY 2 Breakfast: Lunch: Dinner:Snacks: DAY 3 Breakfast: Lunch: Dinner:Snacks: DAY 4 Breakfast: Lunch: Dinner: Snacks:EXERCISE XIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EATING DISORDER 131Food Consumed Thoughts Feelings Secret Behavior DAY 5 Breakfast: Lunch: Dinner:Snacks: DAY 6 Breakfast: Lunch: Dinner:Snacks: DAY 7 Breakfast: Lunch: Dinner: Snacks:EXERCISE XIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
132 EATING DISORDER2. Hopefully, you are becoming more realistic about the fact that you have not eaten normally, your body is in need of adequate nutrition and calories, and your weight and body size are below average. Denial must be broken and distorted thoughts must be recognized in order for you to get on the road to recovery and break the cycle of treating food as your enemy. The next step is to set goals for increasing weight gradually but steadily through increased food intake (and termination of the secret dysfunctional coping behaviors of excessive exercise, vomiting, lying, and so on). On the following form, record your pledge of a minimum weight gain per week based on healthy eating behavior. PLEDGE I, set a goal of gaining per (Name of client) (Weight amount) week. I will eat meals on a regular schedule and eat normal portions of a balanced diet. I will not engage in secret behaviors to control my weight or calorie intake. Witness: Signed: Date: Date: EXERCISE XIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EATING DISORDER 133Therapist's Overview HOW FEARS CONTROL MY EATING GOALS OF THE EXERCISE 1. Identify the fears that exist under the surface of behavior. 2. Identify how these fears control behavior. 3. Accept and implement a plan of facing fears to reduce their infl uence on the behav-ior. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL None SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT A multitude of fears can exert a powerful infl uence on the client who has an eating disor-der. This exercise is designed to help the client identify those fears, note how they impact his / her behavior, and commit to a plan of replacing the negative automatic thoughts as-sociated with each fear. You will have to help the client become aware of how cognitive distortions precipitate fear and then suggest replacement thoughts that are realistic. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
134 EATING DISORDEREXERCISE XIV. B HOW FEARS CONTROL MY EATING Anorexia and bulimia are behavioral problems that are based on fear. The fear may take many forms and can be caused by many distorted thoughts. For this exercise, try to identify the various fears that seem to control your eating behavior. Then focus on the most powerful fears and understand how they are controlling your behavior. Finally, to overcome your fears, you must fi nd ways to face your fears. 1. Review the following list of fears and place a check by those that you struggle with and those that infl uence your eating behavior. If the list is missing one or more of your fears, add them to the list at the bottom in the blank spaces provided. I have a fear of: Gaining weight. Becoming obese. Losing control of my eating and gorging myself. Being a failure in many areas of my life. Food not being available when I want it. Becoming independent and living on my own. Developing a sexually attractive body. Not being perfect. Being rejected by family and / or friends. My sexual fantasies leading to impulsive sexual behavior. Expressing my thoughts and feelings directly. Speaking up for my rights. Not having any worth apart from my appearance. Becoming close and intimate with the opposite sex. Someone else being in control of me. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EATING DISORDER 1352. Now list the three most powerful fears in their order of strength. A. B. C. 3. For each of the three fears listed, write about how that fear infl uences your behavior. What impact does it have on your life? How might it affect your eating? Fear #1: Fear #2: Fear #3: Most irrational fears are triggered by distorted thoughts. First, people have thoughts about a situation and then these thoughts cause an emotional reaction. Therefore, the fears are reduced or eliminated if the negative thoughts can be changed to thoughts that are more realistic, hopeful, and positive. 4. For each of the fears listed in 2, identify the thoughts that you have that are associ-ated with each fear. For example, if you fear gaining weight, one or more of the fol-lowing negative thoughts could be triggering this fear: I'm already too fat. I'm going to become fat like my mother. I want to look skinny like a model. If I start to gain, I won't be able to stop. I look pretty when I'm thin. If I eat normally, I'll get fat. I can't eat like most people because I'll get fat. The only way I can stay fi t is to constantly diet. It is not healthy to eat regular portions. When thoughts like these are held onto, the fear of gaining weight grows. Now write your thoughts that help to maintain or trigger each of your fears. Fear #1: EXERCISE XIV. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
136 EATING DISORDERFear #2: Fear #3: To reduce these fears, you must replace the negative thoughts with positive, realistic thoughts. For example, for fear of gaining weight, the following realistic thoughts could replace the negative thoughts: I'm not fat. In fact, I'm underweight. I need to gain some weight. I can control my weight gain so it is reasonable. Being too skinny is not healthy or attractive. I will look more attractive when I gain some weight. A fi t body needs a normal amount of calories. Regular portions of food provide the necessary nutrition the body requires. When thoughts like these are held onto, the fear of normal weight gain disappears. 5. Now write positive replacement thoughts for each fear that will reduce your irratio-nal fear. Remember, thoughts are under your control and they cause your feelings. Fear #1: Fear #2: Fear #3: EXERCISE XIV. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EDUCATIONAL DEFICITS 137Therapist's Overview MY ACADEMIC AND VOCATIONAL STRENGTHS GOALS OF THE EXERCISE 1. Identify interests and abilities that can be capitalized on for future education and vocational training. 2. Brainstorm possibilities that could motivate the pursuit of further education. 3. Develop a plan for future education or training based on strengths. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Financial Stress Phase of Life Problems Vocational Stress SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Encourage the client to think freely or brainstorm when completing this assignment. Process the results with the goal in mind of developing a plan for future education or vo-cational training. Do not reinforce impulsive shifts into new directions that do not have a solid basis in education, experience, or training. SECTION XV: EDUCATIONAL DEFICITS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
138 EDUCATIONAL DEFICITSEXERCISE XV. A MY ACADEMIC AND VOCATIONAL STRENGTHS We all have different talents, abilities, and interests. Some of those strengths can be as-sets as you look toward increasing your training and education. Many successful people have turned their talents into business ventures after they have received more training that allows them to refi ne and develop their skills. Use this opportunity to explore your strengths. 1. What subjects did you like in grade, middle, or high school? 2. What subjects do you like to read about? 3. In what areas have you been successful in working with your hands? 4. What abilities have others recognized in you and for which you have received compli-ments? 5. What business idea have you thought about pursuing and what would be the best way to prepare yourself for that business? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EDUCATIONAL DEFICITS 1396. What vocational or professional dreams or fantasies have you had that may be pur-sued? 7. What hobbies or special interests might you develop into a vocation if you had more training or education? 8. What types of activities do you really enjoy and feel passionate about? 9. What was the most enjoyable thing you have done or the thing you did very well? 10. What are your fi ve greatest talents, gifts, or abilities? A. B. C. D. E. 11. What educational or vocational training plan could take advantage of your identifi ed abilities or interests? EXERCISE XV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
140 EDUCATIONAL DEFICITSTherapist's Overview THE ADVANTAGES OF EDUCATION GOALS OF THE EXERCISE 1. Recognize the penalties of a lack of education. 2. Explore the benefi ts of completing educational goals. 3. Make a commitment to pursue educational goals. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence Chemical Dependence—Relapse Financial Stress Vocational Stress SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This assignment is designed to focus the client on the many different ways that life is affected by a lack of or presence of a good education. Process the client's responses to the various aspects of life that are affected by education. Seek a concrete and specifi c commit-ment to a realistic plan of action for pursuing educational goals. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EDUCATIONAL DEFICITS 141EXERCISE XV. B THE ADVANTAGES OF EDUCATION In the following space, explore the negative effects that have or will accumulate as a result of pursing and completing your educational goals. Then list the benefi ts that can result from more education. 1. Negative effects of a lack of education: Financial: Self-esteem (self-pride): Respect from others: Types of work opportunities: Degree of challenge to work opportunities: Amount of time and money available for recreation: 2. Positive effects of completing educational goals: Financial: Self-esteem (self-pride): Respect from others: Types of work opportunities: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
142 EDUCATIONAL DEFICITSDegree of challenge to work opportunities: Amount of time and money available for recreation: EXERCISE XV. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FAMILY CONFLICT 143Therapist's Overview APPLYING PROBLEM-SOLVING TO INTERPERSONAL CONFLICT GOALS OF THE EXERCISE 1. Accept responsibility for attempting to fi nd mutually agreeable constructive solu-tions to confl icts. 2. Brainstorm solutions and analyze their advantages and disadvantages. 3. Implement solutions that are designed to produce “win-win” outcomes. 4. Evaluate the implemented solution as to its degree of mutual acceptance and satis-faction. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Antisocial Behavior Intimate Relationship Confl icts Phase of Life Problems Vocational Stress SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Many clients need to learn problem-solving skills because they see no solution to prob-lems other than anger, withdrawal, or aggression. This exercise is designed to help the client use classical problem-solving skills to fi nd “win-win” solutions to confl icts with friends, family members, coworkers, spouse, or supervisor. The client may need consid-erable assistance in completing this assignment since the habit of using dysfunctional problem-solving approaches may be deeply engrained and learned in childhood. SECTION XVI: FAMILY CONFLICT | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
144 FAMILY CONFLICTEXERCISE XVI. A APPLYING PROBLEM-SOLVING TO INTERPERSONAL CONFLICT Getting along with others requires the ability to negotiate solutions to disagreements. All relationships have times of confl ict. It is most important that disagreements not trigger immediate anger and withdrawal. A much better reaction to confl ict is to seek to fi nd a resolution to which both sides agree. This is called a “win-win” situation and results in both parties being satisfi ed. A confl ict that leads to immediate aggression yields a “win- lose” situation and results in hurt, resentment, and anger. This exercise is designed to help you apply problem-solving skills to current confl icts in your life to produce a “win- win” result. 1. Describe a problem of confl ict between yourself and the other party in as much detail as possible. 2. Brainstorm all the possible solutions to the problem that you can think of and list them on the following lines. 3. Pick two or three of the most reasonable and fair solutions from your brainstorm list and list the advantages and disadvantages of each solution. Solution #l: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FAMILY CONFLICT 145Advantages Disadvantages Solution #2: Advantages Disadvantages Solution #3: Advantages Disadvantages 4. Select and write down the best solution option that is apparent from your advan-tages and disadvantages analysis. 5. Indicate when and where you will begin to implement the solution you have se-lected. EXERCISE XVI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
146 FAMILY CONFLICT6. After the solution has been implemented, evaluate the outcome of this effort. 7. What changes need to be made in the confl ict solution that you selected for it to be even more effective? EXERCISE XVI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FAMILY CONFLICT 147THERAPIST'S OVERVIEW A STRUCTURED PARENTING PLAN GOALS OF THE EXERCISE 1. Identify the child's behaviors that are most problematic for parents. 2. Increase parents' focus on interventions for the child's specifi c, targeted problem be-haviors. 3. Develop parental consistency in intervening with and giving consequences for unde-sirable behaviors when they occur. 4. Develop specifi c positive reinforcements that parents can give for cooperative behav-iors or negative consequences they can give for oppositional defi ant behaviors. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Parenting SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Children are masters at manipulation, making parents feel inadequate and constantly on the defensive. To change this, parents must be focused on modifying their child's spe-cifi c, targeted problematic behaviors in a consistent, nonreactive manner. They will need focus, guidance, and encouragement to stick to this goal. Review parents' interventions and assist them by using modeling and role playing of more effective interventions. Re-member to emphasize consistency and positive reinforcement for desired behaviors. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
148 FAMILY CONFLICTEXERCISE XVI. B A STRUCTURED PARENTING PLAN To increase your effectiveness as a parent in guiding and directing your children's behav-ior, it is most helpful to have an organized plan. A plan provides you with a road map to help you make day-to-day decisions regarding how to respond to your children's behavior patterns. Without a plan, you tend to react rather than act and your parenting lacks con-sistency and direction. A plan allows you to be specifi c, focused, and consistent in trying to reach your behavioral goals with your children. This assignment will help you provide structure to your plan as you identify behaviors that you want to see your children in-crease in frequency, as well as behaviors that you would like to see them stop engaging in. The general principle that will guide you is to reinforce the positive behaviors as strongly and consistently as you can while punishing the unwanted behaviors with consequences that are immediate but short term. To be most effective as a parent, you need to stipulate as precisely as you can the behaviors that you desire to see your children engage in as well as specifying clearly the behaviors you want to see terminated. Identify Problematic Behaviors List as specifi cally as possible several of the problematic behaviors of your child. Now go over the list and select three of the behaviors that are the most problematic. (It is necessary to limit your focus to maximize your effectiveness. ) 1. 2. 3. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FAMILY CONFLICT 149Describe Desired Positive Behaviors For each of the behaviors you selected, describe the desired or expected behavior you would like to see from your child. Make the expectation as specifi c and as realistic as possible. Example: Problem: Always argues then refuses to do any reasonable request or task. Desired behavior: Comply with request in a reasonable amount of time with minimal resistance. Problem Desired Behavior A. B. C. Identify Rewards for Positive Behaviors It is necessary to reward or reinforce the positive behavior when it is done by the child in a reasonable way. This is crucial if you want to see more of that behavior. Remember, the rewards do not have to be big things. (See example. ) List at least three rewards for the desired behaviors you described in the previous step. Reward Examples: 1. Thank you for doing that. 2. You sure did a nice job of cleaning up. Desired behavior: Reward 1: Reward 2: Reward 3: Desired behavior: Reward 1: Reward 2: Reward 3: EXERCISE XVI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
150 FAMILY CONFLICTDesired behavior: Reward 1: Reward 2: Reward 3: Identify Punishments for Problem Behaviors Now develop two or three negative consequences for each of the problem behaviors. Keep in mind that consequences are most effective when they are logical and tied as closely as possible with the behavior / offense. Also, it is best if punishments are brief in nature. Punishment Example: Not allowed to go anywhere or have anyone over until the request / task is done. Problem behavior: Punishment 1: Punishment 2: Punishment 3: Problem behavior: Punishment 1: Punishment 2: Punishment 3: Problem behavior: Punishment 1: Punishment 2: Punishment 3: Rewards or punishments should be administered in a prompt manner as soon as possible after the achievement or misbehavior. It will take attention and focus to do this consis-tently. Plan Ahead to Avoid Problems To increase your effectiveness, it is helpful to anticipate and plan for possible misbehav-ior. This will better prepare you to intervene in a timely manner and on your terms and EXERCISE XVI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FAMILY CONFLICT 151make you less likely to overreact. For each of the three problem behaviors, develop a strategy for trying to make the positive behavior occur and avoid the problem behavior. Example : Let the child know ahead of time that you plan to ask him / her to do some thing this afternoon. 1. 2. 3. EXERCISE XVI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
152 FEMALE SEXUAL DYSFUNCTIONTherapist's Overview FACTORS INFLUENCING NEGATIVE SEXUAL ATTITUDES GOALS OF THE EXERCISE 1. Identify experiences that have infl uenced sexual attitudes, feelings, and behavior. 2. Acknowledge the infl uence of childhood experiences on current sexual attitudes. 3. Identify current relational factors that infl uence sexual attitudes. 4. Verbalize a commitment to change unhealthy attitudes about sexuality to attitudes that are more adaptive. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Intimate Relationship Confl icts Male Sexual Dysfunction Sexual Identity Confusion SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT In reviewing the client's assignment material, provide an atmosphere of acceptance and warmth that will promote openness. Ask questions that will allow the client to elaborate on painful or traumatic sexual experiences from childhood that shape her attitude about current sexual activity. Explore the current relationship with her partner to assess for underlying feelings of anger or hurt that nurture an attitude of rejection toward sexual intimacy. SECTION XVII: FEMALE SEXUAL DYSFUNCTION | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FEMALE SEXUAL DYSFUNCTION 153EXERCISE XVII. A FACTORS INFLUENCING NEGATIVE SEXUAL ATTITUDES An adult's attitudes about human sexuality are shaped by many factors, some of which reach back into early childhood. Feelings of fear of and repulsion from sexual activity can be based in subtle or even traumatic experiences of early life. On the other hand, nega-tive attitudes about sexual activity with a partner could be based on more recent dissat-isfaction and unhappiness surrounding the relationship itself. This exercise is designed to help you explore your attitudes about sexuality and the possible causes for those at-titudes. 1. Explain your current feelings and thoughts regarding sexual activity with your part-ner. 2. Looking back into your childhood experiences, describe any attitudes of hostility toward sex to which you were exposed. 3. What parental attitudes toward sexuality were displayed in front of you when you were a child growing up in your family? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
154 FEMALE SEXUAL DYSFUNCTION4. What were your sources of information about sexuality as a young person and what did your parents tell you about sex? 5. Describe any experiences with sexual abuse that contribute to your current feelings about sex. 6. Describe the impact on your sexual attitudes of any religious training that you may have received as a child. 7. Adolescence is a time of sexual development and exploration. What experiences did you have in adolescence that shaped your current attitudes about sexuality? 8. Describe your reaction and degree of satisfaction with your earliest experiences sur-rounding intercourse. 9. Describe your satisfaction and degree of pleasure surrounding your earliest sexual experiences with your current partner. EXERCISE XVII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FEMALE SEXUAL DYSFUNCTION 15510. How would you describe your satisfaction with your relationship with your current sexual partner? 11. How do your underlying feelings toward your current sexual partner affect your at-titudes regarding having sex with that partner? 12. What factors do you believe have had the most powerful infl uence on your current negative attitudes regarding sexual activity? 13. Rate your degree of motivation to overcome your lack of desire for sexual activity. 12 3 456 7 No Motivation Highly Motivated 14. Rate your degree of confi dence in your ability to overcome your resistance to normal sexual activity with your partner. 12 3 456 7 No Confi dence Extremely Confi dent EXERCISE XVII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
156 FEMALE SEXUAL DYSFUNCTIONTherapist's Overview STUDY YOUR BODY: CLOTHED AND UNCLOTHED GOALS OF THE EXERCISE 1. Increase the degree of acceptance of the entire body. 2. Increase the degree of comfort with nudity. 3. Identify positive aspects of your body. 4. Build a positive body image that results in a reduction of sexual inhibitions. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Eating Disorder Low Self-Esteem Sexual Identity Confusion SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This is a delicate assignment that calls for the client to study her body, beginning with being fully clothed and ending with being fully naked. The assignment asks the client to identify positive aspects of her body and to work toward becoming more comfortable and accepting of her body. Be sure to introduce this exercise with an explanation of what will be expected and answer any questions or provide reassurance about the degree of privacy required. Give permission to the client to focus on her positive physical qualities since our culture discourages boastfulness. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FEMALE SEXUAL DYSFUNCTION 157EXERCISE XVII. B STUDY YOUR BODY: CLOTHED AND UNCLOTHED A positive body image is critical to overcoming many sexual inhibitions. However, it is very typical for a person to be critical of his / her body and to focus on the fl aws. Even though there is no perfect body, many people compare themselves to others and feel inadequate. It is common, however, to discover that a sexual partner focuses on his / her partner's assets or aspects that he / she fi nds arousing. So while a woman may be critical of her body, her lover is much more pleased with it. The goal of this exercise is to help you develop a greater degree of comfort with your body, both clothed and unclothed. Too often a negative body image leads to a consistent pattern of trying to cover the body under all circumstances. Healthy sexual freedom calls for a high degree of comfort with your own nudity. Being comfortable with yourself and who you are doesn't mean you like everything about yourself or think you are special, but instead means that you feel okay, accepting of yourself for who you are and what you look like. 1. Locate a mirror in your home where you can be alone and undisturbed for about 5 minutes each day for 5 days. Have a watch / timepiece with you to track the time. Note the time, center yourself directly in front of the mirror, and look straight into it at yourself for the time designated. Day 1 Time: 3 minutes Focus: Study your head and face, beginning with your hair and forehead, and work down to your shoul-ders. Record what you saw that you liked, what you thought, and any feelings you expe-rienced. Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your head and face in the mirror. Very Quite So So Little Not | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
158 FEMALE SEXUAL DYSFUNCTIONDay 2 Time: 3 minutes Focus: Study entire body while clothed in a bathing suit. Record what you saw that you liked, what you thought, and any feelings you expe-rienced. Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your body in the mirror. Very Quite So So Little Not Day 3 Time: 3 minutes Focus: Study body from waist up while unclothed. Record what you saw that you liked, what you thought, and any feelings you expe-rienced. Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your body in the mirror. Very Quite So So Little Not Day 4 Time: 3 minutes Focus: Study body from waist down while clothed. Record what you saw that you liked, what you thought, and any feelings you expe-rienced. Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your body in the mirror. Very Quite So So Little Not Day 5 Time: 3 minutes Focus: Study entire body while unclothed. Record what you saw that you liked, what you thought, and any feelings you expe-rienced. Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your body in the mirror. Very Quite So So Little Not EXERCISE XVII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FEMALE SEXUAL DYSFUNCTION 1592. Describe how the overall experience of the exercise affected you. What do you think you have gained from this experience? When you look at yourself in the mirror now, how comfortable do you feel with your body? Comfort Scale: Place an X on the comfort scale that refl ects your level of comfort looking at your body in the mirror. Very Quite So So Little Not 3. How important is it for you to feel comfortable with your body in order to enjoy sexual interaction? 12 3 456 7 Not Important Very Important 4. List the assets of your body without being discounting or critical. Be bold and brag about yourself! EXERCISE XVII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
160 FINANCIAL STRESSTherapist's Overview PLAN A BUDGET GOALS OF THE EXERCISE 1. Itemize and identify monthly income and expense, monthly totals by category. 2. Calculate any difference between budgeted projected expense and income amounts and actual amounts for each category. 3. Make a plan to reduce differences between projected and actual amounts in order to balance the budget and reduce fi nancial stress. 4. Make a plan to reduce expenses or increase income in order to balance the budget. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Family Confl ict Phase of Life Problems SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Preparing a budget and tracking actual fi nancial data takes considerable discipline that may require signifi cant encouragement from the therapist. Review the client's fi gures on a regular basis to reinforce the recording of data. Make decisions about a new fi nancial plan based on how the budget amounts are different from actual amounts. Review the client's budget as to reasonableness and completeness before he / she moves toward imple-mentation and comparison with actual fi gures. SECTION XVIII: FINANCIAL STRESS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FINANCIAL STRESS 161EXERCISE XVIII. A PLAN A BUDGET Preparing a structured budget allows for the tracking of cash fl ow into and out of your household. It is essential to resolving fi nancial stress that a clear understanding is de-veloped as to where money is being spent and what changes are possible to balance in-come with expense. The following basic budget allows you to enter monthly income and expense amounts that are projected and then enter the actual amounts that develop and evolve through the month. The fi nal column allows you to calculate any difference be-tween what was projected and what actually evolved for income and expense. Perhaps you would like to make several copies of the worksheet before you begin to fi ll in amounts so that expenses can be tracked for several months. 1. First enter monthly budget amounts for each category and then, after these have been reviewed thoroughly, begin to enter actual amounts spent or received in a month. Category Monthly Budget Amount Monthly Actual Amount Difference Income: Wages Bonuses Interest income Capital gains income Dividend income Miscellaneous income INCOME SUBTOTAL Expenses: Mortgage or rent Heating Electricity Water / sewer Trash | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
162 FINANCIAL STRESSCategory Monthly Budget Amount Monthly Actual Amount Difference Cable TVTelephone Home repair / maintenance Car payments Car gasoline / oil Car repairs Other transportation Child care Auto insurance Home owner / renter's insurance Health insurance Computer expense Internet service provider expense Entertainment / recreation Groceries Household products Clothing Eating out Gifts / donations Medical / dental / vision / medications Hobbies Vacation fund Emergency fund College fund Retirement Credit card payment Magazines / newspapers Taxes Pets Miscellaneous EXPENSES SUBTOTAL NET INCOME (Income less Expenses)EXERCISE XVIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
FINANCIAL STRESS 1632. After reviewing the budget, what areas of expense do you feel have been out of con-trol? Where does spending need to be cut back? 3. Can you think of ways to increase the amount of income that would help balance the budget? 4. If more than one person is living off of this budget, what agreements have been reached with the other parties as to sticking with the budget? 5. Now use your new input and track a second month. Note improvement or new areas of overspending. EXERCISE XVIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
164 GRIEF / LOSS UNRESOLVEDTherapist's Overview CREATING A MEMORIAL COLLAGE GOALS OF THE EXERCISE 1. Identify, clarify, and express feelings associated with the lost loved one. 2. Resolve issues of confl ict related to the lost loved one. 3. Create positive memories of the lost loved one that can balance the pain of the loss. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Intimate Relationship Confl icts SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The processing of the collage and accompanying questions are best done in a slow-paced, refl ective manner. Ask numerous questions about the collage to elicit more information and feelings from the client. You may point out themes and patterns that refl ect a posi-tive, warm connection to the lost loved one so that these good memories can be supported as a balance against the painful feelings of the client's grief. This assignment could be used for loss associated with death or loss associated with the breakup of a signifi cant relationship. SECTION XIX: GRIEF / LOSS UNRESOLVED | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
GRIEF / LOSS UNRESOLVED 165EXERCISE XIX. A CREATING A MEMORIAL COLLAGE To begin to balance the pain of your loss with pleasurable memories, you need to start uncovering and remembering the warm and special things about that person so you can hold on to those key memories. By completing the collage, you can begin to fi nd that bal-ance. To help yourself work through the stages of grief, complete the following exercises. 1. Use an X to indicate where you are now in working through the grief cycle (you can use more than one X. ) Shock/ Denial Guilt/ Loneliness Anger Depression Acceptance 2. Create a collage. A. Obtain a poster board 24 inches by 36 inches. B. Carefully search through family photos and select those of your lost loved one that are meaningful to you. C. Next look in magazines / newspapers and cut out words, phrases, and other pic-tures that refl ect your feelings about the lost loved one. D. Arrange the pictures and words / phrases and secure them on the poster board in any way you feel best expresses your feelings. 3. When you have completed your collage, respond to the following: A. Explain briefl y the pictures you chose and which two have greatest signifi cance for you. B. Explain the reasons for the words / phrases you chose. C. Looking over the collage you've created, what does it say to you about the person and your feelings? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
166 GRIEF / LOSS UNRESOLVED D. Do the pictures bring back any of the following feelings? (Circle any that apply. ) Anger Disappointment Other: Hurt Abandonment Other: Guilt Regret Worry Rejection Explain: E. Does looking at the pictures bring to the surface any thoughts of regret about things you wish you had said or done or things you wish you had not said or done? List them. F. Do the pictures bring back any of the following feelings? (Circle any that apply. ) Joy Love Other: Gratitude Empowerment Other: Satisfaction Amazement Peace Forgiveness Explain: EXERCISE XIX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
GRIEF / LOSS UNRESOLVED 167Therapist's Overview DEAR _________: A LETTER TO A LOST LOVED ONE GOALS OF THE EXERCISE 1. Express feelings connected with the loss of a loved one. 2. Clarify thoughts, feelings, and experiences surrounding the lost loved one. 3. Begin a healthy grieving process for the loss of a signifi cant other. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Intimate Relationship Confl icts Phase of Life Problems Vocational Stress SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Traumatic loss can take many forms: death of a loved one, loss of a job, divorce from a loved one, breakup of a signifi cant relationship, loss of a friend, loss of a signifi cant other to a debilitating medical condition, and so on. This letter can be appropriately written and adapted to any of these types of loss as the feelings of grief attached to these losses are similar in many respects. The client is fi rst asked to respond to a series of questions before actually writing the letter to the lost loved one. These questions are designed to help organize his / her thoughts and clarify his / her feelings. After the client responds to the questions, he / she can then begin writing the actual letter. Instruct the client to bring the letter to the following therapy session for processing. It may be helpful to ask the client to read the letter to you to allow for more expression of affect. Allow the client to elaborate on any of the aspects of the letter that you feel are important and tied to unre-solved grief issues. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
168 GRIEF / LOSS UNRESOLVEDEXERCISE XIX. B DEAR ________: A LETTER TO A LOST LOVED ONE Writing letters can be a way to help you identify and express your thoughts and feelings. This is especially true when you need to work through your feelings surrounding the loss of an important person in your life. In this homework assignment, you are asked to write a letter to the lost loved one to help you identify and express your own feelings about the signifi cant loss in your life. 1. First, fi nd a quiet or relaxing place where you can write the letter. This will help you concentrate on writing down your thoughts and feelings without distractions. Perhaps you can write the letter in a quiet room in your house, at the library, or in a favorite outdoor place such as a park or beach. 2. Respond to the following questions designed to help you organize your thoughts and feelings before you begin to actually write the letter. You may fi nd that some of these questions do not apply to you; therefore, leave those items blank. Space is also provided for you to express any additional thoughts or feelings that you may want to include in your letter. Feel free to write down whatever thoughts come into your mind at this stage in the assignment. You can decide later as to whether you want to include these thoughts in your fi nal letter. A. What thoughts and feelings did you experience when you learned of the loss of your loved one? B. What are some of the positive things you miss about your loved one? C. What are some of the hurts, problems, or disappointments that you had in your relationship with your loved one? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
GRIEF / LOSS UNRESOLVED 169 D. It is not uncommon to experience guilt or remorse about not having said or done something with a person before the relationship ended. What, if anything, do you wish you could have said or done? E. Do you feel that the loss of your loved one was in any way your fault? If so, please describe why you feel responsible. F. Are you sorry about some of the things that happened between you and your loved one? Describe. G. How has the death of your loved one affected your present life? H. What are some of the important events that have occurred since the loss of your loved one that you would have liked to have shared with him / her? I. What fond memories of your loved one do you cherish? J. How do you feel about your loved one today? K. How would your loved one want you to live your life now? EXERCISE XIX. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
170 GRIEF / LOSS UNRESOLVED L. How do you feel about your life now? What is good and bad about your life now? M. Use the following space to express any other thoughts or feelings that you would like to include in the letter. 3. Next, review your responses and begin to write the letter. Use the following space or write on separate paper. Bring the completed letter to your next therapy session to discuss with your therapist. After discussing the letter, consider what you would like to do with the letter—do you want to destroy it or throw the letter away? Your therapist can help you answer these questions. EXERCISE XIX. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
IMPULSE CONTROL DISORDER 171Therapist's Overview IMPULSIVE BEHAVIOR JOURNAL GOALS OF THE EXERCISE 1. Increase awareness of impulsive behaviors. 2. Identify thoughts, feelings, or circumstances that may trigger impulsive behavior. 3. Clarify the consequences of impulsive behavior. 4. Acknowledge that impulsive behavior leads to negative consequences for self and others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Attention-Defi cit Disorder (ADD)—Adult Borderline Personality Chemical Dependence Chemical Dependence—Relapse Financial Stress Legal Confl icts Mania or Hypomania Type A Behavior SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT You may need to review the details of this assignment to help the client better under-stand what the homework calls for. The client may tend toward minimization and / or may be out of touch with his / her feelings. Examine the completed journal material for unrealistic, distorted thoughts that trigger feelings and actions of an impulsive nature. Use cognitive change techniques to counteract these distorted thoughts and replace them with more realistic cognitions. Reinforce all verbalizations of acceptance of responsibility for negative consequences related to impulsive actions. SECTION XX: IMPULSE CONTROL DISORDER | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
172 IMPULSE CONTROL DISORDEREXERCISE XX. A IMPULSIVE BEHAVIOR JOURNAL It is sometimes diffi cult to become aware of our own patterns of behavior, the triggers for those behaviors, and the results of those behaviors. We tend to be blind to our own behav-ior patterns and their results. Often other people have to confront us with our behavior and the painful consequences caused by our actions. We tend to minimize the negative consequences and to highlight the positive results that we see. This exercise is designed to increase your awareness of your own behavior patterns related to impulsive actions and their results. You will need to tune in to your own thoughts and feelings as well as be vigilant about the consequences of your actions. 1. Please enter information regarding seven incidents in which you acted impulsively. You may want to select one incident per day over the next week. For each incident enter the Day / Date / Time that the incident occurred. Describe where you were when the incident occurred (Place). Describe what was going on around you prior to your impulsive action (Situation). Next, describe what you were thinking and what your emotions were (Thoughts and Feelings). Then describe the behavior that you en-gaged in that was done without thoroughly thinking it through (Impulsive Act). Fi-nally, describe what you saw as the consequences of your behavior (Result). Repeat the entry of this data for the seven impulsive behavior incidents. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
IMPULSE CONTROL DISORDER 173IMPULSIVE BEHAVIOR JOURNAL Entry 1 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result Entry 2 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result EXERCISE XX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
174 IMPULSE CONTROL DISORDEREntry 3 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result Entry 4 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result EXERCISE XX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
IMPULSE CONTROL DISORDER 175Entry 5 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result Entry 6 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result EXERCISE XX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
176 IMPULSE CONTROL DISORDEREntry 7 Day / Dateand Time: Place Situation Thoughts Feelings Impulsive Act Result 2. List the results of your impulsive actions (e. g., made me feel better, reduced my an-ger, got back at somebody, felt more relaxed afterwards). 3. List all of the negative consequences that have occurred because of your impulsive behavior (e. g., loss of money, embarrassment to self or others, injury to self or others, broken promises, lost friendships). 4. As you review your impulsive behavior, what triggers for these actions can you iden-tify (e. g., thoughts or feelings, a particular situation, a person or place)? EXERCISE XX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
IMPULSE CONTROL DISORDER 1775. What connection do you see between your impulsive behavior and the painful conse-quences for yourself or others? EXERCISE XX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |