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178 INTIMATE RELATIONSHIP CONFLICTSTherapist's Overview HOW CAN WE MEET EACH OTHER'S NEEDS AND DESIRES? GOALS OF THE EXERCISE 1. Identify needs of both partner and self that are expected to be met within the rela-tionship. 2. Identify means to meet each other's needs and desires. 3. Focus energy on meeting the partner's needs and desires rather than exclusively focusing on getting your own needs met. 4. Increase the frequency of participating in mutually enjoyable activities. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Dependency Female Sexual Dysfunction Male Sexual Dysfunction SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This assignment has two parts—one to be completed by each of the partners within the relationship. It is recommended that each partner complete the homework independently and bring the results back for sharing and processing within a conjoint session. Take the opportunity to teach both partners the key concept that mutually satisfying relation-ships necessitate each partner being willing at times to sacrifi ce his / her own needs and desires and choose to meet the needs and desires of the partner. Also teach the partners that each of them should take personal responsibility for reasonable satisfaction of some needs outside of the relationship. SECTION XXI: INTIMATE RELATIONSHIP CONFLICTS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
INTIMATE RELATIONSHIP CONFLICTS 179EXERCISE XXI. A HOW CAN WE MEET EACH OTHER'S NEEDS AND DESIRES? GENERAL INTRODUCTION FOR BOTH PARTNERS A successful and healthy intimate relationship requires that each partner invest some of his / her time and energy into satisfying the needs and desires of his / her partner. When relational needs are not being met satisfactorily, the relationship is in serious trouble and eventually may break. However, all needs cannot be met by one partner. Each must take some responsibility for satisfying needs apart from the relationship. This exercise helps you identify and clarify your needs as well as the needs of your partner. Partner 1 Perspective 1. List the needs and desires that you expect the relationship to meet. A. B. C. D. E. 2. List your partner's needs and desires (as you understand them) that he / she expects the relationship to meet. A. B. C. D. E. 3. List what you are willing to do to meet your partner's needs and desires. A. B. C. D. E. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
180 INTIMATE RELATIONSHIP CONFLICTS4. List what you expect your partner to do to meet your needs and desires. A. B. C. D. E. 5. How have you let your partner down in meeting his / her needs and desires? A. B. C. D. E. 6. How has your partner let you down in not meeting your needs and desires? A. B. C. D. E. 7. What could you do to get some of your needs met outside of the relationship, by your-self or with the help of others? A. B. C. D. E. 8. Describe three times in which you feel that you have sacrifi ced your own needs and desires to meet the needs and desires of your partner instead. A. B. C. 9. List at least three enjoyable and rewarding activities that you feel would help you and your partner satisfy each other's need for social contact. A. B. C. EXERCISE XXI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
INTIMATE RELATIONSHIP CONFLICTS 181Partner 2 Perspective 1. List the needs and desires that you expect the relationship to meet. A. B. C. D. E. 2. List your partner's needs and desires (as you understand them) that he / she expects the relationship to meet. A. B. C. D. E. 3. List what you are willing to do to meet your partner's needs and desires. A. B. C. D. E. 4. List what you expect your partner to do to meet your needs and desires. A. B. C. D. E. 5. How have you let your partner down in meeting his / her needs and desires? A. B. C. D. E. EXERCISE XXI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
182 INTIMATE RELATIONSHIP CONFLICTS6. How has your partner let you down in not meeting your needs and desires? A. B. C. D. E. 7. What could you do to get some of your needs met outside of the relationship, by your-self or with the help of others? A. B. C. D. E. 8. Describe three times in which you feel that you have sacrifi ced your own needs and desires to meet the needs and desires of your partner instead. A. B. C. 9. List at least three enjoyable and rewarding activities that you feel would help you and your partner satisfy each other's need for social contact. A. B. C. EXERCISE XXI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
INTIMATE RELATIONSHIP CONFLICTS 183Therapist's Overview POSITIVE AND NEGATIVE CONTRIBUTIONS TO THE RELATIONSHIP: MINE AND YOURS GOALS OF THE EXERCISE 1. Each partner identifi es the positive things he / she and the partner contribute to the relationship. 2. Each partner identifi es changes he / she and the partner should make to improve the relationship. 3. Establish a balanced perspective on the relationship rather than focusing on part-ner's negatives. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Female Sexual Dysfunction Male Sexual Dysfunction SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise has a separate page to be fi lled out by each of the partners in the relation-ship. Ask each partner to complete the exercise independently and to bring it to a sub-sequent conjoint session. Review each partner's list and attempt to clarify the language and to put the changes requested in positive terms. Clients generally indicate what they would like not to happen rather than what they would like to happen. Ask each client for a commitment to work on making the changes that are called for in his / her own behav-ior. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
184 INTIMATE RELATIONSHIP CONFLICTSEXERCISE XXI. B POSITIVE AND NEGATIVE CONTRIBUTIONS TO THE RELATIONSHIP: MINE AND YOURS GENERAL INTRODUCTION FOR BOTH PARTNERS When confl icts predominate in a relationship, an exaggerated focus gets placed on the negative aspects of the partner. Defenses keep us from evaluating our own contributions to the confl ict and from noticing the positive things that the partner does to enhance the relationship. We become so focused on the negative aspects and primarily see the partner as the cause of the failure of the relationship. This assignment attempts to put things in perspective by asking each partner to take an honest look at himself / herself as well as evaluating the partner's contribution to confl ict. Additional balance is sought by attempt-ing to have each partner list the positive things that are brought to the relationship by each partner. Partner 1 List Complete each of the following four lists. In the fi rst list, itemize those things that you do that contribute positively to the relationship. In the second list, itemize those things that your partner does that enhance the relationship. Third, list the things that you need to do to improve the relationship and make it stronger. Finally (and this is always the easiest part), list the things that you believe your partner needs to do to make the relationship better. 1. What I do to enhance the relationship: A. B. C. D. E. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
INTIMATE RELATIONSHIP CONFLICTS 1852. What does my partner do to enhance the relationship? A. B. C. D. E. 3. Things I need to do to improve the relationship: A. B. C. D. E. 4. What does my partner need to do to make the relationship better? A. B. C. D. E. Partner 2 List Complete each of the following four lists. In the fi rst list, itemize those things that you do that contribute positively to the relationship. In the second list, itemize those things that your partner does that enhance the relationship. Third, list the things that you need to do to improve the relationship and make it stronger. Finally (and this is always the easiest part), list the things that you believe your partner needs to do to make the relationship better. 1. What I do to enhance the relationship: A. B. C. D. E. EXERCISE XXI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
186 INTIMATE RELATIONSHIP CONFLICTS2. What does my partner do to enhance the relationship? A. B. C. D. E. 3. Things I need to do to improve the relationship: A. B. C. D. E. 4. What does my partner need to do to make the relationship better? A. B. C. D. E. EXERCISE XXI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LEGAL CONFLICTS 187Therapist's Overview ACCEPT RESPONSIBILITY FOR ILLEGAL BEHAVIOR GOALS OF THE EXERCISE 1. Describe the behavior that led to current legal confl icts. 2. Accept responsibility for the steps leading to the illegal behavior, as well as the be-havior itself. 3. Acknowledge the harm that the illegal behavior caused to others. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Antisocial Behavior Impulse Control Disorder SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Be alert to the client's attempts to project blame onto others for his / her illegal behavior. Try to highlight the series of decisions that were made that eventually led to the illegal activity. Reinforce acceptance of full responsibility for decisions and actions. SECTION XXII: LEGAL CONFLICTS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
188 LEGAL CONFLICTSEXERCISE XXII. A ACCEPT RESPONSIBILITY FOR ILLEGAL BEHAVIOR When a change in behavior pattern is necessary, the fi rst step to be taken is to accept responsibility for the actions taken previously. Therefore, this assignment is directed toward having you honestly and completely acknowledge what you did that was illegal, who was hurt by your behavior, and what decisions led to this choice of activity on your part. 1. Describe in detail the illegal behavior that you engaged in. 2. List who was harmed by your behavior and how they were affected. Who Harmful Effect | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LEGAL CONFLICTS 1893. Describe the series of steps that led to your illegal action (when did you think of do-ing it, who did you discuss it with, what preparations did you make before initiating the action, etc). 4. Describe how you feel about having acted illegally. 5. Why is it important for you to take full responsibility for your illegal behavior with-out blaming others or excusing yourself ? EXERCISE XXII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
190 LEGAL CONFLICTSTherapist's Overview CROOKED THINKING LEADS TO CROOKED BEHAVIOR GOALS OF THE EXERCISE 1. Identify thoughts that trigger illegal behavior. 2. Create and implement positive thoughts that promote prosocial behavior. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Antisocial Behavior SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The client may need assistance in working through this assignment. Explore his / her dis-torted thoughts that foster illegal behavior by reviewing past behavior and the thought process or basic beliefs that preceded the behavior. Help the client develop prosocial thoughts that foster adaptive, legal behavior choices. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LEGAL CONFLICTS 191EXERCISE XXII. B CROOKED THINKING LEADS TO CROOKED BEHAVIOR People take action based on thoughts that precede that action. These thoughts often serve to justify illegal behavior even when the thinking pattern is distorted and based in unreasonable beliefs. Use this assignment to identify your thinking pattern or beliefs that foster your engagement in illegal behavior. 1. Check off your distorted or unrealistic thoughts that foster breaking the law. Add your own thoughts if they are not listed. I have to take things into my own hands to get what I want, regardless if it is illegal to do so. I deserve to take what I want. Other people get away with breaking the law; I should be able to do it, too. The police are just out to get me. If I get away without getting arrested, then the action was okay. I don't have any choice; this action is my only alternative. I had to do this to get out of a jam. When I am drunk or high, I do crazy things that I'm not responsible for. Life is not fair to me, so I have to break the law just to get by. If I don't break the law, I will not fi t in or get accepted. 2. Replacing thoughts that trigger illegal behavior is hard work. You must catch your-self thinking the trigger thoughts and then talk to yourself in a more positive, pro-social, realistic manner. Focus on two of your trigger thoughts from the previous section and write several positive thoughts to replace the distorted ones. Trigger Thought: Positive Replacement Thoughts: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
192 LEGAL CONFLICTSTrigger Thought: Positive Replacement Thoughts: EXERCISE XXII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LOW SELF-ESTEEM 193Therapist's Overview ACKNOWLEDGING MY STRENGTHS GOALS OF THE EXERCISE 1. Identify individual accomplishments, traits, and skills. 2. Practice repeating positive self-descriptive statements to build self-esteem. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Mania or Hypomania Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Clients with low self-esteem often discount or minimize their accomplishments, posi-tive traits, and skills. Encourage them to include all of these in their completion of this assignment. The concept of accomplishments should be processed to expand the client's scope to include all the things he / she does well every day and not to just consider ma-jor accomplishments. Also encourage the client to overcome his / her resistance to saying good things about himself / herself in the mirror exercise part of the assignment. While processing the results of the homework with the client, reinforce all signs that the client is showing integration of his / her positive accomplishments, traits, and skills into his / her concept of self. SECTION XXIII: LOW SELF-ESTEEM | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
194 LOW SELF-ESTEEMEXERCISE XXIII. A ACKNOWLEDGING MY STRENGTHS When we view ourselves as loveable, valuable, and capable, then we are recognizing key things about ourselves that add to our self-esteem. Completing the exercise that follows will help you recognize your personal traits, skills, and accomplishments. 1. Over the next week, identify three positive things you accomplish each day (e. g., cooked a good meal, found a job, cheered up a friend). Day 1 Day 2 A. A. B. B. C. C. Day 3 Day 4 A. A. B. B. C. C. Day 5 Day 6 A. A. B. B. C. C. Day 7 A. B. C. 2. List fi ve personal traits that you value about yourself (e. g., friendly, trustworthy, ac-cepting). Then ask friends, family, and others for fi ve more. My List Others' List A. A. B. B. C. C. D. D. E. E. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LOW SELF-ESTEEM 1953. Now list fi ve skills that you believe you have (e. g., play piano, can fi x things, good housekeeper). A. B. C. D. E. 4. Reviewing the three areas of accomplishments, traits, and skills, what do you be-lieve are your most valuable assets? 5. Write each of your 15 positive skills and traits on a 3 × 5 card and post them around your home so that you are reminded of them regularly. 6. Take three cards with positive skills or traits written on them and stand in front of a mirror. Look yourself in the eye while repeating the statements, “I am ” (fi lling in one of your positive qualities). Repeat this mirror exercise for 2 minutes each day for a week. Rate how comfortable you were with saying good things about yourself. 12 3 456 7 Very Uncomfortable Very Comfortable 7. Rate how your self-esteem has grown after completing this exercise for 1 week. 12 3 456 7 No Growth Maximum Growth EXERCISE XXIII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
196 LOW SELF-ESTEEMTherapist's Overview REPLACING FEARS WITH POSITIVE MESSAGES GOALS OF THE EXERCISE 1. Identify fearful thoughts that foster low self-esteem. 2. Identify coping techniques to resist the impact of fear on behavior. 3. Implement affi rming self-talk that can be used to build self-esteem. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Dependency Depression Panic Sexual Abuse Social Discomfort Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT It may be helpful to review the list of coping techniques that are presented in the exercise prior to asking the client to complete the homework. You may elaborate on some of these techniques and answer any questions that might arise. Upon completion of the exercise, you may focus on teaching the details of some of the anxiety-reduction coping techniques that are mentioned and / or selected by the client. You may also have to help the client in the development of ways that he / she can keep positive affi rmation statements in mind. Continue to reinforce the client's use of these positive statements to cope with his / her slide back into low self-esteem thought patterns. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LOW SELF-ESTEEM 197EXERCISE XXIII. B REPLACING FEARS WITH POSITIVE MESSAGES It is very important after you start feeling good about yourself that you work to main-tain that attitude. To do this, you need to be prepared to terminate the negative / fear-ful thoughts that can set you back and, at the same time, you need to keep supportive thoughts at the forefront of your mind. The exercise that follows will help you develop ways to address these factors and maintain your esteem. 1. Negative and fearful thoughts can undermine self-esteem by holding people back from doing things. A. Circle the fearful thoughts that you have. Making a mistake Being left out or behind Failing at something Others getting mad at me Being criticized Not being liked Going crazy Others seeing me in a panic Saying / doing something stupid Others seeing me as unattractive Others thinking I'm bad Others hurting my feelings Having a heart attack Getting fi red at work Add your own fearful thoughts to the list. B. Now select from the fearful thoughts you circled the two thoughts that you have most frequently. List them here and then answer the following questions. 1) First fearful thought: What is the worst that could happen if the feared event actually occurred? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
198 LOW SELF-ESTEEMReview the following list of coping techniques and put an X next to two that you believe could help you overcome your fear. Do a reality check with self or others. Replace fearful thought with a positive, realistic thought. Share the fear with others to get reassurance. Affi rm your own ability to cope using positive self-talk. Distract yourself with a pleasurable activity. Use relaxation exercises to reduce tension. Accept the fear and forge ahead with action. Engage in aerobic exercise. Visualize yourself as being successful at the feared task. Withdraw from the feared situation temporarily, and then return to it. Gradually face the feared situation until the fear is overcome. Use problem-solving skills to address the feared situation. Implement assertiveness skills to address the feared situation. Reward yourself for facing the feared situation. Describe why you think the two techniques you selected will help you and how you will apply those techniques to your life. Technique one: Technique two: 2) Second fearful thought: What is the worst that could happen if the feared event actually occurred? Review the list of coping techniques again and put an X next to two that you believe could help you overcome this second fear. EXERCISE XXIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
LOW SELF-ESTEEM 199Describe why you think the two techniques you selected will help you and how you will apply those techniques to your life. Technique one: Technique two: 2. As a way of maintaining our self-esteem, it is important to keep in mind certain im-portant thoughts. A. Circle the affi rmations that you most need to remember. God doesn't make junk. I expect good things. I like myself. I am a good person. Mistakes are learning opportunities. I have things to offer. I know I can do it. I can trust myself. I am loveable. I feel good about me. I can make good decisions. I value myself. No one is perfect. I can say no. I can affi rm myself and others. I can be a friend to someone. I can deal with my fears. I don't have to be perfect. I can learn how. I can grow and change. With God all things are possible. I am a child of God. With God I can let go of fear. With God I can face anything. I can forgive others. With God I'm never alone. I can fi nd strength in God's spirit. I respect myself and others. Others do like me. My family loves me. B. Now develop three ways you can keep these thoughts at the front of your mind (e. g., write two or three thoughts on a note card, carry the card with you, and read it four times during your day). 1) EXERCISE XXIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
200 LOW SELF-ESTEEM2) 3) 3. Evaluate your progress over the next 2 weeks in each of these three areas. A. Stopping fearful thoughts Week 1 (circle): Great Good Okay Poor Comment: Week 2 (circle): Great Good Okay Poor Comment: B. Daily affi rmations Week 1 (circle): Great Good Okay Poor Comment: Week 2 (circle): Great Good Okay Poor Comment: EXERCISE XXIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MALE SEXUAL DYSFUNCTION 201Therapist's Overview JOURNALING THE RESPONSE TO NONDEMAND, SEXUAL PLEASURING (SENSATE FOCUS) GOALS OF THE EXERCISE 1. Participate in nondemand, sexual pleasuring exercises. 2. Record thoughts and feelings generated by the sexual pleasuring exercise. 3. Share and process thoughts and feelings associated with each step in the sexual pleasuring activities. 4. Experience decreased inhibition and performance anxiety and increased sexual arousal and sexual pleasure. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Female Sexual Dysfunction SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This assignment requires that you provide the client with some direction in locating ma-terial on sexual pleasuring exercises that are fairly standard for treating such things as hypoactive sexual desire or high anxiety associated with sexual performance. You may give directions for sexual pleasuring within the session or direct the client to read mate-rial that contains a description of nondemand, sexual pleasuring. Two books are referred to within the directions for the client, but you may suggest others. The power of the sexual pleasuring exercise increases dramatically as the partners learn to share their thoughts and feelings regarding their sexual interplay. This exercise provides some structure to allow partners to describe their thoughts and feelings and then to return to a conjoint session to process this information. You may also encourage them to share thoughts and feelings freely during the sensate focus experience itself. The form for journaling must be copied so that each partner can have his / her own form to complete. SECTION XXIV: MALE SEXUAL DYSFUNCTION | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
202 MALE SEXUAL DYSFUNCTIONEXERCISE XXIV. A JOURNALING THE RESPONSE TO NONDEMAND, SEXUAL PLEASURING (SENSATE FOCUS) This exercise is designed to help you describe your thoughts and feelings that are associ-ated with participation in a nondemand, sexual pleasuring activity often called “sensate focus. ” Rather than describe all of the aspects of nondemand, sexual pleasuring exercis-ing, you are referred to books on human sexuality that describe this standard approach to sexual interaction that is designed to reduce inhibition, desensitize sexual aversion, increase arousal, and enhance sexual pleasure. Many books on human sexuality con-tain a description of this type of sexual exercise (e. g., Rekindling Desire: A Step-by-Step Program to Help Low-Sex and No-Sex Marriages by Mc Carthy and Mc Carthy [Brunner- Routledge, 2003] or Resurrecting Sex—Resolving Sexual Problems and Rejuvenating Your Relationship by Schnarach [Harper Collins, 2002]). Your therapist may want to sug-gest a specifi c resource book for you to consult to obtain the specifi cs of a nondemand, sex-ual pleasuring exercise. One of the most important aspects of engaging in the nondemand, sexual pleasuring exercise is processing the feelings that are generated by the exercise and sharing them openly with your partner. After you have agreed on how to implement the sexual pleasur-ing exercise and established a schedule for doing so, record the steps that you will be tak-ing together under Question 1 on this form. As you implement each step of the exercise, each partner should complete the questions independently and bring the form back to a conjoint counseling session for review and processing. 1. Outline the fi ve or six steps that you will implement in a nondemand, sexual plea-suring exercise often referred to as “sensate focus. ” (Partners complete this sec-tion together. ) A. B. C. D. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MALE SEXUAL DYSFUNCTION 203 E. F. Journal of Thoughts and Feelings Step 1: Date(s) implemented: 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: 2. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: 3. What was the best aspect of the exercise? 4. What would have made the exercise experience better? 5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 456 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 456 7 Not Ready Very Ready EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
204 MALE SEXUAL DYSFUNCTIONStep 2: Date(s) implemented: 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: 2. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: 3. What was the best aspect of the exercise? 4. What would have made the exercise experience better? 5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 4 56 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 4 56 7 Not Ready Very Ready Step 3: Date(s) implemented: 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MALE SEXUAL DYSFUNCTION 2052. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: 3. What was the best aspect of the exercise? 4. What would have made the exercise experience better? 5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 456 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 456 7 Not Ready Very Ready Step 4: Date(s) implemented: 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: 2. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
206 MALE SEXUAL DYSFUNCTION3. What was the best aspect of the exercise? 4. What would have made the exercise experience better? 5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 4 56 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 4 56 7 Not Ready Very Ready Step 5: Date(s) implemented: 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: 2. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: 3. What was the best aspect of the exercise? EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MALE SEXUAL DYSFUNCTION 2074. What would have made the exercise experience better? 5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 456 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 456 7 Not Ready Very Ready Step 6: Date(s) implemented: ________________________ 1. Describe your thoughts and feelings before the exercise began. Toward the exercise: Toward your partner: 2. Describe your thoughts and feelings during the exercise. Toward the exercise: Toward your partner: 3. What was the best aspect of the exercise? 4. What would have made the exercise experience better? EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
208 MALE SEXUAL DYSFUNCTION5. What benefi t did you get from this step of the pleasuring exercise? 6. Rate your degree of sexual arousal during this exercise. 12 3 4 56 7 None Very High 7. How ready are you to move to the next step in the pleasuring sequence? 12 3 4 56 7 Not Ready Very Ready EXERCISE XXIV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 209Therapist's Overview RECOGNIZING THE NEGATIVE CONSEQUENCES OF IMPULSIVE BEHAVIOR GOALS OF THE EXERCISE 1. Identify impulsive behavior as distinct from more reasoned, thoughtful behavior. 2. Understand that impulsive behavior has costly negative consequences for yourself and others. 3. Review own behavior and see the impulsive actions and their negative conse-quences. 4. Think of more reasonable alternative replacement behaviors for those impulsive ac-tions. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Attention-Defi cit Disorder (ADD)—Adult Borderline Personality Chemical Dependence Chemical Dependence—Relapse Impulse Control Disorder SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Impulsive behaviors are much more easily recognized by others than by the clients with impulse control problems. They think their behavior is normal and typical. You must try to sensitize them to their pattern of acting before thinking of the consequences. Re-view this homework with clients slowly, allowing time to process each scene they have described. They will want to quickly dismiss each item and move on to the next. That impulsive action is just the problem you are focusing on. SECTION XXV: MANIA OR HYPOMANIA | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
210 MANIA OR HYPOMANIAEXERCISE XXV. A RECOGNIZING THE NEGATIVE CONSEQUENCES OF IMPULSIVE BEHAVIOR This exercise is meant to help you think before you act so that you end up with better results. Read the two behavior descriptions for each number and then circle the number of the one that shows a lack of proper control. Which One Is Impulsive? 1. Buying the fi rst CD that you think you might like. 1. Looking at all the CDs before selecting the best one. 2. Sitting quietly in a group situation, lis-tening to the person who is speaking. 2. Blurting out some thought that occurs to you and interrupting the group pro-cess. 3. Waiting your turn patiently at Mc Don-alds. 3. Complaining loudly about waiting in line and trying to get ahead of others. 4. Grabbing the fi rst piece of clothing to wear in the morning. 4. Selecting clothes that match and fi t the situation. 5. Blurting out what you think is an an-swer to a question. 5. Thinking for a second or two before speaking. 6. Keeping some money for savings. 6. Spending any and all money as soon as you have it. 7. Waiting for a friend to stop talking be-fore speaking. 7. Butting into a conversation between two friends, interrupting them. 8. Jumping to a new task before another task is fi nished. 8. Complete one task before starting an-other. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 211 9. Start watching one TV program and then switch to another and another before any are over. 9. Watch a TV program until it is com-pleted, then choose another. 10. When given direction by a coworker or supervisor, get angry and yell back at him / her. 10. When given direction by a coworker or supervisor, accept the comment and comply. Now return to each of the preceding 10 behaviors and below write out what you think the bad consequence or result of the behavior of acting without fi rst thinking about the consequences is for each one. (We did the fi rst one for you. ) Impulsive Behavior Leads to Bad Consequences 1. You end up with several CDs that you really did not want after you hear others that you like better. 2. 3. 4. 5. 6. 7. 8. 9. 10. Pick 4 out of the 10 behaviors described previously and write out a similar scene from your own life when you have been impulsive. Use names and places with which you are familiar. EXERCISE XXV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
212 MANIA OR HYPOMANIAMy Impulsive Behaviors 1. 2. 3. 4. Now describe the bad results of your four impulsive actions. My Bad Consequences 1. 2. 3. 4. Finally, look at your four impulsive actions and write out a more calm, reasonable, considerate, polite, thoughtful way that you could have acted that would have brought better results. Good Behavior Choices 1. 2. 3. 4. EXERCISE XXV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 213Therapist's Overview WHAT ARE MY GOOD QUALITIES? GOALS OF THE EXERCISE 1. Increase genuine self-esteem through identifi cation of positive character and per-sonality traits. 2. Reduce braggadocio, self-disparagement, or self-destructive escape behaviors through the realistic identifi cation of strengths and assets. 3. Decrease the fear of inadequacy that underlies exaggerated claims of ability or social withdrawal and refusal to try new things. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence Chemical Dependence—Relapse Depression Low Self-Esteem Sexual Abuse Social Discomfort SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Clients often have a distorted perception of themselves and the world that causes them to see only negative traits and remember only failures. For the manic patient, this underly-ing core of feeling inadequate is covered with a veneer of exaggerated confi dence and will-fulness. Genuine self-esteem must be built through realistic self-assessment bolstered by others' support. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
214 MANIA OR HYPOMANIAEXERCISE XXV. B WHAT ARE MY GOOD QUALITIES? Often we are quick to mention our faults and overlook our good qualities. It is now time for you to pay special attention to what is good about you—focus on the aspects of your personality that make you uniquely a good person. Look at yourself in an honest and re-alistic way. You should not try to be polite and deny your strengths, but also you should not have to exaggerate to make up for not feeling good enough to be accepted by others. 1. Find the words that apply to you in the following list of nice things people say about other good people. Circle all those that describe you. Appreciative Reliable Friendly Humble Thoughtful Wise Creative Warm Thorough Kind Faithful Independent Sensitive Articulate Leader Responsible Open Pleasant Considerate Communicative Tolerant Punctual Spiritual Energetic Attractive Loving Includes others Hard-working Trustworthy Physically fi t Intelligent Reasonable Conscientious Sociable Wide interests Moral Decision maker Easy going Humorous Loyal Mechanical Talented Ethical Honest Athletic Musical Organized Artistic Well-groomed Well-dressed Accepting Insightful Polite Complimentary Practical Patient Happy Approachable Good listener Respectful Obedient Thrifty Helpful Other good things about me that are not on this list are: 2. Now give a copy of the form on the following page to two or three people that know you well (parent, friend, teacher, relative) and ask them to circle words that they believe describe you. Fill in their names and your name in the blank spaces. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 215Dear , (Person's Name) Because you know me very well, I would like you to tell me what you think are the best things about me. Please circle words that really describe . (Your name) Thank you very much for taking the time to do this for me. Appreciative Reliable Friendly Humble Thoughtful Wise Creative Warm Thorough Kind Faithful Independent Sensitive Articulate Leader Responsible Open Pleasant Considerate Communicative Tolerant Punctual Spiritual Energetic Attractive Loving Includes others Hard-working Trustworthy Physically fi t Intelligent Reasonable Conscientious Sociable Wide interests Moral Decision maker Easy going Humorous Loyal Mechanical Talented Ethical Honest Athletic Musical Organized Artistic Well-groomed Well-dressed Accepting Insightful Polite Complimentary Practical Patient Happy Approachable Good listener Respectful Obedient Thrifty Helpful Other good things about me that are not on the list of choices are: EXERCISE XXV. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
216 MANIA OR HYPOMANIA3. Now write a list of your 10 best qualities selected from the circled items on your list and the lists completed by others who circled items to describe you. My Ten Best Qualities A. B. C. D. E. F. G. H. I. J. 4. Post your list of My Ten Best Qualities on a mirror in your home. Look yourself squarely in the eye as you say each of the words out loud at least one time a day for 7 days in a row. At the end of the week, write a paragraph about how you feel about yourself in the following space. EXERCISE XXV. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 217Therapist's Overview WHY I DISLIKE TAKING MY MEDICATION GOALS OF THE EXERCISE 1. Identify reasons for lack of consistency in taking psychotropic medication. 2. Identify reasons to take medication responsibly and reliably. 3. Establish a foundation for a contract to take medication consistently. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Attention Defi cit Disorder (ADD)—Adult Depression Paranoid Ideation Psychoticism SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Medication resistance is a common problem for clients who have been prescribed psycho-pharmacologic remedies for their symptoms. This exercise is designed to assist the client in identifying his / her reasons for resistance to medication compliance. The client is also asked to examine and explore reasons for taking the prescribed psychotropic medication consistently. Process the completed assignment with the client while addressing his / her reasons for resistance and reinforcing the advantages of prescription compliance. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
218 MANIA OR HYPOMANIAEXERCISE XXV. C WHY I DISLIKE TAKING MY MEDICATION Many people resist taking prescribed medication after they have been diagnosed with an emotional disorder. People offer a variety of reasons for not taking their medication on a consistent basis. This exercise will help you identify the reasons that you may resist taking your medication and help you identify the advantages of taking the medication consistently and responsibly. Common Reasons for Medication Resistance Don't feel like myself. Don't need them. Feel groggy. Feel different than other people. Fear getting hooked on pills. Too expensive. Forget to take medication. Too much of a hassle. Side effects (dizzy, sick, etc. ). Fear getting mocked. Lose my creativity. Loss of energy. 1. Review the list and place a checkmark next to those reasons that you resist taking medication for your emotional disorder. What reason(s) might you have other than those listed? 2. What is the main reason that you do not like taking the medication(s)? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MANIA OR HYPOMANIA 2193. Ask a partner, friend, and / or family member to give reasons why they believe it is good for you to take the medication. Write down their answers. 4. List three reasons you believe you should take the medication. How does the medica-tion help you? 5. How can your life be improved with medication helping to control your symptoms? EXERCISE XXV. C | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
220 MEDICAL ISSUESTherapist's Overview HOW I FEEL ABOUT MY MEDICAL TREATMENT GOALS OF THE EXERCISE 1. Verbalize thoughts and feelings about having to receive treatment for a serious or chronic illness. 2. Explore and identify reasons for resistance to receiving treatment. 3. Accept the illness and cooperate with treatment as advised. 4. Cooperate with medical treatment regimen without passive-aggressive or active re-sistance. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Psychoticism SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise not only provides the client with the opportunity to openly express his / her thoughts and feelings, but can also be used to uncover the reasons for his / her resistance to cooperating with the medical treatment regimen. Process the expression of feelings and the reasons for resistance in complying with the medical interventions. You may also want to share the client's responses with his / her physician (after obtaining the necessary releases) to help the physician become aware of the client's thoughts and feelings. The physician could also address the client's resistance and explain the reasons why the cli-ent is receiving the current medical treatment regimen. SECTION XXVI: MEDICAL ISSUES | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MEDICAL ISSUES 221EXERCISE XXVI. A HOW I FEEL ABOUT MY MEDICAL TREATMENT Please take a few minutes to answer the questions that follow. Your answers will help your therapist better understand your thoughts and feelings about having to receive regular medical treatment. 1. What medication(s) do you currently take for your illness? Please give dosage and frequency. Medication Name Dosage Frequency 2. What other types of treatment (besides taking medication) do you receive for your illness? Hospitalizations? How frequent? 3. What do you dislike about receiving the treatment? 4. What are the consequences of not cooperating with your treatment regimen as rec-ommended? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
222 MEDICAL ISSUES5. How does your family react if you do not cooperate with your treatment regimen? 6. What would you like to tell your doctor about your treatment? 7. How much say or control do you feel you have in your current treatment? Place an X above the space that best describes how you feel. None Very Little Some Fair Amount A Lot 8. What would you like to tell your friends or family members about how you feel about receiving the medical treatment? 9. What advice would you give yourself about cooperating with the treatment? EXERCISE XXVI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MEDICAL ISSUES 223Therapist's Overview THE IMPACT OF MY ILLNESS GOALS OF THE EXERCISE 1. Identify the emotional, physical, and relational impact of the medical condition. 2. Identify and openly express feelings connected to the serious or chronic illness. 3. Identify resource people who can be turned to or relied on in time of illness for emo-tional help and support. 4. Reduce the intensity of anxiety, fear, and other painful or distressing emotions re-lated to the serious or chronic illness. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Mania or Hypomania Psychoticism SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The purpose of this exercise is to help the client identify the impact of the illness on his / her life and then to encourage expression of his / her feelings about his / her serious or chronic illness. The client should be encouraged to express these feelings in the therapy sessions and around other family members or trusted individuals. The exercise identi-fi es key people the client can turn to for emotional support and help. Finally, the client is asked to identify what coping strategies or activities help him / her to cope with or manage the symptoms or effects of the illness. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
224 MEDICAL ISSUESEXERCISE XXVI. B THE IMPACT OF MY ILLNESS In dealing with a serious or long-term illness, it is very important that the person suffer-ing from the illness express his / her feelings. This exercise helps your therapist, family members, and other important people in your life better understand your feelings about your illness. Please respond to the following questions or items. 1. What is your illness? 2. How long have you had this illness? 3. List three adjectives to describe your illness. 4. What feelings do you have about your illness? Place a checkmark in front of the words that describe how you feel. Add any other feelings in the blank spaces. Afraid Sad Angry Nervous Helpless Rage Worried Hopeless Frustrated Confused Trapped Guilty Uncertain Different Lonely Inferior Embarrassed Apathetic (“I don't care”) Calm Content At peace 5. What is your biggest concern or worry about your illness? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
MEDICAL ISSUES 2256. What impact do your feelings and stress have on your illness? 7. Who understands how you feel about your illness (e. g., parents, partner, siblings, doctor, friends)? 8. How do you think your partner and other family members feel about your illness? How does your illness affect your relationships with them? 9. How do you think your friends view you and your illness? How does your illness af-fect your relationships with them? 10. Who can you turn to for emotional help and support in dealing with your illness? 11. What are the limitations caused by your illness? 12. How do you feel about these limitations? 13. Describe your strengths, interests, and abilities that continue in spite of your illness. EXERCISE XXVI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
226 MEDICAL ISSUES14. What coping strategies or activities have you found helpful in learning to deal with or manage your feelings about your illness (e. g., writing, talking, distracting activi-ties, prayer, meditation)? EXERCISE XXVI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
OBSESSIVE-COMPULSIVE DISORDER (OCD) 227Therapist's Overview MAKING USE OF THE THOUGHT-STOPPING TECHNIQUE GOALS OF THE EXERCISE 1. Identify obsessive thoughts that produce anxiety and interfere with normal func-tioning. 2. Implement a thought-stopping technique to interrupt the obsessive thoughts and reduce anxiety. 3. Rate the degree of success at reducing obsessive thoughts and the concomitant an xiety. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Eating Disorder SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Thought-stopping is a simple, but effective technique to reduce the impact of obsessive rumination. You may want to review the essential elements of the thought-stopping tech-nique with the client and practice its implementation in the offi ce prior to giving this homework assignment. Review the client's implementation after 1 week and adjust the technique as necessary to increase its effectiveness. You may want to add the element of having the client snap a rubber band around his / her wrist at the time of shouting “STOP. ”SECTION XXVII: OBSESSIVE-COMPULSIVE DISORDER (OCD) | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
228 OBSESSIVE-COMPULSIVE DISORDER (OCD)EXERCISE XXVII. A MAKING USE OF THE THOUGHT-STOPPING TECHNIQUE Obsessive thoughts that recur on a frequent and regular basis can be very frustrating and interfere with normal functioning. You can become preoccupied with these thoughts and therefore unable to focus on other issues. These recurring thoughts can also produce con-siderable anxiety and they often are connected to worries that a harmful or embarrassing event will occur. A simple but effective technique for coping with obsessive thoughts and reducing their ability to raise anxiety is the “thought-stopping” technique. This exercise guides you through the implementation of this technique and assesses its effectiveness. 1. List any obsessive thoughts that recur regularly and interfere with your normal functioning. 2. Rate the degree of interference of the obsessive thought on your normal routine. 1 234 5 Very Strong and Frequent No Interference 3. List three positive, calming scenes that you could place in your mind to replace the obsessive thought (e. g., sunning yourself all alone on a warm beach, fi shing on a quiet lake as the sun sets). Scene 1: Scene 2: Scene 3: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
OBSESSIVE-COMPULSIVE DISORDER (OCD) 2294. Over the next week, each time that the obsessive thought occurs, shout “STOP!” to yourself in your head without making a sound. Picture a large red traffi c sign, and then begin to think about one of the calming scenes from the previous question while breathing deeply and relaxing your muscle tension. Rate on a daily basis the degree of your success at implementing this technique to stop and replace the obsessive thought. Day 1: 1 234 5 No Success Very Successful Day 2: 1 234 5 No Success Very Successful Day 3: 1 234 5 No Success Very Successful Day 4: 1 234 5 No Success Very Successful Day 5: 1 234 5 No Success Very Successful Day 6: 1 234 5 No Success Very Successful Day 7: 1 234 5 No Success Very Successful EXERCISE XXVII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
230 OBSESSIVE-COMPULSIVE DISORDER (OCD)5. Rate again the degree of interference of the obsessive thought on your normal rou-tine after implementing this technique for a week. 1 234 5 Very Strong and Frequent No Interference 6. Describe any anxiety reduction that has occurred as a result of implementing this assignment with its calming scenes and relaxing muscle tension. Then rate the de-gree of anxiety reduction you have experienced. 1 234 5 No Anxiety Reduction Signifi cant Anxiety Reduction EXERCISE XXVII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
OBSESSIVE-COMPULSIVE DISORDER (OCD) 231Therapist's Overview REDUCING THE STRENGTH OF COMPULSIVE BEHAVIORS GOALS OF THE EXERCISE 1. Identify compulsive behaviors and their irrational basis. 2. Develop and implement realistic self-talk techniques to reduce the frequency of com-pulsive behaviors. 3. Develop and implement behavioral interruption techniques to reduce the frequency of compulsive behaviors. 4. Develop a greater sense of control over compulsive behavior rituals and reduce their frequency. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chemical Dependence Chemical Dependence—Relapse Eating Disorder SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Most often clients suffering from Obsessive-Compulsive Disorder (OCD) enter treatment believing that they have no control over their behavior patterns or thought patterns. This exercise is designed to increase their sense of control and reduce the frequency of compul-sive behaviors. You may want to review the main elements of this homework assignment with the client before it is given, helping him / her to understand positive self-talk and behavioral interruption principles. Review the client's success at implementation and make any necessary adjustments in the therapeutic techniques as needed. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
232 OBSESSIVE-COMPULSIVE DISORDER (OCD)EXERCISE XXVII. B REDUCING THE STRENGTH OF COMPULSIVE BEHAVIORS Compulsive behaviors are repetitive and intentional behaviors that are done in response to obsessive thoughts or according to eccentric rules. They are often done to neutralize or prevent discomfort or some dreaded situation in the future. None of these compul-sive behavior rituals are connected in any realistic way with what they are designed to neutralize or prevent. This assignment helps you to examine your compulsive behavior rituals and provides you with two powerful techniques to increase your control over these compulsive behaviors and reduce their frequency of occurrence. 1. List the compulsive behaviors you engage in on a frequent and repeated basis. 2. Rate the degree of control you believe that you have over these compulsive behaviors. 1 234 5 No Control Total Control 3. Describe why you believe engaging in these repetitive behaviors is of benefi t to you (e. g., it's relaxing, feel less anxious or worried, stops my thinking about it). 4. Rate how rational you believe your compulsive behavior is (e. g., Is it reasonable? Is it really effective at reassuring you? Does it make sense?). 1 234 5 Irrational and Unreasonable Very Rational | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
OBSESSIVE-COMPULSIVE DISORDER (OCD) 2335. Positive realistic self-talk can be effective at counteracting the urge to engage in compulsive behavior. Review the following self-talk messages and write any addi-tional messages you believe could be effective for your use. A. This behavior is not reasonable and I will not do it. B. I can resist this urge and it will go away eventually. C. I can think and act rationally about this urge. D. Anxious feelings will return after I perform this action, so I'm not going to do it. E. If I implement relaxation techniques, I will settle down. F. I'm going to think of a pleasant, calm scene until this urge passes. G. H. I. 6. From the list, select the two or three self-talk messages that you think would be most effective for you. Write their letters. 7. It is often effective to develop and implement a ritual that interrupts the current pattern of compulsive behavior. This behavior becomes a substitute for the compul-sive behavior, but it is one that is under your control more directly. Describe two or three behaviors that you could engage in when the urge to perform the compulsive behavior becomes strong (e. g., vacuum the house, take a walk or perform some other exercise, call a friend, write in a journal). A. B. C. 8. For the next week, implement positive self-talk and ritual behavioral interruption to reduce the frequency of engaging in the compulsive behavior. Rate your degree of success at implementing these techniques. Day 1: 1 234 5 No Success Very Successful Day 2: 1 234 5 No Success Very Successful EXERCISE XXVII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
234 OBSESSIVE-COMPULSIVE DISORDER (OCD)Day 3: 1 234 5 No Success Very Successful Day 4: 1 234 5 No Success Very Successful Day 5: 1 234 5 No Success Very Successful Day 6: 1 234 5 No Success Very Successful Day 7: 1 234 5 No Success Very Successful 9. Now that you have implemented cognitive and behavioral control techniques, rate the degree of control you believe you have over your compulsive behaviors now. 1 234 5 No Control Total Control EXERCISE XXVII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PANIC 235Therapist's Overview MONITORING MY PANIC ATTACK EXPERIENCES GOALS OF THE EXERCISE 1. Identify changes in panic attack severity. 2. Identify thoughts or experiences that trigger panic attacks. 3. Note reinforcing reactions of others to the panic attack experience. 4. Track the effectiveness of panic attack coping strategies. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Social Discomfort SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This rating form may be used with the client after coping strategies have been thor-oughly reviewed and taught. After the client is familiar with such coping strategies as re-laxation, deep breathing, positive self-talk, attention diversion, behavioral substitution, and cognitive restructuring, he / she can use the form to track his / her implementation of and success with these techniques in reducing the severity of panic symptoms. Provide the client with seven copies of the form so he / she can complete one on a daily basis to rate his / her experience of panic and the progress toward rehabilitation. The client should also be alerted to the need to monitor internal and external triggering stimuli for his / her panic experience. SECTION XXVIII: PANIC | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
236 PANICEXERCISE XXVIII. A MONITORING MY PANIC ATTACK EXPERIENCES Make copies of this form and answer the questions for each panic attack experience. Anxiety Scale 01 02 03 04 05 06 07 08 09 0 1 0 0 None Mild Moderate High Severe 1. Using the 0 to 100 scale, what number would you use to rate the overall level of your anxiety during the panic attack? 2. What symptoms of panic did you experience? 3. Approximately, how long did your panic attack last? 4. What problems or stressful events were you experiencing shortly before your panic attack? 5. What anxious or negative thoughts were you experiencing shortly before the panic attack? 6. How did your family members, friends, or others react during and after your panic attack? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EXERCISE XXVIII. A PANIC 2377. What strategies did you use to deal with your anxiety? 8. How did the strategies help in managing your anxiety? 9. What would you do differently, in the future, if you have another panic attack? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
238 PARANOID IDEATIONTherapist's Overview CHECK SUSPICIONS AGAINST REALITY GOALS OF THE EXERCISE 1. Verbalize an understanding that fears or suspicions can grow to become irrational. 2. Examine suspicions against history, others' perception, and logic. 3. Acknowledge that some personal fears / suspicions are unreasonable. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Intimate Relationship Confl icts Psychoticism Sleep Disturbance Social Discomfort SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT If the client's paranoia is severe and the client is not open to challenging his / her beliefs, then you will have to be very actively involved in assisting the client in completing this exercise. Review each step of the assignment to help the client yield the irrational belief in the face of contradictory evidence from history, others' perceptions, and logic. SECTION XXIX: PARANOID IDEATION | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARANOID IDEATION 239EXERCISE XXIX. A CHECK SUSPICIONS AGAINST REALITY Fear and suspicion have a way of growing in strength and breadth or scope when the fear is not checked against reality. If we ponder our fears alone, the risk is that they can become irrational, unreasonable, and illogical. It is common to feel more anxious in the middle of the night when worries are on your mind and it is dark, quiet, and lonely. Burdens seem reduced when the light of day arrives and the concerns can be shared with others. We regain a realistic perspective. Use this exercise to examine the fears and suspicions that plague you and interfere with your feeling of trust, peace, and happiness. Check out your suspicious beliefs against reality viewed from a different perspective. 1. Check out your fears / suspicions by thinking about the history of the suspected per-son or agency in terms of dealings with you. Have you, for the most part, been dealt with fairly, reasonably, respectfully, and kindly? 2. Check out your fears / suspicions by writing about the history of the suspected person or agency in terms of dealings with others. Have others, for the most part, been dealt with fairly, reasonably, respectfully, and kindly? 3. Check out your fears / suspicions by writing about how others perceive the suspected person or agency. Ask others about whether they share your beliefs and record their responses. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EXERCISE XXIX. A 240 PARANOID IDEATION 4. Check out your fears / suspicions by considering whether your fear is logical, rational, or reasonable. Can you acknowledge that your suspicions are irrational and should be discounted and revised? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARENTING 241Therapist's Overview LEARNING TO PARENT AS A TEAM GOALS OF THE EXERCISE 1. Each parent identifi es his / her own parenting strengths and weaknesses. 2. Each parent identifi es the parenting strengths and weaknesses of his / her partner. 3. Acknowledge areas where parenting weaknesses exist and request help in these ar-eas. 4. Each parent identifi es ways that he / she can be supportive of his / her partner in the parenting process. 5. Implement a scheduled list of family activities to promote connectedness and har-mony. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL None SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Encourage the parents to work on the fi rst step of this exercise independently before sharing the results with each other in a discussion format. Encourage them to come to you with requests for specifi c kinds of help they need as they try to improve their parent-ing. Reinforce their attempts to support one another as members of the parenting team. Encourage them to involve the children in fi nding family activities that will promote family connectedness. SECTION XXX: PARENTING | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
242 PARENTINGEXERCISE XXX. A LEARNING TO PARENT AS A TEAM Parenting is a diffi cult task that requires good communication between partners as well as good cooperation and consistency. Each of us is a unique human being that brings his / her own strengths and weaknesses to bear on the task of parenting. To be an effec-tive parenting team, you must help your partner in his / her area of weakness while your partner helps you in your area of weakness. Each of you must also support each other in your area of strengths. This exercise is meant to help you identify your strengths and weaknesses and describe ways that you can support each other to become a stronger parenting team. The exercise also calls for you to implement increased family activities to promote a feeling of connectedness between family members and promote harmony between parents as leaders of this family. 1. Each parent lists three to fi ve of his / her own parenting strengths (e. g., playing with the children, making the children do their homework) and weaknesses (e. g., not en-forcing the rules, talking to the children, supporting my spouse in parenting). Then list three to fi ve strengths and weaknesses of your partner. Write your lists without consulting your partner. After all lists have been created, transfer the data to this page. MOTHER'S LIST Her Own Strengths Weaknesses Her Husband's Strengths Weaknesses | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARENTING 243FATHER'S LIST His Own Strengths Weaknesses His Wife's Strengths Weaknesses 2. After sharing your lists with each other, discuss and describe what kind of help you need from your counselor to improve your parenting as a team. 3. List three ways that each of you wishes the other partner would show support for you as a parent (e. g., join me when I discipline, calm me when I'm upset, listen to me when I'm frustrated). MOTHER'S WISHES A. B. C. FATHER'S WISHES A. B. C. EXERCISE XXX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
244 PARENTING4. In a family meeting, construct a list of activities that members would enjoy doing together. Use a brainstorming technique where no idea is rejected to create a begin-ning list of 16 possible activities. 5. Select two activities to be implemented per week for the next 3 weeks. Schedule them for a date and time when all will be available and participate. Week 1 Activity One: Date / Time: Activity Two: Date / Time: Week 2 Activity One: Date / Time: Activity Two: Date / Time: Week 3 Activity One: Date / Time: Activity Two: Date / Time: 6. Describe the reaction of yourself and other family members to the family activity schedule. EXERCISE XXX. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARENTING 245 Therapist's Overview USING REINFORCEMENT PRINCIPLES IN PARENTING GOALS OF THE EXERCISE 1. Parents learn some basic tools of behavior modifi cation. 2. Parents learn to write clear, behaviorally specifi c, positively directed rules. 3. Parents focus more on rule-keeping behavior and develop a repertoire of positive reinforcements for the child. 4. Parents learn to confront rule-breaking in a calm, controlled, reasonable, behavior-ally focused, respectful manner and develop a list of potential logical consequences. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anger Management Family Confl ict Intimate Relationship Confl icts SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Parents fi nd it diffi cult to express expectations in behaviorally specifi c language—so do therapists. We must patiently try to shape parents' behavior as we process the rules that they develop. Also, be careful to bring to light unspoken rules that are left unlisted, but actually are very important for harmony in the household. Use counseling sessions to review lists and to model or role play positive reinforcement of rule-keeping behavior. Watch out for negative consequences for rule breaking that are not “tied to the crime” and are too protracted. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
246 PARENTINGEXERCISE XXX. B USING REINFORCEMENT PRINCIPLES IN PARENTING Rules are best kept when there are as few as possible; they are stated clearly and in a positive direction; obedience is recognized by reward; and disobedience is either ignored (if a minor violation) or met with a consequence that is swiftly administered, brief, not harsh, focuses on the offensive behavior and not on the child, and is somehow related to the broken rule. This exercise helps you think about what your rules are for your child and what the consequences for his / her obedience and disobedience are. Think about, discuss, and then write out the six most important rules of the house-hold for your child. Write them concisely and clearly so there is no misunderstanding as to what is expected from the child. Also, be sure to write them in observable terms and in a positive direction. For example: EXAMPLE A Bad Rule: Johnny must stop causing so much trouble with his sister. Better Rule: Johnny must keep his hands off his sister, talk to her softly and politely, and allow her to fi nish her TV program before asking to change the chan-nel to his preference. EXAMPLE B Bad Rule: Johnny must take his schoolwork more seriously and be more respon-sible about homework assignments. Better Rule: Johnny must attend all his classes promptly and regularly, complete and hand in each assignment on time, keep the rules of the classroom, re-serve at least 1 hour per night for quiet study, and obtain no grade be-low C-. EXAMPLE C Bad Rule: Johnny must not explode in anger whenever he is told he may not do some activity or must stop some activity he is doing. Better Rule: When Johnny is told what he may or may not do, he must accept the pa-rental or teacher limits calmly and respectfully, carrying out the request within 30 seconds or less. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARENTING 247Six Most Important Rules 1. 2. 3. 4. 5. 6. When rules are kept or reasonably obeyed, it is easy to take this behavior for granted and not acknowledge it. But when the goal is to build self-esteem, increase compliance, and reduce confl ict with authority, then it is advisable to focus positive attention on obe-dience or compliance. Find ways to reward obedient behavior whenever and wherever it occurs. Rewards do not have to be elaborate, expensive, or even concrete. The reward can be as simple as “Thanks, I appreciate that” or an affectionate pat on the back. At times, it may be appropriate to stop and talk about how pleasant it is for everyone when rules are kept, respect is shown, and confl ict is at a minimum. Finally, some rewards may be more concrete such as a small gift, a favorite meal, a special outing, a privilege granted, or an appreciative note left on his / her pillow. Now list 10 ways that you could show positive recognition to your child for keeping the rules. 1. EXERCISE XXX. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
248 PARENTING2. 3. 4. 5. 6. 7. 8. 9. 10. Obviously, rules are not going to be kept 100 percent of the time by any child. The diffi cult task for a parent is to decide how to respond to disobedience most effectively and reasonably. Two cardinal rules for punishment: First, do not react when and if your anger is not well controlled; postpone action but make it known that you are doing so. Second, keep your focus on the child's behavior that is out of bounds and do not disparage, name-call, swear at, or belittle the child; give consequences with an attitude of respect. Consequences should be given as soon as reasonably possible after the disobedience— long delays before consequences reduce effectiveness signifi cantly. Consequences should EXERCISE XXX. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PARENTING 249be brief and tied to the offensive behavior, if possible. Long and extended consequences breed resentment, cause hardship for the enforcers of the consequences, and are not any more effective than something more pointed and brief. Finally, be sure to be consistent in giving consequences; both parents have to work together. Misbehavior should not be overlooked one time and addressed the next nor should it be overlooked by one parent and punished by the other. Now list two possible consequences for each of the Six Most Important Rules that you listed previously. 1a. 1b. 2a. 2b. 3a. 3b. 4a. 4b. 5a. 5b. 6a. 6b. EXERCISE XXX. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
250 PHASE OF LIFE PROBLEMSTherapist's Overview WHAT NEEDS TO BE CHANGED IN MY LIFE? GOALS OF THE EXERCISE 1. Identify sources of stress, dissatisfaction, or frustration. 2. Identify responsibilities that are perceived as overwhelming. 3. Identify potential resources that have been overlooked and can reduce stress and in-crease shared responsibilities. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT A central role for the therapist in helping the client with a phase of life problem is that of assisting him / her in clarifying the problem and identifying resources to help reduce the dissatisfaction in life. This assignment is best used in early stages of counseling. You may want to consider the option of completing the assignment with the client during the ses-sion, but if the client has signifi cant strengths, it would be helpful to challenge him / her to work on this assignment between sessions and then process the results together. If his / her list of potential resources is not complete, you may focus on this issue in item number 7 and help him / her expand his / her thinking about this issue. SECTION XXXI: PHASE OF LIFE PROBLEMS | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHASE OF LIFE PROBLEMS 251EXERCISE XXXI. A WHAT NEEDS TO BE CHANGED IN MY LIFE? Your life may be surrounded by circumstances that you wish were different. Or, there may be a set of circumstances that you wish were present in your life that are absent. You may also be searching for resources that can provide you with some assistance to resolve the problems facing you. This assignment is designed to help you clarify those issues and bring you closer to making changes to improve your life. 1. List those circumstances that are present in your life that are contributing to your dissatisfaction, stress, or frustration. 2. Describe why each of the circumstances listed leads to dissatisfaction. 3. List those circumstances that you wish were present in your life and that you believe would increase your sense of fulfi llment. 4. List those activities that you wish you were involved in and that you believe would increase your quality of life. 5. What changes would you like to occur for you to be less stressed and more happy? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
252 PHASE OF LIFE PROBLEMS6. What, if any, responsibilities would you like to be shared with others in order to re-duce your burden? 7. Now it is time for you to brainstorm possibilities that exist in your life that may have been overlooked. These possibilities include resources that could be helpful to you to resolve crises that you face. In the following spaces, fi ll in the names for people, organizations, or activities in the various categories listed that could be sources of support. Family members: Friends: Neighbors: Self-help group members: Counselor: Coworkers: Clergy: Service organizations: Church members or groups: Educational classes: Other resources: 8. Select three resources from your list and describe how these could be helpful to you and how you might begin to include them in your daily life. Resource One: Resource Two: Resource Three: EXERCISE XXXI. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHASE OF LIFE PROBLEMS 253Therapist's Overview WHAT'S GOOD ABOUT ME AND MY LIFE? GOALS OF THE EXERCISE 1. Identify advantages of current life situation. 2. Identify personal strengths and positive traits or talents. 3. Develop an action plan to increase activities that give meaning and satisfaction to life. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Chronic Pain Dependency Depression Suicidal Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This assignment is best given at middle stages of counseling after the problems have been clarifi ed and the client has the potential for establishing some balanced perspective to his / her life. If the client returns the assignment without having fulfi lled all of the re-quests for information, review the items and brainstorm additional data that could have been included. Some clients fi nd it very diffi cult to see anything positive about their life situation or their own personal strengths. Clients may also need help in developing the action plan called for in the fi nal item of the assignment. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
254 PHASE OF LIFE PROBLEMSEXERCISE XXXI. B WHAT'S GOOD ABOUT ME AND MY LIFE? Many people get stuck in a negative perception of themselves or their life circumstances and lose a balanced perspective that includes positive aspects of their lives. This assign-ment is designed to help you focus on your strengths and how you might use them to em-power yourself toward greater satisfaction with your life. You need to make a concerted effort to overcome your belief that your life circumstances are overwhelmingly negative. 1. Describe at least fi ve advantages to your current life circumstance (e. g., opportunity to make own decisions, opportunity for intimacy and sharing with a partner, a time for developing personal interests, meeting the needs of a signifi cant other). A. B. C. D. E. F. G. 2. List at least fi ve of your strengths, positive traits, or talents that you can use to en-rich your life and the lives of others. A. B. C. D. E. F. G. 3. What changes do you believe you could make to help restore balance to your life? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHASE OF LIFE PROBLEMS 2554. What steps will you commit to for using your strengths, interests, and talents to be-gin to make the changes you feel are necessary for increased satisfaction. Describe actions and set target dates for implementation. Action Date EXERCISE XXXI. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
256 PHOBIATherapist's Overview FOUR WAYS TO REDUCE FEAR GOALS OF THE EXERCISE 1. Identify and develop specifi c strategies to resolve the fear. 2. Implement a specifi c strategy on a consistent basis to minimize the impact of the fear. 3. Increase confi dence and effectiveness in coping with the fear. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Anxiety Social Discomfort SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The focus in processing this exercise should be placed on assisting the client in com-pletely developing each of the resolution strategies and in helping him / her to fully imple-ment that strategy. Offer encouragement, feedback, and direction as needed as you follow up on the strategy. If the fi rst strategy chosen does not seem to be effective despite the client's best efforts, another option should be chosen and implemented. SECTION XXXII: PHOBIA | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHOBIA 257EXERCISE XXXII. A FOUR WAYS TO REDUCE FEAR This exercise helps you develop four different ways to minimize your fear. After develop-ing the four ways you will then choose the one that you feel would be best for you and try it for the following week when encountering your fear. 1. Develop fully each of the following methods for resolving your fear. A. Exaggeration: Start with identifying your fear; then imagine it as big, scary, ugly, and so on. Use as many negative descriptive words as possible in describ-ing the fear in the worst possible way and with the most dire consequences. Application: By imagining the worst that can happen in the worst possible way, the things I face don't seem so big or terrible. B. Thought Restructuring: Record the three or four most common thoughts you have that lead to increased feelings of fear (e. g., “I'm going to make a fool of my-self,” “Everyone is staring at me”). After completing that, ask your therapist to help you restructure your fear-producing thoughts into thoughts that are more realistic and positive (e. g., “I will do my best and people will respect me for that effort”). Thought 1: Restructured: Thought 2: Restructured: Thought 3: Restructured: | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
258 PHOBIAThought 4: Restructured: Application: How we think about something affects our feelings. By changing our thoughts and perceptions, we change our feelings. C. Therapist in Your Pocket: Ask your therapist to provide you with four or fi ve statements that will offer reassurance when you are encountering your phobia. Record them and then either commit them to memory or write them on a card to keep in your pocket at all times. 1) 2) 3) 4) Application: Reassuring and encouraging statements from people we respect and trust can help us cope with diffi cult or scary situations. D. Relaxing Distraction: Create a favorite relaxing daydream to use to distract yourself when facing or thinking about the situation your fear. Then choose a relaxing activity to use as a distraction at other times (e. g., sunbathing on the beach). Daydream: Activity (e. g., quietly singing, relaxation breathing): Application: When distracted, we forget our worries, fears, and troubles. 2. Choose an approach to your fear. A. Identify which of the four approaches (i. e., A, B, C, D) you feel would be most effective in helping you resolve your fear. B. Explain briefl y the choice you made and why you feel it would be effective. EXERCISE XXXII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHOBIA 259 C. Use an X to indicate how sure you feel about the approach working for you. Very Sure Sure Somewhat A Little Not at All On a scale of 1 to 10 rate your determination to overcome your fear. 1 I'll live with it. 51 0 I must conquer it. 3. Make a commitment to use the approach you chose whenever you encounter the fear over the next week and then evaluate how effective it was in dealing with the fear after each time you used it. A. B. C. D. EXERCISE XXXII. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
260 PHOBIATherapist's Overview GRADUALLY REDUCING YOUR PHOBIC FEAR GOALS OF THE EXERCISE 1. Identify precisely what the feared object or situation is. 2. Describe the emotional, physiological, and behavioral impact that the feared object or situation has had. 3. Develop and implement a plan of systematic exposure to the feared object or situa-tion until fear is extinguished. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Childhood Trauma Posttraumatic Stress Disorder (PTSD) Social Discomfort SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT Systematic desensitization to a phobic object or situation has proven to be a very suc-cessful approach to extinguishing a fear response. This assignment focuses the client on the phobic stimulus and its effect on his / her life. Then, the client must develop a gradual hierarchy of exposure steps to the feared stimulus. You probably will have to be directly involved in constructing this hierarchy with the client. As preparation for beginning the in vivo exposure to the feared stimulus, it is recommended that you teach the client some behavioral and cognitive anxiety-reduction skills, such as deep breathing, progressive relaxation, positive imagery, confi dence-building self-talk, and so on. Monitor and rein-force his / her implementation of these skills as the exposure program progresses. Urge the patient to increase exposure as anxiety diminishes to the current step. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHOBIA 261EXERCISE XXXII. B GRADUALLY REDUCING YOUR PHOBIC FEAR Fears that are so strong that they control our behavior need to be faced and overcome. This exercise helps you do just that: Identify what your fear is; describe how it affects you; develop a plan to face it systematically; and, fi nally, actually take steps to face your fear and win. 1. It is important to clearly identify what you fear and how it affects you emotionally (e. g., feel nervous and tense), behaviorally (such as avoid contact and / or don't talk about the feared stimulus), and physically (for instance, heart pounds, forehead and palms sweat, stomachache, nausea). Describe what the feared object or situation is and then tell how it affects you. Feared Object or Situation Reaction to Feared Object or Situation Emotional reaction: Behavioral reaction: Physical reaction: To overcome a fear, it must be faced in a gradual but systematic fashion. We call this exposure. When you practice exposure in the proper way, fear steadily diminishes until it does not control your behavior or affect you physically. The key to the process is to develop a plan for gradually increasing exposure to the feared object or situation. Once the plan is developed, you then expose yourself one step at a time to the feared object or situation. You do not take the next step in the gradual exposure plan until you are quite comfortable with the current level of exposure. For example, if your fear is that of driving alone on the expressway during heavy traf-fi c, you could design a plan as follows. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
262 PHOBIAStep 1. Drive on the expressway for 5 minutes at a time of light traffi c with a supportive person to give reassurance. Step 2: Drive on the expressway for 5 minutes at a time of light traffi c, alone. Step 3: Drive on the expressway for 10 minutes at a time of light traffi c, alone. Step 4: Drive on the expressway for 15 minutes at a time of light traffi c, alone. Step 5: Drive on the expressway for 5 minutes at a time of heavy traffi c, alone. Step 6: Drive on the expressway for 15 minutes at a time of heavy traffi c, alone. Each next step is taken only after the fear is low or gone in the current step. 2. Now create a gradual exposure program to overcome your feared object or situa-tion. The steps can increase the time you spend with the feared object or situation, increase your closeness to it, increase the size of the object, or a combination of these things. Use as many steps as you need. Your therapist is available to help you con-struct this plan, if necessary. Step 1. Step 2. Step 3. Step 4. Step 5. Step 6. Now it's time for a gradual but steady exposure to your feared object or situation. Stay relaxed. Your therapist may teach you some deep breathing, muscle relaxation, and posi-tive self-talk techniques that you can use to keep yourself relaxed. For each attempt at exposure, record the coping technique you used and rate your degree of fear on a scale of 1 to 100, with 100 representing total panic, the sweats, and heart-pounding shakes. The rating of 1 represents total calm, complete confi dence, peace of mind, looseness, and EXERCISE XXXII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PHOBIA 263relaxed feeling. When your rating is reduced to 10 or lower on a consistent basis for the exposure to a particular step, then it's time to consider moving on to the next step. Exposure Steps Coping Technique and Fear Rating Step 1. 1st attempt: 2nd attempt: 3rd attempt: Step 2. 1st attempt: 2nd attempt: 3rd attempt: Step 3. 1st attempt: 2nd attempt: 3rd attempt: Step 4. 1st attempt: 2nd attempt: 3rd attempt: Step 5. 1st attempt: 2nd attempt: 3rd attempt: Step 6. 1st attempt: 2nd attempt: 3rd attempt: EXERCISE XXXII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
264 POSTTRAUMATIC STRESS DISORDER (PTSD)Therapist's Overview HOW THE TRAUMA AFFECTS ME GOALS OF THE EXERCISE 1. Identify and clarify the experience of PTSD symptoms. 2. Identify the most distressing symptoms and the frequency of their occurrence. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Childhood Trauma Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This is a simple and straightforward exercise designed to help the client focus his / her thinking on the specifi c PTSD symptoms he / she has experienced. You may want to review the list with the client within the session to clarify the meaning of some of the symptom descriptions. During your review of the completed exercise, allow the client to elaborate on any of his / her symptoms and explore how these symptoms have affected his / her life. SECTION XXXIII: POSTTRAUMATIC STRESS DISORDER (PTSD) | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
POSTTRAUMATIC STRESS DISORDER (PTSD) 265EXERCISE XXXIII. A HOW THE TRAUMA AFFECTS ME After having been exposed to a serious threat or actual physical trauma or abuse, many people develop a set of emotional, cognitive, or behavioral symptoms. The immediate response of fear, helplessness, or horror often gives way to lingering effects that can be intense at times and can affect your life in many ways. This exercise is designed to help you focus in and identify those specifi c symptoms of PTSD that you have experienced. 1. Review the items in the two columns and put a checkmark in front of the symptoms that you have experienced since the traumatic event occurred. Intrusive thoughts / images Sleep pattern abnormal Disturbing dreams Irritable Flashbacks of the trauma Poor concentration Reminders of trauma bring distress On edge Shakes, sweats, heart racing Easily startled Avoid talking about the trauma Sad or guilty feelings Avoid trauma places / people Alcohol / drug abuse Amnesia regarding trauma Suicidal thoughts Withdrawal from activities Confl ict with others Feel detached from other people Verbally / physically violent Emotionally numb Other: Pessimistic regarding future Other: 2. Which three symptoms that you have placed a checkmark next to have caused you the most distress? 3. How frequently does each of the symptoms that you noted in number 2 occur? 4. When was the last occurrence of a PTSD symptom and what was that symptom? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
266 POSTTRAUMATIC STRESS DISORDER (PTSD)Therapist's Overview SHARE THE PAINFUL MEMORY GOALS OF THE EXERCISE 1. Described the traumatic experience in some detail. 2. Identify the ways that the trauma has impacted life. 3. Communicate the feelings associated with the traumatic event. 4. Review treatment options designed to help people recover from PTSD. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Childhood Trauma Sexual Abuse SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT It is always a delicate clinical decision as to when and how to encourage the client to ex-plore the details of severe trauma that he / she has experienced. If there is any question about the ability of the client to focus on the details of the traumatic event outside of the supportive therapeutic relationship, allow the client to answer the fi rst question within a therapy session. Allow the client to begin to express his / her feelings associated with the trauma, both those that were immediately precipitated by the event and those feelings that can be stirred after the event. You may have to review the list of treatment strate-gies found in Item 6 to provide further explanation for the client. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
POSTTRAUMATIC STRESS DISORDER (PTSD) 267EXERCISE XXXIII. B SHARE THE PAINFUL MEMORY It is not unusual for someone who has experienced a physical and / or emotional trauma to want to avoid anything and everything that is associated with that trauma. A common re-action is, “I don't want to talk about it. ” However, refusing to deal with a traumatic event by attempting to bury it will only increase the negative consequences of that trauma and prolong its effects. You need to share, when the time is right, as much detail about the ex-perience as you possibly can. This exercise is designed to help you share what happened and how you feel about it. 1. Describe the traumatic incident, giving as many specifi cs as possible (e. g., your age, the place of occurrence, details of what happened, who was present at the time of the trauma). If necessary, use additional paper to describe your experience. 2. What other events have you experienced in your life that are similar to the trau-matic event you described in item number 1? 3. What are the harmful ways that you have attempted to cope with your emotional reaction to the trauma (e. g., substance abuse, avoid thoughts of the incident, avoid people / places associated with the incident, social withdrawal, sleeping)? 4. How have the trauma and your reaction to it affected your life (e. g., intimate part-ner relationship, relationships with friends, work performance, family relationships, social / recreational activities, spiritual journey, physical health)? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
268 POSTTRAUMATIC STRESS DISORDER (PTSD)5. For each of the following emotions, use an X to indicate the strength of your feeling on the continuum: Anger Very Strong Strong Somewhat Barely Never Sadness Very Strong Strong Somewhat Barely Never Fear Very Strong Strong Somewhat Barely Never Guilt / Shame Very Strong Strong Somewhat Barely Never Embarrassment Very Strong Strong Somewhat Barely Never Tension / On Edge Very Strong Strong Somewhat Barely Never 6. Review various treatment strategies described briefl y and mark those that you be-lieve can help you overcome this trauma. Slowly retelling and gradually reliving the details of the incident in a safe therapy environment. Learning new ways to think about the trauma. Learning to manage and control anger and other strong emotions. Taking medication to deal with depression and anxiety. Developing a recovery program to end substance abuse as an escape from pain. Learning relaxation skills to reduce tension, stress, and panic. Slow, systematic exposure to the memory of the traumatic event while staying calm and relaxed. Sharing your experience in a group setting with others who have been through a trauma. Sharing the experience with family members who can be understanding and supportive. Learning communication and confl ict resolution skills to apply to a strained intimate relationship. Developing a sleep induction routine that will reduce fatigue and restlessness. EXERCISE XXXIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
POSTTRAUMATIC STRESS DISORDER (PTSD) 269 Implementing problem-solving skills with vocational confl icts to stabilize em-ployment. Implementing an exercise regimen to reduce stress and increase energy level. Relying on spiritual faith to build confi dence and foster forgiveness and peace. 7. Explain why you believe each of the treatment selections you made in number 6 will be of benefi t to you. EXERCISE XXXIII. B | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
270 PSYCHOTICISMTherapist's Overview WHAT DO YOU HEAR AND SEE? GOALS OF THE EXERCISE 1. Reduce anxiety associated with the experience of hallucinations. 2. Identify stressors that increase the frequency or intensity of hallucinations. 3. Separate reality from hallucination experience. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Depression Mania or Hypomania Paranoid Ideation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise provides an opportunity for the client to describe the history, nature, and precipitating circumstances surrounding his / her hallucinations. It may be necessary to administer this exercise verbally within a therapy session because the client may not be capable of staying focused enough to complete this as a writing assignment. The therapist should clearly label these hallucination experiences as the result of the client's illness, not a refl ection of reality. Suggestions could be made as to coping techniques (distraction, medication adjustment, sharing with supportive individuals, etc. ). SECTION XXXIV: PSYCHOTICISM | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
PSYCHOTICISM 271EXERCISE XXXIV. A WHAT DO YOU HEAR AND SEE? Hallucinations are those private experiences of hearing voices or sounds, or seeing vi-sions, that others do not experience. You may hear voices that others cannot hear or see people or objects that others cannot see. This can be a very scary experience and it can seem as if the experience is very real, not a result of your mind being confused. This exercise encourages you to describe these private experiences that are not shared by others. Please be as open and honest as you feel comfortable with as you answer these questions. 1. Do you hear voices that others do not hear? Yes No If yes, A. When did you fi rst hear such voices? B. What do the voices say to you? (use additional paper, if necessary) C. Does it seem like the voices come from outside or inside your head? D. Do the voices ever command you to do anything? If so, what do they tell you to do? Do you do what they tell you? | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
EXERCISE XXXIV. A 272 PSYCHOTICISM E. What circumstances seem to bring on the hearing of voices? (when you are tired, afraid, tense, alone, with a crowd, etc. ) F. How does taking your medication affect your hearing of voices? G. On a separate piece of paper draw a picture of what you imagine the person speaking to you looks like. 2. Do you see people or objects that others cannot see? Yes No If yes, A. When did you fi rst experience these visions? B. Please describe what you see that others cannot see. C. What circumstances seem to bring on the vision? D. How does taking your medication affect your seeing these people or objects? E. On a separate piece of paper, draw a picture of what you see that others do not see. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
SEXUAL ABUSE 273Therapist's Overview A BLAMING LETTER AND A FORGIVING LETTER TO PERPETRATOR GOALS OF THE EXERCISE 1. Express feelings to and about the perpetrator including the impact that the sexual abuse has had. 2. Clearly place responsibility for the abuse on the perpetrator, absolving self of any blame. 3. Begin the process of forgiveness in order to relieve self of bitter anger. 4. Clarify current feelings toward the perpetrator and expectations held for him / her. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Dissociation Low Self-Esteem SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT This exercise focuses on two important steps in the recovery process for the survivor of sexual abuse. First, the client must place clear responsibility on the perpetrator for the sexual abuse and absolve himself / herself of any responsibility. Second, the client must begin a process of forgiveness to reduce feelings of anger or revenge that may cripple the recovery process. The letter of forgiveness cannot be assigned too early in the counsel-ing process, and the therapist must be careful that such a letter does not imply that the perpetrator is excused from responsibility for his / her actions. SECTION XXXV: SEXUAL ABUSE | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
274 SEXUAL ABUSEEXERCISE XXXV. A A BLAMING LETTER AND A FORGIVING LETTER TO PERPETRATOR It is very important for your recovery from the trauma of sexual abuse that you sort out your feelings about the abuse and clearly identify the perpetrator as the responsible party. You must resist the common tendency to take some responsibility for the sexual abuse, even in some indirect way or small measure. It is also important during later stages of recovery that you begin to grapple with the concept of forgiveness toward the perpetrator. You will need to discuss the concept of forgiveness and how this is a process that takes time. It is important to develop an understanding of why forgiveness can be a healthy practice for you that brings considerable benefi t in terms of replacing bitter an-ger with a sense of peace. This assignment is designed to help you think through writing a letter of blame, for this is an important step in your recovery, and a letter of forgiveness, a step not to be confused with excusing the perpetrator or absolving him / her of guilt. 1. Blame Letter: On the following lines, compose a letter of blame to the perpetrator and consider including the following elements in your letter. Tell the perpetrator what your accusations are regarding his / her abuse of you. Explain why the perpetrator is solely responsible for this abuse. Describe how the sexual abuse made you feel at the time it occurred and now. Describe how the sexual abuse has affected your life. Describe how you felt toward the perpetrator before, during, and immediately after the sexual abuse. Describe how you feel toward the perpetrator now. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
SEXUAL ABUSE 275 2. Forgiving Letter: On the following lines, compose a letter of forgiveness and consider including the following elements. Tell the perpetrator that he / she is solely responsible for the sexual abuse. Explain why you are attempting to forgive him / her. Explain that forgiveness does not mean that his / her abuse was excusable. Explain that forgiveness is a process that may take a long time to complete and you are only beginning it now. Tell the perpetrator what you expect from him / her now and in the future. Tell the perpetrator what type of relationship you may want with him / her, if any, in the future. EXERCISE XXXV. A | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
276 SEXUAL ABUSETherapist's Overview PICTURING THE PLACE OF THE ABUSE GOALS OF THE EXERCISE 1. Identify the location of the abuse and all those that were in reasonable proximity. 2. Acknowledge avoidance practices associated with the place of the abuse. 3. Increase feelings of empowerment, decrease avoidance practices. ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL Dissociation SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The client who has been through the trauma of sexual abuse often practices avoidance. This avoidance can be demonstrated in trying not to think about the incident, refusing to discuss the incident, staying away from the location of the abuse, and shunning any contact with the perpetrator. As recovery progresses, the client must terminate these avoidance practices and become more confi dent of his / her ability to cope with these re-minders of the abuse. Encourage the client to face these stimuli that are associated with the trauma of the past. If recollection of the trauma begins to lead to decompensation, it is very important that support be given to the client and he / she not be pressured to deal with these stimuli prematurely. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |
SEXUAL ABUSE 277EXERCISE XXXV. B PICTURING THE PLACE OF THE ABUSE A common practice of those who have suffered a traumatic experience is to avoid any-thing associated with the trauma. However, this practice does not promote healing and may exaggerate the negative consequences that occur after a trauma. Healthy recovery requires that you are able to encounter the details of the trauma without being over-whelmed with negative emotions. This exercise is designed to help you come face to face with the traumatic experience, at least in terms of the specifi c environment in which it occurred. 1. On a separate sheet of paper draw a fl oor plan or diagram of the place where the sexual abuse occurred (e. g., house, church, car, park). Indicate on the diagram where you and the perpetrator were and where any other people were that were reasonably close by. If the abuse occurred in several different locations, you may draw more than one diagram on this page or use other pieces of paper to draw your diagrams. 2. Describe any fl ashbacks, nightmares, or other thoughts you have had about the place of the abuse. 3. Describe the feelings you have when you remember the place of the abuse. 4. Describe what steps you have taken to avoid seeing, coming close to, or even think-ing about the place of the abuse. | Arthur E. Jr. Jongsma - Adult Psychotherapy Homework Planner 2nd Edition Practice Planners-Wiley 2006.pdf |