48 THE SEVERE AND PERSI STENT MENTAL ILLNESS PRO GRESS NOTES PLANNER D. “Applying Problem-Solving to Interpersonal Confl ict” from Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma) was assigned to the client. E. The client was provided with feedback about his/her use of the problem-solving assignment. 35. Differentiate between Lapse and Relapse (35) A. A discussion w as held with the client regarding the distinction between a lapse and a relapse. B. A lapse was associated with an initial and reversible return of symptoms, fear, or urges to avoid. C. A relapse was associated with the decision to return to fearful and avoidant patterns. D. The client was provided with support and encouragement as he/she displayed an understanding of the difference between a lapse and a relapse. E. The client struggled to understand the difference between a lapse and a relapse and was provided with remedial feedback in this area. 36. Discuss Management of Lapse Risk Situations (36) A. The client was assisted in identifying future situations or circumstances in which lapses could occur. B. The session focused on rehearsing the manageme nt of future situations or circumstances in which lapses could occur. C. The client was reinforced for his/her appropriate use of lapse management skills. D. The client was redirected in regard to his/her poor use of lapse management skills. 37. Encourag e Routine Use of Strategies (37) A. The client was instructed to routinely use the strategies that he/she has learned in therapy (e. g., cognitive restructuring, exposure). B. The client was urged to find ways to build his/her new strategies into his/her life as much as possible. C. The client was reinforced as he/she reported ways in which he/she has incorporated coping strategies into his/her life and routine. D. The client was redirected about ways to incorporate his/her new strategies into his/her ro utine and life. 38. Apply Secondary Gain ( 38) A. The possible secondary gain associated with anxiety symptoms was reviewed. B. The client identified specific secondary gains that he/she has attained related to anxiety symptoms, such as less involvement i n potentially difficult social situations, and these were reviewed. C. The client denied any pattern of secondary gain related to decreased functioning due to his/her anxiety and was provided with hypothetical examples of the secondary gains. 39. Encoura ge Daily Routines ( 39) A. The client was encouraged to develop a routine daily pattern as a means of reducing stress. B. The client was assisted in setting a routine daily pattern, including his/her regular waking and resting times, mealtimes, and routin ely performing daily chores. C. The client was reinforced for implementing a regular daily routine, which has increased his/her emotional stability. 