240 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER B. Behavioral experiments were used to help test the reality of the client's delusional thoughts. C. As a result of Cognitive Restructuring and Behavioral Experiments the client is less fearful, more confident, and more reality oriented. D. Despite the use of Cognitive Restructuring and Behavioral Experiments the client continues to display significant delusional thoughts, fearfulness, skill deficits, and a lack of confidence; he/she wa s provided with remedial assistance in this area. 31. Explore Schema (31) A. The client was assisted in exploring his/her schema and self-talk that mediate his/her paranoid thoughts. B. The client was assisted in challenging the biases that support his/h er paranoid thoughts. C. The client was assisted in generating alternative appraisals that could be tested for truthfulness. D. The client has gained greater reality orientation through exploring and testing his/her schema and self talk. E. Despite expl oring the client's schema and self-talk, he/she continues to have significant paranoid thoughts; this pattern was summarized to him/her. 32. Assign Reality-Testing Homework (32) A. The client was given a homework exercise in which he/she identifies a few biased beliefs and creates reality-based alternatives. B. The client was directed to utilize the “Check Suspicions Against Reality” task in the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). C. The client's success in becoming more reality orie nted though the homework exercises was reinforced. D. The client was provided with corrective feedback toward improving his/her skills and being reality oriented. 33. Identify Reality Testing Activities (33) A. The client was encouraged to participate in activities that can help him/her to test his/her paranoid predictions against reality-based alternatives. B. The client was assisted in listing activities that may help him/her to test his/her predictions against reality-based alternatives. C. The clien t has engaged in activities that can help to test his/her paranoid predictions against reality-based alternatives, and the results of his/her experiments were reviewed. D. The client has not engaged in activities that can help to test his/her paranoid pre dictions and was redirected to do so. 34. Select Successful Behavioral Experiments (34) A. The client was assisted in selecting initial behavioral experiments that will have a high likelihood of being successful. B. Cognitive restructuring techniques wer e used within and after the exercise in order to reinforce successes and identify obstacles to problem solving. 35. Teach about Coping Package (35) A. The client was taught a variety of techniques to help manage anxiety symptoms. B. The client was taught calming strategies, such as relaxation and breathing techniques. 