4 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER B. The client's decreased reality testing causes him/her to have a decreased motivation to perform ADLs. C. As the client has become more reality focused, his/her completion of ADLs has increased. 6. Social Skills Deficits (6) A. The c lient displayed poor social interaction skills. B. The client displayed poor eye contact, insufficient interpersonal attending, and awkward social responses. C. As the client's severe and persistent mental illness symptoms have stabilized, his/her intera ction skills have increased. D. The client now displays more appropriate eye contact, interpersonal attending skills, and social responses. 7. Others Excuse Poor ADLs (7) A. The client described a history of others excusing his/her poor performance on A DLs. B. The client's family and friends rarely confront him/her on his/her poor performance on ADLs, as they believe this to be an inevitable component of his/her mental illness. C. Friends and family members have become more direct with the client about giving feedback regarding his/her performance on ADLs. D. The client's performance on ADLs has increased, as others have expected increased responsibility from him/her. 8. Inadequate Knowledge Regarding ADLs (8) A. The client displayed an inadequate le vel of knowledge or functioning in basic skills around the home. B. The client indicated that he/she has little experience in doing basic ADLs around the home (e. g., cleaning floors, washing dishes, disposing of garbage, keeping fresh food available). C. As the client has gained specific knowledge about how to perform basic duties around the home, his/her ADLs have become more appropriate. 9. Losses Due to Poor Hygiene (9) A. The client described that he/she has experienced loss of relationship, employm ent, or other social opportunities due to his/her poor hygiene and inadequate attention to grooming. B. The client's family, friends, and employer have all indicated a decreased desire to be involved with him/her due to his/her poor hygiene and inadequate attention to grooming. C. As the client's hygiene and grooming have improved, he/she has experienced improvement in relationships, employer acceptance, and other social opportunities. 