344 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER 30. Discuss Management of Lapse Risk Situations (30) A. The client was assisted in identifying future situations or circumstances in which lapses could occur. B. The session focused on rehearsing the management of future situations or circumstances in which lapses could occur. C. The client was reinforced for his/her appropriate use of the lapse management skills. D. The client was redirected in regard to his/her poor use of lapse management skills. 31. Encoura ge Routine Use of Strategies (31) 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. 32. Develop a Coping Card (32) A. The client was provided with a coping card on which specif ic coping strategies were listed. B. The client was assisted in developing his/her coping card in order to list his/her helpful coping strategies. C. The client was encouraged to use his/her coping card when struggling with anxiety-producing situations. 33. Explore Secondary Gain (33) A. Secondary gain was identified for the client's panic symptoms because of his/her tendency to escape or avoid certain situations. B. The client denied any role for secondary gain that results from his/her modification of life to accommodate panic; he/she was provided with tentative examples. C. The client was reinforced for accepting the role of secondary gain in promoting and maintaining the panic symptoms and encouraged to overcome this gain through living a more norma l life. 34. Differentiate Current Fear from Past Pain (34) A. The client was taught to verbalize the separate realities of the current fear and the emotionally painful experience from the past that has been evoked by the phobic stimulus. B. The client wa s reinforced when he/she expressed insight into the unresolved fear from the past that is linked to his/her current phobic fear. C. The irrational nature of the client's current phobic fear was emphasized and clarified. D. The client's unresolved emotion al issue from the past was clarified. 35. Encourage Sharing of Feelings (35) A. The client was encouraged to share the emotionally painful experience from the past that has been evoked by the phobic stimulus. B. The client was taught to separate the rea lities of the irrational feared object or situation and the painful experience from his/her past. 