SELF-DETERMINATION DEFICI TS 291 5. Decreased Opportunities (4) A. The client described decreased opportunities due to his/her mental illness. B. The client has often been prohibit ed from age-appropriate activities or other opportunities due to his/her mental illness. C. As the client has taken responsibility for his/her own needs, he/she has been more assertive in obtaining opportunities appropriate to his/her age and station, in spite of his/her mental illness, and he/she has reported increased satisfaction. 6. Agencies Limiting Freedom of Choice (5) A. The client described involvement in agencies that have consistently dictated the options/services that are available. B. The c lient has often been denied the assistance he/she desires due to agencies dictating the options/services that are available. C. As the client has been more responsible for determining his/her own needs and services, his/her choice of services has expanded. D. The client reports increased satisfaction with the services that he/she selects. 7. Lack of Independent Living Skills (6) A. The client displayed limited knowledge and lack of skills necessary for living in an independent setting. B. The client ha s been dependent on others for basic needs, limiting his/her ability to obtain independent living skills. C. As the client has obtained skills for living independently, he/she has become more independent and has increased his/her level of functioning. 8. Vocational/Residential Failures (7) A. The client described a pattern of vocational placement failures due to a lack of appropriate decision-making skills and an inability to adjust to changing situations. B. The client described a pattern of residenti al placement failures due to a lack of appropriate decision-making skills and an inability to adjust to changing situations. C. The client has begun to use appropriate decision-making skills to assist him/her in adjusting to changing situations. D. As tr eatment has progressed, the client displayed increased success in vocational and residential placements. 9. Lack of Assertiveness (8) A. The client displayed a lack of assertiveness. B. The client described that he/she has decreased his/her assertivenes s due to his/her caregivers' pattern of overprotecting him/her. C. As the client takes more responsibility for his/her own needs, he/she has increased in assertiveness. 10. Poor Decision Making and Problem Solving (8) A. The client described a pattern o f poor decision making and poor problem solving. B. The client is often overprotected by his/her caregiver, resulting in limited opportunities to solve problems and make decisions. 