104 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER D. The client was reinforced for his/her understanding of the appropriate rational for treatment. E. The client was redirected when he/she displayed a poor und erstanding of the rationale for treatment. 16. Identify Relapse Triggers (16) A. Sources of the client's stress and triggers of potential relapse were identified. B. Negative events, cognitive interpretations, aversive communication, poor sleep hygiene, and medication noncompliance were investigated as potential stressors or triggers of potential relapse. C. Cognitive-behavioral techniques were used to address the sources of stress and triggers for potential relapse. 17. Enhance Engagement in Medication Use (17) A. Motivational interviewing approaches were used to help enhance the client's level of engagement in his/her medication use and compliance to the medication regimen. B. Modeling, role-playing, and behavioral rehearsal were used to help the clie nt use problem-solving skills to work through several current conflicts. C. The client was taught about the risk for relapse when medication is discontinued. D. Commitment was obtained to continuous prescription adherence. E. As a result of motivational interviewing approaches for medication compliance, the subject's use of medication has significantly improved. F. The client continues to be medication noncompliant despite use of motivational interviewing approaches; the client was refocused onto this t ask. 18. Assess Prescription Noncompliance Factors (18) A. Factors that have precipitated the client's prescription noncompliance were assessed. B. The client was checked for specific thoughts, feelings, and stressors that might contribute to his/her pre scription noncompliance. C. A plan was developed for recognizing and addressing the factors that have precipitated the client's prescription noncompliance. 19. Educate about Lab Work (19) A. The client was educated about the need to stay compliant with n ecessary lab work involved in regulating his/her medication levels. B. The client was encouraged to stay compliant with necessary lab work. C. The client was reinforced for his/her compliance to completing necessary lab work to help regulate his/her medi cation levels. D. The client has not been regular in his/her compliance to lab work for regulating his/her medication levels and was redirected to do so. 20. Assess Potential Crises (20) A. The client was assisted in assessing potential crises, including his/her most likely route to decompensation. B. The client was assisted in problem solving how to manage his/her potential crises. C. Family members were engaged in discussing the client's likely potential crises and how to manage them. 