196 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER 19. Educa te about Lab Work (19) A. The client was educated about the need to stay compliant with necessary 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 reinfo rced for his/her compliance to completing necessary lab work to help regulate his/her medication 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. Teach a bout Sleep Hygiene Importance (20) A. The client was taught about the importance of good sleep hygiene. B. The client was assigned the “Sleep Pattern Record” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). C. The client's sleep pattern was routinely assessed. D. Interventions for the client's sleep pattern were provided, as he/she has been noted to have a dysfunctional sleep pattern. 21. Educate about Symptoms of Relapse (21) A. The client was educated about the signs and symptoms of pending relapse. B. The client's family was educated about the signs and symptoms of pending relapse. 22. Develop Relapse Drill (22) A. The client and family were assisted in drawing up a “relapse drill,” detailing roles and responsibilities. B. Family members were asked to take responsibility for specific roles (e. g., who will call a meeting of the family to problem solve potential relapse; who will call physician, schedule a serum level, or contact emergency services, if needed). C. Obstacles to provi ding family support to the client's potential relapse were reviewed and problem solved. D. The family was asked to make a commitment to adherence to the plan. E. The family was reinforced for their commitment to the adherence to the plan. F. The family has not developed a clear commitment to the relapse prevention plan and was redirected in this area. 23. Assess and Educate about Aversive Communication (23) A. The family was assessed for the role of aversive communication in family distress and in the risk for the client's manic relapse. B. The family was educated about the role of aversive communication (e. g., highly expressed emotion) in developing greater family stress and in increasing the client's risk for manic relapse. C. The family displayed a clear understanding of the effects of aversive communication and this was reinforced. D. The family was provided with remedial feedback, as they did not display a clear understanding of the risk for relapse due to aversive communication. 