28 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER B. The client identified a pattern of impulsive anger outbursts without regard to the painful consequences that occur due to these anger outbursts. C. As the client has become more stable in his/her mood, he/she has reported a decrease in impul sive anger outbursts. D. The client reported that he/she is able to inhibit his/her impulses to react in an angry manner and considers the consequences for his/her actions. E. The client reported that he/she has not engaged in any recent incidents of imp ulsive anger outbursts. 5. Hostile Overreaction (4) A. The client described a history of reacting angrily to rather insignificant irritants in his/her daily life. B. The client indicated that he/she recognizes that he/she becomes too angry in the face o f rather minor frustrations and irritants. C. Minor irritants have resulted in explosive, angry outbursts that have led to destruction of property and/or striking out physically at others. D. The client has made significant progress at increasing his/her frustration tolerance and reducing explosive overreactivity to minor irritants. E. The client has not overreacted with anger to minor frustrations or irritants. 6. Paranoid Ideation (5) A. The client described a history of incidents in which he/she has become easily offended and was quick to anger. B. The client described a pattern of defensiveness in which he/she feels easily threatened by others and becomes angry with them. C. The client described periods during which he/she projects threatening mot ivations onto others, then reacts with irritability, defensiveness, and anger. D. The client reported a decreased pattern of inappropriate paranoid thought, which has led to fewer anger outbursts. E. The client has become less defensive and has not shown any recent incidents of unreasonable anger. 7. Intimidation and Control (6) A. The client identified a pattern of violent actions, threats, or verbally abusive language used to intimidate and control others when feeling threatened. B. The client presen ted in a hostile, angry, uncooperative, and intimidating manner during the clinical contact. C. The client is trying to act in a more cooperative manner within social and employment settings. D. The client is showing less irritability and argumentativene ss. E. The client displayed a willingness to not have to be in control of all situations. 8. Challenges Authority (7) A. The client's history shows a consistent pattern of challenging or disrespectful treatment of authority figures. B. The client ackno wledged that he/she becomes angry quickly when someone in authority gives direction to him/her. 