234 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER INTERVENTIONS IMPLEM ENTED 1. Review History of Paranoia Symptoms (1) * A. The client was requested to identify his/her history of persecutory hallucinations, delusions, or other paranoia symptoms. B. The client was provided with positive feedback as he/she gave a description of his/her history of persecutory hallucinations, delusions, or other paranoia symptoms. C. The client tended to minimize his/her history of paranoia symptoms and was provided with gentle confrontation in this area. 2. Assess Paranoia (2) A. The nature and extent of the client's current paranoia were assessed with special attention to severely delusional components. B. The client identified those people and/or agencies that are distrusted and was allowed to give his/her irrational explanation for this distrust. C. The client was accepted as he/she demonstrated a pattern of severe delusional aspects to his/her paranoia, although his/her delusions were not endorsed. D. The cl ient was gently confronted regarding being extremely guarded and defensive, refusing to openly describe the nature and severity of his/her distrust. E. The client was supported for demonstrating a decrease in his/her level of paranoia. 3. Conduct Anteced ent and Coping Interview (3) A. The Antecedent and Coping Interview (ACI) was used to identify the factors relevant to each symptom related to paranoid ideation. B. Emotional and behavioral reactions were identified for the client's paranoid ideation. C. Coping strategies were identified for the client's paranoid ideation. 4. Arrange for Psychological Testing ( 4) A. The client was referred for psychological testing to evaluate the extent and severity of his/her paranoia. B. The client was compliant w ith the testing, which indicated a significant pattern of paranoia. C. The psychological test results indicate only mild levels of paranoia, and this was reviewed. D. The psychological testing results indicate that the client's paranoia has significantly abated, and this was reviewed. E. The client was not compliant with the psychological testing and was redirected to this referral. 5. Obtain Information from Other Sources ( 5) A. A proper authorization to release information was obtained in order to se ek out information about the client. B. Family members have been asked to provide information about the client's pattern of paranoia. C. Other sources (e. g., police officers) have been sought out for additional information. * The numbers in parentheses correlate to the number of the Therapeutic Inte rvention statement in the companion chapter with the same title in The Severe and Persistent Mental Illness Treatment Planner, 2nd ed. (Berghuis and Jongsma) by John Wiley & Sons, 2008. 