108 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER C. The client and his/her family have participated in mutually satisfying social activities, and this was reviewed and supported. D. The client has not identified helpful social activities and was redirected to do so. 36. Refer to an Activity or Recreatio nal Therapist (3 6) A. The client was referred to an activity or recreational therapist for assistance in developing leisure skills or activities to share with family members. B. The client has met with the activity or recreational therapist and is develo ping leisure skills to share with family members. C. The client was reinforced for developing more leisure skills and reporting better relationships with family members. D. The client has not followed through on the referral to an activity or recreationa l therapist and was redirected to do so. 37. Identify Family Patterns That Limit the Client's Functioning (3 7) A. Family roles and behavioral patterns that have developed as a result of the family's reaction to the client's mental illness were identified. B. An analysis of family roles and behavioral patterns focused on how the client's independent functioning has been limited and dependence has been encouraged. C. The client was reinforced for displaying insight into his/her family's reaction to his/he r mental illness symptoms and how this affects his/her functioning. D. The client's family members were supported for displaying insight into their reaction to his/her severe and persistent mental illness symptoms and how this affects his/her functioning. E. The client and his/her family members did not display any insight into their family patterns of behavior, so they were given feedback in this area. 38. Encourage Independence (3 8) A. The client was encouraged to make all possible choices and demonst rate maximum independence in daily events. B. The client's family members were encouraged to allow him/her to make all possible choices and demonstrate maximum independence in daily events. C. The client's growing pattern of independence and ability to m ake his/her own choices were reviewed within the session. D. The client was given positive feedback for his/her increase in independence. E. The client reported that he/she has not focused on making his/her own choices and maximizing independence, and th is resistance was reviewed. 39. Review Backup Caregiver/Advocate (39) A. The options available for backup to the primary caregiver/advocate were reviewed. B. A specific plan was developed for the client's care and advocacy should the primary caregiver/a dvocate be unable to care for the client. C. The client and his/her family have developed a comprehensive plan in the event that the primary caregiver/advocate is unable to care for the client, and they received positive feedback for this. 