216 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER 16. Discuss Usefulness of Treatment (16) A. A discussion was held about how treatment serves as an arena to desensitize learned fear, reality test obsessional fears and underlying beliefs, and build confidence in manag ing fears without compulsions. B. The client was provided with a rationale for treatment as described in Mastery of Obsessive-Compulsive Disorder (Kozak and Foa). C. Positive feedback was provided to the client as he/she displayed a clear understanding a bout the usefulness of treatment. D. The client did not display a clear understanding of the usefulness of treatment and was provided with additional feedback in this area. 17. Explore Schema and Self-Talk (17) A. The client was assisted in exploring how his/her schema and self-talk mediate his/her obessional fears and compulsive behaviors. B. The client's schema and self-talk were reviewed as described in Mastery of Obsessive-Compulsive Disorder (Kozak and Foa). C. The client's schema and self-talk wer e reviewed as described in Obsessive-Compulsive Disorder (Salkovskis and Kirk). D. The client was reinforced for his/her insight into his/her self-talk and schema that support his/her obsessional fears and compulsive behaviors. E. The client struggled to develop insight into his/her own self-talk and schema and was provided with tentative examples of these concepts. 18. Teach Thought-Stopping Techniques (18) A. The client was taught to interrupt obsessive thoughts by shouting “STOP” to himself/herself silently while picturing a red traffic signal and then thinking about a calming scene. B. The client was assisted in developing his/her own thought-stopping techniques and images. C. Positive feedback was provided to the client for his/her helpful use of t hought-stopping techniques. D. The client does not regularly use thought-stopping techniques and was redirected to do so. 19. Assign Thought-Stopping Techniques between Sessions (19) A. The client was assigned the use of thought-stopping techniques on a daily basis between sessions. B. The client was assigned “Making Use of the Thought-Stopping Technique” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). C. The client's implementation of thought-stopping techniques was reviewed and succe sses were reinforced. D. The client's use of thought-stopping techniques was reviewed; successes were reinforced and failures were redirected. 20. Assess Cues (20) A. The client was assessed in regard to the nature of any external cues (e. g., persons, ob jects, situations) that precipitate the client's obsessions and compulsions. 