264 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLANNER 25. Recommend Exercising Your Way to Better Mental Health (25) A. The book Exercising Your Way to Better Mental Health (Leith) was recommended to the client as a means of encouragin g physical exercise. B. The client has followed through with reading the book on exercise and mental health; the key points of this material were reviewed. C. The client was assisted in implementing a consistent exercise regimen. D. The client has not f ollowed through with reading the book on exercise nor has he/she implemented a regular physical exercise regimen. 26. Monitor Sleep Patterns (26) A. The client was encouraged to keep a record of how much sleep he/she gets every night. B. The client was t rained in the use of relaxation techniques to help induce sleep. C. The client was trained in the use of positive imagery to help induce sleep. D. The client was referred for a medication evaluation to determine whether medication is needed to help him/h er sleep. 27. Identify Distorted Thoughts (27) A. The client was assisted in identifying the distorted schemas and related automatic thoughts that mediate PTSD responses. B. The client was taught the role of distorted thinking in precipitating emotional responses. C. The client was reinforced as he/she verbalized an understanding of the cognitive beliefs and messages that mediate his/her PTSD responses. D. The client was assisted in replacing distorted messages with positive, realistic cognitions. E. The client failed to identify his/her distorted thoughts and cognitions and was provided with tentative examples in this area. 28. Read about Cognitive Restructuring of Fears (28) A. The client was assigned to read about cognitive restructuring of fears or worries in books or treatment manuals. B. Overcoming Post-Traumatic Stress Disorder (Smyth) was assigned to the client to help teach about cognitive restructuring. C. Key components of cognitive restructuring and exposure therapy were reviewed. D. The client and parents have not done the assigned reading on cognitive restructuring and were redirected to do so. 29. Assign Self-Talk Homework (29) A. The client was assigned homework exercises in which he/she identifies fearful self-talk and creates realit y-based alternatives. B. The “Negative Thoughts Trigger Negative Feelings” exercise from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma) was used to help the client develop healthy self-talk. C. The client was directed to do homework exercise s about self-talk and reality-based alternatives as described in Overcoming Post-Traumatic Stress Disorder (Smyth). D. The client has completed his/her homework related to self-talk and creating reality-based alternatives; he/she was provided with positiv e reinforcement for his/her success in this area. 