PARENTING 245 B. The client described that his/her severe and persistent mental illness symptoms have exacerbated his/her relationship conflicts. C. The client described a pattern of increasing relationship stress due to disagreements regarding child rearing practices. D. The client reporte d a decrease in his/her level of relationship stress. 6. Extended Family Involvement (6) A. Members of the client's extended family have expressed concern about the welfare of his/her child. B. Members of the client's extended family have taken responsi bility for his/her child. C. Support and assistance have been provided by the client's extended family to assist him/her in maintaining involvement in his/her child. D. As the client has stabilized, his/her extended family has decreased their involvement in his/her parenting. 7. Child's Manipulation (7) A. The client described a pattern of ineffectiveness in his/her parenting style due to his/her severe and persistent mental illness symptoms. B. The client's child has often taken advantage of the clien t's pattern of ineffective parenting. C. As the client's severe and persistent mental illness has stabilized, he/she reports an increased pattern of effectiveness in his/her parenting skills. D. Through the client's increased parenting effectiveness and other natural supports, his/her child has been unable to take advantage of him/her. 8. Shame, Embarrassment, and Confusion (8) A. The client's child described feeling shame and embarrassment due to the client's mental illness symptoms. B. The client's c hild is often confused about his/her parent's mental illness symptoms. C. As treatment has progressed, the client's child has displayed increased understanding and acceptance of the client's mental illness. INTERVENTIONS IMPLEM ENTED 1. Explore Parenting Concerns (1) * A. The client's history of parenting concerns was explored. B. The client was provided with positive feedback for being open and honest regarding his/her history of parenting concerns. C. The client tended to minimize his/her parenting dif ficulties, and this was reflected to him/her. 2. Create a Family Genogram (2) A. The client's description of family members, patterns of interactions, rules, and secrets was translated into a graphic genogram. * The numbers in parentheses correlate to the number of the Therapeutic Intervention 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. 