342 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER C. The client was reinforced as he/she verbalized an understanding of the co gnitive beliefs and messages that mediate his/her anxiety 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 provid ed with tentative examples in this area. 22. Assign Reading about Cognitive Restructuring (22) A. The client was assigned to read about cognitive restructuring in books or treatment manuals on Panic Disorder and Agoraphobia. B. The client was assigned to read Mastery of Your Specific Phobia —Client Manual (Antony, Craske, and Barlow). C. The client was assigned to read excerpts from The Anxiety and Phobia Workbook (Bourne). D. The client has read the assigned material on cognitive restructuring, and impo rtant concepts were reviewed within the session. E. The client has not read the assigned material on cognitive restructuring and was redirected to do so. 23. Assign Homework on Self-Talk (23) A. The client was assigned homework exercises to identify fear ful self-talk, create reality-based alternatives, and record his/her experiences. B. The client was assigned “Journal and Replace Self-Defeating Thoughts” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). C. The client's use of self-talk techniques was reviewed and reinforced. D. The client has struggled in his/her implementation of self-talk techniques and was provided with corrective feedback. E. The client has not attempted to use the self-talk techniques and was redirected to do so. 24. Model/Rehearse Self-Talk (24) A. Modeling and behavioral rehearsal were used to train the client in positive self-talk that reassured him/her of the ability to work through and endure anxiety symptoms without serious consequences. B. The client has i mplemented positive self-talk to reassure himself/herself of the ability to endure anxiety without serious consequences; he/she was reinforced for this progress. C. The client has not used positive self-talk to help endure anxiety and was provided with additional direction in this area. 25. Construct Anxiety Hierarchy (25) A. The client was directed and assisted in constructing a hierarchy of anxiety-producing situations. B. The client was successful in identifying a range of stimulus situations that pro duced increasingly greater amounts of anxiety, and this hierarchy was reviewed. C. The client found it difficult to identify a range of stimulus situations that produce increasingly greater amounts of anxiety and was provided with assistance in this area. 