106 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER 25. Increase Sensitivity to Effects of Behavior (25) A. Role-playing, role reversal, and behavioral rehearsal were used to increase the client's sensitivity to the negative effects of his/h er impulsive behavior. B. The client was reinforced for his/her increased sensitivity to the negative effects of his/her impulsive behavior on others. 26. Confront Mania and Enforce Rules (26) A. Unhealthy, impulsive, or manic behaviors that occur during contacts with the clinician were identified and confronted. B. Clear rules and roles in the relationship were identified and enforced with immediate, short-term consequences for breaking such boundaries. C. The client's unhealthy, impulsive, or manic be haviors have diminished in response to limit setting within the session. 27. Address Problem Solving (27) A. The client was asked to identify conflicts that can be addressed through problem-solving techniques. B. The family members were asked to give inp ut about conflicts that could be addressed with problem-solving techniques. C. The client and family arrived at a list of conflicts that could be addressed with problem-solving techniques. 28. Teach Problem-Solving Skills (28) A. Behavioral techniques su ch as education, modeling, role-playing, corrective feedback, and positive reinforcement were used to teach the client and family problem-solving skills. B. Specific problem-solving skills were taught to the family, including defining the problem construc tively and specifically, brainstorming options, evaluating options, choosing options, implementing a plan, evaluating results, and reevaluating the plan. C. Family members were asked to use the problem-solving skills on specific situations. D. The family was reinforced for positive use of problem-solving skills. E. The family was redirected for failures to properly use problem-solving skills. 29. Assign Problem-Solving Homework (29) A. The client and family were assigned to use newly learned problem-solving skills and record their use. B. The client and family were assigned “Applying Problem-Solving to Interpersonal Conflict” in the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). C. The results of the family members' use of problem-solving ski lls were reviewed within the session. 30. Assess Family Support Network ( 30) A. The family was assessed for the extent to which it has a support network. B. The family was encouraged to use extended family, neighbors, church friends, social relationship s, and other portions of their support network to provide diversion, emotional support, and/or respite care for the client. 