MANIA OR HYPOMANIA 195 E. The client was reinforced for his/her clear understanding of the stress diathesis model of Bipolar Disorder. F. The client struggled to display a clear understanding of the stress diathesis model of Bipolar Disorder and was provided with additional remedial information in this area. 15. Provide Rationale for Treatment (15) A. The client was provided with the rationale for treatment involving ongoing medication and psychosocial treatment. B. The focus of treatment was emphasized, including recognizing, managing, and reducing biological and psychological vulnerabilities that could precipitate relapse. C. A discussion was held about the rationale for treatment. D. The client was reinforced for his/her understanding of the appropriate rationale for treatment. E. The client was redirected when he/she displayed a poor und erstanding of the rationale for treatment. 16. Identify Relapse Triggers (16) A. Sources of the client's stress and triggers of potential relapse were identified. B. Negative events, cognitive interpretations, aversive communication, poor sleep hygiene, and medication noncompliance were investigated as potential stressors or triggers of potential relapse. C. Cognitive-behavioral techniques were used to address the sources of stress and triggers for potential relapse. 17. Enhance Engagement in Medication Use (17) A. Motivational approaches were used to help enhance the client's level of engagement in his/her medication use and compliance to the medication regimen. B. Modeling, role-playing, and behavioral rehearsal were used to help the client use proble m-solving skills to work through several current conflicts. C. The client was taught about the risk for relapse when medication is discontinued. D. Commitment was obtained to continuous prescription adherence. E. As a result of motivational approaches f or medication compliance, the subject's use of medication has significantly improved. F. The client continues to be medication noncompliant despite use of motivational approaches; the client was refocused on this task. 18. Assess Prescription Noncomplianc e Factors (18) A. Factors that have precipitated the client's prescription noncompliance were assessed. B. The client was checked for specific thoughts, feelings, and stressors that might contribute to his/her prescription noncompliance. C. The client w as assigned “Why I Dislike Taking My Medication” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma). D. A plan was developed for recognizing and addressing the factors that have precipitated the client's prescription noncompliance. 