 190 MANIA OR HYPOMANIA CLIENT PRESENTATION 1. Increased, Pressured Speech (1) * A. The client gave evidence of increased, pressured speech within the session. B. The client reported that his/her speech rate increases as he/she feels stressed. C. The client' s pressured speech has shown evidence of a decrease in intensity. D. The client showed no evidence of pressured speech in today's session. 2. Racing Thoughts (2) A. The client demonstrated a pattern of racing thoughts, moving from one subject to another without maintaining focus. B. The client reported that he/she experiences racing thoughts, including difficulty concentrating on one thought as other thoughts interfere. C. The client reported that at times of quiet reflection, he/she is disturbed by th oughts racing through his/her mind. D. The client reported that his/her thoughts are not racing as they had been, and he/she is able to stay focused. 3. Inflated Sense of Self (3) A. The client gave evidence of an inflated sense of self-esteem and an ex aggerated, euphoric belief in capabilities that denies any limitations or realistic obstacles. B. The client appears oblivious to his/her inflated sense of self-esteem or euphoric beliefs but sees others as standing in his/her way. C. In spite of attempt s to try to get the client to be more realistic, his/her inflated self-esteem and exaggerated, euphoric beliefs have persisted. D. The client's sense of self-esteem and beliefs in his/her capabilities have become more reality based. E. There has been no recent evidence of inflated self-esteem or exaggerated, euphoric beliefs. 4. Persecutory Delusions (3) A. The client described a pattern of persecutory delusions, including suspiciousness of others without reasonable cause. B. The client demonstrated a pattern of misinterpretation of benign events as having threatening personal significance. C. The client's history is replete with incidents in which he/she believed he/she was persecuted by others. D. The client is beginning to accept a more reality-based interpretation of events and relationships, which is much less threatening. * The numbers in parentheses correlate to the number of the Behavioral Definition 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. 