210 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER D. The client continues to use substances despite the effects on his/her symptoms and medication efficacy and was provided with additional confrontation in this area. 36. Refer for Substance Abuse Treatment ( 36) A. The client was referred to a 12-step recovery program (e. g., Alcoholics Anonymous or Narcotics Anonymous). B. The client was referred to a substanc e abuse treatment program. C. The client has been admitted to a substance abuse treatment program and was supported for this follow-through. D. The client has refused the referral to a substance abuse treatment program, and this refusal was processed. 37. Process Improvement Due to Medications ( 37) A. The client was requested to identify how his/her reduction in mental illness symptoms has improved his/her social or family system. B. The client identified ways in which his/her mental illness symptoms h ave decreased and how this has improved his/her social and family relationships, and he/she was provided with positive feedback in this area. C. The client failed to identify ways in which his/her medications have improved his/her symptoms and relationshi ps and was provided with examples of these changes. 