90 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER C. As the client's severe and persistent mental illness symptoms have stabilized, he/she has reported an increase in his/her level of occupational involvement, duration, and success. 6. Conflicts Due to Paranoia (6) A. The client described his/her pattern of conflict with authority figures due to unfounded suspiciousness or paranoia. B. The client describ ed that he/she has often rebelled against authority figures due to his/her unfounded suspiciousness or paranoia. C. As the client's pattern of suspiciousness and paranoia have been reduced, he/she reports decreased conflicts with authority figures. D. The client does not experience conflicts with authority figures due to any suspiciousness or paranoia. 7. Psychiatric Destabilization Due to Job Loss (7) A. The client described feelings of anxiety, depression, or other psychiatric destabilization secondar y to being fired or laid off. B. The client describes fears, feelings of worthlessness, and bizarre thoughts as a reaction to the stress of being fired or laid off. C. As treatment has progressed, the client reports increased psychiatric stability despit e employment problems. D. The client's employment problems have stabilized with a commensurate stabilization in his/her psychiatric functioning. 8. Fears Returning to Work (8) A. The client is fearful, due to his/her history of employment problems and f ailures, about returning to the workplace. B. The client's fears of returning to the workplace have exacerbated his/her employment problems. C. The client was able to identify and verbalize his/her fears about returning to the workplace. D. As the clien t has worked through his/her fears about returning to the workplace, he/she has shown more interest in employment. 9. Emotional Reaction to Job Placement (9) A. The client identified specific negative emotions that he/she experiences due to the nature of his/her job placement. B. The client described that his/her anxiety symptoms have increased due to the menial or repetitive nature of his/her job placement. C. The client identified depressed thoughts and feelings due to the nature of his/her job placem ent. D. As the client has worked through his/her feelings of depression and anxiety, he/she has become more emotionally stable. E. The client reports that he/she is content in his/her job placement. 10. Symptom Exacerbation Due to Increased Expectations (10) A. The client described that he/she has been anxious due to his/her increased job expectations. B. The client has experienced an increase in his/her primary mental illness symptoms due to his/her anxiety related to job tasks and expectations. 