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Adult Psychotherapy Homework Planner

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PracticePlanners Arthur E. Jongsma, Jr., Series EditorAdult PsychotherapyHomework PlannerArthur E. Jongsma, Jr.John Wiley & Sons, Inc.

Adult PsychotherapyHomework Planner

PRACTICEPLANNERS SERIESTreatment PlannersThe Complete Adult Psychotherapy Treatment Planner, 3eThe Child Psychotherapy Treatment Planner, 3eThe Adolescent Psychotherapy Treatment Planner, 3eThe Continuum of Care Treatment PlannerThe Couples Psychotherapy Treatment PlannerThe Employee Assistance Treatment PlannerThe Pastoral Counseling Treatment PlannerThe Older Adult Psychotherapy Treatment PlannerThe Behavioral Medicine Treatment PlannerThe Group Therapy Treatment PlannerThe Gay and Lesbian Psychotherapy Treatment PlannerThe Family Therapy Treatment PlannerThe Severe and Persistent Mental Illness Treatment PlannerThe Mental Retardation and Developmental Disability Treatment PlannerThe Social Work and Human Services Treatment PlannerThe Crisis Counseling and Traumatic Events Treatment PlannerThe Personality Disorders Treatment PlannerThe Rehabilitation Psychology Treatment PlannerThe Addiction Treatment Planner, 2eThe Special Education Treatment PlannerThe Juvenile Justice and Residential Care Treatment PlannerThe School Counseling and School Social Work Treatment PlannerThe Sexual Abuse Victim and Sexual Offender Treatment PlannerThe Probation and Parole Treatment PlannerThe Psychopharmacology Treatment PlannerThe College Student Counseling Treatment PlannerThe Speech and Language Pathology Treatment PlannerProgress Note PlannersThe Child Psychotherapy Progress Notes Planner, Second EditionThe Adolescent Psychotherapy Progress Notes Planner, Second EditionThe Adult Psychotherapy Progress Notes Planner, Second EditionThe Addiction Progress Notes PlannerThe Severe and Persistent Mental Illness Progress Notes PlannerThe Couples Psychotherapy Progress Notes PlannerHomework PlannersBrief Therapy Homework PlannerBrief Couples Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Adolescent Therapy Homework PlannerBrief Employee Assistance Homework PlannerBrief Family Therapy Homework PlannerGrief Counseling Homework PlannerGroup Therapy Homework PlannerDivorce Counseling Homework PlannerSchool Counseling and School Social Work Homework PlannerChild Therapy Activity and Homework PlannerAddiction Treatment Homework Planner, Second EditionAdolescent Psychotherapy Homework Planner IIAdult Psychotherapy Homework PlannerClient Education Handout PlannersAdult Client Education Handout PlannerChild and Adolescent Client Education Handout PlannerCouples and Family Client Education Handout PlannerDocumentation SourcebooksThe Clinical Documentation SourcebookThe Forensic Documentation SourcebookThe Psychotherapy Documentation PrimerThe Chemical Dependence Treatment Documentation SourcebookThe Clinical Child Documentation SourcebookThe Couple and Family Clinical Documentation SourcebookThe Clinical Documentation Sourcebook, 2eThe Continuum of Care Clinical Documentation Sourcebook

PracticePlanners Arthur E. Jongsma, Jr., Series EditorAdult PsychotherapyHomework PlannerArthur E. Jongsma, Jr.John Wiley & Sons, Inc.

This book is printed on acid-free paper.Copyright 2004 by Arthur E. Jongsma, Jr. All rights reserved.Published by John Wiley & Sons, Inc., Hoboken, New Jersey.Published simultaneously in Canada.No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through paymentof the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 7508400, fax (978) 750-4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed tothe Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 7486008, e-mail: permcoordinator@wiley.com.Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, theymake no representations or warranties with respect to the accuracy or completeness of the contents of this book and specificallydisclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended bysales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation.You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit orany other commercial damages, including but not limited to special, incidental, consequential, or other damages.This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is soldwith the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical,psychological or any other expert assistance is required, the services of a competent professional person should be sought.Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley& Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contactthe appropriate companies for more complete information regarding trademarks and registration.For general information on our other products and services please contact our Customer Care Department within the UnitedStates at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available inelectronic books. For more information about Wiley products, visit our Web site at www.wiley.com.Note about Photocopy RightsThe publisher grants purchasers permission to reproduce handouts from this book for professional use with their clients.Library of Congress Cataloging-in-Publication Data:Jongsma, Arthur E., 1943–Adult psychotherapy homework planner / Arthur E. Jongsma, Jr.,p. cm. — (Practice planners series)ISBN 0-471-27395-3 (PAPER/CD-ROM)1. Psychotherapy—Planning—Handbooks, manuals, etc.2. Psychotherapy—Problems, exercises, etc. I. Title.II. Practice planners.RC480.5.J6642003 Suppl.616.89ı1—dc21 2003014144Printed in the United States of America.10987654321

To Dave and Lorrie Vander Ark,whose friendship has enriched our lives andwhose support is more reliable than a fine timepiece.

CONTENTSPracticePlanner Series PrefaceAcknowledgmentsIntroductionSECTION I—Anger ManagementExercise I.AAlternatives to Destructive AngerExercise I.BAnger Journalxvxviixix139SECTION II—Antisocial BehaviorExercise II.AHow I Have Hurt OthersExercise II.BLetter of Apology151720SECTION III—AnxietyExercise III.AExercise III.B232529Analyze the Probability of a Feared EventPast Successful Anxiety CopingSECTION IV—Attention Deficit Disorder (ADD)—AdultExercise IV.ASymptoms and Fixes for ADD3133SECTION V—Borderline PersonalityExercise V.AJournal and Replace Self-Defeating ThoughtsExercise V.BPlan Before Acting373946SECTION VI—Chemical DependenceExercise VI.AAftercare Plan ComponentsExercise VI.BRelapse TriggersExercise VI.CSubstance Abuse Negative Impact versus Sobriety’sPositive Impact495155SECTION VII—Chemical Dependence RelapseExercise VII.ARelapse Symptom Line6567SECTION VIII—Childhood TraumaExercise VIII.AChanging from Victim to SurvivorExercise VIII.BFeelings and Forgiveness Letter71737759xi

xiiCONTENTSSection IX—Chronic PainExercise IX.APain and Stress Journal8183Section X—DependencyExercise X.A8991Section XI—DepressionExercise XI.AExercise XI.BExercise XI.CSatisfying Unmet Emotional NeedsIdentify and Schedule Pleasant ActivitiesNegative Thoughts Trigger Negative FeelingsPositive Self-Talk939598103Section XII—Eating DisorderExercise XII.AA Reality Journal: Food, Weight, Thoughts, and FeelingsExercise XII.BHow Fear Controls My Eating105107112Section XIII—Family ConflictExercise XIII.AApplying Problem-Solving to Interpersonal ConflictExercise XIII.BA Structured Parenting Plan115117120Section XIV—Female Sexual DysfunctionExercise XIV.AFactors Influencing Negative Sexual AttitudesExercise XIV.BStudy Your Body: Clothed and Unclothed123125129Section XV—Financial StressExercise XV.APlan a Budget133135Section XVI—Grief/Loss UnresolvedExercise XVI.ACreating a Memorial CollageExercise XVI.BDear : A Letter to a Lost Loved One139141144Section XVII—Impulse Control DisorderExercise XVII.AImpulsive Behavior Journal147149Section XVIII—Intimate Relationship ConflictsExercise XVIII.AHow Can We Meet Each Other’s Needs and Desires?Exercise XVIII.BPositive and Negative Contributions to the Relationship:Mine and Yours155157162

CONTENTSxiiiSection XIX—Low Self-EsteemExercise XIX.AAcknowledging My StrengthsExercise XIX.BReplacing Fears with Positive Messages165167170Section XX—Male Sexual DysfunctionExercise XX.AJournaling the Response to Nondemand, SexualPleasuring (Sensate Focus)175Section XXI—Mania or HypomaniaExercise XXI.ARecognizing the Negative Consequences ofImpulsive BehaviorExercise XXI.BWhat Are My Good Qualities?Exercise XXI.CWhy I Dislike Taking My Medication183Section XXII—Medical IssuesExercise XXII.AHow I Feel about My Medical TreatmentExercise XXII.BThe Impact of My Illness195197200Section XXIII—Obsessive-Compulsive Disorder (OCD)Exercise XXIII.AMaking Use of the Thought-Stopping TechniqueExercise XXIII.BReducing the Strength of Compulsive Behaviors203205209Section XXIV—ParentingExercise XXIV.ALearning to Parent as a TeamExercise XXIV.BUsing Reinforcement Principles in Parenting213215219Section XXV—Phase-of-Life ProblemsExercise XXV.AWhat Needs to Be Changed in My Life?Exercise XXV.BWhat’s Good about Me and My Life?223225228Section XXVI—Phobia-Panic/AgoraphobiaExercise XXVI.AFour Ways to Reduce FearExercise XXVI.BGradually Reducing Your Phobic FearExercise XXVI.CMonitoring My Panic Attack Experiences231233237241Section XXVII—Posttraumatic Stress Disorder (PTSD)Exercise XXVII.AHow the Trauma Affects MeExercise XXVII.BShare the Painful Memory243245247177185189193

xivCONTENTSSection XXVIII—PsychoticismExercise XXVIII.AWhat Do You Hear and See?251253Section XXIX—Sexual AbuseExercise XXIX.AA Blaming Letter and a Forgiving Letter to PerpetratorExercise XXIX.BPicturing the Place of the Abuse255257260Section XXX—Sexual Identity ConfusionExercise XXX.AJournal of Sexual Thoughts, Fantasies, ConflictsExercise XXX.BTo Whom and How to Reveal My Homosexuality263265271Section XXXI—Sleep DisturbanceExercise XXXI.ASleep Pattern Record275277Section XXXII—Social DiscomfortExercise XXXII.ARestoring Socialization Comfort283285Section XXXIII—SomatizationExercise XXXIII.AControlling the Focus on Physical Problems287289Section XXXIV— Suicidal IdeationExercise XXXIV.AJournal of Distorted, Negative ThoughtsExercise XXXIV.BThe Aftermath of Suicide293295299Appendix: Alternate Assignments for Presenting Problems303About the CD-ROM311

PRACTICEPLANNERS SERIES PREFACEThe practice of psychotherapy has a dimension that did not exist 30, 20, or even 15 yearsago—accountability. Treatment programs, public agencies, clinics, and even group andsolo practitioners must now justify the treatment of patients to outside review entities thatcontrol the payment of fees. This development has resulted in an explosion of paperwork.Clinicians must now document what has been done in treatment, what is planned for thefuture, and what the anticipated outcomes of the interventions are. The books and software in this PracticePlanners series are designed to help practitioners fulfill these documentation requirements efficiently and professionally.The PracticePlanners series is growing rapidly. It now includes not only the originalComplete Adult Psychotherapy Treatment Planner, Third Edition, The Child Psychotherapy Treatment Planner, Third Edition, and The Adolescent Psychotherapy TreatmentPlanner, Third Edition, but also Treatment Planners targeted to specialty areas ofpractice, including: addictions, juvenile justice/residential care, couples therapy,employee assistance, behavioral medicine, therapy with older adults, pastoral counseling,family therapy, group therapy, psychopharmacology, neuropsychology, therapy with gaysand lesbians, special education, school counseling, probation and parole, therapy withsexual abuse victims and offenders, and more.Several of the Treatment Planner books now have companion Progress Notes Planners(e.g., Adult, Adolescent, Child, Addictions, Severe and Persistent Mental Illness,Couples). More of these planners that provide a menu of progress statements thatelaborate on the client’s symptom presentation and the provider’s therapeutic interventionare in production. Each Progress Notes Planner statement is directly integrated with“Behavioral Definitions” and “Therapeutic Interventions” items from the companionTreatment Planner.The list of therapeutic Homework Planners is also growing from the original BriefTherapy Homework for adults to Adolescent, Child, Couples, Group, Family, Addictions,Divorce, Grief, Employee Assistance, and School Counseling/School Social WorkHomework Planners. Each of these books can be used alone or in conjunction with theircompanion Treatment Planner. Homework assignments are designed around each presenting problem (e.g., Anxiety, Depression, Chemical Dependence, Anger Management,Panic, Eating Disorders) that is the focus of a chapter in its corresponding TreatmentPlanner.Client Education Handout Planners, a new branch in the series, provides brochuresand handouts to help educate and inform adult, child, adolescent, couples, and familyclients on a myriad of mental health issues, as well as life skills techniques. The list ofpresenting problems for which information is provided mirrors the list of presentingproblems in the Treatment Planner of the title similar to that of the Handout Planner.Thus, the problems for which educational material is provided in the Child andxv

xviPRACTICEPLANNERS SERIES PREFACEAdolescent Client Education Handout Planner reflect the presenting problems listed inThe Child and The Adolescent Psychotherapy Treatment Planner books. Handouts areincluded on CD-ROMs for easy printing and are ideal for use in waiting rooms, atpresentations, as newsletters, or as information for clients struggling with mental illnessissues.In addition, the series also includes TheraScribe , the latest version of the populartreatment planning, clinical record-keeping software. TheraScribe allows the user toimport the data from any of the Treatment Planner, Progress Notes Planner, or HomeworkPlanner books into the software’s expandable database. Then the point-and-click methodcan create a detailed, neatly organized, individualized, and customized treatment planalong with optional integrated progress notes and homework assignments.Adjunctive books, such as The Psychotherapy Documentation Primer, and Clinical,Forensic, Child, Couples and Family, Continuum of Care, and Chemical DependenceDocumentation Sourcebook contain forms and resources to aid the mental health practicemanagement. The goal of the series is to provide practitioners with the resources theyneed in order to provide high-quality care in the era of accountability or, to put it simply,we seek to help you spend more time on patients, and less time on paperwork.ARTHUR E. JONGSMA, JR.Grand Rapids, Michigan

ACKNOWLEDGMENTSAlthough only my name appears as the author of this book, the product is the result of thecombined efforts of many people. I first would like to acknowledge the contribution ofmy coauthors on several other books, William McInnis and Mark Peterson. They bothgave permission for me to borrow and adapt some of the homework exercises we hadcollaborated on in writing the Brief Adolescent Therapy Homework Planner and theAdolescent Psychotherapy Homework Planner II. Several of the assignments in this bookhave been adapted to the adult focus group from their original creation for the adolescentclient. Thank you Bill and Mark.I am grateful to Sue Rhoda, who was so efficient at transcribing this manuscript in avery timely and professional manner.I also want to recognize the fine work done by Jen Byrne, my project assistant, whopulls together many scattered pages of handwritten notes and dictated material so itcomes together at the end looking like a book manuscript. Thanks Jen.My support staff at John Wiley & Sons, David Bernstein, Peggy Alexander, CrisWojdylo, Judi Knott, and Lynne Marsala, continues to move the Practice Planner projectforward with enthusiasm and professional dedication. Thank you all.Finally, my personal support system is grounded in my wife, Judy, who makes me feelimportant even when I am not, and my children and grandchildren who consistently showinterest in my work. Thank you family.A.E.J.xvii

The Behavioral Medicine Treatment Planner The Group Therapy Treatment Planner The Gay and Lesbian Psychotherapy Treatment Planner . Several of the Treatment Planner books now have companion Progress Notes Planners (e.g., Adult, Adolescent, Child, Addictions, Severe and Persistent Mental Illness, .