Avoidance of disagreeing with others for fear of being rejected.
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Achieve a healthy balance between independence and dependence. Decrease dependence on relationships while beginning to meet own needs, build confidence, and practice assertiveness. Establish firm individual self-boundaries and improved self-worth. Break away permanently from any abusive relationships. Emancipate self from emotional and economic dependence on parents. Describe the style and pattern 1.
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Verbalize an increased aware- 2. Develop a family genogram to ness of own dependency. Process key ideas. Verbalize insight into the 4. Process the meaning of the fable. List positive things about self. Assign the client to institute a ritual of beginning each day with 5 to 10 minutes of solitude where the focus is personal affirmation.
Identify and replace distorted 5.
Assist the client in developing positive, reality-based messages for self to replace the distorted, negative self-talk. Verbalize a decreased sensitiv- Assign the client to read books on assertiveness e. Verbally reinforce the client for any and all signs of assertiveness and independence. Assign the client to say no with- requests.
Report incidents of verbally Train the client in assertiveness or stating own opinion. Identify own emotional and Monitor for follow-through and feelings of change about self. Report examples of receiving Process cating. Verbalize an increased sense of Verbalize an increased aware- Assign the client to keep a daily ness of boundaries and when journal regarding boundaries for they are violated.
Ask the client to read the chapter on setting boundaries and limits in the book A Gift To Myself Whitfield and complete the ac- companying survey on personal boundaries.
Process the key ideas and results of the survey. Increase the frequency of ver- Reinforce the client for imple- bally clarifying boundaries with menting boundaries and limits for others. Increase the frequency of Give positive verbal reinforcement for each timely thought-out deci- sion that the client makes.
Attend an Al-Anon group Refer the client to Al-Anon or an- to reinforce efforts to break other appropriate self-help group. Develop a plan to end the Refer the client to a safe house.
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Depressed mood. Loss of appetite.
Diminished interest in or enjoyment of activities. Psychomotor agitation or retardation. Sleeplessness or hypersomnia. Lack of energy. Poor concentration and indecisiveness. Social withdrawal. Feelings of hopelessness, worthlessness, or inappropriate guilt. Low self-esteem.
Unresolved grief issues. Mood-related hallucinations or delusions. History of chronic or recurrent depression for which the client has taken antidepressant medication, been hospitalized, had outpatient treatment, or had a course of electroconvulsive therapy. Alleviate depressed mood and return to previous level of effective func- tioning.
Recognize, accept, and cope with feelings of depression.
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Develop healthy cognitive patterns and beliefs about self and the world that lead to alleviation and help prevent the relapse of depression symp- toms. Develop healthy interpersonal relationships that lead to alleviation and help prevent the relapse of depression symptoms. Appropriately grieve the loss in order to normalize mood and to return to previous adaptive level of functioning. Assess current and past mood experiences with depression episodes including their features, complete with its impact on frequency, intensity, and dura- function and attempts to re- tion e.
Verbally identify, if possible, 2. Ask the client to make a list of the source of depressed mood. Complete psychological test- 4. Verbalize any history of sui- 5. State no longer having thoughts 6. Take prescribed psychotropic 8. Identify and replace cogni- Assign the client to keep a daily journal of automatic thoughts associated with depressive feel- ings e.
Utilize behavioral strate- Assist the client in developing gies to overcome depression. Employ self-reliance training in which the client assumes increased responsibility for routine activities e. Identify important people in Verbalize any unresolved grief Explore the role of unresolved issues that may be contributing grief issues as they contribute to to depression. Learn and implement problem- In conjoint sessions, help the client resolve interpersonal con- flicts.
Implement a regular exercise Develop and reinforce a routine regimen as a depression reduc- of physical exercise for the client. Increase assertive communica- Read books on overcoming Recommend that the client read depression. Show evidence of daily care for Monitor and redirect the client on personal grooming and hygiene daily grooming and hygiene. Increasingly verbalize hopeful Teach the client more about depression and to accept some sadness as a normal variation in feeling. Express feelings of hurt, disap- Explain a connection between of the relationship between previously unexpressed re- depressed mood and repres- pressed feelings of anger and sion of feelings—that is, anger, helplessness and current state of hurt, sadness, and so on.
Arthur Jongsma - Family Therapy Progress
An episode of the sudden inability to remember important personal iden- tification information that is more than just ordinary forgetfulness. Persistent or recurrent experiences of depersonalization; feeling as if one is automated or in a dream. Depersonalization sufficiently severe and persistent as to cause marked distress in daily life. Integrate the various personalities. Reduce the frequency and duration of dissociative episodes. Resolve the emotional trauma that underlies the dissociative disturbance.
Reduce the level of daily distress caused by dissociative disturbances. Regain full memory. Identify each personality and 1. Actively build the level of trust have each one tell its story. Without undue encouragement or leading, probe and assess the existence of the various personali- ties that take control of the client.
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