Adult Treatment Planner
2: Antisocial Behavior
SNOMED Terms
- Adjustment disorder with disturbance of conduct
- Antisocial personality disorder
- Intermittent explosive disorder
- Narcissistic personality disorder
Goals
- Accept responsibility for own behavior and keep behavior within the acceptable limits of the rules of
society.
- Develop and demonstrate a healthy sense of respect for social norms, the rights of others, and the need for
honesty.
- Improve method of relating to the world, especially authority figures; be more realistic, less defiant, and
more socially sensitive.
- Come to an understanding and acceptance of the need for conforming to prevailing social limits and
boundaries on behavior.
- Maintain consistent employment and demonstrate financial and emotional responsibility for children.
Behavioral Definitions
- An adolescent history of consistent rule-breaking, lying, stealing, physical aggression, disrespect for
others and their property, and/or substance abuse resulting in frequent confrontation with authority.
- Failure to conform with social norms with respect to the law, as shown by repeatedly performed antisocial
acts (e.g., destroying property, stealing, pursuing an illegal job) for which he/she may or may not have
been arrested.
- Pattern of interacting in a confrontational, aggressive, and/or argumentative way with authority figures.
- Little or no remorse for causing pain to others.
- Consistent pattern of blaming others for what happens to him/her.
- Little regard for truth, as reflected in a pattern of consistently lying to and/or conning others.
- Frequent initiation of verbal or physical fighting.
- History of reckless behaviors that reflect a lack of regard for self or others and show a high need for
excitement, fun, and living on the edge.
- Pattern of sexual promiscuity; has never been totally monogamous in any relationship for a year and does not
take responsibility for children resulting from relationships.
- Pattern of impulsive behaviors, such as moving often, traveling with no goal, or quitting a job without
having secured another one.
- Inability to sustain behavior that would maintain consistent employment.
- Failure to function as a consistently concerned and responsible parent.
Diagnoses
- Alcohol Dependence
- Cocaine Dependence
- Polysubstance Dependence
- Adjustment Disorder With Disturbance of Conduct
- Conduct Disorder
- Intermittent Explosive Disorder
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Diagnosis Deferred
- No Diagnosis
Objectives and Interventions
- Admit to illegal and/or unethical behavior that has trampled on the law and/or the rights and feelings of
others.
- Explore the history of the client's pattern of illegal and/or unethical behavior and confront
his/her attempts at minimization, denial, or projection of blame.
- Review the consequences for the client and others of his/her antisocial behavior.
- Verbalize an understanding of the benefits for self and others of living within the laws and rules of
society.
- Teach the client that the basis for all relationships is trust that the other person will treat one
with respect and kindness.
- Teach the client the need for lawfulness as the basis for trust that forestalls anarchy in society
as a whole.
- Make a commitment to live within the rules and laws of society.
- Solicit a commitment from the client to conform to a prosocial, law-abiding lifestyle.
- Emphasize the reality of negative consequences for the client if he/she continues to practice
lawlessness.
- List relationships that have been broken because of disrespect, disloyalty, aggression, or dishonesty.
- Review relationships that have been lost due to the client's antisocial attitudes and practices
(e.g., disloyalty, dishonesty, aggression).
- Confront the client's lack of sensitivity to the needs and feelings of others.
- Acknowledge a pattern of self-centeredness in virtually all relationships.
- Confront the client's lack of sensitivity to the needs and feelings of others.
- Point out the self-focused, me-first, look-out-for-number-one attitude that is reflected in the
client's antisocial behavior.
- Make a commitment to be honest and reliable.
- Teach the client the value for self of honesty and reliability in all relationships, since he/she
benefits from social approval as well as increased trust and respect.
- Teach the client the positive effect that honesty and reliability have for others, since they are
not disappointed or hurt by lies and broken promises.
- Ask the client to make a commitment to be honest and reliable.
- Verbalize an understanding of the benefits to self and others of being empathetic and sensitive to the needs
of others.
- Teach the client that the basis for all relationships is trust that the other person will treat one
with respect and kindness.
- Attempt to sensitize the client to his/her lack of empathy for others by revisiting the consequences
of his/her behavior on others. Use role reversal techniques.
- Confront the client when he/she is rude or not being respectful of others and their boundaries.
- List three actions that will be performed that will be acts of kindness and thoughtfulness toward others.
- Assist the client in listing three actions that he/she will perform as acts of service or kindness
for others.
- Indicate the steps that will be taken to make amends or restitution for hurt caused to others.
- Assist the client in identifying those who have been hurt by his/her antisocial behavior.
- Teach the client the value of apologizing for hurt caused as a means of accepting responsibility for
behavior and of developing sensitivity to the feelings of others.
- Encourage the client's commitment to specific steps that will be taken to apologize and make
restitution to those who have suffered from his/her hurtful behaviors.
- Verbally demonstrate an understanding of the rules and duties related to employment.
- Review the rules and expectations that must govern the client's behavior in the work environment.
- Attend work reliably and treat supervisors and coworkers with respect.
- Monitor the client's attendance at work and reinforce reliability as well as respect for
authority.
- Ask the client to make a list of behaviors and attitudes that must be modified in order to decrease
his/her conflict with authorities; process the list.
- Verbalize the obligations of parenthood that have been ignored.
- Confront the client's avoidance of responsibilities toward his/her children.
- Assist the client in listing the behaviors that are required to be a responsible, nurturing,
consistently reliable parent.
- State a plan to meet responsibilities of parenthood.
- Develop a plan with the client that will begin to implement the behaviors of a responsible parent.
- Increase statements of accepting responsibility for own behavior.
- Confront the client when he/she makes blaming statements or fails to take responsibility for own
actions, thoughts, or feelings.
- Explore the client's reasons for blaming others for his/her own actions (e.g., history of physically
abusive punishment, parental modeling, fear of rejection, shame, low self-esteem, avoidance of
facing consequences).
- Give verbal positive feedback to the client when he/she takes responsibility for his/her own
behavior.
- Verbalize an understanding of how childhood experiences of pain have led to an imitative pattern of
self-focused protection and aggression toward others.
- Explore the client's history of abuse, neglect, or abandonment in childhood; explain how the cycle
of abuse or neglect is repeating itself in the client's behavior.
- Point out that the client's pattern of emotional detachment in relationships and self-focused
behavior is related to a dysfunctional attempt to protect self from pain.
- Verbalize a desire to forgive perpetrators of childhood abuse.
- Teach the client the value of forgiving the perpetrators of hurt versus holding on to hurt and rage
and using the hurt as an excuse to continue antisocial practices.
- Practice trusting a significant other with disclosure of personal feelings.
- Explore the client's fears associated with placing trust in others.
- Identify some personal thoughts and feelings that the client could share with a significant other as
a means of beginning to demonstrate trust in someone.
- Process the experience of the client making self vulnerable by self-disclosing to someone.
Index