Adult Treatment Planner

Objectives and Interventions

• Describe the circumstances of life that are contributing to stress, anxiety, or lack of fulfillment.
  • Explore the client's current life circumstances that are causing frustration, anxiety, depression, or lack of fulfillment.
  • Assign the client to write a list of those circumstances that are causing concern and how or why each is contributing to his/her dissatisfaction.
  • Assist the client in listing those desirable things that are missing from his/her life that could increase his/her sense of fulfillment.
• Identify values that guide life's decisions and determine fulfillment.
  • Assist the client in clarifying and prioritizing his/her values.
  • Assign the client to read books on values clarification (e.g., Values Clarification by Simon, Howe, and Kirschenbaum; In Search of Values: 31 Strategies for Finding Out What Really Matters Most to You by Simon); process the content and list values that he/she holds as important.
• Implement new activities that increase a sense of satisfaction.
  • Develop a plan with the client to include activities that will increase his/her satisfaction, fulfill his/her values, and improve the quality of his/her life.
  • Review the client's attempts to modify his/her life to include self-satisfying activities; reinforce success and redirect for failure.
• Identify and implement changes that will reduce feelings of being overwhelmed by caretaking responsibilities.
  • Brainstorm with the client possible sources of support or respite (e.g., parent support group, engaging spouse in more child care, respite care for elderly parent, sharing parent-care responsibilities with a sibling, utilizing home health-care resources, taking a parenting class) from the responsibilities that are overwhelming him/her.
  • Encourage the client to implement the changes that will reduce the burden of responsibility felt; monitor progress, reinforcing success and redirecting for failure.
• Implement increased assertiveness to take control of conflicts.
  • Use role-playing, modeling, and behavior rehearsal to teach the client assertiveness skills that can be applied to reducing conflict or dissatisfaction.
  • Refer the client to an assertiveness training class.
  • Encourage the client to read books on assertiveness and boundary setting (e.g., Asserting Yourself by Bower and Bower; When I Say No, I Feel Guilty by Smith; Your Perfect Right by Alberti and Emmons; Boundaries: Where You End and I Begin by Katherine); process the content and its application to the client's daily life.
• Apply problem-solving skills to current circumstances.
  • Teach the client problem-resolution skills (e.g., defining the problem clearly, brainstorming multiple solutions, listing the pros and cons of each solution, seeking input from others, selecting and implementing a plan of action, evaluating outcome, and readjusting plan as necessary).
  • Use modeling and role-playing with the client to apply the problem-solving approach to his/her current circumstances; encourage implementation of action plan, reinforcing success and redirecting for failure.
• Increase communication with significant others regarding current life stress factors.
  • Teach the client communication skills (e.g., "I messages," active listening, eye contact) to apply to his/her current life stress factors.
  • Invite the client's partner and/or other family members for conjoint sessions to address the client's concerns; encourage open communication and group problem solving.
• Identify five advantages of current life situation.
  • Assist the client in identifying at least five advantages to his/her current life circumstance that may have been overlooked or discounted (e.g., opportunity to make own decisions, opportunity for intimacy and sharing with a partner, a time for developing personal interests or meeting the needs of a significant other).
• Implement changes in time and effort allocation to restore balance to life.
  • Assist the client in identifying areas of life that need modification in order to restore balance in his/her life (e.g., adequate exercise, proper nutrition and sleep, socialization and reaction activities, spiritual development, conjoint activities with partner as well as individual activities and interests, service to others as well as self-indulgence); develop a plan of implementation.
• Increase activities that reinforce a positive self-identity.
  • Assist the client in clarifying his/her identity and meaning in life by listing his/her strengths, positive traits and talents, potential ways to contribute to society, and areas of interest and ability that have not yet been developed.
  • Develop an action plan with the client to increase activities that give meaning and expand his/her sense of identity at a time of transition in life phases (e.g., single to married, employed to homemaker, childless to parent, employed to retired); monitor implementation.
• Increase social contacts to reduce sense of isolation.
  • Explore opportunities for the client to overcome his/her sense of isolation (e.g., joining a community recreational or educational group, becoming active in church or synagogue activities, taking formal education classes, enrolling in an exercise group, joining a hobby support group); encourage implementation of these activities.
  • Use role-playing and modeling to teach the client social skills needed to reach out to build new relationships (e.g., starting conversations, introducing self, asking questions of others about themselves, smiling and being friendly, inviting new acquaintances to his/her home, initiating a social engagement or activity with a new acquaintance).
• Share emotional struggles related to current adjustment stress.
  • Explore the client's feelings, coping mechanisms, and support system as he/she tries to adjust to the current life stress factors; assess for depth of depression, anxiety, or grief and recommend treatment focused on these problems if warranted (see Depression, Anxiety, and Grief chapters in this Planner).
  • Assess the client for suicide potential if feelings of depression, helplessness, and isolation are present; initiate suicide prevention precautions, if necessary (see Suicidal Ideation chapter in this Planner).
• Significant others offer support to reduce the client's stress.
  • Hold family therapy sessions in which significant others are given the opportunity to support the client and offer suggestions for reducing his/her stress; challenge the client to share his/her needs assertively and challenge significant others to take responsibility for support (e.g., partner to increasing parenting involvement, partner to support the client's need for affirmation and stimulation outside the home, family members to take more responsibility for elderly parent's care).