Adult Treatment Planner

Objectives and Interventions

• Describe what it was like to grow up in the home environment.
  • Actively build the level of trust with the client in individual sessions through consistent eye contact, active listening, unconditional positive regard, and warm acceptance to help increase his/her ability to identify and express feelings.
  • Develop the client's family genogram and/or symptom line and help identify patterns of dysfunction within the family.
• Describe each family member and identify the role each played within the family.
  • Develop the client's family genogram and/or symptom line and help identify patterns of dysfunction within the family.
  • Assist the client in clarifying his/her role within the family and his/her feelings connected to that role.
• Identify patterns of abuse, neglect, or abandonment within the family of origin, both current and historical, nuclear and extended.
  • Assign the client to ask parents about their family backgrounds and develop insight regarding patterns of behavior and causes for parents' dysfunction.
  • Explore the client's painful childhood experiences.
• Identify feelings associated with major traumatic incidents in childhood and with parental child-rearing patterns.
  • Support and encourage the client when he/she begins to express feelings of rage, sadness, fear, and rejection relating to family abuse or neglect.
  • Assign the client to record feelings in a journal that describes memories, behavior, and emotions tied to his/her traumatic childhood experiences.
  • Ask the client to read books on the emotional effects of neglect and abuse in childhood (e.g., It Will Never Happen To Me by Black; Outgrowing the Pain by Gil; Healing the Child Within by Whitfield; Why I'm Afraid to Tell You Who I Am by Powell); process insights attained.
• Identify how own parenting has been influenced by childhood experiences.
  • Ask the client to compare his/her parenting behavior to that of parent figures of his/her childhood; encourage the client to be aware of how easily we repeat patterns that we grew up with.
• Acknowledge any dissociative phenomena that have resulted from childhood trauma.
  • Assist the client in understanding the role of dissociation in protecting himself/herself from the pain of childhood abusive betrayals (see Dissociation chapter in this Planner).
  • Assess the severity of the client's dissociation phenomena and hospitalize as necessary for his/her protection.
• State the role substance abuse has in dealing with emotional pain of childhood.
  • Assess the client's substance abuse behavior that has developed, in part, as a means of coping with feelings of childhood trauma. If alcohol or drug abuse is found to be a problem, encourage treatment focused on this issue (see Chemical Dependence chapter of this Planner).
• Decrease feelings of shame by being able to verbally affirm self as not responsible for abuse.
  • Assign writing a letter to mother, father, or other abuser in which the client expresses his/her feelings regarding the abuse.
  • Hold conjoint sessions where the client confronts the perpetrator of the abuse.
  • Guide the client in an empty-chair exercise with a key figure connected to the abuse - that is, perpetrator, sibling, or parent; reinforce the client for placing responsibility for the abuse or neglect on the caretaker.
  • Consistently reiterate that responsibility for the abuse falls on the abusive adults, not the surviving child (for deserving the abuse), and reinforce statements that accurately reflect placing blame on perpetrators and on nonprotective, nonnurturant adults.
• Identify the positive aspects for self of being able to forgive all those involved with the abuse.
  • Assign the client to write a forgiveness letter to the perpetrator of abuse; process the letter.
  • Teach the client the benefits (i.e., release of hurt and anger, putting issue in the past, opens door for trust of others, etc.) of beginning a process of forgiveness of (not necessarily forgetting or fraternizing with) abusive adults.
  • Recommend the client read books on the topic of forgiveness (e.g., Forgive and Forget by Smedes; When Bad Things Happen to Good People by Kushner).
• Decrease statements of being a victim while increasing statements that reflect personal empowerment.
  • Ask the client to complete an exercise that identifies the positives and negatives of being a victim and the positives and negatives of being a survivor; compare and process the lists.
  • Encourage and reinforce the client's statements that reflect movement away from viewing self as a victim and toward personal empowerment as a survivor.
• Increase level of trust of others as shown by more socialization and greater intimacy tolerance.
  • Teach the client the share-check method of building trust in relationships (sharing a little information and checking as to the recipient's sensitivity in reacting to that information).
  • Teach the client the advantages of treating people as trustworthy given a reasonable amount of time to assess their character.