The veteran/service member was assisted in developing a hierarchy of feared and avoided trauma-related stimuli. The veteran’s/service member’s journaling was used to assist in developing a hierarchy of feared and avoided trauma-related stimuli. Direct Imaginal Exposure A. Imaginal exposure was directed by having the veteran/service member describe a chosen traumatic experience at an increasing, but self-chosen, level of detail. The veteran/service member was confronted for his/her therapy-interfering behaviors. The clinician took appropriate responsibility for his/her own therapy-interfering behaviors. Therapy-interfering behaviors were problem-solved.
Provide Social interactions A. The veteran/service member was provided with opportunities for rewarding and nonthreatening social interaction. The veteran/service member has engaged in rewarding nonthreatening social interactions, and his/her experiences were reviewed and processed. D. The veteran/service member displays uncharacteristic disrespect to superiors. The veteran/service member displays increased risky behavior. As treatment has progressed, the veteran/service member displays decreased frequency and intensity of strange and disorganized behavior.
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The veteran/service member was reinforced as he/she agreed to follow through with the Check it out evaluation. The veteran/service member was strongly opposed to being placed on medication to help stabilize his/her mood and anxiety symptoms; his/her objections were processed. The veteran/service member was assessed for psychiatric medication, and a prescription was provided by the prescribing clinician. The veteran/service member was assessed for possible medication to assist in treating his/her more significant mood, anxiety, and sleep disturbance systems, but no medication was prescribed. Monitor Effects of Medication A. The veteran’s/service member’s response to the medication was discussed in today’s therapy session.
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The veteran/service member has attended the chronic pain support group, and his/her experience was processed. The veteran/service member has not attended the chronic pain support group and was reminded to do so. Encourage Medical Separation Appointments A. The service member was encouraged to attend all medical separation appointments. The service member was reinforced for his/her attendance at all medical separation appointments. The service member was redirected as he/she has not attended all medical separation appointments.
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The veteran/service member has not continued the self-care techniques and was reminded to do so. Feelings of Emptiness A. The veteran/service member reported a chronic history of feeling empty and bored with life. The veteran’s/service member’s frequent complaints of feeling bored and that life had no meaning had alienated him/her from others. The veteran/service member has not complained recently about feeling empty or bored but appears to be more challenged and at peace with life.
The veteran/service member was assisted in applying this successful problem-solving approach to the current situation. The veteran/service member struggled to identify situations in which he/she has successfully problem-solved and was assisted in identifying these and applying them to the current situation. Assign Pain Journal A. The veteran/service member was taught to keep a daily log of emotions, behaviors, situations, and environmental factors that influence his/her pain experience.
The service member reported better support from his/her family members, and this progress was reviewed. The service member has started a physical fitness training regimen, and his/her experience was processed. The service member reports better adjustment as he/she experiences better physical fitness; this progress was highlighted. The service member has not coordinated involvement with a certified instructor at his/her local base/post and was reminded to do so. Reinforce Physical Fitness Gains A. The service member was noted to have made significant physical fitness gains. Encouragement was provided to the service member in regard to his/her physical fitness program.
Refer to Grief Support Group A. The veteran/service member was encouraged to attend a grief/loss support group. The veteran/service member has followed through on attending a grief/loss support group, and his/her positive experience was processed. E. The service member has not implemented the relaxation techniques in social situations and continues to feel quite distressed; he/she was redirected to do so.
The pro and con list developed by the service member in regard to his/her new environment and newfound independence was processed. The service member has not created a pro and con list related to his/her newfound independence and was redirected to do so. Normalize Emotions A. The service member was educated about how this initial separation from friends and family can be difficult for anyone. The service member was educated about how separation is a normal part of the developmental process between adolescence and adulthood.
