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Practice Planners
Arthur E. Jongsma, Jr., Series Editor

The Complete

Treatment and Homework Planner

Contains more than 1,000 prewritten goals,
objectives, and interventions for treating depression
and depression-related disorders

Includes clinically proven, ready-to-copy homework

exercises and assignments

Sample treatment plans and customizable exercises

may be easily downloaded online at
www.wiley.com/go/completeplanners

Arthur E. Jongsma, Jr., Editor

Practice Planners
Arthur E. Jongsma, Jr., Series Editor

Helping therapists
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® WILEY
The Complete Depression
Treatment and
Homework Planner
 PRACHCEPLANNERS® SERIES V -

Treatment Planners
The Complete Adult Psychotherapy Treatment Planner, Third Edition
The Child Psychotherapy Treatment Planner, Third Edition
The Adolescent Psychotherapy Treatment Planner, Third Edition
The Addiction Treatment Planner, Second Edition
The Continuum of Care Treatment Planner
The Couples Psychotherapy Treatment Planner
The Employee Assistance Treatment Planner
The Pastoral Counseling Treatment Planner
The Older Adult Psychotherapy Treatment Planner
The Behavioral Medicine Treatment Planner
The Group Therapy Treatment Planner
The Gay and Lesbian Psychotherapy Treatment Planner
The Family Therapy Treatment Planner
The Severe and Persistent Mental Illness Treatment Planner
The Mental Retardation and Developmental Disability Treatment Planner
The Social Work and Human Services Treatment Planner
The Crisis Counseling and Traumatic Events Treatment Planner
The Personality Disorders Treatment Planner
The Rehabilitation Psychology Treatment Planner
The Special Education Treatment Planner
The Juvenile Justice and Residential Care Treatment Planner
The School Counseling and School Social Work Treatment Planner
The Sexual Abuse Victim and Sexual Offender Treatment Planner
The Probation and Parole Treatment Planner
The Psychopharmacology Treatment Planner
The Speech-Language Pathology Treatment Planner
The Suicide and Homicide Risk Assessment & Prevention Treatment Planner
The College Student Counseling Treatment Planner

Progress Note Planners

The Child Psychotherapy Progress Notes Planner, Second Edition
The Adolescent Psychotherapy Progress Notes Planner, Second Edition
The Adult Psychotherapy Progress Notes Planner, Second Edition
The Addiction Progress Notes Planner
The Severe and Persistent Mental Illness Progress Notes Planner
The Couples Psychotherapy Progress Notes Planner

Homework Planners
Brief Therapy Homework Planner
Brief Couples Therapy Homework Planner
Brief Adolescent Therapy Homework Planner
Brief Child Therapy Homework Planner
Brief Employee Assistance Homework Planner
Brief Family Therapy Homework Planner
Grief Counseling Homework Planner
Group Therapy Homework Planner
Divorce Counseling Homework Planner
School Counseling and School Social Work Homework Planner
Child Therapy Activity and Homework Planner
Addiction Treatment Homework Planner, Second Edition
Adolescent Psychotherapy Homework Planner II
Adult Psychotherapy Homework Planner

Client Education Handout Planners

Adult Client Education Handout Planner
Child and Adolescent Client Education Handout Planner
Couples and Family Client Education Handout Planner

Documentation Sourcebooks
The Clinical Documentation Sourcebook, Second Edition
The Forensic Documentation Sourcebook
The Psychotherapy Documentation Primer
The Chemical Dependence Treatment Documentation Sourcebook
The Clinical Child Documentation Sourcebook
The Couple and Family Clinical Documentation Sourcebook
The Continuum of Care Clinical Documentation Sourcebook

Complete Planners
The Complete Depression Treatment and Homework Planner
The Complete Anxiety Treatment and Homework Planner
Practic ePIanners
Arthur E. Jongsma, Jr., Series Editor

The Complete Depression

Treatment and
Homework Planner

Arthur E. Jongsma, Jr., Editor

WILEY

John Wiley & Sons, Inc.

 This book is printed on acid-free paper. ©

Copyright © 2004 by Arthur E. Jongsma, Jr. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
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ISBN: 0-471-64515-X

Printed in the United States of America.

10 987654321
 CONTENTS

Practic^Planners® Series Preface

Introduction

SECTION I—Treatment Planning

Child
Arthur E. Jongsma, Jr., L. Mark Peterson, and William P. Mclnnis

School-Based Child/Adolescent
Sarah Edison Knapp and Arthur E. Jongsma, Jr.

Adolescent
Arthur E. Jongsma, Jr., L. Mark Peterson, and William P. Mclnnis

Adolescent in Juvenile Justice/Residential Care

William P. Mclnnis, Wanda D. Dennis, Michell A. Meyers, Kathleen O’Connell-Sullivan,
and Arthur E. Jongsma, Jr.

Adult
Arthur E. Jongsma, Jr. and L. Mark Peterson

Acute Inpatient Adult

Chris E. Stout and Arthur E. Jongsma, Jr.

Addicted Adult/Adolescent
Robert R. Perkinson and Arthur E. Jongsma, Jr.

Older Adult
Deborah W. Frazer and Arthur E. Jongsma, Jr.

Spouse Depressed Due to Relationship

K. Daniel O’Leary, Richard E. Heyman, and Arthur E. Jongsma, Jr.

Spouse Depressed Independent of Relationship

K. Daniel O’Leary, Richard E. Heyman, and Arthur E. Jongsma, Jr.

Employee
James M. Oher, Daniel J. Conti, and Arthur E. Jongsma, Jr.
x CONTENTS

Parishioner " 87
Arthur E. Jongsma, Jr. and James R. Kok

Medically Ill 91
Douglas E. DeGood, Angela L. Crawford, and Arthur E. Jongsma, Jr.

Trauma Victim 97
Tammi D. Kolski, Michael Avriette, and Arthur E. Jongsma, Jr.

Developmentally Disabled 103

Kellye H. Slaggert and Arthur E. Jongsma, Jr.

Severely Mentally Ill 111

David J. Berghuis and Arthur E. Jongsma, Jr.

Depressive Personality Disorder 119

Neil R. Bockian and Arthur E. Jongsma, Jr.

Neurologically Impaired 129

Michele J. Rusin and Arthur E. Jongsma, Jr.

Parolee 137
Brad M. Bogue, Anjali Nandi, and Arthur E. Jongsma, Jr.

Group Treatment of Depression 145

Kim Paleg and Arthur E. Jongsma, Jr.

Psychotropic Treatment of Depression 153

David C. Purselle, Charles B. Nemeroff, and Arthur E. Jongsma, Jr.

Section II—Homework Planning 161

Child 163
Arthur E. Jongsma, Jr., L. Mark Peterson, and William P. Mclnnis
Exercise IIA.A Surface Behavior/Inner Feelings 165
Exercise IIB.B Three Ways to Change the World 169

Adolescent 173
Arthur E. Jongsma, Jr., L. Mark Peterson, and William P. Mclnnis
Exercise IIB. A Pictures of Activities I Enjoy 175
Exercise IIB.B I Am a Good Person I79
Exercise IIB.C Maintaining Your Self-Esteem 182
Exercise IIB.D Overcoming Helplessness and Hopelessness 186
Exercise IIB.E Take Time to Laugh and Enjoy Life 189
 CONTENTS xi

School Based 195

Sarah Edison Knapp
Exercise IIC.A Accomplishments I Am Proud Of 197
Exercise IIC.B Growing and Changing 200
Exercise IIC.C Heart-to-Heart Smart Talks 204
Exercise IIC.D Planning for Fun 207

Adult 211
Arthur E. Jongsma, Jr.
Exercise IID.A Creating a Memorial Collage 213
Exercise IID.B Identify and Schedule Pleasant Activities 216
Exercise IED.C Journal of Distorted, Negative Thoughts 219
Exercise IID.D Negative Thoughts Trigger Negative Feelings 223
Exercise IID.E Why I Dislike Taking My Medication 228

Addiction 231
James R. Finley and Brenda S. Lenz
Exercise IIE.A Am I Having Difficulty Letting Go? 233
Exercise IIE.B Depression Interacts with Addiction 236
Exercise IIE.C Early Recovery Emotions 240
Exercise IIE.D Why Do I Matter and Who Cares? 243

Couples 247
Gary M. Schultheis, Bill O’Hanlon, and Steffanie O’Hanlon
Exercise IIF.A Changes That Will Improve the Relationship 249
Exercise IIF.B Identify Your Partner’s Feelings 252
Exercise IIF.C Increase Romantic Behaviors 255

259
Employee
Lise B. Mayers and Diana L. Rabatin
Exercise IIG.A Boosting Self-Esteem 261
Exercise IIG.B Practicing Positive Self-Talk 264
Exercise IIG.C Setting Personal Goals 266
Exercise IIG.D Ways to Nurture Yourself 268

Group ^23
Louis J. Bevilacqua
Exercise IIH.A My Feelings Journal 275
Exercise IIH.B There’s Always a Sunrise 278
Exercise IIH.C What Do Others Value about Me? 280

Appendix: Bibliotherapy Suggestions 283

 "

,
 PRACTICEPLAWWERS® SERIES PREFACE

The practice of psychotherapy has a dimension that did not exist 30, 20, or even 15 years
ago—accountability. Treatment programs, public agencies, clinics, and even group and
solo practitioners must now justify the treatment of patients to outside review entities that
control the payment of fees. This development has resulted in an explosion of paperwork.
Clinicians must now document what has been done in treatment, what is planned for the
future, and what the anticipated outcomes of the interventions are. The books and
software in this Practic^Planners series are designed to help practitioners fulfill these
documentations requirements efficiently and professionally.
The Vv&cticQPlanner series is growing rapidly. It now includes not only the original
The Complete Adult Psychotherapy Treatment Planner, Third Edition, The Child
Psychotherapy Treatment Planner, Third Edition, and The Adolescent Psychotherapy
Treatment Planner, Third Edition, but also Treatment Planners targeted to specialty areas
of practice, including: addictions, juvenile justice/residential care, couples therapy,
employee assistance, behavioral medicine, therapy with older adults, pastoral counseling,
family therapy, group therapy, neuropsychology, therapy with gays and lesbians, special
education, school counseling, and more.
Several of the Treatment Planner books now have companion Progress Notes Planners
(e.g., Adult, Adolescent, Child, Addictions, Severe and Persistent Mental Illness,
Couples). More of these planners that provide a menu of progress statements that
elaborate on the client’s symptom presentation and the provider’s therapeutic intervention
are in production. Each Progress Notes Planner statement is directly integrated with
“Behavioral Definitions” and “Therapeutic Interventions” items from the companion
Treatment Planner. . . . . f
The list of therapeutic Homework Planners is also growing from the original Bnet
Therapy Homework to Adult, Adolescent, Child, Couples, Group, Family, Addictions,
Divorce, Grief, Employee Assistance, and School Counseling/School Social Work
Homework Planners. Each of these books can be used alone or in conjunction with their
companion Treatment Planner. Homework assignments are designed around each
presenting problem (e.g., Anxiety, Depression, Chemical Dependence, Anger
Management, Panic, Eating Disorders) that is the focus of a chapter in its corresponding
Treatment Planner. . ., , ,
Client Education Handout Planners, a new branch in the series, provides brochures
and handouts to help educate and inform adult, child, adolescent, couples, and farm y
clients on a myriad of mental health issues, as well as life skills techniques. The list of
presenting problems for which information is provided mirrors the list of presenting
problems in the Treatment Planner of the title similar to that of the Handout Planner
Thus the problems for which educational material is provided in the Child and
Adolescent Client Education Handout Planner reflect the presenting problems listed m

xiii
xiv PRACTICEPLAAWERS® SERIES PREFACE

The Child and The Adolescent Psychotherapy Treatment Planner books, handouts are
included on CD-ROMs for easy printing and are ideal for use in waiting rooms, at
presentations, as newsletters, or as information for clients struggling with mental illness
issues.
In addition, the series also includes TheraScn&e®, the latest version of the popular
treatment planning, clinical record-keeping software. Thera*Sm'6e allows the user to
import the data from any of the Treatment Planner, Progress Notes Planner, or Homework
Planner books into the software’s expandable database. Then the point-and-click method
can create a detailed, neatly organized, individualized, and customized treatment plan
along with optional integrated progress notes and homework assignments.
Adjunctive books, such as The Psychotherapy Documentation Primer, and Clinical,
Forensic, Child, Couples and Family, Continuum of Care, and Chemical Dependence
Documentation Sourcebook contain forms and resources to aid the mental health practice
management. The goal of the series is to provide practitioners with the resources they
need to provide high-quality care in the era of accountability—or, to put it simply, we
seek to help you spend more time on patients, and less time on paperwork.

Arthur E. Jongsma, Jr.

Grand Rapids, Michigan
 INTRODUCTION

Since the early 1960s, formalized treatment planning has gradually become a vital aspect of the
health care delivery system, whether it is treatment related to physical health, mental health,
child welfare, or substance abuse. What started in the medical sector in the 1960s spread into the
mental health sector in the 1970s as clinics, psychiatric hospitals, agencies, and other institutions,
began to seek accreditation from bodies such as the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) to qualify for third-party reimbursements. With the advent of
managed care in the 1980s, treatment planning took on even more importance. Managed care
systems insisted that clinicians move rapidly from assessment of the problem to the formulation
and implementation of a treatment plan. The goal of most managed care companies is to expedite
the treatment process by prompting the client and treatment provider to focus on identifying and
changing behavioral problems as quickly as possible. Treatment plans must be specific as to the
presenting problems, behaviorally defined symptoms, treatment goals, and objectives and
interventions. Treatment plans must be individualized to meet the client s needs and goals, and
the observable objectives must allow for setting milestones that can be used to chart the client s
progress. Pressure from third-party payers, accrediting agencies, and other outside parties has
therefore increased the need for clinicians to produce effective, high-quality treatment plans in a
short time. Because many mental health providers have little experience in treatment plan
development, our purpose in writing this book is to clarify, simplify, and accelerate the treatment
planning process.

PLANNER FOCUS

Currently, there are 28 Treatment Planners and 14 Homework Planners in the Wiley
Practic^Planners series. As the Series Editor, I have been privileged to work with many creative
and well-trained mental health professionals from around the country. Although these books have
been written for implementation with a wide variety of treatment populations (e.g., adult,
adolescent, child, older adult, addicted) or treatment settings (e.g., school, employment), some
presenting problems are common to many of our books.
Various authors have approached the treatment of depression in specific client populations or
treatment settings. Some of the material has been modified slightly to make the style, length, and
form uniform throughout the book. The authors of the individual chapters are cited in a footnote
at the beginning of each chapter. I thank them for their contributions to this book.
The 30 homework assignments are grouped into eight categories based on their treatment
population focus. If an assignment appears applicable to your client, you may visit the Wiley
website www.wiley.com/go/completeplanners to download a full-size customizable version to
your hard drive for current and future print out and distribution. You may download one

1
 2 THE COMPLETE DEPRESSION TREATMENT AND HOMEWORK PLANNER

assignment at a time as it is needed or you may choose to download all 27 assignments in one
visit to the site.
In the Treatment Planning section of The Complete Depression Treatment and Homework
Planner you will find a menu of statements to be included in outpatient and inpatient treatment
plans for a variety of client populations struggling with depression. There is no single bias to the
Objectives and Interventions suggested, but rather you will find items reflecting an eclectic
approach of family therapy, individual therapy, pharmacotherapy, insight orientation, cognitive
and behavioral techniques, and others. The clinician may select those items from the menu that
best fit his or her therapeutic approach and the client's individual strengths and needs.
Each chapter of the Treatment Planning section contains a menu of items from which you
may select “Behavioral Definition” statements that describe your client’s symptom pattern,
“Long-Term Goal” statements that describe the desired outcome of treatment, “Short-Term
Objectives” statements describing observable steps toward the treatment goal, and “Therapeutic
Intervention” statements describing suggested ways for you to help your client achieve the
Objectives (as always, Intervention numbers are placed in parentheses after each Objective as a
way to suggest which Intervention may be most appropriate for the specific Objective). Finally,
DSM-IV-TR™ “Diagnostic Suggestions” associated with the presenting problem are placed at
the end of each chapter.

HOW TO DEVELOP A TREATMENT PLAN

The process of developing a treatment plan involves a logical series of steps that build on each
other much like constructing a house. The foundation of any effective treatment plan is the data
gathered in a thorough biopsychosocial assessment. As the client presents himself or herself for
treatment, the clinician must sensitively listen to and understand what the client struggles with in
terms of family-of-origin issues, current stressors, emotional status, social network, physical
health, coping skills, interpersonal conflicts, self-esteem, and so on. Assessment data may be
gathered from a social history, physical exam, clinical interview, psychological testing, or contact
with a client’s significant others. The integration of the data by the clinician or the
multidisciplinary treatment team members is critical for understanding the client, as is an
awareness of the basis of the client’s struggle. We have identified 6 specific steps for developing
an effective treatment plan based on the assessment data.

Step One: Client Population Selection

The Complete Depression Treatment and Homework Planner assumes that the client is
presenting with depression as the primary or secondary problem. Choose the chapter that best
reflects your client's population characteristics.

Step Two: Problem Definition

Each individual client presents with unique nuances as to how a problem behaviorally reveals
itself in his or her life. Therefore, the depression problem requires a specific definition about how
it is evidenced in the particular client. The symptom pattern should be associated with diagnostic
criteria and codes such as those found in the Diagnostic and Statistical Manual or the
International Classification of Diseases. The Complete Planner, following the pattern established
by DSM-IV-TR, offers behaviorally specific definition statements to choose from or to serve as a
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