CLIENT FULL NAME
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First Name
Last Name
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CBRS UNITS
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0 - NO SHOW/CANCELLED
LOCATION
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Client Home
Coffee Shop
Idaho State University
Library, Chubbuck
Library, Pocatello
Mall, Pine Ridge
McKee Petting Zoo & Pet Store
Park: Pocatello Parkway
Park: Ross Park
Walmart
WinCo
**OTHER**
LOCATION (If other was selected)
ISSUE
*
Anger Management
Attention (Impulsive with difficulty sustaining attention)
Avolition & Anhedonia
Basic Living Skills
Boundaries
Chemical Dependence
Coping Skills
Counseling, Individual
CPS involvement
Crisis
Depression
Educational Stressors
Family, Extended
Family, Immediate
Financial
Grief
Housing
Impulsivity with difficulty sustaining attention
Independent Living Skills
Legal
New Client
Oppositional Defiant Behaviors
Parenting Skills
Peer/Sibling Conflict
Pharmaceutical Management
Positive Coping Skills
Pro-social Behavior
Self-Esteem
Self-Injurious Behaviors
Self-isolation
Social Anxiety with Panic
Social Boundaries
Social Discomfort/Shyness
Social Skills
Suicidal Ideation
Vocational Stressors
*** NO SHOW/CANCELLED ***
TASKS
*
TASK A
TASK B
TASK C
TASK D
TASK E
TASK F
TASK - I
TASK - II
TASK - III
TASK - IV
PRESENTATION
*
Appropriate
Cooperative
Enthusiastic
Good Mood
Good Spirit
Happy
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Angry
Anxious
Attention-seeking
Defensive
Depressed
Distracted
Erratic
Guarded
Irritable
Lethargic
Oppositional
Overwhelmed
Passive
Resistant
Sad
Unfocused
Withdrawn
TECHNIQUES & INTERVENTIONS
*
Active Listening/Reflection
Anger management skills
Boundaries
Breathing techniques
Budgeting
CBT interventions
Chain Analysis
Charting and Logs
Coached
Communication between client and MD
Communication skills
Conflict resolution skills
Coping strategies
Crisis plan
DBT exercises for mindfulness
DBT interventions
Decision-making skills
Decompensation, Skills to identify
Education
Expression of feelings
Evaluation and Assessment
Familial conflict
Goal setting
Hygiene
Identification of personal strengths and weaknesses.
Implementation of assuaging behaviors
Impulsivity
Inappropriate use of language
Interpersonal skills
In-vivo exercise
Journaling
Meditation techniques
Positive implementation of coping strategies
Problem Solving
Processed Alternatives
Pro-social behaviors
Provided Support
Public asocial behaviors
Redirected
Re-education
Refraiming
Reintroduced
Reviewed
Role Play
Self-calming techniques
Self-care techniques
Self-control techniques
Skill Development
Skills for activities of daily living
Social skills
Stress management techniques
Symptom identification
Thinking errors
Utilized Curriculum
Validation
*** NO SHOW/CANCELLED ***
WORKBOOKS - CURRICULUM - WELLNESS JOURNALS
Please Select
DIALECTICAL BEHAVIOR THERAPY SKILLS WORKBOOK: (McKay et al, 2007).
CODEPENDENT NO MORE WORKBOOK: (Beatie, 2011)
LANGUAGE OF LETTING GO: Daily Meditations on Codependency, (Beatie, 1990)
DAILY LIVING SKILLS WORKSHEETS: Reproducible Resources for Teaching Independent Living Skills (Harrison, 2011)
SELF-ESTEEM PROGRAM: Inventories, Activities & Educational Handouts (Liptak et al, 2002)
HURT YOURSELF LESS WORKBOOK (Dace et al, 1998)
SPENDING AND SAVINGS PLAN: Helping you take charge of your money (Well Balanced, 2013)
DEVELOPING PERSONAL BOUNDARIES WORKBOOK (Gateway, 2013)
STRUCTURED PROBLEM SOLVING WORKBOOK: A Step by Step Guide to Addressing your Problems (Gateway, 2013)
WELLNESS JOURNALS - TREATING MOOD DISORDERS USING WELLNESS JOURNALS: A guide for Counselors and PSR workers (Richardson, 2013)
STRESS MANAGEMENT: Techniques for preventing and easing stress, (Harvard Medical School, 2006)
DAILY REFLECTIONS: (A.A. 1990)
COMMUNICATION SKILLS WORKBOOK (Gateway 2013)
BODY IMAGE WORKBOOK (Gateway 2013)
MANIPULATION WORKBOOK (Gateway 2013)
ACCEPTING PERSONAL RESPONSIBILITY WORKBOOK (Gateway 2013)
THE ADHD WORKBOOK FOR KIDS: Helping Children Gain Self-Confidence, Social Skills & Self Control (Shapiro, 2010)
I'M NOT BAD, I'M JUST MAD: A Workbook to Help Kids Control Their Anger, (Lawrence, et al 2008)
SERVICE PROVIDED
*
RISK ASSESSMENT
*
NOT considered to be a significantly elevated risk for self harm or harm to others.
SOME suicidal thoughts or thoughts of self harm, however there are sufficient barriers in place to prevent self injury. Does not require more intense services.
ELEVATED RISK for self harm or harm to others.
CLIENT RESPONSE
*
Client reported understanding of the information taught
Client actively engaged in session with CBR Specialist
Responded positively to CBR Specialist.
Enthusiastically engaged with CBR Specialist
Resistant while working with CBR Specialist.
Oppositional, feeling that the information did not pertain to client
Difficult to engage in the theraputic process
Client engaged, but is struggling to understand, implement and retain.
*** NO SHOW/CANCELLED ***
PLAN
*
Client will need additional instruction and training before the client will be able to implement the skills in to his or her daily routine.
Additional practice is needed to help the client implement skills practiced into his or her daily routine.
Needs a moderate amount of additional training before the client will be able to implement skills into his or her daily routine.
Will be able to implement skills practiced into daily routine without additional instruction
*** NO SHOW/CANCELLED ***
NEXT ANTICIPATED APPOINTMENT DATE & TIME:
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WORKER NAME & TITLE
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