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Negative Blood Effects A. The veteran’s/service member’s blood work results reflected a pattern of heavy substance abuse (e.g., liver enzymes are elevated, electrolytes are imbalanced). The veteran’s/service member’s blood work results indicate that mood-altering drugs have been used. Physical Indicators A. The veteran’s/service member’s physical evaluation results reflect a pattern of heavy substance abuse (e.g., elevated blood pressure, stomach pain, malnutrition). As the veteran/service member has participated in the recovery program and has been able to maintain abstinence from mood-altering drugs, his/her physical status has shown improvement. The veteran’s/service member’s physical status and lab results have returned to normal. B. The veteran/service member was assigned “Share the Painful Memory” from the Adult Psychotherapy Homework Planner, 2nd ed.

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Submit to Urinalysis A. The veteran/service member was encouraged to submit to random urine testing for the presence of supplements. The veteran’s/service member’s successful passing of random urinalysis testing was reinforced and celebrated. The veteran/service member has not successfully passed his/her random urinalysis, and his/her treatment was refocused. B. The non-deployed parent was asked for information regarding the marital relationship, child behavior expectations, and parenting style. The non-deployed parent was provided with positive feedback for being open and honest regarding his/her history of parenting concerns.

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18. Explore Addiction as an Escape A. The veteran’s/service member’s use of opioid abuse as a way to escape stress, emotional pain, and/or boredom was explored. 10.

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The veteran/service member was provided with positive feedback for his/her use of the applied tension technique. The veteran/service member has struggled to appropriately use the applied tension technique and was provided with remedial feedback in this area. Assign Daily Applied Tension Practice A. The veteran/service member was assigned a homework exercise in which he/she practices daily use of the applied tension skills. The veteran’s/service member’s daily use of the applied tension technique was reviewed. The veteran/service member was reinforced for his/her success at using daily applied tension skills.

B. The veteran/service member has followed through on the assignment of writing positive affirmation statements and reported that he/she is feeling more positive about the future. The veteran/service member was reinforced for making positive statements regarding himself/herself and his/her ability to cope with the stresses of life. The veteran/service member has not followed through on the assignment of writing positive affirmation statements and was encouraged to do so. Teach Normalization of Sadness A. The veteran/service member was taught about the variation in mood that is within the normal sphere. The veteran/service member reported that he/she is developing an increased tolerance to mood swings and is not attributing them to significant depression; this progress was reinforced. Explore Childhood Pain A. Experiences from the veteran’s/service member’s childhood that contribute to his/her current depressed state were explored.

The veteran/service member reported that the medication has been beneficial to him/her in reducing his/her experience of anxiety symptoms; the benefits of this progress were reviewed. The veteran/service member reported that the medication does not seem to be helpful in reducing anxiety experiences; this was reported to the prescribing clinician. Inform Chain of Command A. The service member’s chain of command was informed about the service member’s medication use. The service member’s medication was noted to have a change in her/her functioning, which is likely to put others at risk. The service member’s medication is not noted to have significant effects on his/her functioning, and this was related to the chain of command. After a review of the medication being used by the service member, it was decided that there is no need to inform his/her chain of command.

She kept leaving the room and coming back with better deals and I sign saying no. Well, reluctantly, I went in login an appointment expectations past Saturday. I have never been so pressured in my life. Two and a half hours of pure torture. I thought used car salesmen were bad.

Davis sees the symbolism attached to “great expectations” as reinforcing the novel’s impact. S single most obvious literary predecessor is Dickens’s earlier first-person narrator-protagonist LustyLocals David Copperfield. Dickens was conscious of this similarity and, before undertaking his new manuscript, reread David Copperfield to avoid repetition.

What couldn’t be seen just from the metrics was the amount of work the fired coworker had been doing to support the team . In my last office job I asked repeatedly for feedback. I was told every time that I was doing fine until they called me in for a meeting to fire me. I also had a deadly case of fixed mindset which meant my whole identity would shatter to pieces if I wasn’t the best at everything. Luckily for me, I found another job and quit before I was fired. My new growth mindset is a work in progress, but it makes it much easier to handle tough feedback.

The veteran/service member has regularly used behavioral techniques and was reinforced for this progress. It was noted that the veteran/service member has not been regularly using his/her behavioral techniques, and he/she was redirected to do so. Reinforce Use of Cognitive Behavioral Techniques A. The veteran/service member has regularly used cognitive-behavioral techniques, and his/her use was verbally reinforced. The veteran’s/service member’s use of cognitive-behavioral techniques was highlighted as integral to his/her success.

Medication has improved the veteran’s/service member’s problems with sleep disturbance. Lack of Energy A. The veteran/service member reported that he/she feels a very low level of energy compared to normal times in his/her life. It was evident within the session that the veteran/service member has low levels of energy, as demonstrated by slow walking, minimal movement, lack of animation, and slow responses. The veteran’s/service member’s energy level has increased as the depression has lifted. It was evident within the session that the veteran/service member is demonstrating normal levels of energy. Lack of Concentration A. The veteran/service member reported that he/she is unable to maintain concentration and is easily distracted.

It has been really hard for me to admit to myself that there are some things I just don’t do well. But there are, and I owe it to myself to not put myself in a position where those things are the main focus of my job. I guess what I mean is we should not confuse being nice with being kind. Tell employees if they don’t improve X you will have no choice but to fire them.