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The veteran/service member declined to take the objective measures of sleep impairment, and his/her resistance in this area was processed. Explain Connection Between Bad Sleep Habits and Insomnia A. The connection between the veteran’s/service member’s bad sleep habits and insomnia was the focus of today’s session. D. The veteran/service member reported that he/she no longer experiences extremely frightening dreams that awaken him/her in the night. Daytime Sleepiness A. The veteran/service member reported that he/she feels very sleepy during the day and easily falls asleep, even while sitting in a chair. The veteran/service member reported that he/she has fallen asleep in a chair in the presence of others in a social situation on many occasions. Negative Emotions toward Loved Ones The service member reports feeling distant, angry, or resentful toward loved ones.
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A review was made about expenses that will need to be cut in order to balance with current income. List Expenses A. The service member was asked to list expenses. The service member was assisted in identifying expenses that he/she has now that he/she did not have while deployed. The service member was assisted in planning as to how to budget for expenses. The service member was assigned “Plan a Budget” from the Adult Psychotherapy Homework Planner, 2nd ed. The service member has reviewed expenses and budgeting, and this was reviewed within the session.
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The veteran/service member displays agitation through anger outbursts and impulsive, physical acting out. The veteran/service member is difficult to approach due to his/her extreme agitation. As treatment has progressed, the veteran/service member has decreased his/her level of agitation and is less irritable, angry, unpredictable, and impulsive. Social Withdrawal/Isolation A. The veteran/service member has been withdrawn from involvement with the external world and has been preoccupied with egocentric ideas and fantasies. The veteran/service member has shown a slight improvement in his/her ability to demonstrate relationship skills. The veteran/service member has shown an interest in relating to others in a more appropriate manner.
The service member was encouraged to review and update his/her will and/or power of attorney. The service member was encouraged to include his/her spouse/legal guardian in this process. The service member has updated his/her proper documents and was reinforced for this. The service member has avoided updating his/her proper documents and was reminded about this necessary task.
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The service member was encouraged to use progressive muscle relaxation techniques. The service member was encouraged to replace negative thoughts with positive ones. The service member has identified several healthy ways of coping with stress and improving his/her mood; his/her response and progress were monitored.
Social
Encourage Meeting with Coping Peer A. The veteran/service member was encouraged to meet with a current service member or veteran who has experienced the loss of a fellow comrade. The veteran/service member was encouraged to inquire as to how the individual has dealt with his/her loss. The veteran/service member has met with a service member or veteran who has experienced the loss of a fellow comrade, and his/her insights were reviewed.
The veteran/service member reports a decrease in his/her ruminations and a better ability to induce sleep. Refer to Attorney A. The service member was referred to a military attorney to explore the feasibility and impact of filing for bankruptcy. The service member was referred to the judge advocate general in regard to the feasibility and impact of filing for bankruptcy. The veteran/service member was referred to a private attorney in regard to the feasibility and impact of filing for bankruptcy. The veteran/service member has decided to file for bankruptcy and was supported for taking steps to resolve his/her financial crisis.
The Penn State Worry Questionnaire was used to assess the depth and breadth of the veteran’s/service member’s anxiety responses. The OQ-45.2 was used to assess the impact of the veteran’s/service member’s symptom’s impact on his/her functioning. The patient-report measure indicated that the veteran’s/service member’s anxiety is extreme and severely interferes with his/her life. The patient-report measure indicated that the veteran’s/service member’s anxiety is moderate and occasionally interferes with his/her daily life. The patient-report measure indicated that the veteran’s/service member’s anxiety is mild and rarely interferes with his/her daily life.