PST Relapse Prevention

Date of Session: ___/___/__

Your name: ______

Therapist’s name (clinician role playing the therapist): ______

For each item, assess the therapist on a scale of 0-5 and record the rating on the line next to the item number.

0 1 23 4 5

Very PoorPoorBorderline SatisfactoryGoodVery Good

___ / A. Time Management
Set an agenda
Included patient items to agenda
Reminded patient of time limit
Explained how each session will proceed / Notes:
___ / B. Review Client Progress
Review of all current tasks
Praise success
Exploration of failure
Rate Satisfaction and Mood
Reinforce PST-PC Model
Review previous problem areas
___ / C. Education about Relapse Prevention
___ / 1. Explained why relapse prevention is important
Discussed risk of relapse
Importance of watching for “warning signs” of
relapse
Relapse can be prevented
Importance of contacting therapist/PMD when
symptoms become too hard to control
___ / 2. Used patient experience to develop a “warning
signs of relapse” plan
Reviewed with patient signs and symptoms that
indicate potential relapse
Described in behavioral terms (e.g.: doing less or
lack of interest/enjoyment)
___ / 3. Discussed strategies patient found most helpful in
past and during treatment
Brain storm list of strategies will continue to use to
prevent relapse
Brain stormed list of potent activities and strategies
can use when starting to feel down
___ / 4. Medication discussion (optional)
Discussed importance of staying on medications
Discussed timeframe for remaining on medications
Discussed how to contact prescribing provider if
wants to d/c
Discussed importance of not d/c’ing on their own
___ / 5. Creating the relapse prevention plan(s)
Specific tasks identified
Realistic behavior requirements
Plan Pleasant Activities for the week
Developed timeline for how often will check their
symptoms
___ / D. Process Tasks
Asked patient is s/he had questions
Used easy to understand language
Action plan was clear and proscriptive
___ / E. Communication and Interpersonal Effectiveness
Facilitates communication (supportive vocalizations
/ non-verbals)
Use of patient's own language and phrases
Warm / Confident / Professional
Tactful limiting of peripheral and unproductive
discussion
___ / F. Adherence versus competence
Therapist employed PST flexibly
Therapist did not stray too far from PST model
Therapist was able to integrate PST into crises
Therapist appeared comfortable using PST
PST session flowed much like a conversation or
consultation session
___ / H. Global Rating
How would you rate the problem solving therapist
overall in this session? (does not need to approach a mathematical average of previous eight items)
I. Patient Difficulty:
__ Patient was not appropriate candidate for PST
__ Patient required considerable rediretion (redirection
by therapist attempted)
__ Patient dominated the therapist
__ Patient too psychotic to participate
__ Patient too anxious to participate (orientation
strategies not effective)
__ Patient could not understand PST or therapy process
__Other: (indicate here):

COMMENTS AND SUGGESTIONS FOR THE THERAPIST'S IMPROVEMENT: