Midlife Transition Problems

1. Describe Mismatch between Life Goals and Accomplishments (1)

A. The partner experiencing midlife transition difficulties was asked to describe the mismatch between life goals and accomplishments.

B. The partner experiencing midlife transition difficulties was supported and encouraged as he/she identified the mismatch between life goals and accomplishments.

C. The partner experiencing midlife transition problems was supported by his/her partner in describing the mismatch between life goals and accomplishments; this support was encouraged and validated.

D. The partner has struggled to characterize the mismatch between life goals and accomplishments and was provided with common examples in this area.

2. Complete Objective Testing (2)

A. The partner experiencing midlife transition difficulties was asked to complete objective testing.

B. The partner experiencing midlife transition difficulties was asked to complete the Midlife Crisis Scale.

C. The partner has completed the objective testing and feedback was provided to the partner.

D. The partner has not completed the objective testing and was redirected to do so.

3. Probe Cognitive Distortions (3)

A. The client's description of anxiety and uneasiness was probed for causes related to cognitive distortion.

B. The client was asked to identify specific thoughts that lead to anxiety and uneasiness.

C. The client was provided with feedback about the cognitive distortions that he/she displays that lead to anxiety and uneasiness.

4. Assign Diary (4)

A. The client was assigned to keep a daily diary of thoughts that precipitate anxious and depressed feelings.

B. The client has kept a daily diary of thoughts that precipitate anxious and depressed feelings, and this was reviewed and processed within the session.

C. The client has not kept a daily diary of thoughts that precipitate anxious and depressed feelings and was redirected to do so.

5. Demonstrate Situational Analysis (5)

A. The client was shown how to conduct a situational analysis.

B. The client was asked to choose from his/her homework of tracking events/thoughts that precipitate anxious and depressed feelings specific to midlife problem-eliciting situations and tell what his/her interpretations and cognitions were.

C. The client was asked to identify his/her behavior and reaction to the problem-eliciting situation.

D. The client was asked to identify the actual outcome of the situation that was eliciting problems.

E. The client was guided in his/her completion of the situational analysis.

6. Identify Desired Outcome (6)

A. The client was assisted in identifying his/her desired outcome for the problem-eliciting situation.

B. The client was assisted in contrasting his/her desired outcome with the actual outcome of the situation.

7. Assess Thoughts (7)

A. The client was helped to determine whether or not his/her internal cognitions were accurate.

B. The client was assisted in determining whether his/her internal cognitions were anchored to the specific situations.

C. The client was assisted in determining whether his/her internal cognitions were helpful in getting the desired outcome.

D. The client was reinforced for his/her insight into the ways in which his/her internal cognitions were unhelpful, global, or inaccurate.

F. The client struggled to identify ways in which his/her thoughts were unhelpful, global, or inaccurate and was provided with remedial feedback in this area.

G. The client was assisted in identifying more beneficial self-talk.

8. Modify Unhelpful, Global, or Inaccurate Cognitions (8)

A. The client identified some of his thoughts as inaccurate, global, or unhelpful.

B. The client was assisted in identifying alternative thought patterns that were more accurate, more anchored to the situation, and more helpful in getting the desired outcome.

C. The client struggled to identify how to change his/her cognitions and was provided with specific examples in this area.

9. Read Information about Values (9)

A. The partners were asked to read information about values and goals for living a meaningful life.

B. The partners were asked to read First Things First (Covey, Merrill, and Merrill).

C. The partners were assisted in identifying the four key human needs: to live, to learn, to love, and to leave a legacy.

D. The partners were assisted in discussing the four key human needs.

10. Review Physical Needs (10)

A. The partners were asked to consider their approach for fulfilling the need to live.

B. The partners were reminded about the need to live as including physical needs for such things as food, clothing, economic well-being, and health.

C. The partners were asked to write and discuss their past and current goals for meeting financial needs.

D. The partners were assisted in discussing the pros and cons of their current approach to meeting financial needs and “to live.”

11. Review Social Needs (11)

A. The partners were asked to consider their approach for fulfilling the need to love.

B. The partners were reminded about the need to love as including social needs for such things as relating to other people, to belong, to love, and to be loved.

C. The partners were asked to write and discuss their past and current goals for meeting social needs.

D. The partners were assisted in discussing the pros and cons of their current approach to meeting social needs and “to love.”

12. Review Mental Needs (12)

A. The partners were asked to consider their approach for fulfilling the need to learn.

B. The partners were reminded about the need to learn as including mental needs for such things as intellectual development and openness to new experiences and skills.

C. The partners were asked to write and discuss their past and current goals for meeting learning needs.

D. The partners were assisted in discussing the pros and cons of their current approach to meeting mental needs and “to learn.”

13. Review Spiritual Needs (13)

A. The partners were asked to consider their approach for fulfilling the need to leave a legacy.

B. The partners were reminded about the need to leave a legacy as including spiritual needs for meaning, purpose, personal congruence, and contribution.

C. The partners were asked to write and discuss their past and current goals for meeting spiritual needs.

D. The partners were assisted in discussing the pros and cons of their current approach to meeting spiritual needs and “to leave a legacy.”

14. Describe Expectations from Youth (14)

A. The client was asked to describe his/her goals and wishes as a late teen and young adult.

B. The client was asked to describe how his/her goals and wishes have changed over the years.

C. The client was focused on the developmental changes in his/her goals and perceived expectations of others and self.

15. Describe Parent's Goals and Wishes (15)

A. The client was asked to describe the goals and wishes that his/her parents had held for him/her.

B. The client was assisted in describing the goals and wishes that his/her parents had held for him/her.

C. The client described his/her parent's goals and wishes for him/her in some detail, and this material was summarized and processed.

D. The client had little concept of what his parents expected for him/her and was urged to research this from family, friends, and other sources.

16. Describe Partner's Goals and Wishes (16)

A. The client was asked to describe the goals and wishes that his/her partner has held for him/her.

B. The client was assisted in describing the goals and wishes that his/her partner has held for him/her.

C. The client described his/her partner's goals and wishes for him/her in some detail, and this material was summarized and processed.

D. The client had little concept of what his/her partner expected for him/her and was urged to seek this information out from the other partner.

17. Verify Partner's Goals and Wishes (17)

A. The client's partner was asked to provide feedback regarding the goals and wishes that he/she has for the client.

B. The client's partner was asked to verify the client's perception of the goals and wishes that the partner has for the client.

C. It was noted that the client's understanding of the actual goals and wishes that his/her partner has for him/her were quite congruent.

D. It was noted that there was significant discrepancy between the client's understanding of his/her partner's goals and wishes and the partner's actual goals and wishes held for the client.

18. Describe Unfulfilled Goals (18)

A. The client was asked to describe his/her unfulfilled goals.

B. The client was assisted in identifying the goals that he/she has not yet fulfilled in his/her life.

C. The client was assisted in identifying the emotions associated with the lack of fulfillment of goals.

19. Identify Unrealistic Goals (19)

A. The client was assisted in identifying goals that probably are not realistically attainable.

B. The client was urged to accept that some of his/her goals are unrealistic and not likely to be attained.

C. The client's emotions related to accepting some personal goals as unattainable were reviewed and discussed.

20. Identify Attainable Goals and Plans (20)

A. The client was asked to list the goals that he/she has set for himself/herself that are still realistically attainable.

B. The client was asked to identify the specific plan that he/she has to reach his/her realistically attainable goals.

C. Reinforcement was provided for the client's realistic plans.

D. The client was assisted in identifying why his/her goals are meaningful to self, partner, and relationship.

E. The client does not have any specific plans related to his/her realistically attainable goals and was asked to develop such plans.

21. Consult Others about Alternative Goals (21)

A. The client was assigned to consult with other individuals whom he/she respects regarding possible alternative goals for himself/herself and their value.

B. The client has consulted with other individuals whom he/she respects regarding possible alternative goals for self and their value, and the results of this consultation were reviewed.

C. The client was given positive feedback as he/she displayed a greater understanding of alternative goals based on consultation with other individuals.

D. The client has not consulted with other individuals regarding alternative goals and was redirected to do so.

22. Obtain Alternative Goal Feedback (22)

A. Each partner was asked to provide feedback about the perceived value of alternative goals for self and relationship.

B. Feedback from each partner about the perceived value of alternative goals for themselves and the relationship was reviewed and synthesized.

C. Feedback from both partners indicated agreement about the value of alternative goals.

D. The partners have disparate views about the value of the alternative goals, and this was reflected to them and processed.

23. Determine Goals Plausibility (23)

A. The client was asked about the likelihood of the attainment of alternative goals.

B. The client was assisted in determining the likelihood of attaining alternative goals.

C. The client sees his/her alternative goals as quite attainable and was provided with feedback in this area.

D. The client sees his/her alternative goals as difficult to attain and was provided with feedback.

24. Teach about Self-Change Plan (24)

A. The partners were taught about the five components of a self-change plan: (1) describe the behaviors that would be changed; (2) examine the pros and cons of the current behaviors; (3) set a goal, describing as precisely as possible what is to happen; (4) create an action plan, pinpointing a specific plan for enacting the goal; and (5) evaluate enactment of the plan.

B. The partners were asked to practice the use of the self-change plan in-session.

C. Positive feedback was provided as the partners displayed a mastery of the self-change plan technique.

25. Rate Implementation of Self-Change Plan (25)

A. The partners were asked to make a global evaluation of how they did on implementing the self-change action plan before the next session.

B. The partners were asked to jot down short answers to questions such as “What did we actually do?”, “What positives resulted?”, “What negatives resulted?”, and “What do we need to do from here?”

C. The partners have rated themselves on the self-change action plans and the results were reviewed.

D. The partners have not rated themselves on the self-change action plan and were redirected to do so.

26. Describe Respected Older Individual (26)

A. The client was asked to identify an older individual whom he/she respects.

B. The client was asked to describe the attributes of an older individual whom he/she respects.

C. As the client described the attributes of an older person that he/she respects, he/she was directed to notice the advantages that come with maturity.

27. Identify Advantages of Maturity (27)

A. The client was asked to identify the advantages that usually come with maturity (e.g., less impulsive judgments, greater experiential wisdom, broader views of values in life, knowledge of more lifestyle alternatives, more concern about others).

B. The client was reinforced for identifying the advantages that usually come with maturity (e.g., less impulsive judgments, greater experiential wisdom, broader views of values in life, knowledge of more lifestyle alternatives, more concern about others).

C. The client was unable to identify maturity as providing advantages and was given tentative examples in this area (e.g., less impulsive judgments, greater experiential wisdom, broader views of values in life, knowledge of more lifestyle alternatives, more concern about others).

28. Explore/Resolve Emotional Response to Aging (28)

A. The client's possible feelings of anxiety and depression related to aging were explored.

B. The client identified feelings of anxiety related to aging, including the fear of physical deterioration and/or declining health, and these emotions were accepted.

C. The client identified feelings of sadness and depression related to aging, physical deterioration and/or declining health, and these emotions were accepted.

D. The client was helped to resolve his/her emotional responses to aging.

E. As the client was helped to identify and process his/her emotions related to aging, he/she verbalized acceptance and peace regarding these issues.

F. The client continues to feel anxious and depressed about his/her aging, physical deterioration and declining health and was provided with additional support and feedback.

29. Create Self-Change Plan for Financial Security (29)

A. The partners were asked to create a self-change plan related to financial security.

B. The partners have worked together to create and enact a self-change plan related to financial security and this was supported and encouraged.

C. The partners have not developed a self-change plan related to financial security and were redirected to do so.

30. Clarify Benefits of Family Time (30)

A. The client was asked about what he/she perceives the benefits are of giving time to immediate and extended family members.

B. The client endorsed the benefits and need for increased time with family members; this was processed and positive feedback provided.

C. The client was provided with additional examples of the benefits of increased contact with immediate and extended family members (i.e., better relationships, a sense of belonging, a feeling of having roots).

31. Replace Focus on Self with Altruism (31)

A. The partners were asked to identify things that they might do for others, therefore reducing the focus on himself/herself.

B. Positive feedback was provided as the partners identified ways in which they can help others, and a reduced focus on themselves was noted.

C. The partners failed to identify things that they might do for others and were provided with tentative examples.

32. Teach Value of Touching (32)

A. The client was taught about the value of touching in intimate relationships.

B. The client was reinforced as he/she identified ways in which touching increases the partner's feelings of importance and enhances mutual feelings of closeness, warmth, caring, and security.

C. The client has increased his/her touching within his/her intimate relationship and was provided with positive feedback about this.

D. The client and his/her partner report that touching in the intimate relationship has not increased, and the barriers to this were problem-solved.

33. Encourage Physical Affection (33)

A. The client was encouraged to be more physically affectionate with his/her intimate partner.

B. The client has become more physically affectionate with his/her partner, and the benefits of this were reviewed.

C. The client has not become more physically intimate with his/her partner and was assisted in resolving the barriers to this useful practice.

34. Create Self-Change Plan for Experiences and Skills (34)

A. The partners were asked about new experiences and skills in which they might be interested.

B. The partners were asked to create a self-change plan related to trying new experiences and learning new skills.

C. The partners were encouraged to have a variety of experiences and skills, some that could be alone or others that would be together.

D. The partners have developed a healthy self-change plan and were encouraged to implement this.

E. The partners have not developed a healthy self-change plan and were assisted in improving this.

35. Ask about Legacy (35)

A. The partners were asked to consider what they would like others to say about their relationship at a 50th anniversary party.

B. The partners were asked to identify what they would like others to say about them at a 70th birthday party.

C. The partners were assisted in deriving lessons about the legacies they would like to leave.

D. The partners were encouraged to identify behavior changes that would be necessary to achieve the legacy they desire.

36. Create Self-Change Plan for Meaning (36)

A. The partners were asked to create and enact a self-change plan that would give them a sense of meaning, purpose, personal congruence, and contribution.

B. The partners were assisted in reviewing their self-change plan for meaning.

C. The partners were reinforced for their self-change plan related to a sense of meaning, purpose, personal congruence, and contribution and were encouraged to enact this.

D. The partners have not developed a very significant self-change plan for giving themselves a sense of meaning and were redirected in this area.

37. Explore Emotions Related to Employment (37)

A. The partners were asked to express their feelings regarding the client's current employment and what impact it has on each partner and the family.

B. It was reflected back to the partners that they have generally positive feelings related to the client's current employment.

C. It was reflected to the partners that they have very little positive feelings about the client's current employment and its impact on each partner and family.

38. Assist with Career Directions (38)

A. The client was assisted in identifying possible alternative career directions.

B. The advantages and disadvantages of each possible alternative career direction were reviewed, both for the client and for the relationship.

C. The client was given feedback as he/she has developed a clearer understanding of alternative career directions.

D. The client was provided with tentative feedback relating to alternative career directions.

39. Accept Present Employment (39)

A. The client was assisted in accepting his/her present employment.

B. The client was urged to commit himself/herself to his/her present employment.

C. The client was noted to express a sense of satisfaction with accepting and committing to his/her present employment situation.

D. The client has been reluctant to commit to and accept his/her present employment situation and was provided with feedback and further review of these concerns.

40. Develop Responsible Career Exploration (40)

A. The partners were assisted in developing a plan for responsibly exploring alternative career directions.

B. The partners were warned about impulsive actions that could have devastating long-term consequences.

C. The partners' plan for developing alternative career directions was reviewed and feedback about the long-term consequences was provided.