JULIE-

Long Term Goals

To be able to have a long term intimate relationship with a significant other To have a career in the holiday trade To live independently To have improved relationships with family members To be able to parent children

Treatment Hierarchy

Life-threatening behaviour stepping under trains jumping from bridges Stabbing self with screw driver Cutting with razor blades Overdosing self-strangulation Hitting and punching carers/members of the public

Therapy-interfering behaviourJulie

Having unrealistically high expectations of therapy Having unrealistically high expectations of self Walking out of sessions Turning up/telephoning drunk Not noticing successes Being either a ‘star’ or a ‘failure’ Being verbally confrontational/critical with therapist

Therapist Working too hard in sessions/on phone Not standing firm when Julie is confrontational Asking for too much too soon Trusting too much in progress Not cheerleading enough

Quality of life-interfering behaviour

Not thinking about long-term goals Unprotected dangerous sexual behaviour Not saying no Cutting short promising relationships Continuing unpromising/abusive relationships Getting sectioned