Julie has long term goals of having an intimate relationship, a career in the holiday trade, living independently, improving family relationships, and parenting children. Her treatment hierarchy prioritizes eliminating life-threatening behaviors like self-harm and suicide attempts, followed by therapy-interfering behaviors on her part like unrealistic expectations and confrontational behavior, and finally quality of life-interfering behaviors such as dangerous sexual behavior and abusive relationships.

1. 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 behaviour
Julie
 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