Question1: Identify signs, symptoms and diagnostic criteria of substanceuse disorders or other mental health disorders present in the case.Based on the information presented in the case, make a diagnosis.Identify two or more screening instruments or assessment toolsappropriate for this case. Justify your responses with citations fromprofessional resources.
Irrespectiveof the specific substance, diagnosing disorders associated with theuse of substances is founded on a pathological collection of conductsassociated with usage of that substance. The behaviors can beclassified into a number of categories including compromised control,social destruction, hazardous consumption as well as pharmacologicalsihns which include withdrawal as well as tolerance. In this case,impaired control can be seen in the patient as she uses alcohol forlonger periods that it is intended while at the same time consuminglarge amounts, willing to decrease yet not having the capacity toachieve this endeavor, dedicating a lot of time acquiring/consumingand recovering from the use of the substance(Stevens& Smith, 2013). Additionally, the cravings are intensive makingit difficult to concentrate on anything else apart from the alcoholin this case.
Inregards to social impairment, it is important to consider addictionwhich is repeated involvement with an activity or a substanceregardless of the considerable harmful effects associated with itsince the involvement was initially pleasurable. Social impairment isamong the harmful effects of substance use that emanates fromrepeated usage (Stevens & Smith, 2013). In this case, the patientcontinues using alcohol irrespective of the problems with family andat work which included recurrent absenteeism from work as well asfailure to meet some social obligations. The addiction in this caseis further demonstrated as the patient persists with consumption ofalcohol regardless of the fact that she has interpersonal issues as aconsequence of the use. The patient has given up meaningful andimportant recreational and social activities as a consequence ofalcohol use.
Asfar as risky use is concerned, the main aspect that is considered isthe failure to stop using the substance regardless of the harm thatit causes. There may be an indication of addiction when an individualrecurrently uses a substance in circumstances that are physicallydangerous(Stevens& Smith, 2013). In this instance, the patient continues usingalcohol, which is addictive, even though she knows that continuedconsumption can lead to worsening of psychological or physicalproblems. Question2: Identify the stages of dependence, change or recovery the clientis at in this case and give evidence for your answer.
Inthis case, the client has already undergone several stages of changebeginning with pre-contemplation, where she was not consideringchange but was aware of a number of negative ramifications and wasnot likely to take any immediate action. In this stage, the clientrequired information that could link his issues as well as possibleproblems to her alcohol abuse. An intervention was required in orderto ensure that he is educated on the undesirable impact of alcoholabuse and how it increases her depression (Stevens & Smith,2013).
Duringthe contemplation stage, the client was aware of some of thedesirable and undesirable effects of abusing alcohol but feltundecided about changing her habits as she was not yet determined tomake a commitment to change. In this phase, the client was supposedto feelings of ambivalence along with the conflict that existedbetween her abuse of alcohol and the personal values she held. Abrief intervention at this stage would have sought to increase theawareness of the client in regards to ramifications of recurrentabuse and the benefits associated with a decrease or avoiding use(Stevens & Smith, 2013).
Thepreparation stage began when the client decided to change and startedplanning steps towards her recovery. Even though the client was notsuccessful in this stage, she was supposed to work on making hercommitment stronger. In this stage, a short intervention may providethe client with a set of options in regards to treatment which shecan choose from and further be assisted in identifying the mode oftreatment that is best suited for her.
Eventhough the client is yet to reach the action stage, in this stage,she will attempt new behaviors, but they will not be stable yet asthe stage entails the initial active phases towards change. In thisstage, the client must be assisted in execution of an action plan andmay need to work on skills that will assist her to remain sober. Theexperiences and feelings of the client must be acknowledged as anormal component of recovery and some interventions must beimplemented in this stage in order to avoid relapses. The otherstages of change that the client is yet to go through are maintenanceand relapse. However, the relapse stage may be avoided in case theother maintenance stage of change is executed well and effectively(Stevens & Smith, 2013). Question3: Address ethical issues in working with this case
Majorityof people value their autonomy and greatly fear its loss, and eventhough the providers screening and assessing for substance abuse doso since they have a genuine concern for the functioning or health ofa person, screening entails seeking personal information whichunavoidably intrudes upon the privacy and autonomy of a person. Inorder to remain ethical, a provider must do more than merely raisingthe issue as respecting the autonomy of an individual entailsproviding information of pertinent medical facts to the client andengaging her in a discussion concerning the alternatives (Stevens &Smith, 2013). The provider is supposed to provide information as wellas encouragement only in instances where the individual with theproblem has the capacity to change his actions. Respect for theautonomy of the patient including his decision to make choices iscritical to encouragement of this change.
Apartfrom the apparent threats associated with autonomy, the client mayalso worry about the ramifications of admitting to the problem ofsubstance use and such a client may find it challenging or impossibleto get coverage for costs of being hospitalized in the event that aninsurer becomes aware of the traumatic injuries associated withalcohol consumption. Such forms of adverse ramifications coulddiscourage the client with the alcohol uses problem from seekingassistance. There is also a concern about confidentiality and privacythat is worsened by the broad perception that individuals who sufferfrom alcohol use disorders are morally impaired and weak (Stevens &Smith, 2013). This concern can be exuberated by a worry that otherpeople may consider acknowledgment of substance use problem as anindication of lack of ability to continue living autonomously. In theevent that the person is experiencing family issues, informationconcerning the use of substances may have severe effects on thecapacity to resolve such problems.
Question4: Address cultural, spiritual, and diversity issues in working withthis case
Populationsall over the globe are increasingly becoming diversified which makesit imperative to consider the cultural and spiritual background of aclient when assessing dependence or substance use. Some of theaspects that should be considered in regards to the cultural identityof the client are cultural reference groups, engagement with theorigin of the culture, development of cultural factors as well aslanguage. Another aspect that is supposed to be considered is whetherthe client speaks her native language as well as client’s firstlanguage. In most instances, clients may feel alienated from theirhost cultures in the event that they rarely speak their nativelanguages and this can affect the level of involvement by theimmediate family.
Involvementby the family is a significant focus when working with differentpeople from different backgrounds. The immediate and extended familyof the clients are important and must be involved in the process ofintervention since alcohol abuse can erode crucial social andfamilial ties, thus efforts to repair the social and familialnetworks of a person can act as a buffer for the impact of alcoholabuse. The practitioners must ensure that efforts to re-establish acommunity that is culturally integrated are prioritized beforedeveloping a meaningful intervention, and the endeavors must blendbasic cultural values of the community with the recently advancedtreatment interventions. Question5: How do the issues involved in this case relate to your own valuesabout substance use, abuse/dependence, mental illness, substanceabuse treatment, capacity for change and your own approach totreatment?
Inmy view, the most appropriate treatment for substance abuse disordersis an integrated approach that deals with the problems associatedwith substance abuse as well as mental disorders at the same time.Regardless of whether the substance abuse problem or the mentalhealth problem came first, recovery is dependent on treatment of thetwo disorders. Recovery from these two disorders requires courage,commitment and time and it may take a very long time for anindividual who is affected to recover. Moreover, combined treatmentis most appropriate it offers higher chances of recovery whichimplies getting a blend of addiction and mental health treatment fromon provider. It is further important to note that relapses are commonin the process of recovery and the client should not be toodiscouraged in the event that she relapses as it is possible torecover from relapses and continue with the process of recovery.Further, peer support can also be helpful and the client may benefitfrom becoming a member of a support group that will offer a chance todepend on other people who are aware of what the client is goingthrough and get some knowledge from the experiences they share.Question6: Create a treatment plan for this case that includes the followingelements: your theoretical approach, treatment goals and objectives,treatment setting and modality, length of treatment, participants intreatment. Remember to justify your responses with citations fromprofessional resources
Problem:Regardlessof valid endeavors to deal with the issue of alcohol abuse anddecrease of drinking episodes in order to be socially functional andbe able to get her life back together, the client continues to engagein excessive drinking to the point of being late for work on regularoccasions. The client is staring to be convinced that she will not beable to meet her goal of abstaining from alcohol if she does not seekmore intensive treatment.
Goal:Increase the hopes of the client for and her beliefs in thepossibility of achieving her goals of abstaining from alcohol use.
Objective:Establish and increase approaches for the client to be aware while atthe same time strengthen the steps forward that she has made
Method:Ensure that the client enrolls for an individualoutpatient therapy
Method:Ensure the client is enrolled in an intensive outpatient therapygroup immediately
Objective:Assessment of characteristic events, outlook, thoughts or otheraspects which trigger the excessive drinking episodes for the client.
Method:Identify challenges inherent in abstaining from liquor when the urgeto consume develops.
Method:Discuss feelings of letting herself and her employers down.
Objective:Identify potential alternative reactions that the client is convincedare able to make to the identified causes while avoiding going backto substance consumption.
Method:Establish and adopt a diverse approach and settle on tactics toensure that she deals with the urge to go to the liquor store.
Method:Reflect on the possibility of self-forgiveness for errors committedin the past as well as consequences that resulted from consumption ofalcohol.
Method:Increase the support system of the client along with leisurealternatives.
Question7Accordingto Clarke and Myers (2012), DCT serves as a promising approach torelapse prevention. The ___ phase may result in clients beingable to develop in-then thinking (as they begin to noticecommonalities between relapse or relapse triggers). a.CO –concreteb.FO – formal operational c.DS – dialecticsystemic d.F– functionalQuestion8Whichis the most appropriately aligned with group therapy treatment (asopposed to individual treatment only)? a)medicalstabilization (with withdrawal symptoms) b)pharmaceuticaldetoxification treatmentc)dualdiagnosis, hospital inpatient treatmentQuestion9Misuseand overuse of prescription medicine is associated with whichpopulation of people suffering from a substance use disorder? a.a)olderadults b.b)peoplewith disabilities c.c)LGBTQyouth d.d)militaryveterans e.e)allof the aboveReferences
Stevens,P. & Smith, R. (2000). Substanceabuse counseling.Upper Saddle River, N.J.: Prentice Hall.