Posted: February 16th, 2015

Case Study

Case Study

Order Description

Choose 1 of the case studies provided, and read it carefully before you begin writing. This assignment involves more than just writing a research paper. Using the provided template and information gleaned from reading the chosen case study, you will thoroughly assess the subject’s clinical needs.

The assessment must address the spiritual, genetic, and psychosocial aspects of the individual’s behavior; ascertain if he or she is in use, abuse, or addictive cycle; and determine whether there are any co-occurring issues. Think through your readings from the textbook, the definitions of use/abuse/addiction, and treatment needs associated with the level of use. Read the case study several times, paying close attention to the information that has clinical significance (e.g., what substance he/she is using, how often, how long he/she has used, longest periods of time without use, consequences of use, etc.). Also pay close attention to any family history provided and what is reported about the family. Are there genetic indications and environmental influences? How might the client’s spiritual condition affect recovery? Finally, you will be expected to make a referral based on your determination of the subject’s current needs.

Refer to the chapters on treatment in the May and Doweiko textbooks, focusing on what you know about the client’s current use and the treatment indications of his/her use. Incorporate the Reading & Study materials from the course into this assessment paper, using strong literature support for your assessment of the client’s current issues and your referral suggestions. Strong literature support means using the course textbooks and presentations as well as any outside academic sources needed. You must have a well-established argument for treatment; this is where you need to draw from sources to explain why you are making your recommendations.

The assessment paper must be 6–8 pages (in addition to the title page and the reference page). Your paper must be written in current APA format (font, margins, citations, references, etc.) and have a title page and a reference page. (An abstract is not required for this assignment.)

CASE STUDIES
1. Jason
Jason is a 38-year-old factory worker who came into the treatment center after being arrested for drinking and driving (DUI/DWI). His attorney has suggested that he quit drinking and enter treatment at least until his trial, which is scheduled in two months. Jason does not anticipate serving jail time, but he believes that treatment could strengthen his legal case. After his first arrest for DUI two years ago, he simply paid a fine and attended a special driver’s education program for six weeks. Jason found the program to be “a waste of time.”
Jason has been married for 10 years and has two sons aged 8 and 6 years. He has had numerous arguments with his wife, Melissa, concerning his drinking. He gets very angry and defensive when she confronts him about his heavy drinking, and he asserts that he is not an alcoholic. He knows this is true because his father was an alcoholic, and Jason says that he is not like his father. His father died as the result of a fight that occurred in traffic when he was drunk. Jason says that his father used to “beat the tar out” of him and his brother when he was drunk and that his father always belittled, taunted, and threatened their mother, whether he was drunk or sober.
Jason drinks with his buddies from the plant and does not think that his drinking is any more than what they do. He was just “unlucky” and got caught doing what everyone else seems to get away with. Jason’s drinking is very predictable: he drinks 8 or 9 beers on a weeknight. Several of these are consumed at the bar with friends, the remainder at home over the course of the evening. He usually falls asleep in front of the television. On weekends, he often drinks 3–4 twelve packs between Friday and Sunday. A typical Saturday involves getting up at 10:00 a.m., playing soccer with friends, and going to the bar for the rest of the day and night. This pattern leads to arguments with Melissa, who calls him a “lousy father.” At times, Jason has had unsettling episodes of being unable to recall what happened while drinking. He has commented to friends that “maybe I overdo it a bit.” Several times, he has attempted to cut down on his drinking, especially after the last DUI. He once attended a few AA meetings but did not feel that it was helpful: “It was listening to a lot of guys whining” and he especially did not care for the prayers.
Despite these attempts, Jason has experienced increased consumption levels over the past two years. He admits that, as a result of the drinking, he has become increasingly estranged from his wife and sons. Jason feels that his marriage has been basically good, but that he would not blame Melissa for leaving him because of the way things have been going lately. She complains that the house is “falling apart” because Jason does not keep up with his chores. He believes that his marriage would become solid again if he stopped overdoing the drinking. However, he complains about her hassling him about the alcohol.
Jason is not close to his remaining family members. His mother is very religious and wishes Jason would see religion as a way out of his problems. His siblings live in other communities, and they rarely get together. His wife and sons regularly attend his mother’s church, but Jason only attends on Christmas and Easter.
Jason is distraught about having to remain abstinent in preparation for the trial. He has trouble getting to sleep without alcohol. He also “gets jumpy” when he tries to stay away from drinking, feeling “closed in” or “like he is suffocating.” He also cannot imagine how to explain to his buddies why he is not joining them in the bars.

2. Sheena
Sheena is a 28-year-old African American woman who voluntarily came to the center for substance abuse treatment services. She is currently on probation for shoplifting, passing bad checks, vandalism, and parole/probation violations. She has been charged four times with disorderly conduct, once for fishing without a license, and twice for driving without a license (she never applied for one). She is currently awaiting trial for battery. Sheena has been incarcerated twice during her adulthood (once for 10 months and most recently for 10 days).
Sheena says she drinks a lot when she goes out with her friends, but that is only about once a week. She reports two injuries during the last six months that required medical care. Both happened while she was drinking. Her friends recommended she get some help. Sheena lives with her grandmother, who raised her. Sheena is the mother of four children (ages 11, 7, 4, and 2 years).  She was 17 when the first one was born. The older two sons are living in foster care. The younger two daughters have health problems and developmental delays; they live with another relative. She is no longer in contact with any of the children’s fathers (three men) and was only briefly married to the second man. She reports she often feels “down” and drinks to feel better.
Sheena says that several family members have drinking and/or drug use problems. She was physically abused as a child, which prompted her move to the grandmother’s home. Sheena completed all but one year of high school, and her most recent job was as a parking attendant. Her longest period of continuous employment was just over one year, and she has worked irregularly throughout her adult life. She describes her present health as “good.”
Sheena says her primary problem is alcohol use, but she also uses marijuana. She began drinking at age 14 and using marijuana at age 17. The longest that she has gone without using any substances was 60 days; she resumed using approximately two months ago. Sheena reports that she is concerned about her substance use and that seeking treatment is important to her.

3. Lynn
Lynn is a 37-year-old successful businesswoman. She works for a major investment firm. She has been referred to the center by her company’s employee assistance program (EAP). Lynn appears to be a “no-nonsense” business professional. She tells her history without emotion.
Lynn says that she often plans to have one or two glasses of wine with dinner, but often does not stop with one or two glasses and usually finishes the whole bottle.
“A couple of years ago I began having trouble sleeping and started to take a ‘sleeping pill’ three or four times a week to help me sleep through the night. I know it was only about 2 years ago because it was about the same time my dad died.”
Lynn reports that each morning, she drinks at least 3 or 4 cups of coffee to “get her going.” She makes it a point to work out at least three times a week in the morning before going to work. She has a prescription for Xanax as needed for panic attacks, and she also takes diet pills (amphetamine) to control her weight. She says she has had a struggle with her weight since childhood.
Over the last year, Lynn has been spending more time at home alone. She makes excuses to avoid business dinners and after-work functions when she can. She says she has been drinking more wine, as well.

“More often than, not I finish off the bottle before going to bed. I just can’t seem to stop. A lot of times, I will come home and tell myself that I’ll only have one glass and no more, but by the time I go to bed, the bottle is empty, and I’m deciding whether I should open another or not. I never used to drink to excess or take anti-anxiety medication. Now I can’t seem to stop drinking or taking these ‘downers’ at social events. I can’t seem to control when I take them, and things are happening that I’m not too happy about. Of course, the alcohol adds to my weight problem, which then causes me to take more of my Redux. Then, I have to increase my Xanax to calm my nerves and also take my Valium to make sure I get a full night’s sleep. It has become a very vicious circle. All this has been going on for a couple of years, but last week put the ‘cherry on the top.’”
Lynn says that last week, she was to meet the firm’s top client at a business luncheon. She could not get out of bed that morning. It took all her willpower to get up and get dressed. She was still 20 minutes late. She was so nervous and sick, she had to excuse herself in the middle of her presentation. In the bathroom, she took another Xanax to calm her nerves. Then, at lunch, she could not stop herself from ordering several glasses of wine. She had to have help to get to her car after the meeting.
“My client spoke to my boss and staff and then canceled his account with me. The next day, I met with my boss, and he recommended (insisted) I make an appointment with our EAP or be terminated. I’m really scared. Work is all I have. I can’t afford to blow it.”

4. Marcus
Marcus is a 19-year-old college student. His parents are Don and Beth. Beth reports her pregnancy with Marcus was normal with no complications to the labor and delivery. Marcus met all his developmental milestones early and was described as an advanced baby. Marcus reportedly excelled in school, needing very little effort to maintain a straight-A report card even in the gifted and talented program. Marcus was referred for assessment after flunking out of his first year in college. His parents are concerned about his drinking and how it appears to be interfering with his aspirations of being a chemical engineer. Marcus appears reluctant to treatment but agreed to come because his parents state they will not continue financing his college if he does not get help.
Don, his father, is a neurosurgeon, and his mother, Beth, is a geologist. Don was described by Beth as a “functional alcoholic,” displaying heaving drinking patterns and binge drinking when he was not on call. She states, however, that Don quit drinking 3 years ago when they realized Marcus had a problem. Both Beth and Don have fathers that were alcoholics. They report that Marcus began drinking at the age of 12. They described the drinking as experimental initially, but they state they became excessively more concerned as he got older. Marcus and his parents describe his early drinking years as “typical of teenage behavior.” His parents state they first began worrying about Marcus’s drinking when he totaled his first vehicle two weeks after his sixteenth birthday. Marcus lost his driver’s license at that time and was charged with a DUI. Marcus seemed to suggest his parents are overreacting because he has had several friends that have lost their licenses.
Don states he quit drinking after the DUI incident because he wanted to support Marcus in stopping. All three began attending AA together, but Marcus dropped out after 3 months. Don and Beth state that they are both still active in AA and Al-Anon. Marcus states he stopped going because “all they talk about is war stories.” Marcus states that, currently, he drinks a 12 pack or more on the weekends. He qualified this by stating that his friends help him drink the beer. He also does admit that his weekends sometimes start on Thursdays and don’t end until Mondays. He states that he does not believe his drinking is the issue with his grades in college. He states he just gets bored in classes and his professors do not really know as much as they think they do. He states sometimes he just does not feel like going to class because it is “dumb.”
Marcus does admit to blackouts, drinking more than he intends to, and does seem to recognize that many of his friends have similar drinking patterns as he. He also reports a recent break-up with his girlfriend of 2 years. He states he truly loves this girl, but she broke up with him because “she doesn’t like my friends.” He reports spending an average of $75 a week on beer, and his money does not always last until the end of the month. He attributes that to his parents not giving him enough money. He states they only give him $1,000 a month. Marcus states he is willing to come to counseling but does not think he has a drinking problem. However, he would like to figure out how to “win” his girlfriend back.

CASE STUDY ASSESSMENT PAPER INSTRUCTIONS
Choose 1 of the case studies provided, and read it carefully before you begin writing. This assignment involves more than just writing a research paper. Using the provided template and information gleaned from reading the chosen case study, you will thoroughly assess the subject’s clinical needs.

The assessment must address the spiritual, genetic, and psychosocial aspects of the individual’s behavior; ascertain if he or she is in use, abuse, or addictive cycle; and determine whether there are any co-occurring issues. Think through your readings from the textbook, the definitions of use/abuse/addiction, and treatment needs associated with the level of use. Read the case study several times, paying close attention to the information that has clinical significance (e.g., what substance he/she is using, how often, how long he/she has used, longest periods of time without use, consequences of use, etc.). Also pay close attention to any family history provided and what is reported about the family. Are there genetic indications and environmental influences? How might the client’s spiritual condition affect recovery? Finally, you will be expected to make a referral based on your determination of the subject’s current needs.

Refer to the chapters on treatment in the May and Doweiko textbooks, focusing on what you know about the client’s current use and the treatment indications of his/her use. Incorporate the Reading & Study materials from the course into this assessment paper, using strong literature support for your assessment of the client’s current issues and your referral suggestions. Strong literature support means using the course textbooks and presentations as well as any outside academic sources needed. You must have a well-established argument for treatment; this is where you need to draw from sources to explain why you are making your recommendations.

The assessment paper must be 6–8 pages (in addition to the title page and the reference page). Your paper must be written in current APA format (font, margins, citations, references, etc.) and have a title page and a reference page. (An abstract is not required for this assignment.)

Submit this assignment by 11:59 p.m. (ET) on Monday of Module/Week 7.

CASE STUDY ASSESSMENT PAPER TEMPLATE
Use this example as a template for your own assessment and assessment paper.

Chemical Use Assessment/History and Treatment Recommendations

Name:
DOB/Age:
Dates of Interviews:
Evaluator:

Reason for Assessment

Sources of Information

Background Information

Current Status

Indicators of Use/Abuse/Dependency

Attitude and Behavior

Social Functioning

Occupational Functioning

Financial Aspects

Familial Relationships

Legal History

Health History

Spiritual History

Diagnostic Impression

Recommendations