History and Treatment Recommendations of a Substance Abusing Individual Essay Example for Free

History and Treatment Recommendations of a Substance Abusing Individual EssayChemical Use Assessment/History and Treatment Recommendations Upon awake review of Jay Ws case study, a client who is potentiall(a)y suffering from a contentedness abuse disorder, it is deemed indispensable to examine his history, compose a chemical use assessment, and devise a recommended treatment plan that result determine his clinical take. Upon assessing the client, it is vital that he be examined holistically for better recovery results. Considering his spiritual, genetic, and psychosocial conditions go away help to ensure a more accurate analysis of his current situation. Only then can it be determined if Jay W is in use, abuse, or an eggive cycle. Reason for AssessmentDuring the case study of Jay W. it is noted that he was referred to my office by his parents for a clinical assessment. Once a commendable school- while child with excellent grades, his grades began to dwindle after reachi ng college. He eventually failed his prime(prenominal) year of college as a result of his poor grades. Jays parents Don W. who is a neurosurgeon and his fuss Beth W. who is a research scientist, is seeking help for their son because they are concerned that his heavy drink is the cause of his flunking. They believe that if he does not get help, it could very well damage his future goals of becoming a chemical engineer. Sources of InformationDuring the verbal intake of Jay W.s case, his father Don W. and his mother Beth W. were present along with Jay W., to entrust all of the details of his need for assessment. Secondary sources that has been narrowly reviewed and used in making a determination includes, Doweiko, H. E. (2012). Concepts of chemical dependance (8th ed.). Belmont, CA Brooks/Cole. May, G. G. (1991). Addiction grace Love and spirituality in the healing of dependences. New York HarperOne, Clinton, T., Hawkins, R. (2009). The quick-referenceguide to biblical counseli ng Personal and emotional cuts. shocking Rapids, MI baker Books. Hawkins, R. (2009). Theology and Addiction www.libertyuniversity.edu, Clinton, T. (2009). Addiction and Recovery www.libertyuniversity.edu.Background InformationJay W. was born May 2, 1994, to Don and Beth W. The pregnancy was reportedly normal with no complications to the labor and de riflery. Jay W. met all his developmental milest cardinals early and was described as an advanced baby. Jay reportedly excelled in school with needing very little effort to maintain a straight-A report card, even in the gifted and talented program. The current school year, he flunked give away of his first year in college. His parents are concerned just most his swallow and how it appears to be interfering with his aspirations of universe a chemical engineer. He states that he does not believe his drinking is the issue with his grades in college. Instead he assumes that boredom is the sole reason that his grades are failing. He a lso adds that his professors do not really know as much as they think they do. He even admits some ms he just does not feel like going to class because it is dumb. As stated by his parents, Jay began drinking at the age of 12 years old.He totaled his first vehicle two weeks after his sixteenth birthday. Jay lost his drivers license at that time and was charged with a DUI. Shortly after, Jay and both(prenominal) of his parents began attending AA together, but Jay dropped out after 3 months. Jay states he stopped going because, all they talk about is war stories. Jay does admit to blackouts, drinking more than he intends to, and does seem to recognize that more of his friends cause con intrinsic 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 doesnt like my friends. He reports outgo 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 when give him $1,000 a month. Jay states he is willing to bring to counseling but does not think he has a drinking problem, but he would like to figure out how to win his girlfriend arse. Current StatusOut of reluctance, Jay has decided to proceed with obtaining clinical treatment. He realizes that if he doesnt, his parents will no longer fund his college tuition. He also admits to currently drinking at least a 12 pack of beer on the weekends. He qualifies his actions by mentioning that his friends answers him with drinking the beer. He also does admit that his weekends sometimes start on Thursdays and dont 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 b ecause it is dumb. Jay 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. Indicators of Use/Abuse/DependencyAddiction can manifest in the form of obsessive or coercive behaviors. Overtime, over indulgence can cause a dependency to obtain more of the physical or chemical substance. Behaviors that can produce fear and/or excitement are factors that can lead to addictive behaviors (Doweiko, 2012). When at that place is an addiction, usually a manifestation of withdrawal symptoms will be evidenced when the source of addiction is absent. Abuse is usually evidenced when a substance is taken in disregard for directions or ones well- being (Doweiko, 2012). Attitudes and BehaviorAfter careful review of Jay W.s objective data found in his case study, it is apparent that Mr. W is in denial about his drinking problem. He appears indisposed to obtain treatment and is nonchalant in his attitude and behavior. He admittingly says he stopped attending AA because, all they talk about is war stories. Upon further prejudiced analysis, it seems that my client views his drinking with an everybody else is doing it mentality. This is evidenced by his reference to drinking as a typical teenage behavior as well as his command that his parents overreacted to his suspended license because he has several friends who has lost theirs also as if its a normal thing to do. He also seems to be haughty for his actions and constantly shifts blame on others for his current problems. He blames his parents for not giving him enough money kinda of focusing onthe fact that he is using up at least 75$ a week on beer. He also shifts the blame of his failing school on the inability of his professors to engage him cognitively and even claims that the classes are dumb. Jay W. appears saddened by the breakup with his girlfriend of 2 years and sincerely wants to win her back. As Dr. Clinton states in A ddictions and Recovery the tragedy of addiction is that is destroys, individuals, families, and friendships (2009). cordial FunctioningDrinking appears to be a social activity for Jay W. he states that his friends assist him with drinking the 12 pack case of beer that he usually buys on the weekend. He also has mentioned that several of his friends have lost their licenses, implying that it is also a result of obtaining DUIs. Jay goes even further by acknowledging the fact that many of his friends have similar drinking patterns as he does. Apparently his ex-girlfriend of two years had many complaints about the bad company that he was keeping. Jay doesnt take heed and loses her through with(predicate) a breakup instead. According to Doweiko, the consumption of alcohol can interfere with ones social relationships by making preexisting ones worse (2012). This is due to an adverse effect on judgment which causes a lack of control of ones behavior. Irritability, black outs, and lying a re only a few of the manifestations of alcohol addiction. The Psychosocial Models of Substance Use Disorders is another type of model of addiction. It is believed to be closely linked to the medical model (Doweko, 2012). It is proposed that addictions are conditioned behavior, poor psychosocial functioning, or the result of maladaptive thinking (Doiewko, 2012, p. 345), all in which are manifestations of a biological dysfunction. Occupational FunctioningJay W., although obviously an intelligent cuckoo (evidenced by his excellent grades in the gifted and talented program), has just flunked out of his first year of college. His future career goals are dwindling because of the negative choices that he is making. Booze and negative social relationships have become distractions that steered him off the path of success that he once embarked upon. A repetitive cycle of partying Thursday savings bank Monday and trying to maintain normalcy (crashing is also an option) Tuesday and Wednesday is ongoing. It is possible that he is traveling down the road ofaddiction. Those who are bound by abuse can live unfocused and disoriented lives. Over time, this can lead to divorce, job loss, and even the loss of child custody. Although drug abuse may be a one-time event, if one is not careful, the behavior can lead one down the path of addiction as in Jays case. It appears that he have a natural proclivity towards abuse and addiction because his father Don also had a drinking problem. Dr. Clinton tells us in the video presentation that some of the effects of addiction includes control problems, compulsiveness, narrowing focus, denial, tolerance and withdrawal (Clinton, 2009). We see many of these components in Jays occupational functioning. Financial AspectsWhen examining Jay Ws financial condition, it is obvious that he is mismanaging his money. His parents was giving him a 1,000 monthly stipend, and he blew at least $75 per week of it on beer. His excessive spending habits have created a deficit towards necessary items. Instead of accepting responsibility for misappropriating funds, he blames his parents for not giving him enough money. Alcohol abuse often tends to cause make financial problems worse or either create new ones. Sadly, not only the abuser can suffer financially, but oftentimes his or her immediate family suffers as well. This usually occurs when fiscal restrictions are placed on the abuser/addict to control his or her spending. This can force the abuser to start borrowing elsewhere, stealing and/or change others belongings to obtain money so that the addicted habit can be sustained (Doweko, 2012). Familial RelationshipsThe medical model of substance use disorders (SUD) have suggested that the dysfunction have occurred on either a cellular or molecular level and that one is biologically predisposed to alcoholism when he or she is exposed to certain environments (Doweko, 2012). Jay W. has been exposed to alcohol through his father Don who is a neurosurgeon. Jay perhaps saw how he was able to get drunk and that go to work and carry on a seemingly normal life. Don was described by his wife Beth as a functional alcoholic, displaying let loose drinking patterns and binge drinking when he was not on call. Jays parents seems to be very supportive of him though. His father was willing to give up drinking and both he and his wife joined AA along with Jay. Evenwhen he dropped out after 3 months, they continued going to both AA and Al-Anon. It also appears that Jay W. has a genetic predisposition of alcohol abuse/addiction. Both Beth and Don have fathers that were alcoholics. Various genes have been identified by researchers and believed to have an influence in predisposing individuals to substance use disorders. Jay W. familial relationship is starting to reveal the beginning stages of strain. He is claiming that they are overreacting and also accuses them of not giving them enough money. Often, family members of an alcohol a buser/addict report feelings of fear, shame, grief or other negative emotion when dealing with him or her (Doweiko, 2012). When the addict is confronted about their drinking behavior, conflict typically arises causing the familial relationship to be strained. Legal HistoryJay W is starting to have run ins with the equity. According to his parents, he totaled his vehicle two weeks after his 16th birthday. This incident caused the police to get involved. Jay inevitably was charged with a DUI and his drivers license was revoked. His buddies seem to have frequent encounters with law enforcement. Jay has started to defend his and his friends behaviors and suggest that its typical. Jay is destined to misunderstand the story he finds himself in (Clinton Hawkins, 2009) he has become irrational in his behaviors by accusing his parents of overreacting to his license being revoked. Health HistoryJay W. seems to have a pretty clean health history. Thus far, no incidents have been reported. Wh en he was born on May 2, 1991 there were no complications to the labor and delivery. He was considered very advanced for his age due to the fact that he had met all his developmental milestones early. Alcoholism can cause both short-term and long-term problems. Some of the short-term manifestations includes diarrhea, poor coordination and judgment, insomnia, as well as stomach problems (Doweiko, 2012). Some of the long-term problems includes liver problems, cirrhosis of the liver, mental disorders, malnutrition, impotence, among a host of others (Doweiko, 2012). Spiritual HistoryThe spiritual model of addiction assumes that addiction is derived from a sickness of ones spirit that has possibly manifested in a physical manner. It is mankinds way of searching for something to feel a void and escape pain and or discontentment that can often come with daily living (Doweiko, 2012). It is Jays first year in college. Its possible that he wants to fit in and gain the approval of his peers in stead of being a loner. Acceptance and the need to feel cool and included seems to have taken precedent over anything else. Its how he gains his identity. He gets involved with the defame group and starts being influenced by their deviant ways. Now, hes saddened by the fact that his girlfriend has broken up with him. He has also just flunked out of his first year of college. All of these rock-bottom experiences can easily trigger the addiction cycle. It is characterized by pain, hitting bottom, seeking relief, use or do, feeling good, crashing, cycles back to pain, and then tolerance. It is obvious that Jay W. is starting to undergo this cycle of addiction. Alcohols deceptive illusion of giving Jay control and euphoria keeps him on the wheel.Diagnostic ImpressionsFrom all that has been gleaned from Jay Ws case study, it is safe to say that he is at risk for developing a substance use disorder. He is clearly on his way of having a drinking problem. Although he is displaying early pr oblem alcohol usage if he is not careful, he could very well develop an addictive disorder. While evaluating Jay W to get a better diagnostic impression, it is necessary that I use the Psychopathy Checklist Revised (PCL-R) rill on the client (Hawkins, 2009). This test is composed of three categories of assessment 1.) interpersonal or affective defects 2.) social deviance and 3.) additional items such as unstable relationships, etc (Hawkins, 2009). The PCL-R Test will proffer a better analysis of root causes of the clients delinquent acts as well as to help identify prevailing risk factors. By identifying these risk factors, intervention strategies can be developed to counteract these risk factors. The following are a list of dynamic risk factors that has been identified and needs addressing problem solving/impulsivitypoor social/family relationshipsantisocial associates/attitudesalcohol substance abuseRecommendationsBased on the risk factors identified, the following recommendati ons have been made for Jay W. difficulty solving/impulsivityHabitually, Jay W. will be expected to attend group therapy where he will learn to think through decisions before moving impulsively. He will be given various scenarios in which he will have to explain how he should handle those situations appropriately. Role-playing will be a part of his therapy. For example, instead of not going to class because they are boring, he can try to get in more advanced classes if they are available. It could be that hes bored because he is not being challenged enough. He will be expected to work through all possible options and their consequences before making a decision. Poor social/family relationshipsSince Jay W. ex-girlfriend seems to be a good influence on him, their relationship should be encouraged. A relationship coach will be provided to assist him with maintaining healthy relationships. Hopefully, if all goes well, he will do what it takes to win her back (hanging around more positiv e people). Antisocial associates/attitudesJay W. will have access to a mentor who will confront his antisocial behaviors and attitudes and challenging him to participate in healthy functions and associating with positive people. The mentor will do habitual check-ins with the client and provide one on one time when needed to help him work through his feelings. Alcohol AbuseFrequent alcohol tests will be conducted on the client. If at any point alcohol is found in his system, he will be required to attend an alcohol rehabilitation program. According to Dr. Hawkins, recovery is an inside out issue requiring the Holy Spirit (Hawkins, 2009). In order for Jay W to function optimally, his human will must act in project with divine will. (May, 1991, p.178). He needs to have a divine encounter with God so that he can know who he is through Christ. In Addiction and Grace it is stated that the alignment of our will with Gods must happen at a heart level (May,1991, p.178). Jay must first admit that he has a problem and needs help.ReferencesClinton, T. (2009). Addiction and Recovery www.libertyuniversity.edu. Clinton, T., Hawkins, R. (2009). The quick-reference guide to biblical counseling Personal and emotional issues. Grand Rapids, MI Baker Books. Doweiko, H. E. (2012). Concepts of chemical dependency (8th ed.). Belmont, CA Brooks/Cole. Hawkins, R. (2009). Theology and Addiction www.libertyuniversity.edu May, G. G. (1991). Addiction grace Love and spirituality in the healing of addictions. New York HarperOne,