This final assessment explores comorbidity, spirituality, and ethics. Many people with substance use disorders face relapse. Maintaining sobriety is not easy. How might PTSD and the use of alcohol affect a treatment plan? Think about the role religion and spirituality can have in helping someone with a substance use disorder. One ethical consideration is for professionals to not practice outside of his or her area of competence, but that doesn’t mean the professional will always feel confident. How can a professional implement treatment successfully, and maintain ethical behavior throughout the treatment process?
Using the Treatment Plan and Summary Worksheet, supported by information from the case study and scholarly research, write a clinical assessment that includes the following:
A thorough description of the client from the case study you chose.
Diagnose the client using the DSM-5 criteria and ICD-10 code.
Treatment recommendations, and analysis of the ethical concerns that may arise in the treatment you have recommended for the therapist and/or client.
Create long and short-term goals, and describe how you will determine if these goals have or have not been met.
Create an action plan and provide a rationale for your choices.
Case Study: John
I’ve been using meth off and on since I was 21 years old. I don’t use every day, so I know I don’t have a problem. I’m 46 now and it’s never been a problem. I’ve always had a job and with my MBA, I make pretty decent money. Yes, it’s true I’m not working right now. But that’s because my last boss was racist and fired me because I’m black. It has nothing to do with the drug use, I only missed work a few times because I was high. Not enough to justify firing me.
I’ve been married and divorced twice, and I have two kids that I don’t see often. The whole system is completely unfair—the mother always gets custody and the court won’t let me even see my kids unsupervised. It’s just a crock. I’ve got a good place to live — I’m in the old family place with my mother. She’s getting up in years and says she could use some help. The house is paid off, so I just help with the chores. The kids would be welcome here, we have plenty of space. And mom has been much better since she stopped drinking, just a couple beers in the evening. When I was a kid, I don’t think I ever saw her sober.
I’m in pretty good health. Never go to the doctor. I only go to the dentist when I have problems, which is less often now that I’ve got dentures. I’ve never been to any type of therapy either. Doctors of all types are just a waste of good money.
The meth use? I use once every few months just to unwind and party. My friends and I have always gotten together on weekends. Sometimes, alcohol just isn’t enough to really have a good time and we add meth or coke into the mix. I like meth the best, cocaine just doesn’t feel right to me. Oh, I’d say I use cocaine maybe once or twice a year. Alcohol? Well, mom and I have a few beers in the evenings and I’ll drink a case or so with my friends on weekends. This past month? I used meth twice and have had beers in the evening.
Why am I here? Those ignorant cops found some meth on me when they pulled me over for a broken headlight. It wasn’t that much but they charged me with possession in revenge. They didn’t like that I kept arguing with them. I know how this works. My dad’s been in prison most of his life on trumped-up charges of distributing drugs and robbing the convenience store. It was his friend that shot the convenience clerk, my dad didn’t even have a gun. Still, I promised I wasn’t going to turn out like him. I worked hard in school, I’ve worked hard all my life. I’m a success and not like him at all. Dad has a true problem. He used every day he wasn’t in jail.
