Compose a 6-8-page, double-spaced paper with at least six references using APA
formatting. Please answer the question below by analyzing one of the two case study
scenarios below.
General Instructions
Managing personal biases and utilizing a strengths-based perspective, describe your
approach to working with the client. Please use person-first, non-stigmatizing language
throughout. (C1)
Engagement and Assessment
Describe your proposed engagement and assessment process with the individual.
Consider:
• What stage of change is the individual in? What barriers to engagement might you
encounter? How will you address them using motivational interviewing and other
strategies? (C6)
• What cultural, environmental, and developmental factors may be impacting the
individual’s substance use? (C2) Consider individual strengths (C1), along with
other protective and risk factors. How may this impact their recovery? (C2)
• What systemic cultural, economic, and environmental factors are present that may
positively or negatively impact the individual’s substance use and recovery? (C3)
• What formal assessment(s) would you utilize? (C7) Explain your reasons for
selecting this assessment tool(s) including the client’s characteristics (C2), the
drug of choice, the psychometric properties of the instrument (where applicable),
and the evidence-base for the assessment. (C4, C7).
• Summarize your critical evaluation of the individual’s substance use, including the
application of DSM V criteria, groupings of symptoms (i.e. Big 5 or other
method), and problem severity. (C7)
• Using a bio-psychosocial perspective, what additional information would it be
important for you to have to effectively intervene that is not present in the case
study? (C7)
Intervention and Evaluation
Describe your proposed intervention and treatment goals. Consider:
• What level of care would you recommend using the ASAM criteria as a guide?
(C8)
• What intervention(s) would you apply and why? Consider the individual’s
demographic and other characteristics (C2), problem severity, and drug of choice.
(C4, C8) Cite the peer-reviewed literature to justify your selection of the
intervention and how it will address the presenting problem (theory of change).
(C4)
• What treatment goals would you identify? Consider addressing secondary gains,
triggers for use, critical risk factors, and building of recovery capital. (C9)
• How will you know that treatment is successful? What clinical indicators or
assessments would you utilize? (C9)
Organizational/Policy Recommendations
Based on the above, make a concrete recommendation for policy or practice procedures
in organizations that would serve the individual and others with similar characteristics
(i.e. gender, race, age, cultural background, economic/insurance status). The organization
could be your current or previous field placement, place of employment, or another
organization that you are familiar with. Your suggestion may be related to improving
prevention efforts, more effective assessment or intervention, or supporting long-term
recovery and well-being. For example, this might mean a change in agency procedures or
personnel, expansion of intervention and supports offered, or building a relationship with
other organizations/groups. The proposed change should reflect your knowledge of the
population represented by the case analysis and how their characteristics, barriers, or
experiences impact substance use. (C5)
Case Study 1-
Suzanne
Suzanne has come by the free “drop-in” counseling clinic where you work to get some
information and advice. Suzanne is a 22-year-old single woman who has been living with
her boyfriend Jack for the last four years. She and Jack have been using heroin regularly
for as many years.
When Suzanne was 10 years old, her father, whom she says was a very heavy drinker,
left her mom and the kids and never came back. At 14 she started drinking and smoking
marijuana. At 16 she had dropped out of high school and at 18 she moved in with Jack.
He introduced her to heroin.
She reports using about a 1/2 gram of heroin per day just to be able to function and feel
comfortable. In order to pay for the heroin and pay the rent on their apartment, Jack
doesn’t work, instead, she works the streets at night. She usually drinks four or five beers
each night before going out to work. If she can’t score enough heroin, she will try to score
either some Xanax or Klonopin to “tide me over until I can get some ‘dope’”. She says
she has tried cocaine but, “I really didn’t care for the high all that much.”
Suzanne tells you that the alcohol and heroin help to calm her nerves and get her through
the night. She and Jack are not having sex all that much. When they do, he never wears a
condom. He says that’s what makes him different from her “john’s” “Which is true
because I won’t work without a condom.”
Lately she has noticed that her breasts have become swollen and more tender. She also
hasn’t had her period in the last 12 weeks. She is pretty sure she is pregnant and knows
it’s her boyfriend’s baby. However, she not sure she can stop using heroin or work to
have the baby even though Jack wants her to keep it. She really confused at what she
should do and is her asking for you to help her make some decisions. Her friend who
works with her at night told her not to stop using heroin if she is pregnant “Because it’s
worse for the baby than to keep using. I just don’t know what I should do.”
Case Study 2:
William
William arrives at the outpatient counseling office appearing tired and smelling
like alcohol. He is 24 years old and of Filipino and African American
background. William lives with his father and is seeking help as a result of an ultimatum
that he is on his last chance: the next time he messes up, he’ll be looking for a new place
to live. His boss, too, has given him his last warning. His boss is happy with his work on
the painting crew, but he’s unhappy with William’s habit of showing up late at least once
a week. His boss has also wondered if William has gotten high at lunchtime.
William graduated from high school and has attended college classes a couple of
times but felt it was a bad match. He wants to go into the trades but has had a hard time
committing to anything. He acknowledges, too, that it’s difficult to get a good job
without a clean drug test. He says he’d like to stop smoking long enough to get a clean
test and he’s pretty sure he can do it on his own, without treatment. He just needs to be
motivated enough to tell his friends “no” when they come around with a blunt to smoke.
As you talk with William about his teen years, he tells you about the intense
anxiety he experienced. It began in elementary school, when he had a period of time
during which he was afraid to go to school, afraid to sleep in his own room, afraid when
his parents went out, etc. He was never quite able to just let go of his worries, although
they decreased over time and he functioned pretty well throughout middle and high
school.
William is a good natured, friendly and likable young man. He seems open and
honest when you ask him how much he drinks, smokes and whether he uses other
drugs. He drinks 3-4 days a week, sometimes just 2-3 beers, other times to the point of
getting “really drunk.” He smokes marijuana “not that often just every once in a while,”
usually when someone else suggests it. He’s fairly healthy, which is a good thing since
he has no health insurance. He likes his dad and has a pretty good relationship, except
when his dad gets mad about his drinking and smoking. William has a few good friends
that he’s had since high school
