Reggie is a 42-year-old African American male recently referred for outpatient psychotherapy by his PCP. While he is in relatively good health, he admitted to his doctor that he has been drinking alcohol excessively again over the last three months. Reggie had a problem with alcohol when he was in his twenties, but with the help of AA and his first male partner, he was able to cease drinking for the last 19 years. Reggie admits that it has not always been easy for him to abstain, but he is committed to trying again. He has attended AA meetings but has not been able to maintain complete sobriety. On average, he has one or two drinks nearly every evening. His partner, Bob, has a zero-tolerance policy for Reggie’s drinking and has moved in with a friend rather than deal with Reggie’s promises to stop. Reggie is worried that Bob may not come back. Reggie does not want to end up like his father, who drank himself to death at the age of 56. His father and mother divorced when Reggie was only 15. Reggie’s only sister had a serious addiction to benzodiazepines and spent 28 days in a rehab center. She is clean now but also abuses alcohol on occasion.
Summarize the clinical case.
Create a list of the patient’s problems and prioritize them.
Which pharmacological treatment would you prescribe? Include the rationale for this treatment.
Which non-pharmacological treatment would you prescribe? Include the rationale for this treatment.
Include an assessment of treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
