2 references per student. Please seperated each response and reference.
Respond to at least two colleagues who selected a different diagnosis or treatment intervention for the client in the following ways:
Explain why you agree or disagree with your colleague’s diagnosis and treatment approach.
Identify potential barriers your colleague may experience when providing their explanation of the diagnosis to the client.
Describe a strategy your colleague could use to engage the client in treatment.
Katie Paro
Week 10 Diagnosis – Pete
COLLAPSE
Diagnosis
F10.10 Alcohol use disorder, mild
F32.0 Major depressive episode, single episode, mild
Z63.0 Relationship distress with spouse or intimate partner
Pete shows three symptoms of alcohol use disorder (AUD). Pete started increasing alcohol use a year ago when his relationship became unstable, which aligns with the excessive amount and duration of alcohol use in criteria 1. He has attempted to reduce drinking on many occasions, which is aligned with criteria 2, and it is impairing his relationship, which is aligned with criteria 6; this fits the two-symptom criteria for diagnosis (American Psychiatric Association, 2022b).
Pete has been sad for the past month (criteria 1), he has insomnia (criteria 4), he experiences fatigue (criteria 6), he has difficulty concentrating (criteria 8), and has had suicidal ideation with no plan (criteria 9); each fall within criteria A (American Psychiatric Association, 2022a). Pete’s five symptoms fell within the same two-week period and he faces clinically significant distress which aligns with major depressive disorder (American Psychiatric Association, 2022a).
Assessment
To evaluate Pete’s alcohol use I would use the Short Alcohol Dependence Data Questionnaire (SADD). The SADD measures the severity of alcohol dependence, accounting for behavioral or subjective changes due to drinking (Hagman, 2017). To measure Pete’s depression, I would use the Beck Depression Inventory (BDI). The BDI measures 21 different attitudes and symptoms of depression using a likert scale to measure overall severity by a summation of the scores (Jackson-Koku, 2016).
Explaining Diagnosis
I would explain the diagnosis to Pete by sharing that he is showing symptoms of both alcohol use disorder and major depressive disorder that indicate clinically significant diagnosis criteria. I would assure him that we will work together to develop a plan to address them to address his distress.
Engagement
I would meet Pete with warmth and genuineness. Helm (2016) discusses emotional illness in relation to the recovery experience, as many individuals face crisis situations or hit rock bottom. Warmth would ensure that he is understood beyond his diagnosis. I would also acknowledge the prevalence of AUD in men to help buffer the stigma of disorders. It is estimated that around 11.5% of men in the Americas have AUD (American Psychiatric Association, 2022b).
Treatment Recommendation
I would recommend abstinence-based treatment (ABT). Reus et. al (2018) discuss several pharmacological treatments that are recommended for use with moderate or severe alcohol use disorder. Given Pete’s mild diagnosis, I would not yet recommend medication. I would consider cognitive behavioral therapy, either individual or group, as it has been shown to reduce both substance use and depressive symptoms simultaneously (Substance Abuse and Mental Health Administration, 2013).
Resources
I would share resources with Pete that he is able to share with his family or friends. The Substance Abuse and Mental Health Administration (2014) has a booklet about substance abuse treatment that is designed for families to better understand their family member’s disorder and recovery. Pete has indicated that he is close to his family, so involving them may offer a sense of support.
References:
American Psychiatric Association. (2020). Beck depression inventory (BDI). Retrieved from https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/beck-depression
American Psychiatric Association. (2022a). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
American Psychiatric Association. (2022b). Substance related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Hagman, B. T. (2017). Development and psychometric analysis of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: Towards effective diagnosis in college students. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, 31(7), 797–806. https://doi.org/10.1037/adb0000320
Helm, P. (2016). Addictions as Emotional Illness: The Testimonies of Anonymous Recovery Groups. Alcoholism Treatment Quarterly, 34(1), 79-91. DOI: 10.1080/07347324.2016.1114314
Jackson-Koku, C. (2016). Beck Depression Inventory. Occupational Medicine, 66(2), 174–175. https://doi.org/10.1093/occmed/kqv087
Reus, V. I., Fochtmann, L. J., Bukstein, O., Eyler, A. E., Hilty, D. M., Horvitz-Lennon, M., … Hong, S.-H. (2018). The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. American Journal of Psychiatry, 175(1), 86–90. doi:10.1176/appi.ajp.2017.1750101
Substance Abuse and Mental Health Administration. (2013). TIP 42: Substance Abuse Treatment for Persons With Co-Occurring Disorders. Retrieved from https://www.samhsa.gov/resource/ebp/tip-42-substance-abuse-treatment-persons-co-occurring-disorders
Substance Abuse and Mental Health Administration. (2014). What is substance abuse treatment? A booklet for families. Retrieved from https://www.samhsa.gov/find-help/national-helpline
Miya Jackson
Week 1 Discussion 1
COLLAPSE
Pete
305.00 (F10.10) Mild Alcohol Use Disorder
Z codes: V61.03 (Z63.0) Relationship Distress with Spouse or Intimate Partner
Pete states that he has been feeling depressed after a conversation with his partner Tyrone expressed he is wanting to see other people. Pete expressed concern of his partner may be cheating on him and feels devastated and is unable to cope with the loss.
The criteria for Alcohol Use Disorder shares to meet criteria for Mild Alcohol Use Disorder
Two or three symptoms must be displayed.
A5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home
A6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effect of alcohol.
A7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Pete reports drinking socially until about one year ago when he started sensing Tyrone pulling away. Tyrone has had a few conversations with him about cutting down and he has reduced drinking on several occasions. Tyrone said he is tired of competing with alcohol.
There are several different assessments you can use to screen alcohol use. For Pete, I Alcohol Use Disorders Identification Test (AUDIT). The test is made up 10 questions with multiple choice responses and the frequency and amount of alcohol consumed by the client. If the score is 8 or more that is an indication of Alcohol Use Disorder. Another assessment is the Cut down Annoyed, Guilty, Eye-opener (CAGE). This questionnaire is made up four questions. If two or more questions have the answer of “yes” that indicate AUD.
For treatment for Pete, I would suggest Goal Management Training (GMT). (Robertson et al., 2005), an interactive program aimed at improving participants’ organization and ability to achieve goals. Having Pete set some realistic personal goals to address his alcohol use and pairing the GMT with Mindfulness-based meditation to improve attentional scanning of emotional signals involved in adaptive decision-making (Alfonso et al., 2011). I would Pete to attend local AA meetings in his community. AA will provide with a support system for his alcohol use.
A recent analysis using pooled data from the 2005 and 2010 U.S. National Alcohol Surveys examined heavy drinking and alcohol-related consequences for White, Black, and Hispanic men and women (Witbrodt et al. 2014). Denney and colleagues (2013) also found that same-sex cohabiting couples had both higher household incomes and higher educational levels than opposite-sex married couples and cohabiting couples. However, after adjusting for socioeconomic differences, same-sex cohabiting couples had worse health than opposite-sex married couples and similar health as opposite-sex cohabiting couples.
References
Alfonso, J., Caracuel, A., Delgado-Pastor, L., & Verdejo-Garía, A. (2011, August 1). Combined goal management training and mindfulness meditation improve executive functions and decision-making performance in abstinent polysubstance abusers. Retrieved August 3, 2022, from https://doi.org/10.1016/j.drugalcdep.2010.12.025
Editor. (2020). Alcohol use screening tests: Medlineplus medical test. MedlinePlus. Retrieved August 3, 2022, from https://medlineplus.gov/lab-tests/alcohol-use-screening-tests/
Witbrodt J, Mulia N, Zemore SE, Kerr WC. Racial/ethnic disparities in alcohol-related problems: Differences by gender and level of heavy drinking. Alcoholism: Clinical and Experimental Research. 2014;38(6):1662–1670.
Denney JT, Gorman BK, Barrera CB. Families, resources, and adult health: Where do sexual minorities fit? Journal of Health and Social Behavior. 2013;54(1):46–63.
