Running Head: WOKRING WITH ADDICTED POPULATIONS

WORKING WITH ADDICTED POPULATIONS

Name of the Student

Name of the University

Author’s note
 ConclusionConclusion 2

Working with Addicted Populations

Introduction

Substance abuse has gripped people of all ages with an iron fist and it is known to

mess a person’s life inside out. It acts as a dissolving factor of an individual’s hopes and

aspirations, familial area, professional scenario as well as his health. Being abusive of

substances is known to disrupt all aspects of an individual’s life and therefore this particular

phenomenon is to be curbed. However retrieving an individual once he has gone on the path

of addiction is not an easy task and requires a lot of effort. The effort is to be borne by

multiple entities such as the patient himself, the medial practitioner as well as the family and

friends who act as the support system of the individual. Therefore, this particular paper is

intended towards discussing treatment options of such a client who has been into substance

abuse and requires interventional treatment.

Client Scenario

The client here is a twenty-two year old male named Brad. Brad has been into alcohol

abuse for some time and has his mother worried is worried as to his increasing verbal abuse

on her as well as his aggressiveness after the consumption of alcohol. Upon his mother’s

insistence he came for his first session and the talk with him was a very illuminating one as

many of his attributes came into light. According to his medical history, he was diagnosed

with ADD when he was nine years of age and that can be the primary reason s to his poor

performance in academics.

It was also clarified that Brad was never a non-drinker but the same escalated after his

accident with his friends 4 years ago that left one of his friends with a permanent brain injury.

Upon talking to him, it was evident that the particular accident is one of the causative factors
 ConclusionConclusion 3

for his drinking issue as it was a traumatic experience for him. During the session too he

stayed a bit aloof at first and was unwilling to share any details or even make eye contact

which is indicative of the guilt factor within his mind in regards to his alcoholism as well as

the accident. He also has a criminal record for the drunk driving charge but does not accept

any responsibility on the same and states it as just a “mistake.” He also admitted to having

frequent memory lapses after drinking and assures by saying that it is not that big of an issue

and his friends to go through the same.

Family History

Brad’s mother was the one to suggest Brad to go for therapy and this aspect shows

that she cares for Brad and his well-being. From the case study it can also be seem that

Brad’s father used to be an alcoholic who too had aggressive tendencies. As Brad was

diagnosed with ADD when he was nine years of age, the same was also said to be in common

for his sister who was elder to him. In terms of socio-economic conditions, it seems like Brad

and his family does not have any monetary issues as Brad’s mother clarifies that a hefty

amount was spent on Brad’s education and that he was even pursuing law before he took a

year off from college to go to England. Such attributes all point towards Brad having a

financially secure family but his habit might have a link to his father’s drinking habits.

Assessment

In cases as such it is the duty of the medical practitioner to provide the best possible

care and by appropriately assessing the conditions of the patient. Additionally, it is essential

to employ various theories to appropriately assess the condition of Brad and frame a proper

treatment plan. Firstly the assessment tools that I have employed for Brad are as follows:

 Alcohol Use Disorders Assessment Test (AUDIT): It was essential to carry out

this test as it aided me to determine the frequency of Brad’s alcohol consumption and
 ConclusionConclusion 4

what according to him is defined as too much consumption. I framed a series of

questions as prescribed by the WHO in terms of this particular assessment tool and

accordingly seek his participation. Throughout the entire process, I observed his

answers and try to determine how truthful he is being in regards to his answers.

 Severity of Alcohol Dependence Questionnaire (SADQ) : This particular

assessment tool is essential for Brad as it will help in determining how dependent his

body has become to alcoholic substances and what factors set in when he does not

consume alcohol. This assessment was necessary as in terms of severity of the

assessment, I could devise a treatment plan comprising of both behavioral and

medicinal options.

Presenting Issues

Upon conducting the assessment of with the above mentioned tools, I was able to

deduce that Brad is a young and a promising individual who often indulges in alcohol and

finds it hard to let go of the habit. When not under the influence, he does not pose any

problem. His behavior after alcohol consumption can be stated as unruly. Brad also shows

signs of regret in terms of being a causative link to the accident and therefore needs to

address the issue well to curb his drinking habits but he is unwilling to open up about the

incident as a whole. During the session, I also noticed that when talking about the accident,

he took long pauses which show that the incident has had a significant effect on his health.

Additionally, alcohol consumption has started to affect his cognitive skills as he has started to

forget things and if left untreated, it could lead to acute circumstances in the future.

Problem List

 Unable to quit alcohol as evidenced from his repetitive drinking and shirking his

responsibilities towards his family.

 ConclusionConclusion 5

 Behavioral attributes brought o by substance abuse as evidenced by the abusive

behavior towards his mother.

 Attributes of denial evidenced by stating as the drunken driving case, which was a life

threatening event, to be a mere mistake.

 Evidences of superficial talk and joy behind hidden guilt of the drunk driving

incident.

Objectives

In due course of the treatment plan, the following goals are to be attained in terms of Brad:

 To completely eliminate alcohol consumption from Brad’s routine

 To get him more open in terms of the accident and the potential cause to his drinking

problem.

 To ensure accountability from Brad in terms of the drunk driving charge

 To change his behavior in terms of treating his mother and accepting his behavioral

issues and bringing about a positive change in his attitude.

 To have him analyze his decisions and encourage him to attend school to push his life

towards a new start.

Theories of Relevance

Alcoholism can be connected to numerous theories and therefore some of the theories

that might be relevant to Brad’s case are scripted below:

Tension Reduction Hypothesis: Many researchers have centered on the scenario of alcohol

being a dissolving agent in terms of tension and stress. This theory also supports the idea that

drastic and unwelcome life events can be attributed to an individual turning towards alcohol

for support. It also eases into the fact that doing so a couple of times releases from the
 ConclusionConclusion 6

proposed levels of anxiety and that is the primary reason of alcoholism coming into being and

numerous individuals being addicted to it. In Brad’s case too he might have a feeling of guilt

in terms of contributing towards the condition of his friend which pushed him towards

consumption and turned him into an alcoholic.

Reinforcement Theories: This theory too complements the “Tension Reduction Hypothesis”

and states the consumption of alcohol to be reinforcement or a reward in the medium of

mental peace and pain removal. It also states that alcoholism is not in-grown but is learned

from others, mostly adult figures. In Brad’s case, his father was an alcoholic who constantly

created chaos in their lives and therefore Brad’s alcoholism could stem from that cause.

Excuse Theory: This theory states that alcoholism is merely an excuse which is brought in

after showing despicable behavior. Alcoholism provides a way to an individual who has

nothing to lean on for his poor habits and behavior so all of the blame is shifted towards the

consumption of alcohol. In terms of Brad, he did not confide to anyone after the accident and

the when he was overburdened with guilt for the same he turned to alcoholism and blamed

his non-affected attitude towards alcohol consumption.

Treatment Plan

I feel that since Brad is at the young age of 22, I should take the route of a

combination of behavioral therapy as well as limited medicinal approach. The course and

pattern of the treatment is mentioned below:

Withdrawal and Detoxification: The first order of treatment will be that of

detoxification concerning a medically managed withdrawal. The estimated time for this

course of treatment is ten days and is to be done at the center. Acamprosate is to be

 ConclusionConclusion 7

administered to the patient to cut back on his cravings concerning alcohol and alcoholic

substitutes.

Individual Therapy: Individual sessions are essential as it aids in the individual opening about

a disturbing topic and releasing the trigger behind his substance abuse. The same is to be

scheduled twice a week. This therapy is intended to ensure him of being in a safe space and

having discussion of how his ways are proving to be detrimental towards him as well as his

loved ones.

In the course of the therapy, The Revised Clinical Institute Withdrawal Assessment

for Alcohol Scale Assessment (Ciwa- Ar) is to be used to effectively monitor how the

withdrawal is affecting the patient as accordingly the treatment plan is stated to vary.

Contract

The following states the contract agreement points in sync with Brad’s treatment plan.

1. I will ensure that I am to fully cooperate with mu medical practitioner and abide by

the rules and terms of treatment stated to me.

2. I will ensure that the sessions scheduled by my doctor will be met with complete

attendance and any leave taken will be sanctioned by my doctor prior to the event

after careful examination of my state and circumstances.

3. I will take my oral medication as per the prescription of my doctor and failure to do so

may be deemed as an offence on my part and I am ready to bear the consequences of

the same.

4. I will not delay my appointments or cancel them at the last moment.

5. I will show the utmost respect for the fraternity form the facility and uphold the

institutions rules and regulations.

ConclusionConclusion 8

6. I will immediately inform my doctor of any significant or miniscule problem if the

same arises in terms of my medical or behavioral treatment plan.

7. I agree to not take treatment from any other medical professional as long as I do not

complete the present treatment as this particular treatment plan is tailor made to my

needs and requirements.

8. I will not be projecting any sort of violent behavior or illegal activity in the vicinity of

the institution or with any of my medical practitioners.

9. I understand that I might be periodically asked to provide tests for sample to check

my alcohol levels and in case I deny the sample, the same will count as grounds for

my relapse.

10. I understand the more sessions that I miss, the more elongated my treatment duration

will be.

11. In case of a relapse, the treatment sessions will be elevated to thrice a week in terms

of individual sessions as well as family therapy.

12. In case of a second relapse, I am required to admit myself in the facility and will lsoe

the option of out-patient treatment.

13. I fully understand that I may face critical withdrawal symptoms after getting off of

alcohol and I will do every possible measure prescribed by my doctor to fight the urge

to consume alcohol again.

14. I have been well educated about the possible symptoms and difficulties that I may

face after the onset of the treatment and I am also well aware about the minimal side-

effects that the prescribed oral medication can cause me.

15. I understand the failure to comply with any of the above stated contractual pints may

reflect poorly on me and have negative consequences.

 ConclusionConclusion 9

Conclusion

The entirety of the case plan has been customized according to the needs and demands

of Brad’s case and if followed with the utmost amount of precision and care, it shows true

promise. Brad does not present a complex case and therefore, he his treatment is considerably

easier in terms of oral medication and focuses more on counseling and behavioral treatment

due to his aggressive behavior and forgetfulness due to excessive alcohol consumption. The

case also features theories in relation to Brad’s case and simplistic explanation of how each

one is essential to Brad’s case. The report further concludes by presenting a patient contract

that is of the utmost significance in terms of progressing with the said treatment course.