SUBSTANCE ABUSE

Substance Abuse

Substance Abuse

Introduction

It has been my observation that many times a person may become dependant on a substance as a result of a traumatic event in their life or due to overwhelming life circumstances. When life becomes overwhelming, a person may seek comfort in a substance. For example, a drug user may be attempting to alleviate a preexisting condition of depression through the use of cocaine (Rotgers et al., 2006). It has also been my observation that numerous times the use of substances to comfort is a remedy taught by parents in an adverse form of role modeling to lead to a “circle of addiction”. Therefore, substance abuse is frequently termed “self-medication”. I believe that the case history is key in chemical dependency cases because it is the link into the source of the disease and the substance use is just a resulting symptom. In this paper, we will explore the treatment of chemical dependency through a case study from which we will examine the presenting problem, client history, diagnosis, synopsis of sessions and a discussion of how treatment would proceed. For this case study, I will utilize an actual client¡¦s history from my experiences as a case manager. I will approach client¡¦s case as if I were the therapist for the client. I have changed certain information in the case to protect the identity of the client.

Case Presentation Presenting Problem

Tim Harris is a seventeen-year-old Caucasian with a history of alcohol and cannabis use. His probation officer is referring him to treatment because he was carrying a razor blade at his high school and he was suspected of homicidal ideation. This referral is a result of the zero tolerance rule for the carrying of “weapons” after the Columbine High School tragedy. Later, Tim disclosed that the razor in his pocket was to cut his “blunts” or cigars stuffed with marijuana. Tim uses marijuana and alcohol on a regular basis including at school and at home.

Diagnosis

After intake, I reviewed the presenting problem and the client¡¦s history to determine the diagnosis. Client was given the diagnosis of Dysthymic disorder (Diagnostic and Statistical Manual of Mental Disorders-IV: 300.4), Alcohol abuse (DSM-IV: 305.00) and Cannabis Abuse (DSM-IV: 305.20). Symptoms for Dysthymic disorder include depressed mood for most of the day than not for at least two years. In addition, the client was have these factors present for at least for no less than two months at a time: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. The fact that the depression was present before the beginning use of substances and is not substance induced also supports diagnosis (APA, 2004). The abuse of cannabis and alcohol are secondary diagnoses.

Synopsis of Sessions

It is difficult to work with court referrals as they are obligated to attend therapy due to mandate and not out of willingness or self-motivation. Self-motivation is key to opening up in therapy and for ...