LMHC

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Case Conceptualization for Marcus' Alcohol Disorder

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Institutional Affiliation

Case Conceptualization for Marcus' Alcohol Disorder

Client reported he can not stop drinking or using marijuana (smokes for depression and anxiety) and can not stop using Meth. Marcus is 25 year old Caucasian American who has been struggling with alcoholism since he was 12. Client reported girlfriend is in treatment also. After being terminated from employment for attending work while drunk and often missing work, Marcus condition deteriorated as he increased the volume of alcohol intake per day. As a result, Marcus was referred by his family to Palm Partners for counseling and treatment. Before seeking services at PHC clinic, the client has attempted numerous self - rehabilitation but he had not managed to recover from alcoholism fully or marijuana for depression and anxiety.

History

Marcus reports that he first experimented with alcohol during his early childhood age 12, age 16 for meth and marihuana. Marcus was introduced to alcohol by his mother an active addict. Marcus reported mother absent a lot, emotionally disturbed, struggle with education until 11th grade when he quit. From then onwards, he would drink or smoke marijuana whenever available. However, growing up from pillar to post or homeless shelters he began drinking heavily. He was 20 years old and in a troubled relationship with a child. Although Marcus’ heavy drinking was somehow connected to his troubled love life, the condition could also be attributed to family history. For instance, his mother, was also an alcoholic/addict who escaped death twice in accidents caused by driving while drunk and high. He attempted suicide after best friend who he sold him drugs and he overdose died. He mentioned that this event had a profound impact on is life. Marcus dad neglected him, mother neglected and rejected him yet her presence was there high, so fighting an alcohol disorder for over a decade. Other than the biological or family background, Marcus drinks heavily to forget his mother, his baby mama troubled love relationship. He has not been able to sustain positive relationships. He has had over 10 girlfriends and two fiancées who have abandoned in unclear circumstances. At different times, he had moved in with his fiancées but they could not stay for long. As he argues, he can only avoid mental frustrations caused by his failed relationships and termination from work by drinking heavily (American Psychiatric Association, 2013). Moreover, peer influence also compels him to indulge in alcohol. Over the time, he has made many friends in his drinking sprees. Some buy him shots regularly whilst he has also exhausted his savings on them.

Multi-axial diagnosis

As we assessed Marcus, we embarked on a multi-axial diagnostic criterion for his alcohol use disorder. To make a successful diagnosis for his condition, Marcus revealed that, in every drinking session, he takes more alcohol than he could anticipate, his love life has been affected by his alcoholism, he complains his mother is straining him financially as she uses every penny on drugs and alcohol, he/she is consuming almost a gallon of alcohol every day, he has difficulties decreasing his intake alcohol, he has a strong craving for vodka and other spirits, and has perpetually used alcohol even after being diagnosed with depression and anxiety which he smokes marijuana to focus and concentrate. Moreover, he confirmed that whenever he missed drinking he experienced severe withdrawal symptoms. These included depression and anxiety where he smokes marijuana. Withdrawal symptoms of sweating profusely, shaking and mood disturbances and are synonymous with someone experiencing such an alcohol disorder (Berman, 2015). Such mood swings, he says, exacerbates his cravings for alcohol, marijuana and meth.

Treatment Goals and Objectives

Marcus’ treatment will focus on augmenting social support besides endeavoring to develop a sense of productiveness (APA, 2013). Thus, his treatment goals will include:

Goal 1: consistent abstinence from alcohol for the entire duration of treatment and counseling;

Goal 2: increasing his social support so that he can get along well with his family and potential girlfriends or fiancées; and

Goal 3: increase his sense of industriousness. Specifically, this will help him to him to explore his career interests with an aim to return to the labor market either as an employee or self-employed.

Goal 4: Verbalize the powerlessness and unmanageability that result from using addictive behavior to cope with depression.

Goal 5: Identify the pattern of using drugs or alcohol abuse as a means of escaping fro depression and verbalize more constructive means of coping.

Goal 6: maintain a program of recovery, free from addiction an excessive anxiety

Accordingly, these goals will be monitored even after the client has left MVC to ensure he does not go back to alcoholism. Therefore, in future, treatment plan for Marcus will entail attending counseling sessions regularly to ensure he is permanently healed from this disorder.

Theoretical Orientation Theoretical conceptualization:

Cognitive Behavioral Therapy (CBT) is the theoretical approach that will be utilized to help the client to understand his condition. Marcus’ family background and exposure to an alcoholic mother and peer pressure have created cognitive emotions that make him to take refuge in alcoholism. This theoretical perspective (CBT) will help in addressing and changing his thinking patterns and habits associated with alcoholism.

Some cognitive distortions my client is experiencing include:

Tx Planning and Formulation

Long term goals:

Short term goals:

References

American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: American Psychiatric Publishing.

Berman. (2015). Developing case conceptualizations and treatment plans. Sage Publications, Inc.