week 8

6

Eliza’s Treatment Reassessment

Fonda J. Royster

Grand Canyon University

Eliza’s Treatment Reassessment

The changes made to the treatment plan for Eliza were aimed at ensuring that her current situation is addressed effectively. The counselor was required to perform a mandatory evaluation since the patient had been found unconscious in her own dorm room. She was smelling like alcohol, and it was reported that she had been drinking in her dorm room. Initially, the assessment found evidence of the patient’s drinking, although it did not point to substance use disorder or habitual drinking. It is possible that the changes in the patient’s case are as a result of how she blames others for her alcohol use. Additionally, the alcohol use may be as a result of coping with her anxiety and low self-esteem issues.

During the previous assessment, Eliza did not perceive herself to have a problem with drinking and blamed it all on peer pressure from her friends. However, after being found in her dorm passed out as a result of drinking, mandatory counseling was required. This may be evidence that Eliza is likely to have an alcohol use problem, although she is not willing to accept or admit it. Failing to accept the truth about her drinking problem may be a significant factor propelling her to continue her drinking.

Reassessing the Treatment Plan

The care provider for Eliza must carry out an assessment as a result of the reported recent changes. Some of the tools that can be used in the assessment include the Adolescent Drinking Index or the Adolescent Alcohol Involvement Scale. The Adolescent Alcohol Involvement Scale is a questionnaire-like tool designed to uncover patterns of alcohol consumption, their effects, context, and the perception of the patient about alcohol use (Aloi et al., 2020). The Adolescent Drinking Index is designed to measure alcohol use disorder and its severity. To do so, this tool examines the social, psychological, and physical functioning of a client (Aloi et al., 2020). Therefore, the two aforementioned tools could be instrumental in the case of Eliza.

The initial treatment plan targeted Eliza’s problems with sleeping patterns, anxiety, low self-esteem, peer pressure, schoolwork, and her relationship with her parents and friends. The main approach utilized was cognitive behavioral therapy, and this would be very effective in treating the client based on her conditions then. In the initial treatment plan, the focus was on addressing factors like adjusting to her new environment, interoceptive exposure, and cognitive restructuring. The purpose was to enable the patient to recognize any behavioral or thinking patterns that needed to be modified for the purpose of promoting positive thinking patterns.

The treatment approach was effective because it was successful in helping the client understand that her thinking patterns were the ones contributing to some of the problems she had and were the ones driving her to drink. However, the treatment plan did not actually help Eliza cope with problems and other issues, although it helped to uncover maladaptive patterns.

Adjustment of the Treatment Plan

Eliza’s treatment plan should be adjusted so that it reflects approaches for overcoming her current issues based on the new information. It should be designed in such a way that the issues faced by the client are not only addressed but also treated more effectively. Currently, available evidence points to the possibility of the patient having an alcohol use disorder. Alcohol use disorder has specific patterns such as abstinence, relapse, and cravings as they relate to drinking (Ray et al., 2021). The current treatment plan should be adjusted in a manner that is effective in treating alcohol use, struggles with abstinence, and approaches to likely relapse. This plan should be dedicated to helping the client understand and accept that she has a drinking problem.

Ethical and Legal Justifications

The proposed adjustments and changes to Eliza’s treatment plan meet both ethical and legal regulations and considerations. As reported by the ACA Code of Ethics, it is the responsibility of counselors to ensure that any actions that may lead to harm in the case of the client are avoided (Ray et al., 2021). As a result, various legal implications arise when a counselor knowingly or unknowingly results in harm to the patient during the treatment process. Therefore, reassessing the initial treatment plan for Eliza and making specific changes that can help in addressing her current problems effectively helps to abide by both ethical and legal standards. Failing to reassess the treatment plan would be a violation of ethical principles and standards (Knox et al., 2019). There would then be the risk of legal consequences as a result of problems with the client’s treatment plan. The current adjusted treatment plan will be effective and beneficial for the client in terms of treating the current problems she is facing.

Effects of Client Changes on the Treatment Plan

The current client changes have in a way invalidated the initial treatment plan. The initial treatment plan must therefore be adjusted to reflect the client’s current situation. In the initial treatment plan, the main focus was on the possibility of an adjustment disorder in the patient due to the various issues she was facing as she had adjusted to her new environment. Nevertheless, potential alcohol use disorder issues were also addressed in the initial treatment plan. However, they were not the main focus of treatment in the plan. Therefore, the current client changes have resulted in the major focus being on alcohol use disorder and associated problems.

Referrals

It is important for the counselor to be able to understand the various resources needed to make a referral. The available resources would be evaluated by taking into consideration various factors such as the client’s self-image, age, resistance, and diagnosed conditions (Knox et al., 2019). These factors would provide a guiding light regarding specific resources that would be more effective when used in treating the patient. The need for referrals can be communicated through a face-to-face sit down with the patient to provide room for the patient to ask any questions and receive answers from the counselor. Some of the referrals that can be suggested for the client include family therapy, where her family members and friends may learn how to support her, and exercise physiologist sessions where she can learn how to engage in physical activities and hobbies that do not involve alcohol.

References

Aloi, J., Blair, K. S., Crum, K. I., Bashford-Largo, J., Zhang, R., Lukoff, J., ... & Blair, R. J. R. (2020). Alcohol use disorder, but not Cannabis use disorder, symptomatology in adolescents is associated with reduced differential responsiveness to reward versus punishment feedback during instrumental learning. Biological psychiatry: cognitive neuroscience and neuroimaging, 5(6), 610-618.

Knox, J., Hasin, D. S., Larson, F. R., & Kranzler, H. R. (2019). Prevention, screening, and treatment for heavy drinking and alcohol use disorder. The Lancet Psychiatry, 6(12), 1054-1067.

Ray, L. A., Grodin, E. N., Leggio, L., Bechtholt, A. J., Becker, H., Feldstein Ewing, S. W., ... & Koob, G. F. (2021). The future of translational research on alcohol use disorder. Addiction biology, 26(2), e12903.