SOCW Week 11 - Final Project: Scholar Practitioner Project

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Running head: SCHOLAR PRACTITIONER PROJECT 1

Scholar Practitioner Project

Stud ent

Walden University

PROJECT 2

Narrative Case Study

Identifying Information

The client in this case is Marge C. Marge is a forty-one-year-old, Caucasian female.

Marge is married to Ken. Marge and Ken are parents of three children, ages sixteen, twelve, and

ten. Marge has a background in education and has previously been employed as a teacher

(Laureate Education, 2014a).

Presenting Problem

Marge was brought into the residential treatment program by her husband, Ken. Prior to

their arrival, Marge’s family and friends held an intervention in the home. Marge’s family and

friends are concerned about Marge’s alcohol use. Marge’s physical appearance is described as

disheveled. Her eyes are red, and she appears to have been crying. Marge is without makeup and

her face shows a black eye and other facial abrasions. Marge is possibly experiencing alcohol

withdrawal, as evidenced by her unsuccessful attempts to control the visibility of her trembling.

Upon entering the facility, it became clear that Marge does not want to be here. Marge is

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defensive and blames her husband for bringing her into the treatment facility. Marge’s body

language also shows resistance, as she avoids eye contact with therapist and sits with her arms

closed (Laureate Education, 2014a).

Assessment

The clinical interview is a critical portion of the screening process. The screening process

seeks to detect unhealth use and should lead to further assessment if the findings indicate a risk

for substance misuse or abuse (Doweiko, 2019). Self-reports from the client and her husband at

intake can explore the family’s purpose for visiting the facility and provide another perspective

PROJECT 3

on Marge’s substance use. Use of brief verbal screening aids such as the TWEAK questionnaire

may be useful with Marge. The TWEAK questionnaire is brief and may be more effective

considering Marge is not happy to be at the treatment facility. The questionnaire can also provide

insight into the intensity of Marge’s alcohol use, which can further inform assessment efforts

(Laureate Education, 2014a; Doweiko, 2019). Marge also verbalizes “constant depression.”

Administering Beck’s Depression Inventory will help to identify if the client is at risk of

depression. Ongoing assessment consists of standardized tools such as the Drug Use Screening

Inventory- Revised (DUSI-R) to explore domains of drug/substance use, psychiatric and

behavioral concerns, adjustment concerns in school and work, impact on health and relationship

with peers, social competencies, and leisure. Exploring these domains align with

recommendations from Frances’ on elements of better assessments (Laureate Education, 2014a;

Doweiko, 2019). Finally, the initial week of treatment will introduce use of the Structured

Clinical Interview for DSM to fully explore the client’s mental health symptoms and lead to

diagnosis. The clinician can also gather information from interviews with families and blood

screenings to assess for comorbidity (Laureate Education, 2014a; Doweiko, 2019).

Addiction History

According to Marge’s self-reports, Marge’s use of alcohol began at least sixteen years

ago. She reported initially having a glass of wine after work several days out of the week and

progressed to having a drink daily, which eventually turned into drinking every morning to get

her day started and “feel normal.” Marge reported hiding her drinking from her family, friends,

and co-workers and admits to becoming “horribly ill” if she doesn’t have alcohol. Marge also

reports hallucinations and recalls seeing the same symptoms in her father and uncle (Laureate

Education, 2014a). Marge’s use of alcohol led to termination from employment, a DUI, and

PROJECT 4

drastically impairs her roles of wife, mother, friend, and sister. Marge has attempted to stop

drinking on her own and has abstained from alcohol for “a month or two”, citing participation in

AA and visits to a counselor in the community. In the initial contact, Marge admits that she has a

problem drinking but believes she has been unsuccessful in stopping use of alcohol because she

hasn’t exerted maximum efforts. Eventually Marge expresses willingness to undergo treatment

as a means of restoring her usefulness to her family (Laureate Education, 2014a).

Co-Occurring Disorders

Marge reports being depressed since a teenager, expressing that she could not recall a

happy moment in her childhood. Marge reported constantly feeling stressed, angry, and

depressed. Marge reported daily symptoms of depression that impact her functioning and trigger

use of alcohol (Laureate Education, 2014b).

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Medical History

Marge reports a prior history of diabetes and expressed her health has been complicated

by her use of alcohol. Marge admits she has “totally ignored her health.” (Laureate Education,

2014b).

Educational/Vocational History

Marge appears to be well-educated. Marge has previously been employed as a teacher.

However, Marge was terminated after her superiors smelled alcohol on her. She admits to

drinking daily before work.

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As a result of the termination, Marge has no income and her husband

has adapted to working two jobs to support the family (Laureate Education, 2014a; Laureate

Education, 2014b).

PROJECT 5

Legal History

Marge is currently facing charges for Driving Under the Influence after a one-car,

alcohol-related accident a few days ago. Based on reports from Marge, this is her first legal

infraction. Marge is not optimistic about having to address this incident when she returns home

from treatment (Laureate Education, 2014a).

Social/Cultural Status

Socioeconomic status can be determined by considering the individual’s education

attainment, occupation, and income levels. Higher educational attainment often influences

occupation and income levels, increasing comfort and status in life (Holosko, Dulmus & Sowers,

2013). Marge’s employment as a teacher suggests she has at least a bachelor’s level education.

Little information is presented on Ken’s vocational training or education. However, it is

documented that he works two jobs. Marge described the family’s finances as “a mess.” As a

teacher, Marge may have a high level of respect in the community and share connections with

others in the profession as well as within the community. American culture views alcohol use as

an acceptable social activity but also encourages control of consumption. Before seeking help at

the facility, Marge attempted to hide her drinking to appear in control. This is a direct reflection

of the culture’s influence on Marge’s alcohol use. Moreover, advertisements glamourizing

alcohol use are rampant today. These cultural factors may further influence Marge’s use of

alcohol (Laureate Education, 2014b; Doweiko, 2019). Marge shares no information on any social

or leisure activities outside of the mention of a few close friends.

PROJECT 6

Family/Relationship Status

Like any other system, the slightest change in the family environment can influence other

members in the family (Doweiko, 2019). Marge and Ken have three children: twelve-year-old

Roger, sixteen-year-old Carla, and ten-year-old Scotty. Ken reported their youngest Scotty may

be less influenced by Marge’s alcoholism; however, Scotty’s attempts to bring laughter to the

family may be an effort to reduce conflict in the home. Roger’s behaviors seem to concern both

Marge and Ken. The only unified efforts to address Roger’s behavior or give him attention occur

when he gets into trouble at school, confirming that Roger’s behaviors may be attention-seeking

ff t M d K ’ i t ld d ht C l t h d ti

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efforts. Marge and Ken’s sixteen-year-old daughter Carla appears to have assumed parenting

roles in the absence of her parents. Carla makes good grades, is involved in sports, and is popular

in school. (Laureate Producer, 2014c). Carla’s assumption of parenting responsibilities has

reduced responsibility for both of her parents, further delaying addressing Marge’s alcoholism

and contributing to ongoing substance use and development of codependent patterns of

behaviors. Carla is at risk of self-esteem issues because there is a likelihood that she will

determine her own value by the effectiveness of her attempts to maintain the family unit

(Doweiko, 2019. Laureate Producer, 2012; Margasinski, 2017).

Models of Addiction

The Sociocultural Model of Addiction

The Sociocultural Model of addiction seeks to identify and likely intervene to address the

systemic issues that might influence an individual to drink. This perspective asserts culture,

environmental factors, and even elements of the individual’s family system can either contribute

to the development of a substance use disorder or be useful in helping the individual to build a

PROJECT 7

resistance against substance use disorders (Doweiko, 2019). The Sociocultural Model also

focuses on the role of culture in development of addictions. The model recognizes that culture

can encourage use of chemicals to alter an individual’s perception of reality and factors such as

the drug of choice, expectations for use and current state of mind, as well as the context of use

can contribute to ongoing substance use (Doweiko, 2019). In short, the social perspective places

more emphasis on the interactions within the environment of the individual struggling with

addiction.

Strengths and Limitations of the Model

As with any model, there are specific strengths and limitations to use of the Sociocultural

Model of Addiction. The model’s systemic approach to addiction empowers individuals dealing

with addiction to accept responsibility for some of society’s norms and expectations for human

behavior (Doweiko, 2019; Winters, 2012). The model’s focus on the influence of environmental

factors is useful for identifying populations that may be considered at risk of developing

substance use disorders and informs prevention efforts in the addiction field. Finally, the

Sociocultural Model can help to increase cultural competency in clients by increasing their

awareness of cultural norms, impacting their relationships and interactions with others across

systems in their ecology (Doweiko, 2019; Winters, 2012).

Rationale for Use

Marge’s reports to the clinician suggest a need for further assessment of the client’s use

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of substances. Marge reported that her father and uncle were alcoholics, and while many may

believe this statement is evidence of a genetic influence, the statement also suggests that Marge’s

use of alcohol may be a result of social learning (Laureate Education, 2014; Doweiko, 2019).

Moreover, Marge’s expression of the escalation of her drinking from its’ socially acceptable use

PROJECT 8

after work to drinking through the day to deal with negative factors such as caretaking and

hopelessness suggests Marge’s alcohol use is largely influenced by sociocultural factors

(Laureate Education, 2014: Doweiko, 2019). Use of the sociocultural model will help to increase

positive or protective factors, counteracting factors contributing to substance use.

Model of Treatment

Family/Marital Therapies

Family/Marital therapy is a generic term that applies to an umbrella of approaches that

focus on psychodynamics, structural and behavioral systems, and family systems. The family

disease model is one of the most common forms of family therapy (Doweiko, 2019). This

treatment model recognizes the family as a system and asserts that impacting any part of the

system can affect change in other parts. Family and marital therapies use family strengths to

encourage abstinence and recovery. Family therapies also helps to reduce the impact of chemical

dependency on the family unit by capitalizing on family strengths. In this respect, the individual

suffering from addiction negatively impacts the entire family system (Doweiko, 2019). There

may be unclear roles, ineffective communication, unbalanced hierarchies, and ongoing conflict

in families of substance users and these factors can contribute to problematic use of chemicals.

Therefore, family and marital therapies can involve the family while focusing on the individual

with substance use disorder as the client, providing psychoeducation and other interventions to

manage the family’s response the member’s substance use and plan for social supports through

the recovery process (Doweiko, 2019; SAMHSA, 2004).

Strengths and Limitations

PROJECT 9

Family and Marital therapies presents specific strengths and limitations as it relates to

treatment of addictions. For example, the model of treatment is strength-based and promotes

self-efficacy by incorporating client/family/systemic strengths into plans for recovery (Doweiko,

2019; Freed, 2012). Including the family in therapy to address addiction can counteract barriers

to engagement and continued delivery of services, improves family functioning, and increases

effective use of natural supports which has been shown to reduce the likelihood of relapse

(SAMHSA, 2004). On the other hand, because the approach includes the family unit, there is

also a chance that additional problems may arise in the course of treatment. The family and

marital model of addiction also requires the clinician to develop an alliance with the family, but

there is a greater risk of triangulation and a need for attention to survival or basic needs over the

course of services (Doweiko, 2019; SAMHSA, 2004).

Rationale for Use

Marge’s statements to the clinician are evidence of her value of the family system, and

since she attributes her use to environmental factors mostly involving her husband and children,

it is appropriate to implement family and marital therapies to address Marge’s substance use

(Laureate Producer, 2014). Marge’s family may benefit from addressing the roles and

expectations for Marge as a caregiver while identifying ways the family can be more supportive

of Marge in her quest for recovery. Since Marge’s family prompted her visit to the clinician,

including her family in therapy can maintain engagement and follow through and increase the

likelihood of abstinence from alcohol use.

Models of Case Management

Minnesota Model of Substance Use Treatment

PROJECT 10

The Minnesota Model is commonly used in treatment of addiction. The model

emphasizes in-depth and continuous assessment of all aspects of the client’s life. This model also

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utilizes a combination of therapeutic approaches to improve the client’s holistic health. Use of

multidisciplinary teams offers a wide range of individualized goals for the client. The treatment

team approach may be most effective for Marge considering there are persistent struggles with

depression and negligence to her diabetes. Moreover, Marge’s family issues that contribute to

substance use can be addressed using the model. This will ensure a greater chance of support

through recovery and prepare Marge for relapse prevention. It is appropriate to note that the

model is heavily influenced by the philosophies governing Alcoholics Anonymous (AA) and

participation in AA is mandated by treatment programs applying the Minnesota Model

(Doweiko, 2019; Borkman, Kaskutas & Owen, 2007).

Strengths and Limitations of Minnesota Model

One obvious strength of the Minnesota Model is the use of multidisciplinary teams.

Commonly referred to as treatment teams, treatment teams encourage focus on the needs of the

client as a whole and allow for interprofessional collaboration in a timely manner.

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The model is

also compatible with concurrent treatment efforts such as family therapy and medication

management (Doweiko, 2019; Borkman et al., 2007). On the other hand, the model’s distinction

in treatment lasting twenty-eight days limits the length of stay in residential programs. Lastly, the

model’s reflection of AA philosophies could also be viewed as forcing individuals to embrace

spirituality in recovery (Doweiko, 2019; Borkman et al., 2007).

The Role of Spirituality

PROJECT 11

While there are different understandings of spirituality, the modern concept of spirituality

suggests a spiritual transformation that shapes the life, personal identity, self-knowledge,

relationships and peace seeking activities of an individual, defining their purpose (Doweiko,

2019). Marge does not identify an affiliation to a religion. When asked to report on her faith,

Marge stated, “No, I try so hard to believe, but I feel so sinful. No God would have anything to

do with me” (Laureate Education, 2014b). Marge’s remarks suggest she attributes her perceived

isolation from a higher power to her sin, or alcoholism. Nevertheless, spirituality can also refer to

a heightened sense of self-awareness and usefulness, which would be beneficial for Marge. She

has attended twelve-step programs before but have not attended consistently (Doweiko, 2019;

Laureate Education, 2014b).

According to Doweiko, the likelihood of sustainable outcomes after participation in AA

or twelve-step programs is closely related to the frequency of attendance, the individual’s level

of participation, and adherence to the focus on “one day at a time” (2019). Other research shows

that twelve-step programs have obtained longer abstinence and recovery for participants, even

empowering individuals to address factors such as depression and physical illnesses that may

contribute to substance use. Attending twelve-step programs outside of churches present a higher

chance for anonymity and participation for the individual, especially in rural areas. Twelve-step

programs outside of churches tend to be more action-oriented rather than focusing on reading

and study of Biblical text (Dunnington, 2019; Worley, Tate & Brown, 2012). Given this

information, a twelve-step program delivered in a setting outside of a church would best benefit

Marge.

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Course of Treatment

PROJECT 12

Use of American Society of Addiction Medicine (ASAM) criteria will inform the

continuum of care provided to Marge. At intake, Marge most closely fits the criteria for Level III

Inpatient/Residential Treatment. Level 3.7, Medically Monitored Inpatient Programs are

effective for patients with biomedical, behavioral, or other cognitive conditions that are best

addressed through highly structured around-the-clock care. There is ongoing evaluation and

observation and use of team meetings. Individuals at this level do not present needs severe

enough for a recommendation at the highest level of care, which would be medically managed

instead of monitored (Doweiko, 2019; Medicaid.Gov, 2017). As it relates to Marge, her possible

depressive diagnosis, diabetes, current state of dysfunction within the family, and risks to her

safety if she continues to drive suggest a need for a medically monitored inpatient program

(Laureate Education, 2014b).

Ongoing assessment of biomedical needs as well as support systems and mental health

symptoms will determine the appropriate level of care for referrals. Upon completion of

residential treatment, the client’s biomedical and mental health needs will be stabilized, and the

client is better able to manage these needs in the home setting. Marge will then be referred to a

Level 2.1 Intensive Outpatient Program where she can have access to medical and psychological

support. She will also have access to services such as psychotherapy, family therapy, and

recovery enhancement building activities over the course of twelve months. Finally, Marge will

be stepped down to Level 1 services on an outpatient level to sustain skills and strategies

gathered in higher levels of care (Doweiko, 2019; Laureate Education, 2014b; Medicaid.Gov,

2017).

PROJECT 13

Discharge Plan

Upon completion of the thirty-day residential treatment, Marge will still need services to

maintain recovery and abstinence from alcohol use. Marge will be immediately referred to

intensive outpatient programs such as Individual Outpatient Therapy/Medication Management

and Family and Marital Therapy for twelve and six months, respectively. Marge will

simultaneously participate in Alcoholics Anonymous to provide recovery support in the group

setting and increase positive social interactions. Marge’s participation in Medication

Management can help to ensure compliance with medication and evaluate the medicine’s

effectiveness.

Reflection on Personal Mission Statement

In order to effectively assess and address substance use in clients, the social worker must

be keenly aware of how their own personal experiences and values impact their views on

addiction. The social worker needs to take such actions to ensure ethical practice and reduce risk

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of harm to clients (Doweiko, 2019). As a child of a recovering addict, my views on addiction

may be unique. Witnessing my father’s journey to recovery and abstinence inspires hope for

others suffering from similar conditions. Over the last eleven weeks, it has also become clear that

my approach to those battling addiction might have initially limited their autonomy. While

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excessive use of chemical substances may impair thought and decision-making processes, there

is still a strong need for person-centered care planning. This course has also reiterated a need for

supervision and consultation to ensure ethical practice and collaborative-decision-making. My

understanding of addictions, its causes, symptoms, and treatment has substantially increased and

in turn, has increased my preparation for positively contributing to the field of addiction through

social work.

PROJECT 14

Marge’s Treatment Plan

Long Range Outcome: Marge will achieve and maintain abstinence from alcohol and better

manage symptoms associated with other diagnoses.

Identified Strengths: Marge demonstrates help-seeking behaviors, cares about her children,

and has a family support system (husband, sister, best friend).

Identified Needs/Deficits: Marge admits alcohol dependency, is diabetic, show signs of a

depressive disorder, and is facing legal trouble for driving under the influence.

Short Term Goal:

Marge will complete the inpatient treatment facility detoxification program.

Objectives:

1. Marge will refrain from use of alcohol for the next thirty days as required by the detoxification program.

Strategies:

a. Urinalysis and Blood Screenings will be administered daily b. Ongoing contacts with substance abuse counselor will assess Marge’s motivation

for change.

c. Team members will implement monitoring plans to ensure Marge does not have access to alcohol.

Expected Outcomes:

Marge will achieve thirty days without use of alcohol, as evidenced by urinalysis reports,

self-reports from client, and reports from treatment teams.

Short Term Goal:

Marge will complete the inpatient treatment facility detoxification program.

Objectives:

2. Marge will actively participate in individual and family therapy sessions over the course of treatment to address substance use and other diagnoses.

Strategies:

a. Substance Abuse Counselor will provide individual therapy bi-weekly to explore and assess the client’s substance use.

b. Substance Abuse Counselor will provide weekly family therapy sessions to educate the family on addiction as well as Marge’s other diagnoses.

c. Substance Abuse Counselor will teach recovery/relapse prevention skills to both client and social supports.

d. Substance Abuse Counselor will coordinate scheduling of a psychiatric evaluation to further evaluate the client’s mental health needs.

Expected Outcomes:

Marge will identify at least two drivers/triggers contributing to substance use

before discharge.

Marge and family will identify and demonstrate use of at least two relapse

prevention skills

Marge and team will identify any other mental health needs contributing to

ongoing substance use before discharge.

PROJECT 15

Short Term Goal:

Marge will complete the inpatient treatment facility detoxification program.

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Objectives:

3. Marge will increase use of services to aid in addressing challenges related to diabetes and possible depressive disorder.

Strategies:

a. Treatment team will actively identify community resources available for the diabetic.

b. Treatment team will actively identify community resources available to increase management of symptoms related to depression.

c. Ongoing contacts with substance abuse counselor will further identify any unmet needs.

d. An interdisciplinary team meeting will be held before discharge to coordinate delivery of services.

Expected Outcomes:

Marge will be able to identify and participate in at least one supportive program

designed to meet the needs of individuals with diabetes and depressive disorders and will

schedule initial sessions with providers before discharge from detoxification/inpatient

treatment program.

Short Term Goal:

Marge will maintain abstinence from alcohol use for twelve-months beyond discharge.

Objectives:

1. Marge will utilize Individual Outpatient therapy for One year

Strategies:

a. Treatment team will link Marge to Individual OPT at discharge session b. Provider will continue to build on relapse prevention plan and recovery

building skills.

c. Provider will coordinate scheduling monthly team meetings (providers, family, supports).

d. Provider will address Marge’s vocational needs to prepare her to return to work.

e. Ongoing use of assessments to identify any unmet needs warranting additional referrals.

Expected Outcomes:

Marge will have enhanced the skills gained in residential treatment to sustain positive

outcomes as it relates to maintaining abstinence from alcohol use.

Short Term Goal:

Marge will maintain abstinence from alcohol use for twelve-months beyond discharge.

Objectives:

2. Marge (and family) will participate in Family and Marital Therapy

Strategies:

PROJECT 16

a. Family will attend a minimum of twelve, hour-long sessions.

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b. Ongoing use of structured/unstructured tools to evaluate family functioning and

effectiveness of services delivered.

c. Therapist will provide psychoeducation, conflict resolution, role enhancement, and other services to prepare the family to support Marge’s recovery.

d. Therapist will coordinate referral to additional services if needs are presented.

Expected Outcomes:

Marge and family will increase family functioning, evidenced by increased role

fulfillment, reduced conflict, and effective support in Marge’s recovery.

PROJECT 17

REFERENCES

Borkman, T., Kaskutas, L. A., & Owen, P. (2007). Contrasting the Converging Philosophies of

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Source Matches (207)

Three Models of Alcohol/Other Drugs Treatment: Minnesota Model, Social Model, and

Addiction Therapeutic Communities. Alcoholism Treatment Quarterly, 25(3), 21.

Doweiko, H. E. (2019). Concepts of chemical dependency (10th ed.). Stamford, CT: Cengage.

Dunnington, K. (2019). Small groups Anonymous: Why the best church small groups might take

their cues from the Twelve Steps. Christianity Today, 4, 50.

Freed, C. R. (2012). Historical perspectives on addiction. In APA addiction syndrome handbook,

Vol. 1: Foundations, influences, and expressions of addiction. (pp. 27–47). American

Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/13751-002

Holosko, M. J., Dulmus, C. N., & Sowers, K. M. (2013). Social work practice with individuals

and families: Evidence-informed assessments and interventions. Hoboken, NJ: John

Wiley & Sons, Inc.

Laureate Education (Producer). (2014a). Counseling session 1. [Multimedia file]. Retrieved from

https://class.waldenu.edu

Laureate Education (Producer). (2014b). Counseling session 2. [Multimedia file]. Retrieved from

https://class.waldenu.edu

Laureate Education (Producer). (2014c). Counseling session 3. [Multimedia file]. Retrieved from

https://class.waldenu.edu

Margasiński, A. (2017). Psychological roles of young adults growing up in alcoholic and

nonalcoholic families measured by Family Roles Questionnaire. Alcoholism and Drug

Addiction, 30(1), 13-40.

https://doi-org.ezp.waldenulibrary.org/10.1037/13751-002

https://class.waldenu.edu/

PROJECT 18

REFERENCES

Medicaid.Gov (2017). Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A

Resource for States Developing SUD Delivery System Reforms. Retrieved from

https://www.medicaid.gov/state-resource-center/innovation-accelerator-program/iap

downloads/reducing-substance-use-disorders/asam-resource-guide.pdf

Substance Abuse and Mental Health Services Administration (SAMHSA). (2004). Substance

Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series,

No. 39. Chapter 1 Substance Abuse Treatment and Family Therapy. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK64269/

Winters, K. C., Botzet, A., Fahnhorst, T., Arria, A., Dykstra, L. G., & Oliver, J. (2012). Social

factors and the addiction syndrome. In APA addiction syndrome handbook, Vol. 1:

Foundations, influences, and expressions of addiction. (pp. 229–250). American

Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/13751-012

Worley, M. J., Tate, S. R., & Brown, S. A. (2012). Mediational relations between 12- Step

attendance, depression and substance use in patients with comorbid substance

https://doi-org.ezp.waldenulibrary.org/10.1037/13751-012

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SCHOLAR PRACTITIONER PROJECT 1 Scholar Practitioner Project

Original source

SCHOLAR PRACTITIONER PROJECT 1 Scholar Practitioner Project

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Student paper

The client in this case is Marge C. Marge is a forty-one-year-old, Caucasian female. Marge is married to Ken. Marge and Ken are parents of three children, ages sixteen, twelve, and

Original source

Narrative Case Study Identifying Information The client in this case is Marge C Marge is a forty-one-year-old, Caucasian female Marge is married to Ken Marge and Ken are parents of three children, ages sixteen, twelve, and ten

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Student paper

Marge has a background in education and has previously been employed as a teacher

Original source

Marge has a background in education and has previously been employed as a teacher (Laureate Education, 2014a)

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Student paper

Marge was brought into the residential treatment program by her husband, Ken.

Original source

Presenting Problem Marge was brought into the residential treatment program by her husband, Ken

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Student paper

their arrival, Marge’s family and friends held an intervention in the home.

Original source

Prior to their arrival, Marge’s family and friends held an intervention in the home

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friends are concerned about Marge’s alcohol use. Marge’s physical appearance is described as

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Marge’s family and friends are concerned about Marge’s alcohol use Marge’s physical appearance is described as disheveled

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Her eyes are red, and she appears to have been crying.

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Her eyes are red, and she appears to have been crying

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her face shows a black eye and other facial abrasions.

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Marge is without makeup and her face shows a black eye and other facial abrasions

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withdrawal, as evidenced by her unsuccessful attempts to control the visibility of her trembling. Upon entering the facility, it became clear that Marge does not want to be here.

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Marge is possibly experiencing alcohol withdrawal, as evidenced by her unsuccessful attempts to control the visibility of her trembling Upon entering the facility, it became clear that Marge does not want to be here

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defensive and blames her husband for bringing her into the treatment facility.

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Marge is defensive and blames her husband for bringing her into the treatment facility

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language also shows resistance, as she avoids eye contact with therapist and sits with her arms

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Marge’s body language also shows resistance, as she avoids eye contact with therapist and sits with her arms closed (Laureate Education, 2014a)

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The clinical interview is a critical portion of the screening process.

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Assessment The clinical interview is a critical portion of the screening process

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seeks to detect unhealth use and should lead to further assessment if the findings indicate a risk

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The screening process seeks to detect unhealth use and should lead to further assessment if the findings indicate a risk for substance misuse or abuse (Doweiko, 2019)

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for substance misuse or abuse (Doweiko, 2019).

Original source

Doweiko & Evans’ (2019) use of the term, substance abuse, or misuse, coincides with this definition

1

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intake can explore the family’s purpose for visiting the facility and provide another perspective

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Self-reports from the client and her husband at intake can explore the family’s purpose for visiting the facility and provide another perspective on Marge’s substance use

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Use of brief verbal screening aids such as the TWEAK questionnaire

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Use of brief verbal screening aids such as the TWEAK questionnaire may be useful with Marge

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The TWEAK questionnaire is brief and may be more effective considering Marge is not happy to be at the treatment facility.

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The TWEAK questionnaire is brief and may be more effective considering Marge is not happy to be at the treatment facility The TWEAK questionnaire is brief and may be more effective considering Marge is not happy to be at the treatment facility

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insight into the intensity of Marge’s alcohol use, which can further inform assessment efforts

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The questionnaire can also provide insight into the intensity of Marge’s alcohol use, which can further inform assessment efforts (Laureate Education, 2014a

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Administering Beck’s Depression Inventory will help to identify if the client is at risk of

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Marge also verbalizes “constant depression.” Administering Beck’s Depression Inventory will help to identify if the client is at risk of depression

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recommendations from Frances’ on elements of better assessments (Laureate Education, 2014a;

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Exploring these domains align with recommendations from Frances’ on elements of better assessments (Laureate Education, 2014a

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Clinical Interview for DSM to fully explore the client’s mental health symptoms and lead to

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Finally, the initial week of treatment will introduce use of the Structured Clinical Interview for DSM to fully explore the client’s mental health symptoms and lead to diagnosis

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The clinician can also gather information from interviews with families and blood screenings to assess for comorbidity (Laureate Education, 2014a;

Original source

The clinician can also gather information from interviews with families and blood screenings to assess for comorbidity (Laureate Education, 2014a The clinician can also gather information from interviews with families and blood screenings to assess for comorbidity (Laureate Education, 2014a

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According to Marge’s self-reports, Marge’s use of alcohol began at least sixteen years

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Addiction History According to Marge’s self- reports, Marge’s use of alcohol began at least sixteen years ago

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reports hallucinations and recalls seeing the same symptoms in her father and uncle (Laureate

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Marge also reports hallucinations and recalls seeing the same symptoms in her father and uncle (Laureate Education, 2014a)

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Marge’s use of alcohol led to termination from employment, a DUI, and

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Marge’s use of alcohol led to termination from employment, a DUI, and drastically impairs her roles of wife, mother, friend, and sister

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drastically impairs her roles of wife, mother, friend, and sister.

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Marge’s use of alcohol led to termination from employment, a DUI, and drastically impairs her roles of wife, mother, friend, and sister

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drinking on her own and has abstained from alcohol for “a month or two”, citing participation in

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Marge has attempted to stop drinking on her own and has abstained from alcohol for “a month or two”, citing participation in AA and visits to a counselor in the community

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problem drinking but believes she has been unsuccessful in stopping use of alcohol because she

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In the initial contact, Marge admits that she has a problem drinking but believes she has been unsuccessful in stopping use of alcohol because she hasn’t exerted maximum efforts

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as a means of restoring her usefulness to her family (Laureate Education, 2014a).

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Eventually Marge expresses willingness to undergo treatment as a means of restoring her usefulness to her family (Laureate Education, 2014a)

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Marge reports being depressed since a teenager, expressing that she could not recall a

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Co-Occurring Disorders Marge reports being depressed since a teenager, expressing that she could not recall a happy moment in her childhood

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Marge reported constantly feeling stressed, angry, and

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Marge reported constantly feeling stressed, angry, and depressed

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Marge reported daily symptoms of depression that impact her functioning and trigger use of alcohol (Laureate Education, 2014b).

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Marge reported daily symptoms of depression that impact her functioning and trigger use of alcohol (Laureate Education, 2014b) Laureate Education, 2014b)

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Marge reports a prior history of diabetes and expressed her health has been complicated

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Medical History Marge reports a prior history of diabetes and expressed her health has been complicated by her use of alcohol

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Marge admits she has “totally ignored her health.” (Laureate Education,

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Marge admits she has “totally ignored her health.” (Laureate Education, 2014b)

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Educational/Vocational History

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educational and vocational training

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Marge appears to be well-educated. Marge has previously been employed as a teacher. However, Marge was terminated after her superiors smelled alcohol on her.

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Educational/Vocational History Marge appears to be well-educated Marge has previously been employed as a teacher However, Marge was terminated after her superiors smelled alcohol on her

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drinking daily before work. As a result of the termination, Marge has no income and her husband has adapted to working two jobs to support the family (Laureate Education, 2014a;

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She admits to drinking daily before work As a result of the termination, Marge has no income and her husband has adapted to working two jobs to support the family (Laureate Education, 2014a As a result of the termination, Marge has no income and her husband has adapted to working two jobs to support the family (Laureate Education, 2014a

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Marge is currently facing charges for Driving Under the Influence after a one-car,

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Legal History Marge is currently facing charges for Driving Under the Influence after a one- car, alcohol-related accident a few days ago

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Based on reports from Marge, this is her first legal

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Based on reports from Marge, this is her first legal infraction

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Marge is not optimistic about having to address this incident when she returns home

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Marge is not optimistic about having to address this incident when she returns home from treatment (Laureate Education, 2014a)

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Socioeconomic status can be determined by considering the individual’s education

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Social/Cultural Status Socioeconomic status can be determined by considering the individual’s education attainment, occupation, and income levels

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occupation and income levels, increasing comfort and status in life (Holosko, Dulmus & Sowers,

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Higher educational attainment often influences occupation and income levels, increasing comfort and status in life (Holosko, Dulmus & Sowers, 2013)

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Marge’s employment as a teacher suggests she has at least a bachelor’s level education. Little information is presented on Ken’s vocational training or education.

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Marge’s employment as a teacher suggests she has at least a bachelor’s level education Little information is presented on Ken’s vocational training or education

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documented that he works two jobs.

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However, it is documented that he works two jobs

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teacher, Marge may have a high level of respect in the community and share connections with

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Marge described the family’s finances as “a mess.” As a teacher, Marge may have a high level of respect in the community and share connections with others in the profession as well as within the community

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an acceptable social activity but also encourages control of consumption.

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American culture views alcohol use as an acceptable social activity but also encourages control of consumption

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the facility, Marge attempted to hide her drinking to appear in control.

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Before seeking help at the facility, Marge attempted to hide her drinking to appear in control

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of the culture’s influence on Marge’s alcohol use.

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This is a direct reflection of the culture’s influence on Marge’s alcohol use

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alcohol use are rampant today. These cultural factors may further influence Marge’s use of alcohol (Laureate Education, 2014b;

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Moreover, advertisements glamourizing alcohol use are rampant today These cultural factors may further influence Marge’s use of alcohol (Laureate Education, 2014b Laureate Education, 2014b)

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or leisure activities outside of the mention of a few close friends.

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Marge shares no information on any social or leisure activities outside of the mention of a few close friends

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Family/Relationship Status Like any other system, the slightest change in the family environment can influence other

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Family/Relationship Status Like any other system, the slightest change in the family environment can influence other members in the family (Doweiko, 2019)

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Marge and Ken have three children:

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Marge and Ken have three children

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Roger, sixteen-year-old Carla, and ten-year-old Scotty. Ken reported their youngest Scotty may be less influenced by Marge’s alcoholism;

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twelve-year-old Roger, sixteen-year-old Carla, and ten-year-old Scotty Ken reported their youngest Scotty may be less influenced by Marge’s alcoholism Ken reported their youngest Scotty may be less influenced by Marge’s alcoholism

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family may be an effort to reduce conflict in the home. Roger’s behaviors seem to concern both Marge and Ken. The only unified efforts to address Roger’s behavior or give him attention occur

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however, Scotty’s attempts to bring laughter to the family may be an effort to reduce conflict in the home Roger’s behaviors seem to concern both Marge and Ken Marge is married to Ken The only unified efforts to address Roger’s behavior or give him attention occur when he gets into trouble at school, confirming that Roger’s behaviors may be attention-seeking efforts

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when he gets into trouble at school, confirming that Roger’s behaviors may be attention-seeking

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The only unified efforts to address Roger’s behavior or give him attention occur when he gets into trouble at school, confirming that Roger’s behaviors may be attention-seeking efforts

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Marge and Ken’s sixteen-year-old daughter Carla appears to have assumed parenting

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Marge and Ken’s sixteen-year-old daughter Carla appears to have assumed parenting roles in the absence of her parents

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Carla makes good grades, is involved in sports, and is popular

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Carla makes good grades, is involved in sports, and is popular in school

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(Laureate Producer, 2014c).

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(Laureate Producer, 2014c)

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reduced responsibility for both of her parents, further delaying addressing Marge’s alcoholism

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Carla’s assumption of parenting responsibilities has reduced responsibility for both of her parents, further delaying addressing Marge’s alcoholism and contributing to ongoing substance use and development of codependent patterns of behaviors

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Carla is at risk of self-esteem issues because there is a likelihood that she will determine her own value by the effectiveness of her attempts to maintain the family unit

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Carla is at risk of self-esteem issues because there is a likelihood that she will determine her own value by the effectiveness of her attempts to maintain the family unit (Doweiko, 2019 Carla is at risk of self-esteem issues because there is a likelihood that she will determine her own value by the effectiveness of her attempts to maintain the family unit (Doweiko, 2019

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Laureate Producer, 2012;

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Laureate Producer, 2012

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Models of Addiction

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Models of Addiction

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The Sociocultural Model of Addiction The Sociocultural Model of addiction seeks to identify and likely intervene to address the

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Models of Addiction The Sociocultural Model of Addiction The Sociocultural Model of addiction seeks to identify and likely intervene to address the systemic issues that might influence an individual to drink

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focuses on the role of culture in development of addictions.

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The Sociocultural Model also focuses on the role of culture in development of addictions

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more emphasis on the interactions within the environment of the individual struggling with

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In short, the social perspective places more emphasis on the interactions within the environment of the individual struggling with addiction

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As with any model, there are specific strengths and limitations to use of the Sociocultural

Original source

Strengths and Limitations of the Model As with any model, there are specific strengths and limitations to use of the Sociocultural Model of Addiction

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with addiction to accept responsibility for some of society’s norms and expectations for human

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The model’s systemic approach to addiction empowers individuals dealing with addiction to accept responsibility for some of society’s norms and expectations for human behavior (Doweiko, 2019

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behavior (Doweiko, 2019;

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(Doweiko & Evans, 2019)

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factors is useful for identifying populations that may be considered at risk of developing

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The model’s focus on the influence of environmental factors is useful for identifying populations that may be considered at risk of developing substance use disorders and informs prevention efforts in the addiction field

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Marge’s reports to the clinician suggest a need for further assessment of the client’s use

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Rationale for Use Marge’s reports to the clinician suggest a need for further assessment of the client’s use of substances

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positive or protective factors, counteracting factors contributing to substance use. Model of Treatment

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Use of the sociocultural model will help to increase positive or protective factors, counteracting factors contributing to substance use Model of Treatment

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Family/Marital therapy is a generic term that applies to an umbrella of approaches that

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Family/Marital Therapies Family/Marital therapy is a generic term that applies to an umbrella of approaches that focus on psychodynamics, structural and behavioral systems, and family systems

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disease model is one of the most common forms of family therapy (Doweiko, 2019).

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The family disease model is one of the most common forms of family therapy (Doweiko, 2019)

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treatment model recognizes the family as a system and asserts that impacting any part of the

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This treatment model recognizes the family as a system and asserts that impacting any part of the system can affect change in other parts

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Family and marital therapies use family strengths to

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Family and marital therapies use family strengths to encourage abstinence and recovery

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Family therapies also helps to reduce the impact of chemical dependency on the family unit by capitalizing on family strengths.

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Family therapies also helps to reduce the impact of chemical dependency on the family unit by capitalizing on family strengths Family therapies also helps to reduce the impact of chemical dependency on the family unit by capitalizing on family strengths

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suffering from addiction negatively impacts the entire family system (Doweiko, 2019).

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In this respect, the individual suffering from addiction negatively impacts the entire family system (Doweiko, 2019)

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may be unclear roles, ineffective communication, unbalanced hierarchies, and ongoing conflict in families of substance users and these factors can contribute to problematic use of chemicals.

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There may be unclear roles, ineffective communication, unbalanced hierarchies, and ongoing conflict in families of substance users and these factors can contribute to problematic use of chemicals There may be unclear roles, ineffective communication, unbalanced hierarchies, and ongoing conflict in families of substance users and these factors can contribute to problematic use of chemicals

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Family and Marital therapies presents specific strengths and limitations as it relates to

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Strengths and Limitations Family and Marital therapies presents specific strengths and limitations as it relates to treatment of addictions

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treatment of addictions.

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Week 11 Treatment of Addictions

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self-efficacy by incorporating client/family/systemic strengths into plans for recovery (Doweiko,

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For example, the model of treatment is strength-based and promotes self-efficacy by incorporating client/family/systemic strengths into plans for recovery (Doweiko, 2019

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On the other hand, because the approach includes the family unit, there is also a chance that additional problems may arise in the course of treatment.

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On the other hand, because the approach includes the family unit, there is also a chance that additional problems may arise in the course of treatment On the other hand, because the approach includes the family unit, there is also a chance that additional problems may arise in the course of treatment

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The family and

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Alcohol and the Family

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there is a greater risk of triangulation and a need for attention to survival or basic needs over the

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The family and marital model of addiction also requires the clinician to develop an alliance with the family, but there is a greater risk of triangulation and a need for attention to survival or basic needs over the course of services (Doweiko, 2019

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(Laureate Producer, 2014).

Original source

Laureate Education (Producer)

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expectations for Marge as a caregiver while identifying ways the family can be more supportive

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Marge’s family may benefit from addressing the roles and expectations for Marge as a caregiver while identifying ways the family can be more supportive of Marge in her quest for recovery

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including her family in therapy can maintain engagement and follow through and increase the

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Since Marge’s family prompted her visit to the clinician, including her family in therapy can maintain engagement and follow through and increase the likelihood of abstinence from alcohol use

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Models of Case Management

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Models of Case Management

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The Minnesota Model is commonly used in treatment of addiction.

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Minnesota Model of Substance Use Treatment The Minnesota Model is commonly used in treatment of addiction

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emphasizes in-depth and continuous assessment of all aspects of the client’s life.

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The model emphasizes in-depth and continuous assessment of all aspects of the client’s life

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utilizes a combination of therapeutic approaches to improve the client’s holistic health.

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This model also utilizes a combination of therapeutic approaches to improve the client’s holistic health

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multidisciplinary teams offers a wide range of individualized goals for the client.

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Use of multidisciplinary teams offers a wide range of individualized goals for the client

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team approach may be most effective for Marge considering there are persistent struggles with

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The treatment team approach may be most effective for Marge considering there are persistent struggles with depression and negligence to her diabetes

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Moreover, Marge’s family issues that contribute to substance use can be addressed using the model.

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Moreover, Marge’s family issues that contribute to substance use can be addressed using the model Moreover, Marge’s family issues that contribute to substance use can be addressed using the model

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through recovery and prepare Marge for relapse prevention.

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This will ensure a greater chance of support through recovery and prepare Marge for relapse prevention

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Borkman, Kaskutas & Owen, 2007).

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Borkman, Kaskutas & Owen, 2007)

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One obvious strength of the Minnesota Model is the use of multidisciplinary teams. Commonly referred to as treatment teams, treatment teams encourage focus on the needs of the client as a whole and allow for interprofessional collaboration in a timely manner.

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Strengths and Limitations of Minnesota Model One obvious strength of the Minnesota Model is the use of multidisciplinary teams Commonly referred to as treatment teams, treatment teams encourage focus on the needs of the client as a whole and allow for interprofessional collaboration in a timely manner Commonly referred to as treatment teams, treatment teams encourage focus on the needs of the client as a whole and allow for interprofessional collaboration in a timely manner

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also compatible with concurrent treatment efforts such as family therapy and medication

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The model is also compatible with concurrent treatment efforts such as family therapy and medication management (Doweiko, 2019

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management (Doweiko, 2019;

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(Doweiko & Evans, 2019)

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Borkman et al., 2007).

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Borkman et al., 2007)

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in treatment lasting twenty-eight days limits the length of stay in residential programs.

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On the other hand, the model’s distinction in treatment lasting twenty-eight days limits the length of stay in residential programs

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model’s reflection of AA philosophies could also be viewed as forcing individuals to embrace

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Lastly, the model’s reflection of AA philosophies could also be viewed as forcing individuals to embrace spirituality in recovery (Doweiko, 2019

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Borkman et al., 2007).

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Borkman et al., 2007)

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Marge does not identify an affiliation to a religion.

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Marge does not identify an affiliation to a religion

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Marge stated, “No, I try so hard to believe, but I feel so sinful.

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When asked to report on her faith, Marge stated, “No, I try so hard to believe, but I feel so sinful

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do with me” (Laureate Education, 2014b). Marge’s remarks suggest she attributes her perceived isolation from a higher power to her sin, or alcoholism.

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Laureate Education, 2014b) Marge’s remarks suggest she attributes her perceived isolation from a higher power to her sin, or alcoholism Marge’s remarks suggest she attributes her perceived isolation from a higher power to her sin, or alcoholism

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a heightened sense of self-awareness and usefulness, which would be beneficial for Marge.

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Nevertheless, spirituality can also refer to a heightened sense of self-awareness and usefulness, which would be beneficial for Marge

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has attended twelve-step programs before but have not attended consistently (Doweiko, 2019; Laureate Education, 2014b).

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She has attended twelve-step programs before but have not attended consistently (Doweiko, 2019 Laureate Education, 2014b)

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that twelve-step programs have obtained longer abstinence and recovery for participants, even

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Other research shows that twelve-step programs have obtained longer abstinence and recovery for participants, even empowering individuals to address factors such as depression and physical illnesses that may contribute to substance use

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Attending twelve-step programs outside of churches present a higher chance for anonymity and participation for the individual, especially in rural areas.

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Attending twelve-step programs outside of churches present a higher chance for anonymity and participation for the individual, especially in rural areas Attending twelve-step programs outside of churches present a higher chance for anonymity and participation for the individual, especially in rural areas

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programs outside of churches tend to be more action-oriented rather than focusing on reading

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Twelve-step programs outside of churches tend to be more action-oriented rather than focusing on reading and study of Biblical text (Dunnington, 2019

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Worley, Tate & Brown, 2012).

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Worley, Tate & Brown, 2012)

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information, a twelve-step program delivered in a setting outside of a church would best benefit

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Given this information, a twelve-step program delivered in a setting outside of a church would best benefit Marge

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Use of American Society of Addiction Medicine (ASAM) criteria will inform the

Original source

Course of Treatment Use of American Society of Addiction Medicine (ASAM) criteria will inform the continuum of care provided to Marge

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At intake, Marge most closely fits the criteria for Level III

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At intake, Marge most closely fits the criteria for Level III Inpatient/Residential Treatment

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observation and use of team meetings.

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There is ongoing evaluation and observation and use of team meetings

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enough for a recommendation at the highest level of care, which would be medically managed

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Individuals at this level do not present needs severe enough for a recommendation at the highest level of care, which would be medically managed instead of monitored (Doweiko, 2019

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Medicaid.Gov, 2017).

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Medicaid.Gov, 2017)

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(Laureate Education, 2014b). Ongoing assessment of biomedical needs as well as support systems and mental health

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Laureate Education, 2014b) Ongoing assessment of biomedical needs as well as support systems and mental health symptoms will determine the appropriate level of care for referrals

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residential treatment, the client’s biomedical and mental health needs will be stabilized, and the

Original source

Upon completion of residential treatment, the client’s biomedical and mental health needs will be stabilized, and the client is better able to manage these needs in the home setting

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Level 2.1 Intensive Outpatient Program where she can have access to medical and psychological

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Marge will then be referred to a Level 2.1 Intensive Outpatient Program where she can have access to medical and psychological support

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She will also have access to services such as psychotherapy, family therapy, and recovery enhancement building activities over the course of twelve months.

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She will also have access to services such as psychotherapy, family therapy, and recovery enhancement building activities over the course of twelve months She will also have access to services such as psychotherapy, family therapy, and recovery enhancement building activities over the course of twelve months

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be stepped down to Level 1 services on an outpatient level to sustain skills and strategies

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Finally, Marge will be stepped down to Level 1 services on an outpatient level to sustain skills and strategies gathered in higher levels of care (Doweiko, 2019

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Laureate Education, 2014b;

Original source

Laureate Education, 2014b)

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Upon completion of the thirty-day residential treatment, Marge will still need services to

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Discharge Plan Upon completion of the thirty- day residential treatment, Marge will still need services to maintain recovery and abstinence from alcohol use

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intensive outpatient programs such as Individual Outpatient Therapy/Medication Management

Original source

Marge will be immediately referred to intensive outpatient programs such as Individual Outpatient Therapy/Medication Management and Family and Marital Therapy for twelve and six months, respectively

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simultaneously participate in Alcoholics Anonymous to provide recovery support in the group

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Marge will simultaneously participate in Alcoholics Anonymous to provide recovery support in the group setting and increase positive social interactions

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Management can help to ensure compliance with medication and evaluate the medicine’s

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Marge’s participation in Medication Management can help to ensure compliance with medication and evaluate the medicine’s effectiveness

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The social worker needs to take such actions to ensure ethical practice and reduce risk

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The social worker needs to take such actions to ensure ethical practice and reduce risk of harm to clients (Doweiko, 2019)

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Student paper

As a child of a recovering addict, my views on addiction

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As a child of a recovering addict, my views on addiction may be unique

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Student paper

Witnessing my father’s journey to recovery and abstinence inspires hope for

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Witnessing my father’s journey to recovery and abstinence inspires hope for others suffering from similar conditions

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Student paper

my approach to those battling addiction might have initially limited their autonomy.

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Over the last eleven weeks, it has also become clear that my approach to those battling addiction might have initially limited their autonomy

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Student paper

excessive use of chemical substances may impair thought and decision-making processes, there

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While excessive use of chemical substances may impair thought and decision-making processes, there is still a strong need for person-centered care planning

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Student paper

supervision and consultation to ensure ethical practice and collaborative-decision-making.

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This course has also reiterated a need for supervision and consultation to ensure ethical practice and collaborative-decision-making

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Student paper

in turn, has increased my preparation for positively contributing to the field of addiction through

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My understanding of addictions, its causes, symptoms, and treatment has substantially increased and in turn, has increased my preparation for positively contributing to the field of addiction through social work

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Marge’s Treatment Plan

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Marge’s Treatment Plan

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Long Range Outcome: Marge will achieve and maintain abstinence from alcohol and better

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Marge’s Treatment Plan Long Range Outcome Marge will achieve and maintain abstinence from alcohol and better manage symptoms associated with other diagnoses

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Marge demonstrates help-seeking behaviors, cares about her children,

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Maria demonstrates help-seeking behaviors, cares about her children, and has a family support system

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Student paper

and has a family support system (husband, sister, best friend). Identified Needs/Deficits: Marge admits alcohol dependency, is diabetic, show signs of a depressive disorder, and is facing legal trouble for driving under the influence.

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Marge demonstrates help-seeking behaviors, cares about her children, and has a family support system (husband, sister, best friend) Identified Needs/Deficits Marge admits alcohol dependency, is diabetic, show signs of a depressive disorder, and is facing legal trouble for driving under the influence Marge admits alcohol dependency, is diabetic, show signs of a depressive disorder, and is facing legal trouble for driving under the influence

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Short Term Goal: Marge will complete the inpatient treatment facility detoxification program.

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Short Term Goal Marge will complete the inpatient treatment facility detoxification program

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Student paper

Marge will refrain from use of alcohol for the next thirty days as required by the detoxification program.

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Marge will refrain from use of alcohol for the next thirty days as required by the detoxification program

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Student paper

Urinalysis and Blood Screenings will be administered daily b. Ongoing contacts with substance abuse counselor will assess Marge’s motivation

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Urinalysis and Blood Screenings will be administered daily Ongoing contacts with substance abuse counselor will assess Marge’s motivation for change

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Team members will implement monitoring plans to ensure Marge does not have access to alcohol.

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Team members will implement monitoring plans to ensure Marge does not have access to alcohol

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Marge will achieve thirty days without use of alcohol, as evidenced by urinalysis reports,

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Marge will achieve thirty days without use of alcohol, as evidenced by urinalysis reports, self-reports from client, and reports from treatment teams

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Student paper

Short Term Goal: Marge will complete the inpatient treatment facility detoxification program.

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Short Term Goal Marge will complete the inpatient treatment facility detoxification program

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Student paper

Marge will actively participate in individual and family therapy sessions over the course of treatment to address substance use and other diagnoses.

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Marge will actively participate in individual and family therapy sessions over the course of treatment to address substance use and other diagnoses

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Substance Abuse Counselor will provide individual therapy bi-weekly to explore and assess the client’s substance use.

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Substance Abuse Counselor will provide individual therapy bi-weekly to explore and assess the client’s substance use

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Student paper

Substance Abuse Counselor will provide weekly family therapy sessions to educate the family on addiction as well as Marge’s other diagnoses.

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Substance Abuse Counselor will provide weekly family therapy sessions to educate the family on addiction as well as Marge’s other diagnoses

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Student paper

Substance Abuse Counselor will teach recovery/relapse prevention skills to both client and social supports.

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Substance Abuse Counselor will teach recovery/relapse prevention skills to both client and social supports

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Student paper

Substance Abuse Counselor will coordinate scheduling of a psychiatric evaluation to further evaluate the client’s mental health needs.

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Substance Abuse Counselor will coordinate scheduling of a psychiatric evaluation to further evaluate the client’s mental health needs

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Student paper

Marge will identify at least two drivers/triggers contributing to substance use

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Marge will identify at least two drivers/triggers contributing to substance use before discharge

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Student paper

Marge and family will identify and demonstrate use of at least two relapse

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Marge and family will identify and demonstrate use of at least two relapse prevention skills

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Student paper

Marge and team will identify any other mental health needs contributing to

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Marge and team will identify any other mental health needs contributing to ongoing substance use before discharge

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Short Term Goal: Marge will complete the inpatient treatment facility detoxification program.

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Short Term Goal Marge will complete the inpatient treatment facility detoxification program

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Marge will increase use of services to aid in addressing challenges related to diabetes and possible depressive disorder.

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Marge will increase use of services to aid in addressing challenges related to diabetes and possible depressive disorder

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Treatment team will actively identify community resources available for the diabetic.

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Treatment team will actively identify community resources available for the diabetic

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Treatment team will actively identify community resources available to increase management of symptoms related to depression.

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Treatment team will actively identify community resources available to increase management of symptoms related to depression

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Ongoing contacts with substance abuse counselor will further identify any unmet needs.

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Ongoing contacts with substance abuse counselor will further identify any unmet needs

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Student paper

An interdisciplinary team meeting will be held before discharge to coordinate delivery of services.

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An interdisciplinary team meeting will be held before discharge to coordinate delivery of services

1

Student paper

Short Term Goal: Marge will maintain abstinence from alcohol use for twelve- months beyond discharge.

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Short Term Goal Marge will maintain abstinence from alcohol use for twelve- months beyond discharge

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Student paper

Marge will utilize Individual Outpatient therapy for One year

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Marge will utilize Individual Outpatient therapy for One year

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Student paper

Treatment team will link Marge to Individual OPT at discharge session b. Provider will continue to build on relapse prevention plan and recovery

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Treatment team will link Marge to Individual OPT at discharge session Provider will continue to build on relapse prevention plan and recovery building skills

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Provider will coordinate scheduling monthly team meetings (providers, family, supports).

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Provider will coordinate scheduling monthly team meetings (providers, family, supports)

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Student paper

Provider will address Marge’s vocational needs to prepare her to return to work.

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Provider will address Marge’s vocational needs to prepare her to return to work

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Ongoing use of assessments to identify any unmet needs warranting additional referrals.

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Ongoing use of assessments to identify any unmet needs warranting additional referrals

1

Student paper

Marge will have enhanced the skills gained in residential treatment to sustain positive outcomes as it relates to maintaining abstinence from alcohol use. Short Term Goal: Marge will maintain abstinence from alcohol use for twelve-months beyond discharge.

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Marge will have enhanced the skills gained in residential treatment to sustain positive outcomes as it relates to maintaining abstinence from alcohol use Marge will have enhanced the skills gained in residential treatment to sustain positive outcomes as it relates to maintaining abstinence from alcohol use Short Term Goal Marge will maintain abstinence from alcohol use for twelve- months beyond discharge

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Marge (and family) will participate in Family and Marital Therapy

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Marge (and family) will participate in Family and Marital Therapy

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Family will attend a minimum of twelve, hour- long sessions.

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Family will attend a minimum of twelve, hour- long sessions

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Ongoing use of structured/unstructured tools to evaluate family functioning and

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Ongoing use of structured/unstructured tools to evaluate family functioning and effectiveness of services delivered

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Student paper

Therapist will provide psychoeducation, conflict resolution, role enhancement, and other services to prepare the family to support Marge’s recovery.

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Therapist will provide psychoeducation, conflict resolution, role enhancement, and other services to prepare the family to support Marge’s recovery

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Student paper

Therapist will coordinate referral to additional services if needs are presented.

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Therapist will coordinate referral to additional services if needs are presented

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Student paper

Marge and family will increase family functioning, evidenced by increased role fulfillment, reduced conflict, and effective support in Marge’s recovery.

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Marge and family will increase family functioning, evidenced by increased role fulfillment, reduced conflict, and effective support in Marge’s recovery Marge and family will increase family functioning, evidenced by increased role fulfillment, reduced conflict, and effective support in Marge’s recovery

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Student paper

Borkman, T., Kaskutas, L. A., & Owen, P.

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Borkman, T., Kaskutas, L A., & Owen, P

1

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Three Models of Alcohol/Other Drugs Treatment: Minnesota Model, Social Model, and

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Contrasting the Converging Philosophies of Three Models of Alcohol/Other Drugs Treatment Minnesota Model, Social Model, and Addiction Therapeutic Communities

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Addiction Therapeutic Communities.

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Therapeutic communities for addiction

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Alcoholism Treatment Quarterly, 25(3), 21.

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Alcoholism Treatment Quarterly, 25(3), 21

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Student paper

Concepts of chemical dependency (10th ed.).

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Concepts of chemical dependency (10th ed.)

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Small groups Anonymous: Why the best church small groups might take

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Small groups Anonymous Why the best church small groups might take their cues from the Twelve Steps

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Christianity Today, 4, 50.

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Historical perspectives on addiction. In APA addiction syndrome handbook,

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Foundations, influences, and expressions of addiction.

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https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 002

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J., Dulmus, C. N., & Sowers, K.

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J., Dulmus, C N., & Sowers, K

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Social work practice with individuals

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Evidence-informed assessments and interventions.

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Wiley & Sons, Inc. Laureate Education (Producer).

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https://class.waldenu.edu Laureate Education (Producer).

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Counseling session 2

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https://class.waldenu.edu Laureate Education (Producer).

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Retrieved from https://class.waldenu.edu Laureate Education (Producer)

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https://class.waldenu.edu

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Psychological roles of young adults growing up in alcoholic and nonalcoholic families measured by Family Roles Questionnaire.

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Psychological roles of young adults growing up in alcoholic and nonalcoholic families measured by Family Roles Questionnaire Psychological roles of young adults growing up in alcoholic and nonalcoholic families measured by Family Roles Questionnaire

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Addiction, 30(1), 13-40. https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 002 https://class.waldenu.edu/

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Alcoholism and Drug Addiction, 30(1), 13-40 https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 002 Retrieved from https://class.waldenu.edu

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Medicaid.Gov (2017). Overview of Substance Use Disorder (SUD) Care Clinical Guidelines:

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Resource for States Developing SUD Delivery System Reforms.

Original source

A Resource for States Developing SUD Delivery System Reforms

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https://www.medicaid.gov/state-resource- center/innovation-accelerator-program/iap downloads/reducing-substance-use- disorders/asam-resource-guide.pdf

Original source

https://www.medicaid.gov/state-resource- center/innovation-accelerator-program/iap- downloads/reducing-substance-use- disorders/asam-resource-guide.pdf https://www.medicaid.gov/state-resource- center/innovation-accelerator-program/iap- downloads/reducing-substance-use- disorders/asam-resource-guide.pdf

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Substance Abuse and Mental Health Services Administration (SAMHSA).

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1

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Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series,

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https://www.ncbi.nlm.nih.gov/books/NBK6426 9/

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https://www.ncbi.nlm.nih.gov/books/NBK6426 9/ Winters, K

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C., Botzet, A., Fahnhorst, T., Arria, A., Dykstra, L. G., & Oliver, J.

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C., Botzet, A., Fahnhorst, T., Arria, A., Dykstra, L G., & Oliver, J

1

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factors and the addiction syndrome. In APA addiction syndrome handbook, Vol.

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Social factors and the addiction syndrome In APA addiction syndrome handbook, Vol

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Foundations, influences, and expressions of addiction.

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Foundations, influences, and expressions of addiction

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https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 012

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J., Tate, S. R., & Brown, S.

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J., Tate, S R., & Brown, S

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attendance, depression and substance use in patients with comorbid substance https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 012

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Mediational relations between 12- Step attendance, depression and substance use in patients with comorbid substance https://doi- org.ezp.waldenulibrary.org/10.1037/13751- 012