CASE STUDY ANALYSIS TWO 2
Identify the Issues
In this case, there are several underlying issues to consider. First, there is the most
obvious problem of Steve’s drug and alcohol use. In order to preserve Steve’s mental and
physical health, as well as his future, Steve’s drug use must be addressed. Second, there is
Steve’s refusal to allow information about his issues to be released to his parents. Without his
consent, Steve and his family cannot participate in the family counseling that the counselors
from his school and treatment program believe is essential to his recovery.
Additionally, there is the issue of Steve’s fear of his family’s reaction to news of his
substance abuse issues. Steve’s father has seen the effects of alcoholism firsthand, and has zero
tolerance. Steve fears that if his father knows what Steve is going through, there would be a
serious disruption in his family life. Another issue it the idea that Steve’s substance abuse issues
may stem from depression.
Outline the Options
The first option is to continue the current treatment plan as it stands. That is, Steve could
continue to attend the individual counseling sessions at school, and the group sessions at the
local treatment center. This would continue to bring in the perspective of other adolescents
which is valuable as adolescents have difficulty perceiving the problems with drug abuse, as they
“tend to overestimate the number of their peers that are using” (Fagan 2006, p. 327). Another
component of this option, however, is that Steve’s parents will continue to stay in the dark about
his substance abuse problems. A second option would be to change Steve’s interventions to a
more rigorous cognitive behavior therapy (CBT) program. This program has been shown to be
effective in changing thought patterns in adolescents when employed with fidelity, and does not
CASE STUDY ANALYSIS TWO 3
necessarily require the involvement of Steve’s parents (Killeen, McRae-Clark, Waldrop,
Upadhyaya, & Brady, 2012, p. 38).
A third, more drastic option would be to have Steve screened for depression. Depression
in adolescents has been linked to noncompliance in school, higher dropout rates, and drug use
(Wells & Albano, 2005, p. 219). This would also legally free up the counselors to involve
Steve’s parents without Steve’s consent. The parents would then be involved under this option,
and additional forms of counseling, including family counseling, could be used.
Construct Your Arguments
Regarding Steve’s case, there is a very real issue with his substance abuse and the impact
on his present and future life. There is also the legal and ethical issue of the counselors’ desire to
involve his family, and Steve exercising his right to refuse. However, complicating this issue is
the likelihood of a family disruption due to the potential reaction of Steve’s father. This could
potentially be helped with a private session with Steve’s father, acknowledging his fears and
issues, but reminding him that “Fathers, do not exasperate your children; instead, bring them up
in the training and instruction of the Lord” (Ephesians 6:4). With combined family counseling, it
is possible for the family to “Start children off on the way they should go, and even when they
are old they will not turn from it” (Proverbs 22:6). By altering the course of Steve’s life as a
family, there will be a better chance that Steve will learn how to live right, avoid substance
abuse, and succeed in life.
Make a Decision
I believe the best way to deal with Steve’s issue as well as the ethical dilemma is to
respect Steve’s wishes not to involve his family at this time is to alter the nature of counseling to
CBT. With this program, there is some efficacy in treating substance abuse problems, but this
CASE STUDY ANALYSIS TWO 4
comes with the added possibility of changing Steve’s mind about involving his parents. Through
the CBT techniques, Steve’s cognitive abilities could be employed to realize value of the
assistance of his parents. With this goal in mind, Steve could eventually give consent to involve
his parents, and his father could also be counseled in the proper home response (Wells & Albano,
2005, p. 216).
CASE STUDY ANALYSIS TWO 5
References
Fagan, R. (2006). Counseling and treating adolescents with alcohol and other substance use
problems and their families. Family Journal, 14(4), 326-333. Retrieved December 9,
2016, from http://ezproxy.liberty.edu/login?
url=http://search.proquest.com.ezproxy.liberty.edu/docview/227935729?
accountid=12085
Killeen, T. K., McRae-Clark, A. L., Waldrop, A. E., Upadhyaya, H., & Brady, K. T. (2012)
Contingency management in community programs treating adolescent substance abuse: A
feasibility study. Journal of Child and Adolescent Psychiatric Nursing, 33-41.
Wells, K. C., & Albano, A. M. (2005). Parent involvement in CBT treatment of adolescent
depression: Experiences in the Treatment for Adolescents with Depression Study
(TADS). Cognitive and Behavioral Practice, 209-220.
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