Prevention Plan 1
Treatment/Relapse Prevention Plan
Brett A Smith
School of Counseling, Liberty University
Prevention Plan 2
Treatment/Relapse Prevention Plan
Diagnostic Impression
The client has reported excessively using alcohol over the course of the last five years
continuously. His claims state that his alcohol use would start in the morning shortly after
awakening in small amounts using hard liquor and would increase as the day progressed to using
primarily vodka mixed with other drinks to drinking the vodka straight in the evenings. He also
notes he has occasionally used other drugs, in his case primarily uppers like cocaine to combat
the tiredness or prevent passing out. He has made multiple attempts to recover and has only
limited success with his longest stretch being almost six months.
His triggers seem to all come in the form of stress and anxiety driven by life events that
come unexpectedly. He also notes that the most difficult times of the day for him in general are
in the morning when the withdrawal symptoms are usually at their peak causing his hands to
tremble, anxiety, inability to focus, and stomach irritation. He also reports that he is always tired
regardless of the amount of alcohol consumption which suggests the substances causing trouble
with his body reaching REM sleep.
The client has stated that most of his day is centered around making sure he has enough
alcohol so that he doesn’t run out and that the this ultimately impacts the rest of his schedule. He
claims most of the negative occurrences in his life are directly impacted by his substance use or
his attempts to counteract its effects when he has consumed too much. He reports having had one
DUI, but that number could and should be much higher. He also notes that it takes anywhere
from 3 to 4 times the amount of alcohol consumption to reach its desired effects as it did just 18
months ago and without its effects he refrains from or completely avoids all activates.
Prevention Plan 3
Based on the information provided by the client and my utilizing a the wholistic approach
proposed Heilig et al., (2022) where the most applicable aspects of each addiction model are
used for diagnosis and treatment planning following diagnosis and treatment plan were devised.
In accordance with the criterion set by the American Psychiatric Association the diagnosis is
shown below:
DSM-5-TR Diagnostic Criteria: Alcohol
Use Disorder Severe 303.90 (F10.20)
Client’s Signs/Reported Symptoms:
Criterion A: A repeated and problematic
alcohol use resulting in a significant
impairment or distress which requires
clinical attention and has manifested by at
least two of the following, occurring within a
12-month period:
1. Alcohol is often taken in large
amounts or over a longer period that
was intended.
2. The client shows there is a persistent
desire or unsuccessful efforts to cut
down or control alcohol use.
3. Most daily activities are spent in
search of the necessary alcohol felt
needed, the use alcohol, or recover
from its effects.
4. Craving, or a strong desire or urge to
use alcohol.
5. Recurrent negative impacts resulting
from alcohol use causing start or
finish obligations at work, school, or
home.
6. Continued alcohol use despite
recurring social or interpersonal
problems caused or exacerbated by
the effects of alcohol.
7. Important social, work, or sociall
activities are given up or reduced due
to alcohol use.
8. Multiple situations in which client has
become physically unstable even
dangerous.
Client reports (A1) The client reports using
alcohol repeatedly over the course of over 5
years from the time he awakes until he
sleeps. (A3) Client reports many of his
activities are based around alcohol and
intoxication. (A4) Client reports that his most
difficult times managing or confronting the
issue is in the morning. (A5) Client reports
having anxiety in the morning and if he does
not continue drinking it manifests during the
day making the thought of drinking constant
on his mind (A6) Client reports having one
DUI, but that number does not reflect his
infractions (A7) Client will not partake or
engage in any activities unless he is under the
influence. (A8) Client reports drinking daily
and often driving intoxicated. (A9) Client
reports feelings of physical illness associated
with the kidneys and liver likely contributed
using alcohol. (A10) Client reports having to
drink 2 to 3 times as much alcohol to reach
desired effects than that of 18 months ago.
Prevention Plan 4
9. Alcohol use is continued despite the
continuous use results in the known
negative impacts on his life.
10. Tolerance, as defined by either of the
following:
a. A need to considerably reduce the
amount of alcohol consumed.
b. The substance having a less
substantial effect on the individual
and more is needed to replicate
effects previously experienced.
11. Withdrawal, as resulting from either
of the following:
a. Direct withdrawal symptoms
manifest from when use of the
substance is sustained.
b. The stimulant or similar stimulants
are taken to relieve or avoid
withdrawal symptoms.
Counselor’s Role & Inclusion of Client’s Influences in Treatment
The counselor’s role and inclusion in the client’s road to recovery comes in many
forms. First and foremost the counselor’s role is to evaluate the patient’s health and their history
with addiction as this serves as the foundation for them to recommend treatments, help the client
find and enroll in the necessary treatments, create a recovery plan that is composed of the overall
plan, goals (both individual, psychiatric, and with the assistance of a medical doctor, physical
goals, a mailable timeline to assist the client in staying on track, and to provide continuous
support throughout the process whether they succeed or stumble to make sure they have the best
chance to obtain their goal of sobriety (Oberleitner et al., 2021)
Prevention Plan 5
Treatments Recommendations and Recommendations to Maintain Sobriety
Given the length of time in which the client has battled his addiction and his previous
failed attempts the following recommendations are made. The first the is client should enroll in
and participate fully in an overnight dual-diagnostic treatment facility for a minimum of 4 weeks.
According to Kamath et al., (2020) patients attending a 30 day or less in-patient treatment
facility have shown a substantial increase in their likelihood to maintain sobriety compared to
those who do not.
The theoretical approach chosen for this client’s circumstances and addiction will be a
cognitive behavioral based model focusing on how his emotional state and ability to manage
those emotions has led to his addiction and help him to formulate a plan to resolve further issues
without returning to alcohol. This CBT model while incorporating faith through a Christian
worldview approach of counseling will assist in finding out the client’s mindset and emotional
management abilities prior to addiction providing a road map to how he would ultimately
succumb to it (the addiction), give us a current model of how the client manages and deals with
life events and the emotional states these events create (Heather et al., 2022), and finally by
adding the faith based aspect it will give the client the power greater than himself to believe he
can and ultimately will defeat the disease of addiction (Capuzzi and Stauffer, 2020).
The CBT model will assist in changing the clients from an initial negative perception to
teaching him how to perceive them as positive as well as resourceful (McHugh, 2010). After the
use of the CBT approach and faith bath approach and conjoining them into a wholistic approach
through the model suggested by Heilig (2021), the next step will be the get the client involved in
group therapy, specifically AA and the 12 Steps program. The program of AA will provide the
client with the needed social support, understanding of his circumstances, and a step-by-step plan
Prevention Plan 6
he can apply to his life (through the guidance of a sponsor) that anyone, especially those new to
treatment need in order conquer their addiction (Alcoholics Anonymous, 2023). The support he
will receive through these groups, as well as being able to witness the success of others involved
in the group will provide the encouragement and stability that was most likely lacking in his
prior sobriety attempts. In addition to AA support groups, other support groups will be
recommended such as family and relationship support groups to assist in restoring damaged
relationships, repairing any existence of co-dependency that may have formed, and help the
family understand addiction and the circumstances that caused it to be such an overwhelming
force in the client’s life (Dekkers, 2020).
TREATMENT PLAN WORKSHEET
Brett A Smith:
Mike B Lewis:
Case #1431:
Problem 1.: Mike is struggling to accept and confront the role of his addiction to alcohol and its
impact on his life.
Goal 1.: The client will accept his addiction to alcohol and its impact on his life.
Objective 1.: Enroll in an in-patient treatment facility.
Intervention 1.: The counselor will remain in contact on a weekly basis
with the counselors and other members of the facility to stay adept to his
status, progress, or lack of progress, and stay prepared for his sessions
after treatment.
Objective 2.: The client will accept the impact stress and anxiety change his
emotions and are a direct precursor to him picking up a drink.
Intervention 1.: While in treatment and in sessions with the counselor
afterwards the client will address historically how he has managed stress
and emotions and how it compares today and then will formulate a plan
for dealing with future emotions based on therapeutic discovery.
Goal 2.: The client will attend 90 AA meetings in 90 days.
Prevention Plan 7
Objective 1.: The counselor will hold the client accountable by having him turn
in an attendance sheet at each counseling session and a summary of the meeting’s
topics and discussions.
Intervention 1.: Assist the client in finding an AA group and the
appropriate meeting.
Objective 2.: The client will continue to work towards managing his emotions,
particularly those induced by stress and unexpected events.
Intervention 1.: The counselor will continue to follow up on his progress
throughout his time in the meetings i.e., what he has learned, what he can
take away from them, and how he can apply it to his life to better manage
those situations that he struggles with.
Problem 2.: Mike isolates himself both before and after his drinking has commenced leaving
him to battle his addiction and other life struggles alone.
Goal 1.: The client will learn how to be comfortable using communication skills.
Objective 1.: The client will keep a daily diary/log of encounters with others and
how they went.
Intervention 1.: During sessions with his counselor the two will go over
the events and determine which were successful and which were not, then
identify what assisted in the success of his positive communication events.
Objective 2.: Cover communication skills with the client, the different types, the
reasons why they are necessary, how to have healthy communication skills and
apply them to life.
Intervention 1.: During sessions with the client the counselor and the
client will roll play different types of communication types by roll playing
different aspects of the process to help the client learn and hone their skills
for real life purposes.
Goal 2.: The client learns how to develop healthy coping skills.
Objective 1.: The client will keep a diary of the different events that were triggers
in his past or any triggers he encounters to establish awareness of them, how to
manage them, and when possible, avoid them.
Intervention 1.: During sessions the counselor will go over the diary the
client kept and they will review the positive and negative aspects they can
derive from it identifying aspects that the client could use in future events.
Objective 2.: The client will create mooring lines to help them overcome triggers.
Prevention Plan 8
Intervention 1.: The counselor will explain what mooring lines are, how
some already exist in his life and others he can adopt, then teach him how
to use this network of lines to defeat future triggers as he encounters them.
Prevention Plan 9
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental
disorders (5th ed., text rev.).
Capuzzi, D., & Stauffer, M. D. (2020). Foundations of addictions counseling (4th ed.). Pearson.
Dekkers, A., De Ruysscher, C., & Vanderplasschen, W. (2020). Perspectives on addiction
recovery: focus groups with individuals in recovery and family members. Addiction
Research & Theory, 28(6), 526-536. https://doi.org/10.1080/16066359.2020.1714037
Heilig, M., MacKillop, J., Martinez, D., Rehm, J., Leggio, L., & Vanderschuren, L. J. (2021).
Addiction as a brain disease revised: why it still matters, and the need for
consilience. Neuropsychopharmacology, 46(10), 1715-1723.
Kamath, P. S., Karpyak, V. M., Davis, B., Desai, V., Liangpunsakul, S., Sanyal, A., ... &
Simonetto, D. A. (2020). Alcohol rehabilitation within 30 days of hospital discharge is
associated with reduced readmission, relapse, and death in patients with alcoholic
hepatitis. Clinical Gastroenterology and Hepatology, 18(2), 477-485.
https://doi.org/10.1016/j.cgh.2019.04.048
McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive-behavioral therapy for
substance use disorders. The Psychiatrics Clinic of North America, 33(3), 511-525.
https://doi:10.1016/j.psc.2010.4.012
Oberleitner, D. E., Marcus, R., Beitel, M., Muthulingam, D., Oberleitner, L., Madden, L. M., ...
& Barry, D. T. (2021). “Day-to-day, it’s a roller coaster. It’s frustrating. It’s rewarding.
It’s maddening and it’s enjoyable”: A qualitative investigation of the lived experiences of
addiction counselors. Psychological Services, 18(3), 287.
https://psycnet.apa.org/doi/10.1037/ser0000394
