lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
1
Case Study 2 Wan DeRer
Tina Blakeman
Liberty University
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
2
Wan DeRer is in demand of a solid inpatient treatment and detoxification program. The
assessment is to come up with a strategy to plan a therapy method that will help him.
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
3
Case Study
Sources of Information: Sources are from the case study vignette. The main source of data that
we have about Wan DeRer consist of the meetings from the medical team and the clinical staff at
the treatment center. We do have a couple reports from the local police department after a report
was filed saying that Wan was found passed out in the alley.
Biological History: Wan DeRer background is unknow when asked questions concerning
his family, he closes off and refuses to offer any clarification. The children’s parents died years
ago.
His family background reveals that he and his brothers and sisters were harshly mistreated along
with disciplined substantially physically and emotionally as kids. Wan refuses to talk when it’s
regarding family issues during therapy sessions. There is an increasing frame of solid evidence
that Adverse Childhood Experiences (ACEs) (which occur when the average expected
environment fails) partake a lengthy long-lasting effect across the lifecycle (Choi, Dinitto, Marti,
& Choi, 2017; Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, Marks, et al.,
1998). We know from previous research that children are known to be abused or neglected when
they come from a home of alcoholic or substance abuse. Wan’s life growing up was anything but
ordinary. The absence of affection and support that he received from his parents has deeply
affected the sculpting of his temperament and individuality. It is unclear of Wan’s ethical
background but Clinton & Scalise, (2013) say people of ethnic minorities aren’t provided the
equivalent quality of health care, social supports, or gain access to treatment plans. His genetic
may have a role in his drinking. A child’s structure and background circumstances and
experiences shape his/her psychological development. Children that are affected by trauma early
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
4
at the same time as the brain is still developing can lead to shifts in brain chemistry and could
cause an individual to self-medicate (Inaba & Cohen,2014).
Psychological History: Wan’s life hasn’t been easy he was abused as a child and is
drinking to the point that he is passing out and having blackouts. He has been admitted
and being treated at a drug abuse treatment facility. Wan is having trouble managing his
finances and keeping employment due to his inability to stay sober. The evidence of
alcohol dependency he is passing out from drinking, he cannot hold a job and his life is
unmanageable (DSM-IV-TR). We are unsure of the length that Wan has been abusing
alcohol but to be experiencing homelessness and blackouts he is drinking in large
quantities. A person that is experiencing blackouts and risky behaviors needs medical
attention. We know that he has been coming to the treatment center for months.
Social History: Wan’s life consist of drinking and going to treatment. He refuses to talk
about his life with his family. He does admit to the abuse that him and his siblings
endured. I’m very interested to know information about his past with his parents and their
cause of death. “ I’m wondering if it was from substance abuse.” Does Wan have a
relationship with his brother’s and sister’s?
Wan DeRer is a skilled welder, so where did he receive his schooling? He manages to
stay connected to the Union Hall. Wan makes very good money as a high-end welder and
is so good that he gets promotions that come with a lot of responsibility after a short time.
Then he goes off on another binge and loses his job.
Development. Childhood development is very important. Wan must open up and talk
about his childhood and learn if there are genetics the reason behind his drinking. Did one or
both of his parents abuse substances and was that the reason for both of his parents dying at such
a young age.
What age did Wan meet all his milestones? Was he behind due to the abuse that he
experienced? I don’t feel that the client has a learning disability because he is a successful
tradesman with a good skill . Whatever occurs when the household dysfunction of childhood is
transformed into the biopsychosocial framework that leads growth and development (Larkin,
Felitti, & Anda, 2014)? The answers to these questions need to be answered when it comes to
Wan. “17,000 individuals were questioned with the intention to explain evidence on child abuse
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
5
(physical, emotional, sexual), neglect (emotional, physical), interpersonal violence, parental
incarceration, alongside domestic substance abuse and mental illness” (Felitti et al., 1998).
Family: Wan seems very withdrawn when it comes to talking about his family. We do
know that he and his siblings were abused by one or both of his parents. I want to slowly try to
get Wan to open up concerning his past and present relationship with his family. Establishing a
family connection with his brothers & sisters could be a great benefit to fixing the gap in his free
time to drink. Individuals use drugs for several reasons. One characteristic that can contribute to
the progress of addiction is an individual's situation. Research will show that recollections of
one’s past is attached to the emotional events in one's life and can have negative consequences
(Inaba & Cohen, 2014). An individual that has a history of abuse or peer pressure can encourage
them to take solace from drug use in order to avoid their horrible condition (Inaba & Cohen,
2014).
Current Status: Wan DeRer was taken to a treatment center after being found by the local
police department and emergency unit. He was in a blackout in the alley next to the treatment
center. Wan has had a heap of attempts to get treatment but continues to depart the facility. Wan
is unable to commit to a long-term treatment contract and makes excuses concerning the Union
Hall. The chronic use of alcohol can enhance the odds of forming a mental illness or suffering
from mental symptoms according to Inaba & Cohen (2014). When Wan is under the influence he
is very ambitious about getting into treatment.
Indicators of Abuse and Dependency:
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
6
•
Attitude and Behavior of Wan he seems depressed, stressed, and his health is
declining due to the continue daily drinking. Wan is a severe chronic drinker
and has a history of alcohol abuse and has become very depended on a drink.
He is living a risky life drinking and passing out in alleys and seeking help
from the treatments programs while drunk. It seems that Wan is avoiding
talking regarding his life as a child. Wan DeRer is only able to stay sober for a
couple of weeks at a time and returns to the same risky behavior of drinking.
Relapses and pleas for help are a daily part of Wan’s life. Wan does have the
ability to perform at his jobs and skill if he could only stay sober and fight his
cravings of alcohol and deal with the trauma of the abuse from his childhood.
•
Social Functioning of Wan’s social life is trying to get his next drink. There is
little information that Wan has much of a social life. He refuses to talk about
his brothers and sisters, and it doesn’t seem like they are a part of his life.
•
Occupational Functioning of Wan he is a skilled tradesman and does welding.
Wan’s main source of income is a high-end welder but he works only a short
time and loses’ his job. His skills allow him to get jobs through the Union Hall
and he can earn promotions very easily. Alcohol may be able to control the
reasoning portion of the Frontal cortex and impact the judgement as well as the
lower centers of your limbic system that would oversee mood, emotion, and
craving (Inaba,& Cohen,2014).
•
Financial Aspects: Wan is homeless due to his drinking. He does have the skills
to have a stable financial stability if he stays clean and sober. Wan DeRer is a
member of the Union Hall and is able to occasionally obtain work.
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
7
•
Legal I would like to ask the client if he has had legal problems in the past or
present. Wan was found in the alley sleeping by the police and they took him
for treatment a few times and not jail so he may not have legal problems at this
moment.
•
Health of Wan now he is in great danger from the elements living in the outside
conditions. Normal behaviors shown by addicts/substance abusers are similar
to Wan’s “diagnosis of substance use disorder is based on the evidence of
impaired control, social impairment, risky use, and pharmacological criteria, a
craving or a strong desire or urge to use a substance”(DSM-IV-TR).
Spiritual History: Wan spirituality is unknown. He does seem repentant and pleading for help,
but he doesn’t give the program much of a chance and leaves after a few weeks. If Wan wasn’t
brought up in church this could be the reason that he isn’t able to seek support through a local
church. Raising a child is an important job and one that should be done with love and discipline.
2 Timothy 3:15 “And that from a child thou hast known the holy scriptures, which are able to
make thee wise unto salvation through faith which is in Christ Jesus.” (KJV) 1 Peter 5:8 “ Be
sober, be vigilant; because your adversary the devil, as a roaring lion,walketh about, seeking
whom he may devour” (KJV).
A. DIAGNOSTIC IMPRESSION: Wan is suffering from more than one disorder, he has a
co-occurring disorder (Clinton & Scalise,2013) the first impression is he dealing with a
chronic alcohol dependency, depression, anxiety that has impacted his performances
throughout his life. Comorbidity applies interaction among substance abuse and mental
illness, with one illness that influences the path and probable results of both illnesses. He
is challenged by the way his brain processes, and stores, and analyzes information. Wan
has symptoms of the biological model known as the medical model. (Doweiko,2018).
Individual's, genetics may cause somebody to be at a greater risk of having a substance
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
8
abuse disorder (Clinton&, Scalise,2013).Wan’s behavior comes from his out of control
drinking and the abuse that he has suffered as a child. Wan was abused as a child
mentally and physically and he is trying to block the trauma of his childhood feeling that
he has toward his parents by drinking this helps him deal with the pain of neglect
(Liberty university lecture,2019). Dr. Jenkins on the disease model says, " you have it or
you don't." Doweiko said about the disease model " viewed as being powerless over
their substance use disorder" (Doweiko, 2018). Common behaviors shown by
addicts/substance abusers are similar to Wan DeRer’s “diagnosis of substance use
disorder is based on the evidence of impaired control, social impairment, risky use, and
pharmacological criteria, a craving or a strong desire or urge to use a substance”(DSM-
V). There are numerous social factors that have contributed to the social impact of Wan’s
life including being abused as a child, his upbringing, parenting (Doweiko,2019).
According to the DSM Wan is experiencing severe alcohol abuse and needs a long-term
inpatient treatment program. Wan is suffering from 2 or more of the different criteria that labels it
within the severe range of alcohol abuse disorder.
•
Intending to cut back or halt using the substance but not controlling.
•
Spending a lot of time getting, using, or recovering from use of the substance.
•
Yearnings and urges to consume the substance.
•
Not performing what you should at work, home, or school because of substance
use.
•
Persisting to use, even when it causes complications in connections.
•
Giving up vital social, professional, or recreational activities because of substance
use.
•
Using substances again and again, even when it leaves you in risk.
•
Continuing to use, even when you know you have a physical or psychological
problem that could have been caused or made worse by the substance.
•
Needing more of the substance to get the effect you want (tolerance).
•
Development of withdrawal symptoms, which can be relieved by taking more of the
substance (DSM-V).
According to the DSM Wan is experiencing severe alcohol abuse and needs a long-
term inpatient treatment program.
Treatment Plan: A suggestion to Wan DeRer is that we come up with an individual
written treatment plan. Step one is medical detoxification. First, a plan that we both can
read, discuss, and sign helps makes sure that we are on the same page; second, this will
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
9
give us a road map of the progress According to the DSM Wan is experiencing severe
alcohol abuse and is in need of a long-term inpatient treatment program. Wan will set goals
that he can meet. While planning an appropriate therapy program for Wan, factors must be
considered. I will recommend the harm-reduction approach as a means to encourage and
limit the number of drinks until he is more stable in his thinking and make a change toward
abstinence ( Liberty University lecture,2019). Like most situations, treatment requirements
are to combine psychological therapy with the treatment for substance addiction illness.
Wan’s treatment plan will include a setting that will address his mental health and his
severe alcohol abuse. The serial treatment approach is a starting point for Wan he has had
years of alcohol abuse and this would allow him to work on the most serious problem
(Doweiko,2019). Furthermore, he requires a medical treatment plan to focus on the
treatment and management of his ongoing medical problems. Wan’s difficulties can be
improved by counseling and mental health services. Wan DeRer must express a desire to be
changed. He has been living in spiritual darkness for such a long time, a separation with
God must be renewed. He will have to analyze his life.
Aftercare Recommendations: Wan’s after care needs to consist of a sober living
community due to his severity of alcohol abuse and limited support. Wan need to continue
pursuing counseling with a cognitive behavioral therapy. After a few months he needs to
join a support group to deal with the childhood trauma. Wan needs a 12-step program 3 or
more times a week until his craving is gone. Wan need to reconnect with his siblings they
will offer him the emotional connection that he lacks having.
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
10
Tina Blakeman Signature April 25/2020 Date
lOMoARcPSD|255728 27
CASE STUDY 2 WAN DERER
11
References:
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental
Choi, N., DiNitto, D., Marti, C., & Choi, B. (2017). Association of adverse childhood
experiences with lifetime mental and substance use disorders among men and women
aged 50 years. International Psychogeriatrics, 29(3), 359-372. doi:10.1017/S1041610216001800
Disorders (DSM-5). Arlington, VA: American Psychiatric Pub.
Doweiko, H.E. (2019). Concepts of Chemical Dependency (10th ed.). Boston, MA Cengage.
Dr. Tim Clinton and Dr. Eric Scalise. (2013). The quick- Reference Guide to Addictions and
Recovery. Grand Rapids, Michigan: Baker Books.
Inaba, D. S., & Cohen, W. E. (2014). Uppers, Downers, and All Arounders, Medford, Oregon: CNS
Productions.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., …
Liberty University Presentation: (2019). Addictions and Recovery: An Introduction. Lynchburg,
VA:
Marks, J. S. (1998). Relationship to childhood abuse and household dysfunction to many of the
leading causes of death in adults. Journal of Preventive Medicine, 14(4), 1–
4. https://doi.org/10.1080/14443058.2018.1459782
