Group treatment

Unit 8 Discussion Scenarios

COURSE #

Juanita Scenario: You first learn of Juanita’s case from her probation officer. In a frustrated voice her probation officer explains, “I don’t know what else to do. She just can’t seem to finish the treatment that was ordered by the judge. This is her last chance. If she is not compliant this time, she will go back to prison.” W hen Juanita calls to arrange an appointment she sounds upbeat, positive, and committed to do whatever it takes to avoid prison. She states that she knows she will use “pot” again when she is “off paper” but that it isn’t worth prison so she will comply with treatment and pass all UAs. The day before the appointment she called to confirm the time and seemed confused about the appointment day and time. W hen she comes to your office, her demeanor seems quite different. Her appearance is somewhat unkempt and she complains of being tired and unsure of being able to keep all of the required appointments. She says that she is overwhelmed, at which point she begins to cry and states that she feels her probation officer is trying to set her up for failure. She concludes with “maybe this is just a waste of time and I should just do my time and get it over with.” Brad Scenario: Brad has been referred to treatment by the local drug court. He has several past drug charges ranging from possession to intent to distribute. He also has several assault and fraud charges. He has most recently been convicted of possession of cocaine. Brad freely admits to use of cocaine and alcohol as well as experimental use of several other substances. However he insists that addiction is just a mindset. He states that he is not addicted because if he wanted to he could stop at any time. Brad shows little emotion throughout the evaluation. His tone remains fairly constant, except for an increase in volume when discussing his legal charges or anything about “the system” as he calls it. In an effort to roll with resistance, you switch direction and begin talking about his personal history. He again shows little emotion but answers the questions presented. W hen asking about his family history his volume again increases when asked who raised him. He states that he raised himself. He says, “my old man beat me the first chance he got” and that his mom would claim that she raised him but that “she was too busy with work and the latest boyfriend.” As you conclude the interview you go through some standard questions to briefly assess the client’s mental status. As part of this process you ask if he has ever been homicidal. He says, “yes.” To determine the client’s level of intent and whether or not he understands what has being asked you ask him to tell you how he defines that word. He flatly states “I wish I had a bullet for the cop that arrested me.” This comment prompted a screening for homicidal ideation and based on that screening it was determined that he is not currently homicidal. However, he indicates that although he would not directly harm the officer he would be pleased to hear that he had been injured or killed. Maxine Scenario: You are familiar with this client because she has been in treatment with your agency on two other occasions. Maxine has recently been convicted of a third DUI. You know from Maxine’s previous treatment episodes that she has had multiple attempts at achieving sobriety but that she also has a history of multiple relapses following periods of

1

Unit 8 Discussion Scenarios

COURSE #

sobriety ranging from a few days to 18 months. Maxine appears embarrassed to be presenting for treatment again. She greets you and emphatically states, I have learned my lesson this time, and I have to “get it” this time because next time I’ll be in DOC instead of here. As her counselor in her last treatment episode you believe that she is genuine in her resolve to achieve and maintain sobriety but wonder what is causing the chronic relapses, so you ask more about her background. You find out that Maxine has had three previous marriages and multiple long term relationships. W hen inquiring about these relationships you begin to sense a pattern as she describes each previous partner with a mixture of admiration and disdain. She then begins to speak of needing another relationship and seems nearly frantic in this discussion. She says that it is important because the other three abandoned her.

2