SWL 372 Addictions Take Home Test Please pick one of the case studies and answer all the questions pertaining to the specific case study you picked. Please note do not cut and paste any answers from text book or readings. Please ensure that all definitions are cited in proper APA format. Case 1 Laura Laura is a very successful businesswoman in the high-stress high-powered world of corporate finance. She has been referred to you by the companyâ€™s employment assistance program. Laura presents herself as a no nonsense business professional. She is frank and honest about the events that has brought her to your office. Laura tells you that although she tells herself that she will only have one or two glasses with dinner, she usually finishes the whole bottle. â€œAbout five years ago I started having trouble sleeping and started to take a tranquilizer (5 mg Valium). I normally take one or two pills every two to four times a week to help her sleep through the entire night.â€ In the morning she drinks at least 3 to 4 cups of coffee daily, even on the weekends. She noticed that her sleeping problems developed around the same time her Dad died. He was only in his early 50â€™s and they were very close. His death hit her hard and she says she wanted to give in to a big depression. However, she fought it and lost herself in her work. She makes it a point to work out at least three times a week in the morning before going to work. In addition to the above medications, Laura is also prescribed valium as needed for panic attacks and diet pills (amphetamine congeners) to control her weight, a problem she had since she was a child. Over the last year she has become more reclusive. She can barely make it to business dinners and after-work functions. Lately however, she has noticed that she has been steadily increasing her use of wine. Before, she would only have a few glasses with dinner but now: â€œ….more often than not I finish off the bottle before going to bed. I just canâ€™t seem to stop. A lot of times I will come home and tell myself that Iâ€™ll only have one glass and no more but by the time I go to bed, the bottle is empty and Iâ€™m deciding whether I should open another or not. I never used to drink to excess or take anti-anxiety medication before. Now I canâ€™t seem to stop drinking or taking these â€˜downersâ€™ at social events. I canâ€™t seem to control when I take them and things are happening that Iâ€™m not too happy about. Of course the alcohol adds to my weight problem which then causes me to take more of my Redux. Then I have to increase my Xanax to calm my nerves and also take my Valium to make sure I get a full nights sleep. It has become a very vicious circle. All this has been going on for about a years but last week put the â€œcherry on the pie.â€ Laura tells you that last week she was to meet the firm’s top client at a business luncheon. She could not get out of bed that morning. It took all her willpower to get up and get dressed. As it was, she was still 20 minutes late, “which is inexcusable.” She was so nervous and sick she had to excuse herself in the middle of her presentation. In the bathroom she took another Xanax to calm her nerves. Then at the luncheon she could not stop herself from ordering several glasses of wine and had to be assisted to her car after the meeting was over. “My client spoke to my boss and staff and then canceled his account with me. The next day I met with my boss and he recommended (ordered) I make an appointment with our EAP program (or be terminated.) Iâ€™m really scared. Work is all I have. I canâ€™t afford to blow it. Do you mind if I smoke?” Questions- Case One Laura 1. What would your initial assessment of Laura be? 2. What drugs does Laura seem to be using regularly that may be contributing to her present mental health problems? 3. What would you say Lauraâ€™s main drug of choice is? Based on Lauraâ€™s emotional situation and the medications she is taking, what if any dangers doyou need to be aware of? 4. Based on the information Laura has given you what are some of the negative and physical health, psychological, and social interpersonal effects are? 5. What possible concurrent disorders might Laura have and how would you work with Laura in organizing an integrated approach for a best practice model approach? 6. What might be some consequences of Lauraâ€™s addiction? Please give examples 7. If Laura decided to stop using alcohol by utilizing a abstinence approach how would you go about supporting her as a counsellor? 8. If Laura decided to stop using alcohol by utilizing a harm reduction approach how would you go about supporting her as a counsellor? 9. What is the definition of addictions? And how does Laura fall into this definition? If yes, please can you elaborate on you assessment. Taking into account the consideration criteria for substance use disorder in the DSM-V 10. How does the iceberg theory relate to Lauraâ€™s situation? 11. Please explain the bio-psycho-social-spiritual model in relation to Lauraâ€™s situation. What questions would you still need to ask Laura that you have not received from the case study to best support her? 12. Are there any other issues that you feel may need to be addressed in this case? 13. What classification of substance is Laura using? a) stimulant b) hallucinogens c) depressants Please explain and elaborate on your answer. 14. If you were designing a treatment plan with Laura and it involved motivational interviewing what stage of change would you assess Laura at? What approach in the Motivational Interviewing process would you utilize to support Laura? OR Case Study 2 Suzanne Suzanne has come by the free â€œdrop-inâ€ counseling clinic were you work to get some information and advice. Suzanne is a 18-year-old single woman who has been living with her boyfriend Jack in Toronto for the last four years. She and Jack have been heroin addicted for 2 years. When Suzanne was 10 years old, her father, whom she says was a very heavy drinker, left her mom and the kids and never came back. At 14 she started drinking and smoking marijuana. At 16 she had dropped out of high school and at 18 she moved in with Jack. He introduced her to heroin. She reports using about a 1/2 gram of heroin per day just to be able to function and feel comfortable. In order to pay for the heroin and pay the rent on their apartment, Jack doesnâ€™t work, instead, she works the streets at night. She usually drinks four or five beers each night before going out to work. If she canâ€™t score enough heroin, she will try to score either some Valium to â€œtie me over until I can get some heroin.â€ She says she has tried cocaine but, â€œI really didnâ€™t care for the high all that much.â€ Suzanne tells you that the alcohol and heroin help to calm her nerves and get her through the night. She and Jack are not having sex all that much. When they do make love he never wears a condom. He says thatâ€™s what makes him different from her â€œjohnâ€™sâ€ â€œWhich is true because I wonâ€™t work without a condom.â€ Lately she has noticed that her breasts have become swollen and tender. She also hasnâ€™t had her period in the last 12 weeks. She is pretty sure she is pregnant and knows itâ€™s her boyfriendâ€™s baby. However, sheâ€™s not sure she can stop using dope or work to have the baby even though Jack wants her to keep it. She really confused at what she should do and is her asking for you to help regarding her addiction. â€œI just donâ€™t know what I should do. I really do not want to use drugs anymore?â€ 1. What drug(s) does Suzanne seem to be most addicted to? 2. Addictive behaviour can have negative effects, physical and psychosocial affects in Suzanneâ€™s case what affects does her addiction have on her well-being? 3. If Suzanne decided to stop using substance by attending a twelve step program how you would go about supporting her? 4. If Suzanne decided to stop using substance from a harm reduction approach how would you go about supporting her? 5. What is the definition of addiction according to the DSM-V and does Suzanne fall into this category? Please elaborate on your answer 6. How does the ice-berg theory relate to Suzanneâ€™s situation? 7. Please explain the bio-psycho-social model in relation to Suzanneâ€™s situation what questions would you still need to ask Suzanne and information that you have not received from the case study to best support her in developing a treatment plan? 8. We have studied many aspects of the physical effects of alcohol and other drugs on the body. Please explain what Suzanne might experience with regards to tolerance and withdrawal? 9. What classification of substance is Suzanne using? a) stimulantb) hallucinogens c) depressants. Please explain and elaborate on your answer. 10. Are there any social determinants of health that should be explored with Suzanne? 11. What referrals would you give to her and in what order? 12. What legal issues are more than likely to present themselves in this case if she decides to keep the child? 13. Do you see any issues of your own bias that could affect your judgment in handling this case? Please explain? And how would you work with Suzanne regardless of your bias? 14. If you were designing a treatment plan with Suzanne and it involved motivational interviewing what stage of change would you assess Suzanne at? What approach in the Motivational Interviewing process would you utilize to support Suzanne?
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