Of the substance disorders, alcohol-related disorders are the most prevalent even though only a small percentage of individuals actually receive help. Recidivism in the substance treatment world is also very high. As research into treatment has developed, more and more evidence shows that genes for alcohol-metabolizing enzymes can vary by genetic inheritance. Women have been identified as particularly vulnerable to the impacts of alcohol. Native Americans, Asians, and some Hispanic and Celtic cultures also have increased vulnerability to alcohol misuse. Even with these developments, treatment continues to spark debate. For many years, the substance use field itself has disagreed with mental health experts as to what treatments are the most effective for substance use disorders and how to improve outcomes. The debate is often over medication-assisted treatment (MAT) versus abstinence-based treatment (ABT). Recently the American Psychiatric Association has issued guidelines to help clinicians consider integrated solutions for those suffering with these disorders. In this Discussion, you consider your treatment plan for an individual with a substance use disorder. To prepare: Read the case provided by your instructor for this week’s Discussion and the materials for the week. Then assume that you are meeting with the client as the social worker who recorded this case. Post  a 300- to 500-word response in which you address the following: Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention). Keep in mind a diagnosis covers the most recent 12 months. Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis. Describe the assessment(s) you would use to validate the client’s diagnosis, clarify missing information, or track her progress. Summarize how you would explain the diagnosis to the client. Explain how you would engage the client in treatment, identifying potential cultural considerations related to substance use. Describe your initial recommendations for the client’s treatment and explain why you would recommend MAT or ABT. Identify specific resources to which you would refer the client. Explain why you would recommend these resources based on the client’s diagnosis and other identity characteristics (e.g., age, sex, gender, sexual orientation, class, ethnicity, religion, etc.). Note: You do not need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the assessment tool and any other resources you use to support your response. Case of Jordan Intake: June 2020 IDENTIFYING/DEMOGRAPHIC DATA: Jordan (31) an.

1. Of the substance disorders, alcohol-related disorders are the
most prevalent even though only a small percentage of
individuals actually receive help. Recidivism in the substance
treatment world is also very high. As research into treatment
has developed, more and more evidence shows that genes for
alcohol-metabolizing enzymes can vary by genetic inheritance.
Women have been identified as particularly vulnerable to the
impacts of alcohol. Native Americans, Asians, and some
Hispanic and Celtic cultures also have increased vulnerability to
alcohol misuse.
Even with these developments, treatment continues to spark
debate. For many years, the substance use field itself has
disagreed with mental health experts as to what treatments are
the most effective for substance use disorders and how to
improve outcomes. The debate is often over medication-assisted
treatment (MAT) versus abstinence-based treatment (ABT).
Recently the American Psychiatric Association has issued
guidelines to help clinicians consider integrated solutions for
those suffering with these disorders. In this Discussion, you
consider your treatment plan for an individual with a substance
use disorder.
To prepare:
Read the case provided by your instructor for this week’s
Discussion and the materials for the week. Then assume that
you are meeting with the client as the social worker who
recorded this case.
Post
a 300- to 500-word response in which you address the
following:

2. Provide the full DSM-5 diagnosis for the client. Remember, a
full diagnosis should include the name of the disorder, ICD-10-
CM code, specifiers, severity, and the Z codes (other conditions
that may need clinical attention). Keep in mind a diagnosis
covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in
the case to the specific criteria for the diagnosis.
Describe the assessment(s) you would use to validate the
client’s diagnosis, clarify missing information, or track her
progress.
Summarize how you would explain the diagnosis to the client.
Explain how you would engage the client in treatment,
identifying potential cultural considerations related to substance
use.
Describe your initial recommendations for the client’s treatment
and explain why you would recommend MAT or ABT.
Identify specific resources to which you would refer the client.
Explain why you would recommend these resources based on
the client’s diagnosis and other identity characteristics (e.g.,
age, sex, gender, sexual orientation, class, ethnicity, religion,
etc.).
Note:
You
do not
need to include an APA reference to the DSM-5 in your

3. response. However, your response should clearly be informed
by the DSM-5, demonstrating an understanding of the risks and
benefits of treatment to the client. You
do
need to include an APA reference for the assessment tool and
any other resources you use to support your response.
Case of Jordan
Intake: June 2020
IDENTIFYING/DEMOGRAPHIC DATA:
Jordan (31) and Sheri (28) are a married Caucasian couple who
live with their sons, Myles (10) and Levi (8), in a two-bedroom
condominium in a middle-class neighborhood. Sheri has
recently found out that she is pregnant with their third child.
Jordan is an Iraq War veteran and employed as a human
resources assistant for the military. Sheri is a special education
teacher in a local elementary school.
CHIEF COMPLAINT/PRESENTING PROBLEM:
Jordan stated that he came to the VA for services only because
his wife had threatened to leave him if he did not get help. Sheri
was particularly concerned about his drinking and lack of
involvement in his sons’ lives.
HISTORY OF PRESENT ILLNESS:
Jordan said that since his return to civilian life 10 months ago
he had experienced difficulty sleeping, heart palpitations, and
moodiness. He described being proud to join the army and
deployed and described himself as upbeat and happy prior to his

4. deployments. He felt that he had to “change” to stay alive there.
Jordan continued that he and his wife had been fighting a lot
and that he drank to take the edge off and to help him sleep,
saying, "Nights are the hardest." Jordan noted that just keeping
his intrusive thoughts at bay took all the energy he could
muster. Jack noted that loud noises, open spaces, and green
lights triggered intrusive memories. He said he was exhausted
from being always alert and looking for potential problems
around him. He told me he always felt on edge and every sound
seemed to startle him when he was not drinking. He shared that
he often thinks about what happened “over there” but tries to
push it out of his mind. The night is the worst time for Jordan,
as he has terrible recurring nightmares of one particular event.
He said he wakes up shaking and sweating most nights.
PAST PSYCHIATRIC HISTORY:
Jordan does not report any significant previous medical history.
SUBSTANCE USE HISTORY:
As a teenager, Jordan used marijuana and drank. He does not
use marijuana now but still drinks. Jordan admitted to drinking
heavily nearly every day, drinking four to five drinks in the
evenings during the week and eight to ten drinks on Saturdays
and Sundays. Sheri told Jordan his drinking had gotten out of
control and was making him mean and distant.
PAST MEDICAL HISTORY:
Jordan is physically fit, but an injury he sustained in combat
sometimes limits his ability to use his left hand. Jordan had
previously visited his primary care physician, Dr. Zoe, where he
was given a prescription of Paxil to help reduce his symptoms
of anxiety and depression. Dr. Zoe recommended that he get
ongoing treatment.

5. FAMILY HISTORY INCLUDING MEDICAL AND
PSYCHIATRIC:
Jordan and Sheri identify as being Jewish and attend a local
synagogue on major holidays. Jordan’s parents are deceased,
and he has a sister who lives outside London. He and his sister
are not very close but do talk twice a year. Sheri is an only
child, and her mother lives in the area but offers little support.
Her mother never approved of Sheri marrying Jordan and thinks
Sheri needs to deal with their problems on her own. The couple
has some friends, but due to Jordan’s recent behaviors, they
have slowly isolated themselves.
CURRENT FAMILY ISSUES AND DYNAMICS (OPTIONAL):
Jordan reported that he was not engaged with his sons at all and
he kept to himself when he was at home. He gave some
examples of having a “hair-trigger temper” with his sons,
especially if they surprised him inadvertently. Jordan spent his
evenings on the couch drinking beer and watching TV or
playing video games. Jordan’s expressed fear of losing his job
and his family if he did not get help.
Jordan worked in an office with civilians and military personnel
and mostly got along with people in the office. Jordan tended to
keep to himself and said he sometimes felt pressured to be more
communicative and social. He was also very worried that Sheri
would leave him. He said he had never seen her so angry before
and saw she was at her limit with him and his behaviors.
Sheri talked about wanting to be able to communicate with
Jordan without feeling that she was “nagging him” or fearful
that she was making him withdraw and that she would “trigger
his anger.” She said that she avoided asking him things or
talking to him for fear it would “set him off” and make him

6. retreat to the basement on his own.
MENTAL STATUS EXAM:
Jordan was well-groomed but appeared somewhat guarded and
anxious. He was coherent and articulate. Speech was at a normal
rate, although the pace was noted to accelerate when he
approached or discussed disturbing content. He denied
depression but admitted anxiety and hyperarousal in situations,
such as when strangers stand close to him in check-out lines.
His affect was somewhat constricted but appropriate to content.
His thought process was coherent and linear. He denied all
suicidal and homicidal ideations but admitted that if startled
“not much thought happens” between the event and his
aggression responses. He had no psychotic symptoms,
delusions, or hallucinations. He had reasonable insight, was
well oriented, and seemed to have average intelligence.