SlideShare a Scribd company logo
1 of 22
Readings
Enter your MyWalden user name: ([email protected]) and
password (3#icldyoB1) at the prompt.
· Lichtenberger, E. O. Mather, N., & Kaufman, N. L. (2004).
Essentials of assessment report writing. New York, NY:
Wiley. Follow this link the main book title, then select your
chapter from the Table of Contents.
. Chapter 1, “Introduction and Overview”
Focus on the goals of report writing and how the general goals
of any psychological report pertain to individuals facing
addictions.
. Chapter 2, “Technical Aspects of Writing”
Although they are not specific to the addictions field, focus on
the helpful “Don’t Forget” sidebar boxes on eliminating
redundancies, shortening sentences, and other writing tips.
. Chapter 3, “Referral and Background Information”
Focus on critical information and language needed for the
referral and background section of a report as well as the
standard framework for this section of a report, including
common headings. Some of the information refers more to
education settings, but focus on Rapid References 3.6 and 3.7.
· Perkinson, R. R. (2012). Chemical dependency counseling: A
practical guide (4th ed.). Thousand Oaks, CA: SAGE.
. Appendix 6, “Sample Biopsychosocial Interview”
· Enter your MyWalden user name: ([email protected]) and
password (3#icldyoB1) at the prompt.
· Stewart, S. H., & Connors, G. J. (2004/2005). Screening for
alcohol problems: What makes a test effective? Alcohol
Research & Health, 28(1), 5–16.
Focus on which addictions and disorders are and are not
amenable to screening. For your Discussion, focus on the
description of cutoff scores and their meaning and implications
for next steps.
Consider the following scenario:
Terrence is considering next steps for a client, Angela, who has
come for therapy at the family counseling center where he
works. When Angela scheduled her appointment on the
telephone, she had described her concerns with marital
difficulties, insomnia, and depression. During her first session,
however, Terrence noticed that Angela had a very nervous
demeanor, picked at her skin constantly, and had a rasping
cough. When Terrence asked Angela about her employment, she
admitted that she had lost her job and that her husband was
angry about it. She said she was afraid her husband was on the
brink of becoming abusive.
Terrence is not sure what to do first. He suspects Angela might
have a substance addiction, but clearly she has several
interlocking problems, and many are urgent. Should Terrence
administer a screening for addiction or a more general clinical
assessment? If he does decide to administer an addictions
assessment, which of the many that are available should he
choose and why?
Simple Screening Instrument for Substance Abuse Disorders
Figure H-3. Simple Screening Instrument for Substance Abuse
Self-Administered Form
During the past 6 months…
1. Have you used alcohol or other drugs? (Such as wine, beer,
hard liquor, pot, coke, heroin or other opioids, uppers, downers,
hallucinogens, or inhalants.) (yes/no)
2. Have you felt that you use too much alcohol or other drugs?
(yes/no)
3. Have you tried to cut down or quit drinking or using drugs?
(yes/no)
4. Have you gone to anyone for help because of your drinking
or drug use? (Such as Alcoholics Anonymous, Narcotics
Anonymous, Cocaine Anonymous, counselors, or a treatment
program.) (yesB)
5. Have you had any of the following?
• Blackouts or other periods of memory loss
Yes
• Injury to your head after drinking or using drugs
No
• Convulsions, or delirium tremens (“DTs”)
No
· • Hepatitis or other liver problems
No
· Feeling sick, shaky, or depressed when you stopped drinking
or using drugs
Yes
• Feeling “coke bugs,” or a crawling feeling under the skin,
after you stopped using drugs No
• Injury after drinking or using drugs No
• Using needles to shoot drugs No
6. Has drinking or other drug use caused problems between you
and your family or friends? (yes/no)
7. Has your drinking or other drug use caused problems at
school or at work? (yes/no)
8. Have you been arrested or had other legal problems? (Such as
bouncing bad checks, driving while intoxicated, theft, or drug
possession.) (yes/no)
9. Have you lost your temper or gotten into arguments or fights
while drinking or using drugs? (yes/no)
10. Are you needing to drink or use drugs more and more to get
the effect you want? (yes/no)
11. Do you spend a lot of time thinking about or trying to get
alcohol or other drugs? (yes/no)
12. When drinking or using drugs, are you more likely to do
something you wouldn't normally do, such as break rules, break
the law, sell things that are important to you, or have
unprotected sex with someone? (yes/no)
13. Do you feel bad or guilty about your drinking or drug use?
(yes/no)
Now I have some questions that are not limited to the past 6
months.
14. Have you ever had a drinking or other drug problem?
(yes/no)
15. Have any of your family members ever had a drinking or
drug problem? (yes/no)
16. Do you feel that you have a drinking or drug problem now?
(yes/no)
• Thanks for answering these questions.
• Do you have any questions for me?
• Is there something I can do to help you?
Notes: ________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
View in own window
Thanks for filling out this questionnaire.
Scoring for the Simple Screening Instrument for Substance
Abuse
Name/ID No.: ____________________________________ Date:
________________________________
Place/Location:
_____________________________________________________
_____________________
Items 1 and 15 are not scored. The following items are scored as
1 (yes) or 0 (no):
___ 2 ___ 7 ___ 12
___ 3 ___ 8 ___ 13
___ 4 ___ 9 ___ 14
___ 5 (any items listed) ___ 10 ___ 16
___ 6 ___ 11
Total score: ____ Score range: 0-14
Preliminary interpretation of responses:
Score Degree of Risk for Substance Abuse
0-1 None to low
2-3 Minimal
>4 Moderate to high: possible need for further assessment.
Adapted from U.S. Department of Health and Human Services.
(2005). Substance abuse treatment for persons with co-occurring
disorders: A treatment improvement protocol TIP 42 (pp. 509-
511). Washington, DC: Author. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK64197/pdf/TOC.pdf
Book Reference
Perkinson, R. R. (2012). Chemical dependency counseling: A
practical guide (4th ed.). Thousand Oaks, CA: SAGE.
Appendix 6
Sample Biopsychosocial Interview
DATE: 2-2-11
CLIENT NAME: Jane Roberts
DEMOGRAPHIC DATA: This is a 28-year-old single white
female. She is childless. She lives in Sioux, South
Dakota, by herself. She has lived in Watertown for the past 5
years. She has a high school education. She is
self-employed as a beautician at The Cut Above.
CHIEF COMPLAINT: "I could not go on drinking the way I
was. "
HISTORY OF THE PRESENT ILLNESS : This client's father
died when she was very young. She was raised
by an overly demanding alcoholic mother. Her mother had strict
rules and made the client work hard to
keep the house clean. The client never made an emotional
connection with her mother. "I grew up feeling
left out, abandoned, lost, and alone. I think I was loved, but I
was not shown it. " In school, she continued to
feel isolated from her peers. She began drinking during her
early teens. In high school, the client did not
date a lot, but when she did, she fell immediately in love. She
began a series of addictive relationships with
men. In these relationships , she was able to experience the
affection she had always longed for. The client
was "devastated" when her boyfriends would go out with
someone else. She would frantically "keep grasp-
ing" to hold on to these relationships . After high school, the
client had an affair with a married man. This
man was demonstrative in his affection, and this fooled the
client into thinking that he "really loved me." The
client was unable to disengage from this relationship, even
though the man was married and emotionally
and physically abusive. The client's drinking began to increase.
Her tolerance to alcohol increased. She had
blackouts. The client began to use Valium for sleep. Her dose of
Valium has more than doubled. She
currently is drinking at least a six-pack of beer and taking 30
milligrams of Valium every night. The client
currently is suffering from acute alcohol and anxiolytic
withdrawal. Her withdrawal will probably be pro-
tracted because she has been on Valium for 5 years. In
withdrawal, she reports that she feels restless and is
sleeping poorly. The client has few assertive skills and can be
excessively dependent. She enjoys men who
are powerful and controlling. The client has few healthy
relationship skills, and she is dishonest. The client
is accepting of treatment and has a strong desire to get help for
her chemical dependency.
PAST HISTORY: This client was born in Livingston , South
Dakota, on June 28, 1983. She reports a normal
birth and normal developmental milestones . She was raised
with her mother and two younger sisters. Her
father died when she was too young to know him. Her ethnic
heritage is Irish. She describes her home of
origin as "I did not like it. I felt alone." In grade school, "I was
timid, not very outgoing." In high school, "I
was scared to relate. " The client denies ever serving in the
military. Her occupational history includes a
5-year stint as a secretary. She has held her current job as a
beautician for 5 years. She is happily employed .
Sexually, the client is heterosexual. She has a complex history
of addictive relationships with men who have
been abusive both verbally and physically. The client currently
is involved with a new boyfriend. She has
been seeing him for the past few months. She reports that this
relationship is going well. Her friends and
family support her coming into treatment. Spiritually, the client
believes in God. She was raised in the
261
262 CHEMICAL DEPENDENCY COUNSELING
Lutheran faith. She attends church regularly. She denies any
legal difficulties. For strengths, the client
identifies that "I am caring. I get along with people real well. I
think that I am intelligent. " For weakness,
the client states, "I have a drinking problem. " For leisure
activities , the client enjoys biking and jogging. Her
leisure activities have been only mildly affected by her
chemical use.
MEDICAL HISTORY:
• Illnesses: Measles, mumps , chicken pox
• Hospitalizations: None
• Allergies: None
• Medications at present: 5 milligrams of Valium three times a
day for withdrawal
FAMILY HISTORY:
• Father: Age of death, "in his 20s"; cause of death, unknown;
client does not remember her father
• Mother: Age 53, in good health; history of alcoholism;
described as "quiet, demanding"
• Other relatives with significant psychopathology: None
MENTAL STATUS : This is a tall , thin , 28-year-old white
female. She has short, curly light brown hair and blue
eyes. She has a broad smile and a freckled face. She was
dressed in white jeans and a white sweatshirt. Her
sensorium was clear. She was oriented to person, place, and
time. Her attitude toward the examiner was coop-
erative, friendly, and pleasant. Her motor behavior was mildly
restless. The client fidgeted in her chair. She
made good eye contact. Her speech was spontaneous and
without errors. Her affect was mildly anxious. Her
range of affect was within normal limits. Her mood was mildly
anxious. Her thought processes were productive
and goal directed. Suicidal ideation was denied. Homicidal
ideation was denied. Disorders of perception were
denied. Delusions were denied. Obsessions and compulsions
were denied. The client exhibited an above aver-
age level of intellectual functioning. She could concentrate
well. Her immediate, recent, and remote memories
were intact. She exhibited fair impulse control. Her judgment
was fair. She is insightful about her alcohol prob-
lem and is in minimal denial about her drinking. She is in more
denial about her problem with Valium.
Diagnostic Summary
DATE: 2-10-11
CLIENT NAME: Jane Roberts
This is a 28-year-old single white female. She is childless. She
lives in Watertown, South Dakota, by her-
self. She has lived in Sioux Falls for the past 5 years. She has a
high school education. She currently is self-
employed as a beautician. She comes to treatment with a chief
complaint of a drinking problem. The client's
father died when she was very young. She was raised by an
emotionally distant alcoholic mother. Patty grew
up feeling a profound sense of abandonment. All her life, she
has felt empty and lost. She could gain her
mother's approval only by being a hard worker. In grade school,
the client was timid and shy. In high school,
she began a series of addictive relationships with men. Patty
gets love and sex mixed up. She is starved for
attention and affection. She is vulnerable to manipulation. She
had an affair with a married man. Her relation-
ships with men have been dysfunctional and abusive . The client
has few assertive skills. She cannot ask
people for what she wants or share how she feels. She is
dishonest. She lies to get what she wants. Patty
began drinking during her early teens. After high school, her
drinking began to increase. Her tolerance to
alcohol increased. She has had multiple blackouts and has
suffered withdrawal symptoms. She is drinking at
least a six-pack of beer per day. Patty has been taking Valium
for sleep for the past 5 years. She has increased
her tolerance to Valium, and she has more than doubled her
bedtime dose. The client currently is experienc-
ing symptoms of alcohol and Valium withdrawal. She has been
anemic for the past several years. She is being
treated with vitamins . She has cold symptoms and is taking
aspirin and an antihistamine. She has a history
Appendix 6 Sample Biopsychosocial Interview 263
of arthritis , but she exhibits no current symptoms. She has a
history of a heart murmur. The client is highly
mo tivated for treatment, and her relapse potential is low. She is
psychologically minded and is opening up
"'-ell in group. She shows minimal resistance to treatment. Her
current recovery environment is poor. She
has no social support system except for her boyfriend of the
past 2 months. The psychological testing shows
that Patty is emotionally unstable and manipulative. She will
break the rules of society to get her own way.
She will openly defy authority She is suffering from mild
depressive symptoms , and she is experiencing
ignificant daily anxiety These symptoms seem to relate to the
client's chemical dependency
DIAGNOSIS:
Axis I: 303.90 Alcohol dependence
304.10 Anxiolytic dependence
291.80 Alcohol withdrawal
292.00 Anxiolytic withdrawal
Axis II: V 71.09 No diagr:osis Axis II
Axis III: Anemia, mild cold symptoms
Axis IV: Severity of psychosocial stressors, personal illness,
Severity 3 (moderate)
Axis V: Current global assessment of functioning : 50
Highest global assessment of functioning past year: 70
PROBLEM LIST AND RECOMMENDATIONS :
Problem 1: Extended withdrawal from alcohol and Valium, as
evidenced by autonomic arousal and
elevated vital signs
Problem 2: Inability to maintain sobriety outside a structured
program of recovery, as evidenced by cli-
ent having tried to quit using chemicals many times
unsuccessfully
Problem 3: Anemia, as evidenced by a chronic history of low
red cell counts
Problem 4: Upper respiratory infection, as evidenced by sore
throat and rhinitis
Problem 5: Fear of rejection and abandonment , as evidenced by
client feeling abandoned by both her
mother and her father and now clinging to relationships even
when abusive
Problem 6: Poor relationship skills, as evidenced by client not
sharing the truth about how she feels or
asking for what she wants , leaving her unable to establish and
maintain intimate relationships
Problem 7: Dishonesty, as evidenced by client chronically lying
about her chemical use history
Problem 8 : Poor assertiveness skills, as evidenced by client
allowing other people to make important
decisions for h er, inhibiting her from developing a self-directed
program of recovery
Treatment Plan
Problem 1: Inability to maintain sobriety outside a structured
program of recovery, as evidenced by
repeated unsuccessful attempts to remain abstinent as well as
increased tolerance and
withdrawal symptoms
Goal A: Acquire the skills necessary to achieve and maintain a
sober lifestyle.
264 CHEMICAL DEPENDENCY COUNSELING
Objective 1: Patty will discuss three times when she unsu
ccessfully attempted to stop drug and alcohol
use with her counselor by 2-15-11.
Intervention: Assign the client to list three times when she
unsuccessfully attempted to stop
or cut down on her drug and alcohol use , and have her discuss
this in a one-to-one session.
*Responsible professional: Carla Smith, C.C.D.C. , Level II
Objective 2: Patty will verbalize her powerlessness and
unmanageability in group by 2-15-11.
Intervention: Encourage the client to share her powerlessness
and unmanageability in group .
*Responsible professional: Carla Smith, C.C.D .C. , Level II
Objective 3: Patty will verbalize her understanding of her
chemical dependency with her group by 2-15-11.
Intervention: Assign the client to complete her chemical use
history, and encourage her to
share her story in group.
*Responsible professional: Robert Johnson , C.C.D .C. , Level
III
Objective 4: Patty will share her understanding of how to use
Step Two in recovery with her counselor
by 2-20-11.
Intervention: Assign the client to meet with her clergy person to
discuss how to use a
Higher Power in recovery.
*Responsible professional: Father Larry Jackson
Objective 5: Patty will log her meditation daily and will discuss
how she plans to use the Third Step in
sobriety with her clergy person by 2-25-11.
Intervention : The staff will administer medications as ordered
and monitor for side effects .
*Responsible professional: Margaret Roth , RN
Objective 6: Patty will develop a written relapse prevention
plan by 2-30-11.
Intervention: Help the client to develop a written relapse
prevention plan.
*Responsible professional: Carla Smith, C.C.D .C. , Level II
Objective 7: Patty will develop a continuing care plan with her
counselor by 3-5-11.
Intervention: Have the continuing care coordinator help the
client to develop a continuing
care program.
*Responsible professional: Martha Riggs , C.C.D.C., Level I
Problem 2: Chronic fear of abandonment, as evidenced by fear
of losing all interpersonal relationships
CoalE: To alleviate the fear of abandonment by connecting the
client to her Higher Power and her
Alcoholics Anonymous (AA)/Narcotics Anonymous (NA)
support group
Objective 1: In one-to-one counseling, Patty will share her
feelings of abandonment by her parents and
how this relates to her chemical dependency by 2-15-11.
...
Intervention : In a one-to-one session, encourage the client to
share her feelings of aban-
donment by her parents , and help her to connect this to her
chemical dependency.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 2: Patty will share her feelings of fear, loneliness ,
and isolation with her group by 2-20-11 .
Appendix 6 Sample Biopsychosocial Interview 265
Intervention: Assign the client to share her feelings of fear,
loneliness, and isolation in group.
*Responsible professional: Carla Smith, C.C.D .C. , Level II
Objective 3: Patty will discuss her fear that the group will
abandon her and receive feedback from the
group by 2-25-11.
Intervention: In group, encourage the client to share her fears
that the members of the
group will abandon her.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 4: In one-to-one counseling, the client will discuss
accepting her AA/NA group as her new sup-
port system by 2-28-11.
Intervention: Teach the client about how her recovery group can
be her new support system.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 5: Patty will write a letter to her father and mother
telling them how she felt as a child, and
she will share this letter with her counselor and in group by 2-
20-11.
Intervention: Assign the client to write a letter to her father and
mother telling them about
the abandonment she felt as a child, and have her read this letter
to her primary counselor
and the group.
*Responsible professional: Carla Smith, C.C.D .C. , Level II
Problem 3: Poor interpersonal relationship skills, as evidenced
by inability to share emotions, wishes,
and wants with others
Goal C: To develop healthy interpersonal relationship skills
Objective 1: Patty will verbalize an identification of her
problem with relationships with her counselor
by 2-15-11.
Intervention: Teach the client about interpersonal relationship
skills and how her addiction
affected her ability to have healthy relationships.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 2: Patty will ask five treatment peers for something
she wants and share with them how she
feels, keeping a log of each conversation and sharing this with
her counselor by 2-15-11.
Intervention : Assign the client to ask five treatment peers for
something she wants and
share how she feels, and have her log each event and share in a
one-to-one session.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 3: Patty will complete the Addictive Relationships
exercise (see Appendix 12) and share her
understanding of the differences in addictive and healthy
relationships with her counselor
by 2-20-11 .
Intervention: Assign the client to complete the Addictive
Relationships exercise, and teach
her the difference between addictive and healthy relationships.
*Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 4: Patty will use and log 10 "I feel" statements a day
until the end of treatment, and she will
share her daily feeling log with her counselor weekly by 2-25-
11.
266 CHEMICAL DEPENDENCY COUNSELING
Intervention: Assign the client to log 10 feeling statements a
day and to share in one-to-one
sessions.
*Responsible professional: Carla Smith , C.C.D.C. , Level II
Objective 5: Patty will discuss her normal and addictive
relationships with her group by 2-30-11.
Intervention: In group, encourage the client to share her
understanding of addictive relation-
ships and the tools she can use to develop and maintain healthy
relationships in recovery.
*Responsible professional: Carla Smith, C.C.D.C. , Level II
Problem 4: Dishonesty, as evidenced by chronic lying about
chemical use
GoalD: To develop a program of recovery based on rigorous
honesty
Objective 1: Patty will complete the Honesty exercise (see
Appendix 8) and verbalize in group 10 times
when she was dishonest about her chemical use by 2-15-11.
Intervention: Assign the client to complete the Honesty
exercise, and in group have her
verbalize 10 times when she was dishonest about her addiction.
'~Responsible professional: Bill Thompson, MSW
Objective 2: Patty will discuss in group how her alcohol use
contributed to her dishonesty by 2-20-11.
Intervention: In group, have the client discuss the connection
between addiction and
dishonesty.
*Responsible professional: Bill Thompson, MSW
Objective 3: Patty will keep a daily log of the times when she
lies in treatment and will share this log with
her counselor weekly by 2-25-11.
Intervention: Help the client to keep a daily log of the lies she
tells in treatment, and discuss
with her how it feels to lie and how it feels to tell the truth.
'''Responsible professional: Carla Smith, C.C.D.C., Level II
Objective 4: Patty will give a 20-minute speech to her group
about why it is important to be honest in
recovery by 2-25-11.
Intervention: Assign the client to write a 20-minute speech
about why it is important for her
to get honest , and then encourage her to read her paper in
group.
*Responsible professional: Carla Smith, C.C.D.C. , Level II
Objective 5: In a conjoint session with her mother, Patty will
share her chemical use history by 2-30-11.
Intervention: In a family session , have the client share her
chemical use history with her
mother.
'''Responsible professional: Ronda Vocal, L.M.F.T.
Objective 6: Patty will discuss how dishonesty separated her
from her Higher Power with the clergy by
2-20-11.
.. Intervention: Have clergy meet with the client and discuss
how her lies kept her away from her Higher Power .
*Responsible professional: Pastor Steve Schultz
-
Appendix 6 Sample Biopsychosoc ial Interview 267
Problem 5: Poor assertiveness skills, as evidenced by being too
passive and allowing other people to
make important decisions
CoalE: To develop assertiveness skills
Objective 1: In group, Patty will verbalize an identification of
her problem of being passive and will
directly relate her passivity to her chemical use by 2-20-11.
Intervention: The psychologist will help the client to understand
passive traits and how this
relates to addiction.
*Responsible professional: Frank Rockman, PhD
Objective 2: Patty will verbalize an understanding of how her
passive behaviors lead directly to increased
chemical use with her group by 2-15-11.
Intervention: Assign the client to discuss in group how her
passive traits lead to chemical use.
*Responsible professional: Carla Smith, C.C.D.C. , Level II
Objective 3: Patty will practice the assertiveness formula with
two treatment peers per day, keeping a
daily log of each interaction by 2-20-11.
Intervention: The psychologist will teach the client the
assertiveness formula and, using
behavior rehearsal, will role-play several assertiveness
situations.
*Responsible professional: Frank Rockman , PhD
Objective 4: Patty will have weekly individual sessions with the
psychologist in which she will role-play
assertiveness situations by 2-30-11.
Intervention: The psychologist will meet with the client weekly
to role-play assertiveness
situations.
*Responsible professional: Frank Rockman , PhD
ReadingsEnter your MyWalden user name ([email protected]) and.docx

More Related Content

Similar to ReadingsEnter your MyWalden user name ([email protected]) and.docx

If you see it, say it!
If you see it, say it!If you see it, say it!
If you see it, say it!
kilmartinadmin
 
Elim Clinic Newsletter final - Feb15
Elim Clinic Newsletter final  - Feb15Elim Clinic Newsletter final  - Feb15
Elim Clinic Newsletter final - Feb15
Sorika de Swardt
 
Living with Mental Illness - A Student's Guide
Living with Mental Illness - A Student's GuideLiving with Mental Illness - A Student's Guide
Living with Mental Illness - A Student's Guide
meducationdotnet
 
Benchmark Assignment—Risk and Quality Management PaperImagine .docx
Benchmark Assignment—Risk and Quality Management PaperImagine .docxBenchmark Assignment—Risk and Quality Management PaperImagine .docx
Benchmark Assignment—Risk and Quality Management PaperImagine .docx
tangyechloe
 
Healthy Relationships
Healthy RelationshipsHealthy Relationships
Healthy Relationships
jpelgrin
 

Similar to ReadingsEnter your MyWalden user name ([email protected]) and.docx (20)

The pathway to addiction recovery
The pathway to addiction recoveryThe pathway to addiction recovery
The pathway to addiction recovery
 
Lecture 2 Couple assessment: common problems experienced by couple
Lecture 2 Couple assessment: common problems experienced by coupleLecture 2 Couple assessment: common problems experienced by couple
Lecture 2 Couple assessment: common problems experienced by couple
 
Abstinence
AbstinenceAbstinence
Abstinence
 
If you see it, say it!
If you see it, say it!If you see it, say it!
If you see it, say it!
 
Lgbtqi health care experiences in rural settings
Lgbtqi health care experiences in rural settingsLgbtqi health care experiences in rural settings
Lgbtqi health care experiences in rural settings
 
Narcissistic.pptx
Narcissistic.pptxNarcissistic.pptx
Narcissistic.pptx
 
Compassion, Mindfulness, & Child Abuse & Neglect
Compassion, Mindfulness, & Child Abuse & NeglectCompassion, Mindfulness, & Child Abuse & Neglect
Compassion, Mindfulness, & Child Abuse & Neglect
 
Mental Health.pptx
Mental Health.pptxMental Health.pptx
Mental Health.pptx
 
LGBTQIA+ in Healthcare (Med Ethics) FINAL.pptx
LGBTQIA+ in Healthcare (Med Ethics) FINAL.pptxLGBTQIA+ in Healthcare (Med Ethics) FINAL.pptx
LGBTQIA+ in Healthcare (Med Ethics) FINAL.pptx
 
Elim Clinic Newsletter final - Feb15
Elim Clinic Newsletter final  - Feb15Elim Clinic Newsletter final  - Feb15
Elim Clinic Newsletter final - Feb15
 
Case study on conduct disorder
Case study on conduct  disorderCase study on conduct  disorder
Case study on conduct disorder
 
Common psycological cases in clinical practice
Common psycological cases in clinical practiceCommon psycological cases in clinical practice
Common psycological cases in clinical practice
 
Stress and depression
Stress and depressionStress and depression
Stress and depression
 
Lean On Me: Student Life
Lean On Me: Student LifeLean On Me: Student Life
Lean On Me: Student Life
 
Living with Mental Illness - A Student's Guide
Living with Mental Illness - A Student's GuideLiving with Mental Illness - A Student's Guide
Living with Mental Illness - A Student's Guide
 
Project care depression and anxiety
Project care depression and anxietyProject care depression and anxiety
Project care depression and anxiety
 
Benchmark Assignment—Risk and Quality Management PaperImagine .docx
Benchmark Assignment—Risk and Quality Management PaperImagine .docxBenchmark Assignment—Risk and Quality Management PaperImagine .docx
Benchmark Assignment—Risk and Quality Management PaperImagine .docx
 
Healthy Relationships
Healthy RelationshipsHealthy Relationships
Healthy Relationships
 
Healthy and unhealthy relationships
Healthy and unhealthy relationshipsHealthy and unhealthy relationships
Healthy and unhealthy relationships
 
Emotional Wellbeing. HED 44025-001
Emotional Wellbeing. HED 44025-001Emotional Wellbeing. HED 44025-001
Emotional Wellbeing. HED 44025-001
 

More from sodhi3

a able aboutaccomplishaccomplishmentachieveachieving.docx
a able aboutaccomplishaccomplishmentachieveachieving.docxa able aboutaccomplishaccomplishmentachieveachieving.docx
a able aboutaccomplishaccomplishmentachieveachieving.docx
sodhi3
 
A 32-year-old female presents to the ED with a chief complaint of fe.docx
A 32-year-old female presents to the ED with a chief complaint of fe.docxA 32-year-old female presents to the ED with a chief complaint of fe.docx
A 32-year-old female presents to the ED with a chief complaint of fe.docx
sodhi3
 
92 S C I E N T I F I C A M E R I C A N R e p r i n t e d f r.docx
92 S C I E N T I F I C  A M E R I C A N R e p r i n t e d  f r.docx92 S C I E N T I F I C  A M E R I C A N R e p r i n t e d  f r.docx
92 S C I E N T I F I C A M E R I C A N R e p r i n t e d f r.docx
sodhi3
 
A 12,000 word final dissertation for Masters in Education project. .docx
A 12,000 word final dissertation for Masters in Education project. .docxA 12,000 word final dissertation for Masters in Education project. .docx
A 12,000 word final dissertation for Masters in Education project. .docx
sodhi3
 
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
sodhi3
 
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
sodhi3
 
96 Young Scholars in WritingFeminist Figures or Damsel.docx
96    Young Scholars in WritingFeminist Figures or Damsel.docx96    Young Scholars in WritingFeminist Figures or Damsel.docx
96 Young Scholars in WritingFeminist Figures or Damsel.docx
sodhi3
 

More from sodhi3 (20)

A brief description of your employment historyYour career .docx
A brief description of your employment historyYour career .docxA brief description of your employment historyYour career .docx
A brief description of your employment historyYour career .docx
 
A budget is a plan expressed in dollar amounts that acts as a ro.docx
A budget is a plan expressed in dollar amounts that acts as a ro.docxA budget is a plan expressed in dollar amounts that acts as a ro.docx
A budget is a plan expressed in dollar amounts that acts as a ro.docx
 
A 72-year-old male with a past medical history for hypertension, con.docx
A 72-year-old male with a past medical history for hypertension, con.docxA 72-year-old male with a past medical history for hypertension, con.docx
A 72-year-old male with a past medical history for hypertension, con.docx
 
a able aboutaccomplishaccomplishmentachieveachieving.docx
a able aboutaccomplishaccomplishmentachieveachieving.docxa able aboutaccomplishaccomplishmentachieveachieving.docx
a able aboutaccomplishaccomplishmentachieveachieving.docx
 
a brief explanation of the effect of Apartheid in South Africa. Prov.docx
a brief explanation of the effect of Apartheid in South Africa. Prov.docxa brief explanation of the effect of Apartheid in South Africa. Prov.docx
a brief explanation of the effect of Apartheid in South Africa. Prov.docx
 
A 32-year-old female presents to the ED with a chief complaint of fe.docx
A 32-year-old female presents to the ED with a chief complaint of fe.docxA 32-year-old female presents to the ED with a chief complaint of fe.docx
A 32-year-old female presents to the ED with a chief complaint of fe.docx
 
A 4 years old is brought to the clinic by his parents with abdominal.docx
A 4 years old is brought to the clinic by his parents with abdominal.docxA 4 years old is brought to the clinic by his parents with abdominal.docx
A 4 years old is brought to the clinic by his parents with abdominal.docx
 
A 19-year-old male complains of burning sometimes, when I pee.”.docx
A 19-year-old male complains of burning sometimes, when I pee.”.docxA 19-year-old male complains of burning sometimes, when I pee.”.docx
A 19-year-old male complains of burning sometimes, when I pee.”.docx
 
A 34-year-old trauma victim, the Victor, is unconscious and on a.docx
A 34-year-old trauma victim, the Victor, is unconscious and on a.docxA 34-year-old trauma victim, the Victor, is unconscious and on a.docx
A 34-year-old trauma victim, the Victor, is unconscious and on a.docx
 
A 27-year-old Vietnamese woman in the delivery room with very st.docx
A 27-year-old Vietnamese woman in the delivery room with very st.docxA 27-year-old Vietnamese woman in the delivery room with very st.docx
A 27-year-old Vietnamese woman in the delivery room with very st.docx
 
A 25 year old male presents with chronic sinusitis and allergic .docx
A 25 year old male presents with chronic sinusitis and allergic .docxA 25 year old male presents with chronic sinusitis and allergic .docx
A 25 year old male presents with chronic sinusitis and allergic .docx
 
A 500-700 word APA formatted PaperInclude 2 sources on your re.docx
A 500-700 word APA formatted PaperInclude 2 sources on your re.docxA 500-700 word APA formatted PaperInclude 2 sources on your re.docx
A 500-700 word APA formatted PaperInclude 2 sources on your re.docx
 
A 65-year-old obese African American male patient presents to his HC.docx
A 65-year-old obese African American male patient presents to his HC.docxA 65-year-old obese African American male patient presents to his HC.docx
A 65-year-old obese African American male patient presents to his HC.docx
 
A 5-year-old male is brought to the primary care clinic by his m.docx
A 5-year-old male is brought to the primary care clinic by his m.docxA 5-year-old male is brought to the primary care clinic by his m.docx
A 5-year-old male is brought to the primary care clinic by his m.docx
 
92 S C I E N T I F I C A M E R I C A N R e p r i n t e d f r.docx
92 S C I E N T I F I C  A M E R I C A N R e p r i n t e d  f r.docx92 S C I E N T I F I C  A M E R I C A N R e p r i n t e d  f r.docx
92 S C I E N T I F I C A M E R I C A N R e p r i n t e d f r.docx
 
a 100 words to respond to each question. Please be sure to add a que.docx
a 100 words to respond to each question. Please be sure to add a que.docxa 100 words to respond to each question. Please be sure to add a que.docx
a 100 words to respond to each question. Please be sure to add a que.docx
 
A 12,000 word final dissertation for Masters in Education project. .docx
A 12,000 word final dissertation for Masters in Education project. .docxA 12,000 word final dissertation for Masters in Education project. .docx
A 12,000 word final dissertation for Masters in Education project. .docx
 
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
918191ISMM1-UC 752SYSTEMS ANALYSISFall 2019 –.docx
 
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
915Rising Up from a Sea of DiscontentThe 1970 Koza.docx
 
96 Young Scholars in WritingFeminist Figures or Damsel.docx
96    Young Scholars in WritingFeminist Figures or Damsel.docx96    Young Scholars in WritingFeminist Figures or Damsel.docx
96 Young Scholars in WritingFeminist Figures or Damsel.docx
 

Recently uploaded

會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
中 央社
 
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
中 央社
 
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
EADTU
 

Recently uploaded (20)

Basic Civil Engineering notes on Transportation Engineering & Modes of Transport
Basic Civil Engineering notes on Transportation Engineering & Modes of TransportBasic Civil Engineering notes on Transportation Engineering & Modes of Transport
Basic Civil Engineering notes on Transportation Engineering & Modes of Transport
 
demyelinated disorder: multiple sclerosis.pptx
demyelinated disorder: multiple sclerosis.pptxdemyelinated disorder: multiple sclerosis.pptx
demyelinated disorder: multiple sclerosis.pptx
 
PSYPACT- Practicing Over State Lines May 2024.pptx
PSYPACT- Practicing Over State Lines May 2024.pptxPSYPACT- Practicing Over State Lines May 2024.pptx
PSYPACT- Practicing Over State Lines May 2024.pptx
 
male presentation...pdf.................
male presentation...pdf.................male presentation...pdf.................
male presentation...pdf.................
 
Trauma-Informed Leadership - Five Practical Principles
Trauma-Informed Leadership - Five Practical PrinciplesTrauma-Informed Leadership - Five Practical Principles
Trauma-Informed Leadership - Five Practical Principles
 
Climbers and Creepers used in landscaping
Climbers and Creepers used in landscapingClimbers and Creepers used in landscaping
Climbers and Creepers used in landscaping
 
會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽會考英聽
 
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
 
Supporting Newcomer Multilingual Learners
Supporting Newcomer  Multilingual LearnersSupporting Newcomer  Multilingual Learners
Supporting Newcomer Multilingual Learners
 
Major project report on Tata Motors and its marketing strategies
Major project report on Tata Motors and its marketing strategiesMajor project report on Tata Motors and its marketing strategies
Major project report on Tata Motors and its marketing strategies
 
OS-operating systems- ch05 (CPU Scheduling) ...
OS-operating systems- ch05 (CPU Scheduling) ...OS-operating systems- ch05 (CPU Scheduling) ...
OS-operating systems- ch05 (CPU Scheduling) ...
 
e-Sealing at EADTU by Kamakshi Rajagopal
e-Sealing at EADTU by Kamakshi Rajagopale-Sealing at EADTU by Kamakshi Rajagopal
e-Sealing at EADTU by Kamakshi Rajagopal
 
diagnosting testing bsc 2nd sem.pptx....
diagnosting testing bsc 2nd sem.pptx....diagnosting testing bsc 2nd sem.pptx....
diagnosting testing bsc 2nd sem.pptx....
 
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
 
The Story of Village Palampur Class 9 Free Study Material PDF
The Story of Village Palampur Class 9 Free Study Material PDFThe Story of Village Palampur Class 9 Free Study Material PDF
The Story of Village Palampur Class 9 Free Study Material PDF
 
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading RoomSternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
 
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
TỔNG HỢP HƠN 100 ĐỀ THI THỬ TỐT NGHIỆP THPT TOÁN 2024 - TỪ CÁC TRƯỜNG, TRƯỜNG...
 
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
 
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
Transparency, Recognition and the role of eSealing - Ildiko Mazar and Koen No...
 
The Liver & Gallbladder (Anatomy & Physiology).pptx
The Liver &  Gallbladder (Anatomy & Physiology).pptxThe Liver &  Gallbladder (Anatomy & Physiology).pptx
The Liver & Gallbladder (Anatomy & Physiology).pptx
 

ReadingsEnter your MyWalden user name ([email protected]) and.docx

  • 1. Readings Enter your MyWalden user name: ([email protected]) and password (3#icldyoB1) at the prompt. · Lichtenberger, E. O. Mather, N., & Kaufman, N. L. (2004). Essentials of assessment report writing. New York, NY: Wiley. Follow this link the main book title, then select your chapter from the Table of Contents. . Chapter 1, “Introduction and Overview” Focus on the goals of report writing and how the general goals of any psychological report pertain to individuals facing addictions. . Chapter 2, “Technical Aspects of Writing” Although they are not specific to the addictions field, focus on the helpful “Don’t Forget” sidebar boxes on eliminating redundancies, shortening sentences, and other writing tips. . Chapter 3, “Referral and Background Information” Focus on critical information and language needed for the referral and background section of a report as well as the standard framework for this section of a report, including common headings. Some of the information refers more to education settings, but focus on Rapid References 3.6 and 3.7. · Perkinson, R. R. (2012). Chemical dependency counseling: A practical guide (4th ed.). Thousand Oaks, CA: SAGE. . Appendix 6, “Sample Biopsychosocial Interview” · Enter your MyWalden user name: ([email protected]) and password (3#icldyoB1) at the prompt. · Stewart, S. H., & Connors, G. J. (2004/2005). Screening for alcohol problems: What makes a test effective? Alcohol
  • 2. Research & Health, 28(1), 5–16. Focus on which addictions and disorders are and are not amenable to screening. For your Discussion, focus on the description of cutoff scores and their meaning and implications for next steps. Consider the following scenario: Terrence is considering next steps for a client, Angela, who has come for therapy at the family counseling center where he works. When Angela scheduled her appointment on the telephone, she had described her concerns with marital difficulties, insomnia, and depression. During her first session, however, Terrence noticed that Angela had a very nervous demeanor, picked at her skin constantly, and had a rasping cough. When Terrence asked Angela about her employment, she admitted that she had lost her job and that her husband was angry about it. She said she was afraid her husband was on the brink of becoming abusive. Terrence is not sure what to do first. He suspects Angela might have a substance addiction, but clearly she has several interlocking problems, and many are urgent. Should Terrence administer a screening for addiction or a more general clinical assessment? If he does decide to administer an addictions assessment, which of the many that are available should he choose and why? Simple Screening Instrument for Substance Abuse Disorders Figure H-3. Simple Screening Instrument for Substance Abuse Self-Administered Form During the past 6 months… 1. Have you used alcohol or other drugs? (Such as wine, beer, hard liquor, pot, coke, heroin or other opioids, uppers, downers, hallucinogens, or inhalants.) (yes/no)
  • 3. 2. Have you felt that you use too much alcohol or other drugs? (yes/no) 3. Have you tried to cut down or quit drinking or using drugs? (yes/no) 4. Have you gone to anyone for help because of your drinking or drug use? (Such as Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, counselors, or a treatment program.) (yesB) 5. Have you had any of the following? • Blackouts or other periods of memory loss Yes • Injury to your head after drinking or using drugs No • Convulsions, or delirium tremens (“DTs”) No · • Hepatitis or other liver problems No · Feeling sick, shaky, or depressed when you stopped drinking or using drugs Yes • Feeling “coke bugs,” or a crawling feeling under the skin, after you stopped using drugs No • Injury after drinking or using drugs No • Using needles to shoot drugs No 6. Has drinking or other drug use caused problems between you and your family or friends? (yes/no) 7. Has your drinking or other drug use caused problems at school or at work? (yes/no) 8. Have you been arrested or had other legal problems? (Such as bouncing bad checks, driving while intoxicated, theft, or drug possession.) (yes/no) 9. Have you lost your temper or gotten into arguments or fights
  • 4. while drinking or using drugs? (yes/no) 10. Are you needing to drink or use drugs more and more to get the effect you want? (yes/no) 11. Do you spend a lot of time thinking about or trying to get alcohol or other drugs? (yes/no) 12. When drinking or using drugs, are you more likely to do something you wouldn't normally do, such as break rules, break the law, sell things that are important to you, or have unprotected sex with someone? (yes/no) 13. Do you feel bad or guilty about your drinking or drug use? (yes/no) Now I have some questions that are not limited to the past 6 months. 14. Have you ever had a drinking or other drug problem? (yes/no) 15. Have any of your family members ever had a drinking or drug problem? (yes/no) 16. Do you feel that you have a drinking or drug problem now? (yes/no) • Thanks for answering these questions. • Do you have any questions for me? • Is there something I can do to help you? Notes: ________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ View in own window Thanks for filling out this questionnaire. Scoring for the Simple Screening Instrument for Substance Abuse Name/ID No.: ____________________________________ Date: ________________________________ Place/Location:
  • 5. _____________________________________________________ _____________________ Items 1 and 15 are not scored. The following items are scored as 1 (yes) or 0 (no): ___ 2 ___ 7 ___ 12 ___ 3 ___ 8 ___ 13 ___ 4 ___ 9 ___ 14 ___ 5 (any items listed) ___ 10 ___ 16 ___ 6 ___ 11 Total score: ____ Score range: 0-14 Preliminary interpretation of responses: Score Degree of Risk for Substance Abuse 0-1 None to low 2-3 Minimal >4 Moderate to high: possible need for further assessment. Adapted from U.S. Department of Health and Human Services. (2005). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol TIP 42 (pp. 509- 511). Washington, DC: Author. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64197/pdf/TOC.pdf Book Reference
  • 6. Perkinson, R. R. (2012). Chemical dependency counseling: A practical guide (4th ed.). Thousand Oaks, CA: SAGE. Appendix 6 Sample Biopsychosocial Interview DATE: 2-2-11 CLIENT NAME: Jane Roberts DEMOGRAPHIC DATA: This is a 28-year-old single white female. She is childless. She lives in Sioux, South Dakota, by herself. She has lived in Watertown for the past 5 years. She has a high school education. She is self-employed as a beautician at The Cut Above. CHIEF COMPLAINT: "I could not go on drinking the way I was. " HISTORY OF THE PRESENT ILLNESS : This client's father died when she was very young. She was raised by an overly demanding alcoholic mother. Her mother had strict rules and made the client work hard to keep the house clean. The client never made an emotional connection with her mother. "I grew up feeling left out, abandoned, lost, and alone. I think I was loved, but I was not shown it. " In school, she continued to feel isolated from her peers. She began drinking during her early teens. In high school, the client did not date a lot, but when she did, she fell immediately in love. She began a series of addictive relationships with
  • 7. men. In these relationships , she was able to experience the affection she had always longed for. The client was "devastated" when her boyfriends would go out with someone else. She would frantically "keep grasp- ing" to hold on to these relationships . After high school, the client had an affair with a married man. This man was demonstrative in his affection, and this fooled the client into thinking that he "really loved me." The client was unable to disengage from this relationship, even though the man was married and emotionally and physically abusive. The client's drinking began to increase. Her tolerance to alcohol increased. She had blackouts. The client began to use Valium for sleep. Her dose of Valium has more than doubled. She currently is drinking at least a six-pack of beer and taking 30 milligrams of Valium every night. The client currently is suffering from acute alcohol and anxiolytic withdrawal. Her withdrawal will probably be pro- tracted because she has been on Valium for 5 years. In withdrawal, she reports that she feels restless and is sleeping poorly. The client has few assertive skills and can be excessively dependent. She enjoys men who are powerful and controlling. The client has few healthy relationship skills, and she is dishonest. The client is accepting of treatment and has a strong desire to get help for her chemical dependency. PAST HISTORY: This client was born in Livingston , South Dakota, on June 28, 1983. She reports a normal birth and normal developmental milestones . She was raised with her mother and two younger sisters. Her father died when she was too young to know him. Her ethnic heritage is Irish. She describes her home of origin as "I did not like it. I felt alone." In grade school, "I was timid, not very outgoing." In high school, "I was scared to relate. " The client denies ever serving in the
  • 8. military. Her occupational history includes a 5-year stint as a secretary. She has held her current job as a beautician for 5 years. She is happily employed . Sexually, the client is heterosexual. She has a complex history of addictive relationships with men who have been abusive both verbally and physically. The client currently is involved with a new boyfriend. She has been seeing him for the past few months. She reports that this relationship is going well. Her friends and family support her coming into treatment. Spiritually, the client believes in God. She was raised in the 261 262 CHEMICAL DEPENDENCY COUNSELING Lutheran faith. She attends church regularly. She denies any legal difficulties. For strengths, the client identifies that "I am caring. I get along with people real well. I think that I am intelligent. " For weakness, the client states, "I have a drinking problem. " For leisure activities , the client enjoys biking and jogging. Her leisure activities have been only mildly affected by her chemical use. MEDICAL HISTORY: • Illnesses: Measles, mumps , chicken pox • Hospitalizations: None • Allergies: None • Medications at present: 5 milligrams of Valium three times a day for withdrawal FAMILY HISTORY:
  • 9. • Father: Age of death, "in his 20s"; cause of death, unknown; client does not remember her father • Mother: Age 53, in good health; history of alcoholism; described as "quiet, demanding" • Other relatives with significant psychopathology: None MENTAL STATUS : This is a tall , thin , 28-year-old white female. She has short, curly light brown hair and blue eyes. She has a broad smile and a freckled face. She was dressed in white jeans and a white sweatshirt. Her sensorium was clear. She was oriented to person, place, and time. Her attitude toward the examiner was coop- erative, friendly, and pleasant. Her motor behavior was mildly restless. The client fidgeted in her chair. She made good eye contact. Her speech was spontaneous and without errors. Her affect was mildly anxious. Her range of affect was within normal limits. Her mood was mildly anxious. Her thought processes were productive and goal directed. Suicidal ideation was denied. Homicidal ideation was denied. Disorders of perception were denied. Delusions were denied. Obsessions and compulsions were denied. The client exhibited an above aver- age level of intellectual functioning. She could concentrate well. Her immediate, recent, and remote memories were intact. She exhibited fair impulse control. Her judgment was fair. She is insightful about her alcohol prob- lem and is in minimal denial about her drinking. She is in more denial about her problem with Valium. Diagnostic Summary DATE: 2-10-11 CLIENT NAME: Jane Roberts This is a 28-year-old single white female. She is childless. She
  • 10. lives in Watertown, South Dakota, by her- self. She has lived in Sioux Falls for the past 5 years. She has a high school education. She currently is self- employed as a beautician. She comes to treatment with a chief complaint of a drinking problem. The client's father died when she was very young. She was raised by an emotionally distant alcoholic mother. Patty grew up feeling a profound sense of abandonment. All her life, she has felt empty and lost. She could gain her mother's approval only by being a hard worker. In grade school, the client was timid and shy. In high school, she began a series of addictive relationships with men. Patty gets love and sex mixed up. She is starved for attention and affection. She is vulnerable to manipulation. She had an affair with a married man. Her relation- ships with men have been dysfunctional and abusive . The client has few assertive skills. She cannot ask people for what she wants or share how she feels. She is dishonest. She lies to get what she wants. Patty began drinking during her early teens. After high school, her drinking began to increase. Her tolerance to alcohol increased. She has had multiple blackouts and has suffered withdrawal symptoms. She is drinking at least a six-pack of beer per day. Patty has been taking Valium for sleep for the past 5 years. She has increased her tolerance to Valium, and she has more than doubled her bedtime dose. The client currently is experienc- ing symptoms of alcohol and Valium withdrawal. She has been anemic for the past several years. She is being treated with vitamins . She has cold symptoms and is taking aspirin and an antihistamine. She has a history Appendix 6 Sample Biopsychosocial Interview 263
  • 11. of arthritis , but she exhibits no current symptoms. She has a history of a heart murmur. The client is highly mo tivated for treatment, and her relapse potential is low. She is psychologically minded and is opening up "'-ell in group. She shows minimal resistance to treatment. Her current recovery environment is poor. She has no social support system except for her boyfriend of the past 2 months. The psychological testing shows that Patty is emotionally unstable and manipulative. She will break the rules of society to get her own way. She will openly defy authority She is suffering from mild depressive symptoms , and she is experiencing ignificant daily anxiety These symptoms seem to relate to the client's chemical dependency DIAGNOSIS: Axis I: 303.90 Alcohol dependence 304.10 Anxiolytic dependence 291.80 Alcohol withdrawal 292.00 Anxiolytic withdrawal Axis II: V 71.09 No diagr:osis Axis II Axis III: Anemia, mild cold symptoms Axis IV: Severity of psychosocial stressors, personal illness, Severity 3 (moderate) Axis V: Current global assessment of functioning : 50 Highest global assessment of functioning past year: 70
  • 12. PROBLEM LIST AND RECOMMENDATIONS : Problem 1: Extended withdrawal from alcohol and Valium, as evidenced by autonomic arousal and elevated vital signs Problem 2: Inability to maintain sobriety outside a structured program of recovery, as evidenced by cli- ent having tried to quit using chemicals many times unsuccessfully Problem 3: Anemia, as evidenced by a chronic history of low red cell counts Problem 4: Upper respiratory infection, as evidenced by sore throat and rhinitis Problem 5: Fear of rejection and abandonment , as evidenced by client feeling abandoned by both her mother and her father and now clinging to relationships even when abusive Problem 6: Poor relationship skills, as evidenced by client not sharing the truth about how she feels or asking for what she wants , leaving her unable to establish and maintain intimate relationships Problem 7: Dishonesty, as evidenced by client chronically lying about her chemical use history Problem 8 : Poor assertiveness skills, as evidenced by client allowing other people to make important decisions for h er, inhibiting her from developing a self-directed program of recovery
  • 13. Treatment Plan Problem 1: Inability to maintain sobriety outside a structured program of recovery, as evidenced by repeated unsuccessful attempts to remain abstinent as well as increased tolerance and withdrawal symptoms Goal A: Acquire the skills necessary to achieve and maintain a sober lifestyle. 264 CHEMICAL DEPENDENCY COUNSELING Objective 1: Patty will discuss three times when she unsu ccessfully attempted to stop drug and alcohol use with her counselor by 2-15-11. Intervention: Assign the client to list three times when she unsuccessfully attempted to stop or cut down on her drug and alcohol use , and have her discuss this in a one-to-one session. *Responsible professional: Carla Smith, C.C.D.C. , Level II Objective 2: Patty will verbalize her powerlessness and unmanageability in group by 2-15-11. Intervention: Encourage the client to share her powerlessness and unmanageability in group . *Responsible professional: Carla Smith, C.C.D .C. , Level II Objective 3: Patty will verbalize her understanding of her chemical dependency with her group by 2-15-11.
  • 14. Intervention: Assign the client to complete her chemical use history, and encourage her to share her story in group. *Responsible professional: Robert Johnson , C.C.D .C. , Level III Objective 4: Patty will share her understanding of how to use Step Two in recovery with her counselor by 2-20-11. Intervention: Assign the client to meet with her clergy person to discuss how to use a Higher Power in recovery. *Responsible professional: Father Larry Jackson Objective 5: Patty will log her meditation daily and will discuss how she plans to use the Third Step in sobriety with her clergy person by 2-25-11. Intervention : The staff will administer medications as ordered and monitor for side effects . *Responsible professional: Margaret Roth , RN Objective 6: Patty will develop a written relapse prevention plan by 2-30-11. Intervention: Help the client to develop a written relapse prevention plan. *Responsible professional: Carla Smith, C.C.D .C. , Level II Objective 7: Patty will develop a continuing care plan with her
  • 15. counselor by 3-5-11. Intervention: Have the continuing care coordinator help the client to develop a continuing care program. *Responsible professional: Martha Riggs , C.C.D.C., Level I Problem 2: Chronic fear of abandonment, as evidenced by fear of losing all interpersonal relationships CoalE: To alleviate the fear of abandonment by connecting the client to her Higher Power and her Alcoholics Anonymous (AA)/Narcotics Anonymous (NA) support group Objective 1: In one-to-one counseling, Patty will share her feelings of abandonment by her parents and how this relates to her chemical dependency by 2-15-11. ... Intervention : In a one-to-one session, encourage the client to share her feelings of aban- donment by her parents , and help her to connect this to her chemical dependency. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 2: Patty will share her feelings of fear, loneliness , and isolation with her group by 2-20-11 . Appendix 6 Sample Biopsychosocial Interview 265
  • 16. Intervention: Assign the client to share her feelings of fear, loneliness, and isolation in group. *Responsible professional: Carla Smith, C.C.D .C. , Level II Objective 3: Patty will discuss her fear that the group will abandon her and receive feedback from the group by 2-25-11. Intervention: In group, encourage the client to share her fears that the members of the group will abandon her. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 4: In one-to-one counseling, the client will discuss accepting her AA/NA group as her new sup- port system by 2-28-11. Intervention: Teach the client about how her recovery group can be her new support system. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 5: Patty will write a letter to her father and mother telling them how she felt as a child, and she will share this letter with her counselor and in group by 2- 20-11. Intervention: Assign the client to write a letter to her father and mother telling them about the abandonment she felt as a child, and have her read this letter to her primary counselor and the group. *Responsible professional: Carla Smith, C.C.D .C. , Level II
  • 17. Problem 3: Poor interpersonal relationship skills, as evidenced by inability to share emotions, wishes, and wants with others Goal C: To develop healthy interpersonal relationship skills Objective 1: Patty will verbalize an identification of her problem with relationships with her counselor by 2-15-11. Intervention: Teach the client about interpersonal relationship skills and how her addiction affected her ability to have healthy relationships. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 2: Patty will ask five treatment peers for something she wants and share with them how she feels, keeping a log of each conversation and sharing this with her counselor by 2-15-11. Intervention : Assign the client to ask five treatment peers for something she wants and share how she feels, and have her log each event and share in a one-to-one session. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 3: Patty will complete the Addictive Relationships exercise (see Appendix 12) and share her understanding of the differences in addictive and healthy relationships with her counselor by 2-20-11 . Intervention: Assign the client to complete the Addictive
  • 18. Relationships exercise, and teach her the difference between addictive and healthy relationships. *Responsible professional: Carla Smith, C.C.D.C., Level II Objective 4: Patty will use and log 10 "I feel" statements a day until the end of treatment, and she will share her daily feeling log with her counselor weekly by 2-25- 11. 266 CHEMICAL DEPENDENCY COUNSELING Intervention: Assign the client to log 10 feeling statements a day and to share in one-to-one sessions. *Responsible professional: Carla Smith , C.C.D.C. , Level II Objective 5: Patty will discuss her normal and addictive relationships with her group by 2-30-11. Intervention: In group, encourage the client to share her understanding of addictive relation- ships and the tools she can use to develop and maintain healthy relationships in recovery. *Responsible professional: Carla Smith, C.C.D.C. , Level II Problem 4: Dishonesty, as evidenced by chronic lying about chemical use GoalD: To develop a program of recovery based on rigorous honesty
  • 19. Objective 1: Patty will complete the Honesty exercise (see Appendix 8) and verbalize in group 10 times when she was dishonest about her chemical use by 2-15-11. Intervention: Assign the client to complete the Honesty exercise, and in group have her verbalize 10 times when she was dishonest about her addiction. '~Responsible professional: Bill Thompson, MSW Objective 2: Patty will discuss in group how her alcohol use contributed to her dishonesty by 2-20-11. Intervention: In group, have the client discuss the connection between addiction and dishonesty. *Responsible professional: Bill Thompson, MSW Objective 3: Patty will keep a daily log of the times when she lies in treatment and will share this log with her counselor weekly by 2-25-11. Intervention: Help the client to keep a daily log of the lies she tells in treatment, and discuss with her how it feels to lie and how it feels to tell the truth. '''Responsible professional: Carla Smith, C.C.D.C., Level II Objective 4: Patty will give a 20-minute speech to her group about why it is important to be honest in recovery by 2-25-11. Intervention: Assign the client to write a 20-minute speech about why it is important for her to get honest , and then encourage her to read her paper in
  • 20. group. *Responsible professional: Carla Smith, C.C.D.C. , Level II Objective 5: In a conjoint session with her mother, Patty will share her chemical use history by 2-30-11. Intervention: In a family session , have the client share her chemical use history with her mother. '''Responsible professional: Ronda Vocal, L.M.F.T. Objective 6: Patty will discuss how dishonesty separated her from her Higher Power with the clergy by 2-20-11. .. Intervention: Have clergy meet with the client and discuss how her lies kept her away from her Higher Power . *Responsible professional: Pastor Steve Schultz - Appendix 6 Sample Biopsychosoc ial Interview 267 Problem 5: Poor assertiveness skills, as evidenced by being too passive and allowing other people to make important decisions CoalE: To develop assertiveness skills Objective 1: In group, Patty will verbalize an identification of her problem of being passive and will directly relate her passivity to her chemical use by 2-20-11.
  • 21. Intervention: The psychologist will help the client to understand passive traits and how this relates to addiction. *Responsible professional: Frank Rockman, PhD Objective 2: Patty will verbalize an understanding of how her passive behaviors lead directly to increased chemical use with her group by 2-15-11. Intervention: Assign the client to discuss in group how her passive traits lead to chemical use. *Responsible professional: Carla Smith, C.C.D.C. , Level II Objective 3: Patty will practice the assertiveness formula with two treatment peers per day, keeping a daily log of each interaction by 2-20-11. Intervention: The psychologist will teach the client the assertiveness formula and, using behavior rehearsal, will role-play several assertiveness situations. *Responsible professional: Frank Rockman , PhD Objective 4: Patty will have weekly individual sessions with the psychologist in which she will role-play assertiveness situations by 2-30-11. Intervention: The psychologist will meet with the client weekly to role-play assertiveness situations. *Responsible professional: Frank Rockman , PhD