Case Study Formulation Drug and Alcohol

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3. specific strategies

Although it was previously thought that cannabis was not a drug of addiction, it is now recognized that cannabis use can lead to substance dependence, according to the internationally accepted DSM-IV definition of ‘substance dependence’ . .

With this knowledge in mind, Rick could possibly display withdrawal symptoms such as • Irritability
• Frustration
• Anxiety
• Compulsion to smoke Cannabis

1 presenting problem

Rick: Rick appears to have substance use disorder traits; his drug of choice is Cannabis. Rick appears to be in the stage of contemplation:

Although Rick’s motivation is high and he indicates legitimately wants to cease his cannabis use, he is unsure that he will actually be able to stop. Rick appears to have a low self esteem and a lack of confidence in successfully remaining abstinence from cannabis.

Prochaska & Prochaska (1999) argue that contemplators are very ambivalent about changing; they also evaluate the pros as about equal to the cons. This appears to ring true in Rick’s case. Rick could also be hesitant about changing and appears to be unsure if altering his drug use will actually help his life situation at present.

Rick fears he cannot cope without drugs.

2. stage of change

How to help contemplators? Craving evidence. Applying the process that is appropriate to ricks stage of change is important.

Motivational interviewing techniques such as supporting his self- efficacy might be very useful as a specific intervention strategy. Helping Rick to believe that he has the potential to change may become a self fulfilling prophecy. (Miller & Rollnick,(2002)

Behavior change tends to occur when the pros and cons (benefits and costs) of doing a particular thing are weighed up and the costs are seen to be too high. But if the benefits outweigh the costs, the behavior continues. Sometimes a decision or resolution to change behavior is difficult to make and keep because of ambivalence. Rick will be better supported in making his decision regarding change if he is supported in weighing up the costs versus the benefits of his drug use. and sub-consciously made a decision to continue smoking.

As previously stated Rick does want to stop his cannabis use, he just might not know how to. When people struggle to grasp how to change, they may not recover from their extreme behavior problems. (Prochaska& Prochaska, 1999)

Intervention strategies may include:

• Further assessment i
• Refer to psychologist for further counseling and diagnosis.

• Refer to a general practitioner
Referring Rick to a medical professional may be appropriate for diagnosis and treatment for anxiety, depression and or significant mental health concern.

• Marijuana’s Anonymous
Self help group such as Marijuana’s anonymous may help Rick to identify with other Cannabis users. • Referral to drug and alcohol rehabilitation residential facility. • Referral to alcohol and drug services re: harm minimisation programs. • To elevate Rick’s concern with his partner relationship counseling may be in order. •

According to Orford (2000) the excessive appetite model of addiction describes marijuana as the most used psychoactive drug in the world, and withdrawal symptoms are reported to be prevailing among cannabis smokers. With this in mind, this young man’s care plan may be more suited to one of an extensive nature. As opposed, to brief intervention.

Jim orford’s paper based on the excessive appetite model of addiction, describes cannabis as the most used psychoactive drug in the world and that withdrawal symptoms are prevalent among cannabis smokers.

Case: Lesley

This client is in pre- contemplation.

Lesley does not see that her drinking may be affecting her health. For several months now Lesley consumes an average of 8 standard drinks per day. The NHMRC Australian Alcohol Guidelines recommend that to minimize harm:...
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