Partial Fulfillment of Requirements in
Practicum in School Setting
“Case Study of an Individual with
Substance Abuse Disorder”
Mr. John Jamir Benzon R. Aruta
Andagan, Joseph I,
SUBSTANCE – USE DISORDER
Miguel’s symptoms of alcohol dependence started at the same time he learned how to smoke. At the tender age of 14, Miguel started engaging in drinking alcohol with his high school friends, Miguel belongs to a family of eleven children him being the eldest. Unlike any first born, Miguel was not given the attention he should have had. His father worked as an accountant in an electric company in Saudi Arabia while his mother stays at home to look after the eleven of them. Instead of what could have been a light and convenient life, Miguel was deprived of an easy attendance in school. His mother was very expensive in terms of extravagance and was not able to provide for his schooling, making him unable to attend his classes regularly. On his last year in college, he went away to marry the girl he met in Manila. Miguel’s becoming a family man worsened his alcohol dependence. He would often go home late at night, heavy drunk with an empty pocket. For 21 years since his marriage, Miguel kept coming back to his old way of drinking with his friends. During the first few years of his alcohol dependence, he would usually end up angrily shouting at everybody and throwing things inside the house. This incident brought trauma to his wife and three children. These days, he still drinks but has lessen the habit of throwing tantrums over everybody.
CASE FORMULATION USING THE INTEGRATIVE MODEL
The integrative theory of substance-related disorders is based on a diathesis model. The diathesis model integrates several points of view including the link between biological, psychological, and environmental factors. In the case of Miguel’s alcohol dependence, it was observed that he actually experienced a feeling of deprivation regarding his position as the eldest child. Unlike Adler’s theory on birth order, that of Miguel didn’t seem to count. Despite being the eldest, he was deprived of proper education. His parents developed favoritism among them, and he would always feel left out because they were eleven in the family. Miguel had to be independent at an early age. When they were younger, they were not allowed to wake their mother up to ask for money as they are going to school. When they have no money, they have no choice but to be absent. In college Miguel would usually have twenty pesos for transport fare without food. Miguel suffered from epilepsy when he was a little younger. Nobody in the family attended to his health, surprisingly his epilepsy faded when he started having a family of his own. He also had insomnia which he uses as a reason for drinking every night. When Miguel got married, his independence turned into dependence to his wife, his wife did everything in the house while he was jobless and unable to provide for the family. When he finally got a job, Miguel did nothing but to spend his salary in drinking with friends. This was believed to be a manifestation of his desire to feel powerful and capable to do whatever he wants. Indeed, his family suffered greatly from his wrong actions.
TREATMENT GOALS AND PLANNING
Based on the case of Miguel, it was observed that his dependence with alcohol was caused by deprivation in childhood and being sickly as a child. His relationship with his family played an important role in building his disposition. He felt a certain feeling of insecurity with his siblings especially his brother Tony who was able to finish college because of their parents’ great support. Miguel had to face all these feelings of discrimination from his own parents. Even when he had a family of his own, he never felt the support that his parents could have given him. At the time when he got married, his parents were abroad. The focus of the treatment would be to identify the things that impede communication between him and his family. The best thing he could is to submit him to proper treatment. Treatment for alcohol abuse and dependence usually includes group therapy, one or more types of counseling, and alcohol education. You also may need medicine. A 12 step-program often is part of treatment and continues after treatment ends. Treatment does not just deal with alcohol. It will help you manage problems in your daily life so you don’t have to depend on alcohol. You’ll learn good reasons to quit drinking. Treatment helps you overcome dependence, but it doesn’t happen all at once. Recovery from alcohol abuse or dependence-staying sober-is a lifelong process that takes commitment and effort. You may be in group therapy or counseling for a year or more. Recovery helps you to stay sober and adjust to life without alcohol. It helps you avoid a relapse, which happens when you slip up and drink again. Most people relapse, so it’s best to accept it and move on. Your family and friends are affected by your treatment. They can benefit from education, family therapy, or other self-help support groups.
Alcohol abuse means having unhealthy or dangerous drinking habits, such as drinking every day or drinking too much at a time. Alcohol abuse can harm your relationships, cause you to miss work, and make it hard to do the things you need to do. It can lead to legal problems, such as being arrested for disorderly conduct or driving while intoxicated. If alcohol abuse continues, it can lead to alcohol dependence. Alcohol dependence is also called alcoholism. Alcoholics cannot quit drinking or control how much they drink, even when they try to. They are physically and emotionally addicted to alcohol. They often feel like they must drink just to get by. They might drink secretly or hide the amount they drink. Alcohol controls their lives. Over time, alcoholics need to drink more before they can feel the effects of alcohol. They get grouchy or shaky or have other withdrawal symptoms when they are not able to drink or when they try to quit. Over time, drinking too much alcohol can cause or make worse health problems such as heart disease, high blood pressure, stroke, liver disease, gallstones, pancreatitis, and certain types of cancer. If you have trouble with alcohol, cutting back or quitting can help you live a happier, healthier life. While some studies show that moderate drinking may have some health benefits, most doctors do not recommend that you start drinking for your heart or other health reasons. The risks of drinking alcohol usually outweigh any benefits. Many people who have alcohol problems are successful in other areas of their lives, and they might even be able to hide their problem for years. These people often deny that they have a problem. The good news is that when people admit to themselves and others that they have a problem and make a commitment to change, most are able to cut their drinking back to a safe level or quit altogether. It is not clear why some people have problems with alcohol and others do not, although experts know that alcoholism can be passed down in families (genetic links). Experts believe that alcohol problems are also caused by cultural values (such as being part of a group of people who drink a lot) and mental health issues (such as drinking as a way of coping with stress or problems). Addiction to alcohol is not a sign of weakness and does not mean you lack willpower. Alcoholism is a long-term disease, just like asthma or diabetes.