recovery

Client is a Caucasian female D.O.B 11/11/1980 age 33 yrs. Name Taylor Jones current address 55566 Rose Lane Bellflower California 90242. Phone number is (562- 862-2696). Taylor lives with Brother Bob wife Sue, and their 5yr old son. Client has one son age 5yrs old who is currently living with Father. Husband is seeking a divorce from Taylor, and sole custody of son David. Taylor is currently unemployed. Taylor recently lost job due to being late, leaving early and missing too many days. Client attends church every Sunday with brother, and brother’s family. On October 1 2013 Taylor was arrested for possession of a controlled substance methamphetamine, and court order to complete a program by Bellflower Justice Center. First interviewed on 11/15/2013 client admitted to using methamphetamine, but blame her husband for recent arrest. Client said she started using when her father died in January 2011, and has continued until her arrest on 10/1/2013. Client denied having any prior arrest. Client stated that although at first the meth help numbed the pain it was taking more of the drug to numb the pain. Client also stated that when the client tried to stop using the client could not. Client started out snorting the drug, but began smoking for a stronger affect. Clients use has increased over time and is now at 2 grams a day. A check into criminal history revealed two prior arrests, March 7 2012 for driving under the influence of a controlled substance, and May 5 2010 for disorderly conduct. Both arrest resulted in convictions, and have been delt with. Client is currently on calendar for 12/13/2013 for proof of enrollment in a program. During interview client blamed husband for the problems client is having with drugs. When ask why client did not say anything about prior arrest client downplayed her lie, she said she did not think it was a big deal, and it was taken care of. Client has a past history of juvenile hall. Client blames others for her actions that got her in trouble. Client has a history of using meth that started at age 14. Client also has a history of being reckless with no regard for anyone’s safety. She was that teenager that would talk her friends into doing the things that would get them into trouble, and later place the blame on her friends when they would get into trouble for their actions. Client was expelled from the high school she attended for pulling pranks on other students with no regard for their feelings. She was enrolled in a continuation school, but did not graduate, she did time in Juvenile Hall for repeated petty theft, joy riding, and possession of a controlled substance. The controlled substance was meth. Taylor does not have any close personal relationship, and tells lies repeatedly. Taylor uses others for her own gain, and when they are of no use to her she moves on. Taylor does not care who she has to step on to get what she wants she feels she is entitled. Client also lacks remorse as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. Client seems to lack empathy for others as indicated by her behavior. Taylor can be quite charming, and witty, which she uses to her advantage when manipulating others. On 12/15/2015 Taylor Jones was interviewed for second time. When asked about when she stared using methamphetamines she admitted to lying at first interview, and stated she began at age 14.Taylor said she had tried to quit , but has always returned to it shorty after because she did not like the come down. After further conversation with client, it was determined that client met the Criteria for a Diagnosis of Substance Dependence Disorder. It was the observation of the Substance Abuse counselor that Taylor Jones also meets the Criteria for a personality disorders. Antisocial personality disorder, although it is out of the Substance Abuse Counselor’s scope of practice to diagnoses mental disorders it is helpful to gather the information needed for the diagnoses and refer the client to the proper channels to receive the care that is needed. The diagnoses for substance dependence were determined by the criteria given for substance dependence from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association [APA] 1994). Produced by the APA and updated periodically, DSM-IV is used by the medical and mental health fields for diagnosing mental and substance disorders. Substance dependence, as defined in DSM-IV-TR (4th edition, Text Revision; APA 2000 is more serious than abuse This maladaptive pattern of substance use includes such features as increased tolerance for the substance resulting in the need for ever-greater amounts of the substance to achieve the intended effect; an obsession with securing the substance, and with it use; or persistence in using the substance in the face of serious physical or mental health problems. (APA 2000, p 197). The information gathered for Anti-social personality disorder showed that Taylor meets the criteria for anti-social personality disorder. Taylor more than likely had a conduced disordered as a teenager that went undiagnosed. Taylor had more than three things that met the criteria, reckless disregard for the safety of others and self, Lack of remorse, and failure to conform to social norms with the respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. DSM-IV-TR (APA 2000, pp. 701,702,706). The client will have to be closely monitored to see if her symptoms for APD continue after she has been clean from methamphetamine. Substance induced disorders are distinct from co-occurring mental disorders in that all or most of the psychiatric symptoms are the direct result of the substance use. Once the client is not using the substance the sypmtoms could disappear. Personality disorders exspecially APD is one of the hardest disorders to treat. One of the reasons is that people with this disorder do not seek help most of them do not believe anything is wrong with them. The theoretical model utilized for this client would be Cognitive-Behavioral Therapeutic Techniques. Cognitive-Behavioral Therapy (CBT) is a therapeutic approach that seeks to modify negative or self-defeating thoughts and behavior. CBT is aimed at both thoughts and behavior change (i.e., coping by thinking differently and coping by acting differently). One cognitive technique is known as “cognitive reconstructuring.” For example’ a client may think initially, “The only time I feel comfortable is when I’m high, “and learn through the counseling to think instead, “It’s hard to learn to be comfortable socially without doing drugs, but people do so all the time” (TIP 34, Brief Interventions and Brief Therapies for Substance Abuse [CSAT 1999a],pp.64-65). CBT includes a focus on overt, observable behaviors such as the act of taking a drug and identifies steps to avoid situation that lead to drug taking. CBT also explores the interaction among beliefs, values, perceptions, expectation, and the client’s expectations for why events occurred. An underlying assumption CBT is that the client systematically and negatively distorts her view of the self, the environment, and the future (O’Connell 1998). Therefore, a major tenet of CBT is that the person’s thinking is the source of difficulty and that this distorted thinking creates behavioral problems. CBT approaches use cognitive and/or behavioral strategies to identify and replace irrational beliefs with rational beliefs (TIP 42 pp.125). CBT for substance abuse combines elements of behavioral theory, cognitive social learning theory, cognitive theory, and therapy into a distinctive therapeutic approach that helps clients recognize situations where they are likely to use substances, find ways of avoiding those situations and learn better ways to cope with feelings and situations that might have, in the past, led to substance use (Carroll 1998). CBT is an active approach that works most effectively with persons who are stabilized in an acute stage of their substance use and mental disorders. To be effective the client and the counselor must develop rapport and a working alliance. The client problem is assessed extensively and through historical data is collected. Then, collaboratively, dysfunctional automatic thoughts, schemas, and cognitive distortion are identified. Treatment consists of the practice of adaptive skills within the therapeutic environment and in homework sessions. The client with COD is an active participate in treatment, while the role of counselor is that of an educator. The counselor collaborates with the client or group in identifying goals and setting an agenda for each session. The counselor also guides the client by explaining how thinking affects behavior. Clients with COD may need very specific coping skills to overcome the combine challenges of their substance abuse and mental disorder (TIP 42 pp127). Treatment plan for Taylor Jones, client was referred for medical evaluation. Client had a physical, and is in good health. Client was also tested for H.I.V and hepatitis both tests were negative. Clients treatment plan consist of individual counseling, contracting, psychoeducational classes, group therapy, mutual self-help groups, and urine testing. Individual counseling offers the counselor an opportunity to point out client s’ errors without causing them to feel humiliated in the presence of the group. Other issues for individual counseling may include continual relapse management and identity of empathy. Three key words when working with people with APD corral, confront, and consequences. Contracting is essential in working with clients with APD. Without contracts and clear expectations of what is to be done, when, how, and the consequences of failing to comply, the therapeutic relationship can become a constant argument about why something was not done, and why it is unfair to be punished for an infraction or omission. As a general rule, when working with individuals with substance use disorders, and APD, it is advised to put everything in writing. (TIP 42 pp365). Group therapy clients with APD can learn to identify errors not only in their own thinking, but in thinking of others as well as thinking that makes them vulnerable to relapse. Client has group meeting with family and treatment professional as a way of providing collateral data this is sometimes called network therapy. Client has a wonderful support group which consists of two sisters the ladies from church, and recently client began attending Celebrate Recovery a church based recovery group.

Substance Dependence With Co-Occurring disorder

The theoretical model utilized for this client would be Cognitive-Behavioral Therapeutic Techniques. Cognitive-Behavioral Therapy (CBT) is a therapeutic approach that seeks to modify negative or self-defeating thoughts and behavior. CBT is aimed at both thoughts and behavior change (i.e., coping by thinking differently and coping by acting differently). One cognitive technique is known as “cognitive reconstructuring.” For example’ a client may think initially, “The only time I feel comfortable is when I’m high, “and learn through the counseling to think instead, “It’s hard to learn to be comfortable socially without doing drugs, but people do so all the time” (TIP 34, Brief Interventions and Brief Therapies for Substance Abuse [CSAT 1999a],pp.64-65). CBT includes a focus on overt, observable behaviors such as the act of taking a drug and identifies steps to avoid situation that lead to drug taking. CBT also explores the interaction among beliefs, values, perceptions, expectation, and the client’s expectations for why events occurred. An underlying assumption CBT is that the client systematically and negatively distorts her view of the self, the environment, and the future (O’Connell 1998). Therefore, a major tenet of CBT is that the person’s thinking is the source of difficulty and that this distorted thinking creates behavioral problems. CBT approaches use cognitive and/or behavioral strategies to identify and replace irrational beliefs with rational beliefs (TIP 42 pp.125). CBT for substance abuse combines elements of behavioral theory, cognitive social learning theory, cognitive theory, and therapy into a distinctive therapeutic approach that helps clients recognize situations where they are likely to use substances, find ways of avoiding those situations and learn better ways to cope with feelings and situations that might have, in the past, led to substance use (Carroll 1998). CBT is an active approach that works most effectively with persons who are stabilized in an acute stage of their substance use and mental disorders. To be effective the client and the counselor must develop rapport and a working alliance. The client problem is assessed extensively and through historical data is collected. Then, collaboratively, dysfunctional automatic thoughts, schemas, and cognitive distortion are identified. Treatment consists of the practice of adaptive skills within the therapeutic environment and in homework sessions. The client with COD is an active participate in treatment, while the role of counselor is that of an educator. The counselor collaborates with the client or group in identifying goals and setting an agenda for each session. The counselor also guides the client by explaining how thinking affects behavior. Clients with COD may need very specific coping skills to overcome the combine challenges of their substance abuse and mental disorder (TIP 42 pp127). Treatment plan for Taylor Jones, client was referred for medical evaluation. Client had a physical, and is in good health. Client was also tested for H.I.V and hepatitis both tests were negative. Clients treatment plan consist of individual counseling, contracting, psychoeducational classes, group therapy, mutual self-help groups, and urine testing. Individual counseling offers the counselor an opportunity to point out client s’ errors without causing them to feel humiliated in the presence of the group. Other issues for individual counseling may include continual relapse management and identity of empathy. Three key words when working with people with APD corral, confront, and consequences. Contracting is essential in working with clients with APD. Without contracts and clear expectations of what is to be done, when, how, and the consequences of failing to comply, the therapeutic relationship can become a constant argument about why something was not done, and why it is unfair to be punished for an infraction or omission. As a general rule, when working with individuals with substance use disorders, and APD, it is advised to put everything in writing. (TIP 42 pp365). Group therapy clients with APD can learn to identify errors not only in their own thinking, but in thinking of others as well as thinking that makes them vulnerable to relapse. Client has group meeting with family and treatment professional as a way of providing collateral data this is sometimes called network therapy. Client has a wonderful support group which consists of two sisters the ladies from church, and recently client began attending Celebrate Recovery a church based recovery group.