Janet just completed her fourth divorce. She is in her early 30s. Her personal life is in chaos. She has children by three of her former husbands. Janet has struggled with addiction issues over the years including alcohol and drugs. She came from a very difficult family where her parents were alcoholics and often fought with each other. Her uncle sexually abused Janet on more than one occasion when he lived with the family during her early teen years. Janet’s problems with drugs and alcohol began as a teenager. Counseling is a process used to help another person to better handle their problems. When counseling someone you must share mutual trust, respect and understanding. Preferably, counseling is an opportunity to help people perceptively adjust to different situations and help them cope with past experiences.
I selected scenario number two. The personal information I would collect from this client is basic demographic information, personal background such as family, trauma history, history of domestic violence or sexual abuse, marital status, financial situation, health, education, housing status, strengths, resources, and employment. I would also collect family history of mental health problems, client history of mental health problems, any hospitalization, medications, and medication complacent. Gathering this personal information helps me to understand the client’s readiness for change, problem areas weaknesses, and strengths. I would found out in detail the client substance abuse history such as what was the age of first use, primary drug abused and family history of substance use. This information is collected to illuminate the role of substance abuse in maintaining, worsening, and/or interfering with the treatment and therapy. I would also obtain an informed consent from the client.
To counsel this patient effectively I would have to keep an open mind. By remaining open-minded I allow freedom from fixed or preconceived ideas that may hinder the benefits of therapy and affect the outcomes. Enlightenment and knowledge of the outside world is important. Maintaining a dire understanding of how one’s standards, values, assumptions, perceptions, and myths can be projected on clients is imperative to keep in mind. Open-mindedness allows me to accommodate clients’ feelings, attitudes, and behaviors that may be different from my own. It promotes honest communication. Therefore, I don’t have any kind of personal bias counseling this client. Goals for therapy include identify and address the client’s problems. Developing a substance‐free environment.
Help client cope with the emotional distress that the removal of substance abuse can cause. Uses a social‐learning framework to conceptualize drinking and other substance abuse problems. Develop positive reinforcers for abstinence. Enhancing the functioning of the client intimate relationships. Developing effective communication and problem solving skills. Developing relapse prevention skills. Consolidate abstinence by focusing on resolving dysfunctional rules, roles, and alliances such as the sexual abuse and domestic violence from childhood. After sobriety is achieved, deepen intimacy through appropriate expression of suppressed feelings from the sexual abuse. The most important goal of therapy is achieve abstinence from drug and alcohol abuse. This is the most important goal because once sobriety is achieve you can focus on the real problems and issues the client is struggling with that cause her to abuse drugs and alcohol in the first place.
Sociocultural theory focus on stressors in social and cultural environment that influence the use of substance use and abuse. This theory is best for this client because it looks at how environmental influences such as socioeconomic status, employment, family norms, and peer expectations have an impact on a person’s substance use and abuse. Treating substance abuse, according to these theories, requires changing a person’s physical and social environment. Other interventions may involve community‐ and faith‐based activities or participation in self‐help groups, all of which can help the client regain hope and connect with other people.
I would schedule a session each week for a month and then I would reassess the therapy and make changes as need by increasing or decreasing the sessions based on the progress the client has made then continue therapy for 3 to 6 months. I would encourage the client to start to attend a 12 step program. The counseling technique I would use is active listening and note taking. The way to measure effectiveness of therapy is to have a written treatment plan that includes clear and define goals and objectives identified by the client. Discuss these goals and objectives throughout the course of therapy to determine progress and completion of treatment. I can also develop an outcome checklists to track therapy progress, effectiveness, and outcomes.
Anderson, C. (2013). Using the Integrated Developmental Model in a Substance Abuse Practicum. Journal of Teaching in The Addictions, 67. Clarke, P. B., & Myers, J. E. (2012). Developmental counseling and therapy: A promising intervention for preventing relapse with substance-abusing clients. Journal of Mental Health Counseling, 308-321. Koehn, C., O’Neill, L., & Sherry, J. (2012). Hope-Focused Interventions in Substance Abuse Counselling. International Journal of Mental Health & Addiction, 441-452.
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