Scenario/Case Study: This is a final project (with milestones) in which students will analyze a
scenario of an individual dealing with an addiction in order to explore potential diagnoses that fl
could apply and to articulate a treatment plan for the individual. The goal of this assignment is to
understand how addictions impact the individual, family, community, and/or society This 5
assessment will assess your mastery with respect to the following course outcomes: D Evaluate
major intervention techniques for their efi‘ectiveness in treating addictions D Differentiate between
the physiological and psychological effects of mood-altering substances on behaviors and mental
processes D Analyze addictive behaviors for their social and psychological effects on the individual,
family, community, or society I] Difierentiate between the biological, environmental, and
philosophical perspectives an addiction
Case History 1
Case Study 1 | Case Study 2 | Case Study 3
(Identifying information has been changed in order to maintain confidentiality.)
Identified Client: Robert, 66-year-old male, retired for the past 4 years. He is a husband, father, grandfather, and friend.
Drug of Choice: Alcohol
Initial contact: Harriet, Robert’s adult daughter, made the initial contact asking whether or not Family Intervention might be an option in trying to get her father some help for his drinking problem.
Because this family lives in a large city on the West Coast, the initial interview was done over the phone.
Client History: “The drinking got worse after Robert retired, or maybe I started noticing it more.”
Robert has been married to Colleen for 44 years. They raised 2 daughters, numerous pets, and have lived in the same house for the past 35 years. Some things have changed in their marriage such as they now sleep in separate bedrooms; mostly because of Robert’s drinking.
Robert would begin drinking in the late mornings just as soon as he could get his chores and errands done.
Robert and Colleen began to have less and less to talk about as time went by. Colleen didn’t want to talk to Robert when he had been drinking and it began to seem like he was always drinking. And Robert really didn’t have much to say to Colleen. She was always coming and going and when she did stick around it seemed as though she just had something negative to say about what he was doing or not doing, “have you been drinking?” He felt like all she did was nag.
“The drinking got worse after Robert retired or maybe I started noticing it more” complained Colleen. Robert began to go to bed earlier and earlier. “Now that I look back at it, I think he went off to bed to be able to drink and not have me on his back.”
Some health issues began to arise, complicated by years of drinking. Roberts’ doctor was having him get his blood tested every 3 months to monitor his diabetes and prostrate concerns. The doctor had long ago told Robert to stop drinking.
Harriet (Robert’s daughter) stated that others were concerned about her dads drinking as well.
(A more complete history, not included here, was gathered.)
Intervention Team members: During the course of the initial interview a list of possible intervention participants were discussed over the phone (this is often the case where family members live at a distance from each other). Harriet was asked to contact potential participants and ask them to give the Interventionist a call so they might discuss their concerns and also to see if they would be appropriate members of the intervention team.
Those that called and became part of the team included; older sister Marsha, older brother Franz (living and calling from Sweden), younger brother Bill, wife Colleen, oldest daughter Harriet, younger daughter Liz, nephew Mark, long-time co-worker/friend Arthur and friend Terry. Interviews were conducted and homework assignments given – to write a letter to Robert about their concerns and feelings.
Treatment Program: A residential treatment program was contacted by Harriet. Arrangements were made for admission should Robert agree to go to rehab.
Schedules were arranged and dates set for the upcoming role-play followed the next day by the Intervention.
The Role-Play: The day of the role-play arrived. The team members met at older sister Marsha’s house in the same city in which Robert and Colleen lived. We arrived at Marsha’s at 1:30pm . Over the next four hours we heard from everyone. There was a wide range of emotion and a lot of anxiety about whether or not this would actually work.
Many agreed that Robert was most likely depressed. Some voiced concerns that there were certainly more issues than just the alcohol to be dealt with. “Maybe if his marriage was better he wouldn’t drink so much.” Some were very worried that Robert might get up and walk out.
“Have you ever had someone just walk out?” someone asked. “Rarely” I responded. “But what do we do if he does?” they asked. “What if he tells us all to get the heck out of his house?”
The team talked about the anxiety and solutions were discussed.
People read their letters aloud. Some cried. One person was very angry with Robert. We talked and processed through the feelings and arrived at a shared group conclusion that Robert was killing himself by continuing his drinking behavior.
After years of having to be vigilant for her children’s safety, Harriet stated in her letter that if Robert was unwilling to accept the help being offered through this Intervention and go to the treatment program that she would no longer allow her father to be around his grandchildren. Some team members had strong reactions about her feelings and decision.
By the time the role-play was complete we had heard all the letters, team members had received feedback from others about how their letters sounded, and some received editing suggestions. We decided the order of who would go first to last.
Everyone made the decision to be firm with a willingness to hold the line with Love, Concern, and Respect: to encourage Robert to say yes and go directly to the treatment program.
We addressed all the logistical questions again, making a plan for how Robert would physically get to the treatment program and who would go with him. By the end of the role-play all team members agreed that we had done our best.
We were providing a plan that could succeed. We were collectively offering Robert the opportunity and method to get his life back.
We agreed on a time early the following morning to meet at Robert’s home and have the Intervention.
The Intervention: No one had mentioned to Robert that an Intervention was in the works. We met just down the street from Robert and Colleen’s home at 8:30 am . When we were assembled we walked to the house. We knocked and with Harriet in the lead we went directly in and got seated in the living room. Robert was in the back of the house. By the time he made his way to the living we were all in position.
He looked at us, looked at his wife, and his daughters. I introduce myself.
“Hello Robert, my name is Jerry Wittman and I’m a counselor. I’ve been consulted by your family and friends to help facilitate a family meeting. Everyone has some things to talk with you about, please hear them out. We are going to start with your friend, Arthur.”
One at a time, each read their letters. Tears were shed. Robert cried as well. When the letters were complete, I briefly summarized the intention of the meeting and discussed where and what the treatment program was and that what was being asked of him today was to agree to go to treatment and begin the process of recovery. He said yes.
All congratulated him, gave hugs and prepared for departure to the program.
Within 45 minutes of completing the Intervention, Robert was on his way to Treatment.
Post-Intervention: After Robert had left the house the remaining team members and I sat down and processed through the feelings and thoughts people were experiencing. Team members had previously been given information about self-help (Alanon meetings) and therapist names in their community to follow up with as needed. Immediately family members were encouraged to attend the program’s Family Program. We all agreed to do a check-in via phone in three days.
Since then, I have talked with all the participants. Every single one expressed their gratitude for being part of this process. They’ve said that this has been a very powerful and important event in their lives. Colleen (his wife) and I have talked several times. She says that this has been the hardest and most important thing she has ever done in her life. She followed the recommendations and is attending family week at the program.
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