Final Project: Scholar Practitioner Project Narrative Case Study Section

Final Project: Scholar Practitioner Project Narrative Case Study Section

IDENTIFYING INFORMATION

Marge C is a 41 year old female, Married to her husband Ken. Marge also has 3 kids ages 10, 12, 16. Marge was a teacher that lost her job due to alcohol reasons. Patient was in a single car accident and got a DUI. Family member and friends determined that they need to intervene and an intervention occurred. Patient went through one week of detox, during the first week in treatment to address the withdrawal and reduce alcohol needs. Presenting problem Client was brought into treatment due to client alcohol usage, it has caused great concern with family and this is client's last straw to correct her addiction. Client was in an alcohol related car accident. Marge was brought into residential treatment and accompanied by her husband Ken, the husband explained to the counselor that he didn't know what else to do. Assessment An initial assessment was completed, as Marge came to the facility and looked disheveled and red eyes from crying. Marge position was turned away from the counselor and avoiding eye contact. Marge is trembling throughout the interview, her mood is up and down. Marge thinks of herself as the victim initially. Marge admits that she has a problem with alcohol and needs to go to rehab. Marge states that she has a lot of stress and she deals with it by drinking. Marge stressors are raising a family, job, and constant depression. Marge tried to stop drinking for a month and attended AA in the month's duration. Marge stated that she started off drinking after 5 a couple of days throughout the week and it progressed to drinking daily. Marge feels guilty and weak because she knows that effects of alcohol. Marge's father and uncle died from alcoholism. ADDICTION HISTORY March went from drinking a glass of wine throughout the week to daily and progressed to every morning and during work.Marge's father and uncle passed away from alcoholism. Marge has blacked out and has gained an increase tolerance over time from days to daily drinking. Marge has lost her job due to her addiction and was in a car accident. Marge attempted to stop drinking and was unsuccessful in maintaining sobriety. When Marge initially entered treatment Marge was at a mild to moderate level of treatment. Marge knew that she needed treatment but she was

3 in denial that she needed to be at the facility and that she would be able to do it on her own. Marge is motivated to begin treatment and go through the process and her family is a motivating factor as she wants to be a better wife and mother. CO-OCCURRING DISORDERS Marge was diagnosed with depression and she has trouble dealing with life's stressors such as her family, job etc. Marge uses alcohol as a coping mechanism. Marge has previously attended AA as well as counseling at the Community Mental Health Clinic. Medical History Marge is diabetic and alcohol has caused complications to Marge's health. Marge is not currently on any psychotic medications. Education Marge has some college education and is a teacher, but is currently unemployed due to alcohol related reasons. Marge does not have any past legal problems other than the current DUI followed by the car accident. Social/Cultural Status Marge believes in a higher power, but client has been facing addiction for so long, she's unsure the higher power will help her. Marge is family oriented and wants to build back a healthy relationship with her friends and family. FAMILY/RELATIONSHIP STATUS Marge has a husband and three kids, Roger is 12 years old, and he has been getting into trouble at school to get parents attention. Carla is the oldest of the kids and she takes care of her younger siblings, she fulfills most of the parental duties. Scotty is the youngest child her uses his sense of humor to keep the family laughing. Ken is the husband he works two jobs to support the family so he is not at home most of the time. Marge's family helps enable Marge's addiction, each family member pays a role. The oldest daughter is the Hero as she takes care of her siblings as she feels obligated. Marge's oldest son could be seen as the scapegoat, his defiant behavior is a displayed reflection of the atmosphere displayed in the home. Marge's youngest son plays the role of the Mascot, where he is uncomfortable in the home environment but uses humor as a coping mechanism and the monetary sense of relief to the family. Ken the husband makes

4 excuses for Marge and her behavior. It is recommended that the family is included in Marge's intervention. Family counseling is also recommended as well as individual counseling sessions. Models of Addiction The Brain disease model, the brain is associated with 3 parts that contribute to addiction. Environmental and social factors help contribute to vulnerability of addiction. The model adopts a medical stand point of addiction and a person's being powerless and that they can't he