Substance use abuse.

Instructions:

Over the past decade, cases of substance use and abuse have appeared more prevalent in society. From the mental health perspective, research has shown an increase in cases of substance use and abuse, particularly with adolescents. This increase has prompted further investigation into adolescent risk and resilience factors, as well as accuracy in diagnosis and appropriate treatment plans. Yet, in cases of adolescent substance use and abuse, further investigation is still needed concerning notification rights of parents, legal authorities, and/or case workers.

For this Application, review the client case study in the Learning Resources. Consider the characteristics of the client. Which specific characteristics might you consider important in developing an Axes I through IV diagnosis? Consider your rationale for assigning particular diagnoses on the basis of the DSM-IV-TR. Also, think about what other information or people you may need to include in the assessment in order to make an accurate diagnosis.

Case Study:

Mother and Adolescent visit a counselor. Mother says that for the Axis 4 always doing things on the computer talking in the phone texting he never stops even to eat him never eats much anymore. Adolescent responds: Drink you milk eat your veggies, eat you veggies drink your milk who needs to eat I been eating daily zombies special the fast ones. Mother says that’s not alcohol in the house or drugs we never done that. I think is the music he listens to it; he screaming, and aggressive and angry. The minister is the one that recommend me to come and talk to you the minister thinks that something is going on. Adolescent responds talk about zombies doesn’t do drugs. The counselor asks to the adolescent he is maybe you agree with your mom that you been depresses in the past the adolescent responds: because I was stupid. Mother says you are not stupid. He had to repeat 5th grade he is a year behind his friends at school. Adolescent say they aren’t my friends you heat my friends. Mother says I think you should not be hanging around with boys much older than you.

 

The Assignment (3€“4 pages)

€¢ An Axes I through IV diagnosis of the client in the case study

€¢ An explanation of your rationale for assigning these diagnoses on the basis of the DSM-IV-TR

€¢ An explanation of what other information you might need about the client to make an accurate diagnosis

€¢ A brief description of additional individuals you might include in your assessment and explain why

 

References:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.) (DSM-IV-TR). Washington, DC: Author.

 

Chapter 4, Substance-Related Disorders Hersen, M., & Beidel, D. C. (Eds.). (2012). Adult psychopathology and diagnosis (6th ed.). Hoboken, NJ: John Wiley & Sons.

 

€¢ Helwig, A. A., & Holicky, R. (1994). Substance abuse in persons with disabilities: Treatment considerations. Journal of Counseling & Development, 72(3), 227€“233.  

 

 

 

 

 

SUBSTANCE USE ABUSE; CASE STUDY

DSM-IV-TR multi-axial diagnosis of the client in the case study

 

The DSM-IV-TR is widely used in classifying disorders and illnesses. This system is useful as it gives efficient planning and treatment for different health conditions. It provides the clinicians with a conclusive diagnosis of the intervening factors in psychiatric conditions. In this case therefore this system is employed for the diagnosis of the adolescent and the following results are found (American Psychiatric Association, 2000).

Axis I          307.50         Eating disorder

V62.3          Reading disorder

303.90         Alcohol dependence

Axis II          293              Delirium due to alcohol dependence

Axis III                            None

Axis IV                            Academic problems

 

An explanation of your rationale for assigning these diagnoses on the basis of the DSM-IV-TR.

In axis I, eating disorders, reading disorders and alcohol dependence are the manifest characteristics of the client. Alcohol being the most influential of them combines with the others to cause the client to suffer delirium as shown through the client’s depression and agitation. From the case, no past or present medical condition for the client was presented and so axis III registered no diagnosis of any medical condition. Finally, in Axis IV, the client shows one environmental and psychological problem. This is his inability to excel academically like his peers. This therefore is the root cause of his indulgence in drug and alcohol use.

An explanation of what other information you might need about the client to make an accurate diagnosis

In order to come up with accurate information, I need to know that there could be other factors contributing to the adolescent’s condition. These may not be visible or easily determined. I will therefore need to inquire from the client and the mother before coming up with a conclusive diagnosis (Hersen & Beidel, 2012).

The client’s medical history is necessary. I will find out if the client has a presenting illness and if so, its history will also be useful. Past psychiatric history is as well crucial. This information will help me know how the medical conditions have influenced the individual. A mental health assessment will also be resourceful in determining the individual’s judgment.

Examination of mental state is crucial in finding out the client’s symptoms as well as the degree of impact of the condition. The client’s mood, content, thought, behavior and speech will be analysed in order to give correct diagnosis. Past cases of abuse will also be inquired.

Substance abuse history will show if the client’s condition is a recurring one or not. This will help in giving right kind of treatment. Finally, family history is most important. I will find out about familial diseases in the client’s family, history of substance abuse in the family and details of client’s relationship with parents and siblings. Personal issues such as relationships with schoolmates, early childhood development and adolescence will be of guidance. Family issues such as economic status will also be of great help (Helwig & Holicky, 1994).

A brief description of additional individuals you might include in your assessment and explain why.

In the assessment process, I will not solely depend on the client alone for information gathering. I will however include a number of individuals whom I am sure interact closely with the client. These are individuals who know and better understand the client in person.

The client’s mother will be first on the list. This is a person with whom the client has shared most of his life with. She is therefore in a better position to give a lot of crucial information about their family and different other aspects of the client’s life.

One of the client’s siblings will also be instrumental in providing information that may lead to diagnosis. This will be one who is closest to the client. This way, I understand the client is always at liberty to share innermost feelings and experiences with them.

The client’s best friend will also be on the list. Friends influence each other greatly and so this might help me decipher where and how my client got that kind of influence resulting in his condition.

In conclusion, from this diagnosis, the course of treatment for the client could begin. This multiaxial diagnostic formulation however should be a continuous process that clinicians engage in with skill and right judgment. In as much as it is used today, this system remains subject to revisions in the future.

 

 

References:

 

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders

 

(4th ed., text rev.) (DSM-IV-TR). Washington, DC: Author.

 

Hersen, M., & Beidel, D. C. (Eds.). (2012). Adult psychopathology and diagnosis (6th ed.).

 

Hoboken, NJ: John Wiley & Sons. Chapter 4, Substance-Related Disorders

 

 

Helwig, A. A., & Holicky, R. (1994). Substance abuse in persons with disabilities: Treatment

 

considerations. Journal of Counseling & Development, 72(3), 227€“233.