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Response below discussion post.
Discussion topic: Read Chapters 5 & 6 (Textbook: Capuzzi, D. & Stauffer, M.D.(2020).Foundations of Addictions Counseling, 4th edition. Boston: Pearson.) Watch the video “The Clinical Assessment of Substance Use Disorders-role modeling the initial visit” (also available on YouTube)
For this discussion, respond to the following:
Watch the video “The Clinical Assessment of Substance Use Disorders-role modeling the initial visit” (also available on YouTube) and identify the screening instrument utilized by the provider to assess presenting needs. (The screening instrument is one of those described under “Substance Use Disorder Instruments” in Chapter 6, pp. 124-129.)
Read the Case Study “The Case of Dwayne” in Chapter 9, pp. 198-204. Use the American Society of Addiction Medicine’s biopsychosocial dimensions (Table 5.1) to organize the relevant parts of Dwayne’s case. In your application, you are responding to the italicized questions (found within table 5.1 at the beginning of each dimension.
The provider in the video administered the Substance Abuse Subtle Screening Inventory- 4 (SASSI-4) with the client. The practitioner attempts to subtly examine the motivation behind and frequency of the client’s prescription drug use. She is able to maintain a conversation with the client while gaining information about the client’s drug and alcohol use, and how it impacts her work, home and family life.
Dimension 1: Acute Intoxication and Withdrawal Potential
Dwayne is currently drinking 4-6 beers a night. When he is able to, he drinks a pint of vodka each week. Dwayne also smokes about 5 cigarettes of marijuana each week.
Dimension 2: Biomedical Conditions and Complication
Dwayne is in good physical health and not currently on medication for any recurrent health issues. He is of large, athletic build.
Dimension 3: Emotional, Behavioral and Cognitive Conditions and Complications
Dwayne tends to be impulsive when faced with opportunities to engage in physical altercations. Due to his impulsivity and history of fighting, stealing, truancy and theft, he was diagnosed with an adolescent onset conduct disorder. Dwayne’s propensity for violence and impulsivity began to be apparent before his alcohol use.
Dimension 4: Readiness for Change.
Dwayne is in counseling due to an expulsion; he pulled a knife on a peer which caused him to be removed from school. In order to return to school, Dwayne was ordered to complete three counseling sessions. He completed those sessions and was soon expelled again for an alcohol related infraction. These past occurrences seem to suggest Dwayne is not ready to change his alcohol abuse. Although Dwayne has been able to abstain from alcohol and drug use to receive benefits from his family, he does not seem intrinsically motivated to change. Motivation to change is an important factor in successful drug treatment (DiClemente et al., 1999). Further, Dwayne denies he has an issue with alcohol abuse and expresses he can stop using alcohol when he wants to, despite becoming intoxicated even when he plans to only partake in one or two drinks. Dwayne has experienced many consequences due to his drinking; his expulsions, he has been kicked off of his athletic teams, and his once high GPA has fallen. He has also been in trouble with the law on multiple occasions, including for a pending rape charge, due to his drug and alcohol use.
Dimension 5: Relapse Prevention And Continued Use or Problem Potential
Dwayne has completed a 28 day inpatient alcohol treatment in the past. Due to issues getting to treatment following discharge, he did not complete aftercare. Dwayne has also attended Alcoholics Anonymous meetings, but did not continue the meetings beyond two weeks. Dwayne lives with his mother and seems to be lacking a supportive adult in his household to provide transportation, or access to transportation, to successfully commit to alcohol treatment sessions or meetings.
Dimension 6: Recovery Environment
Dwayne lives with his mother in a majority White neighborhood. Dwayne lacks a positive male figure in his life; his mother has a boyfriend but Dwayne does not like him. Dwayne’s father has been absent from his life for years, and when his father was around, he was physically abusive to Dwayne. Due to Dwayne’s race (African American), he reports feeling out of place in his majority White community. Dwayne’s mother appears to have some potentially emotionally abusive communication with Dwayne, but she is interested in receiving professional help with her parenting. Dwayne’s mother has not been helpful with his continued treatment in the past, but with family therapy, this may change.
DiClemente, C. C., Bellino, L. E., & Neavins, T. M. (1999). Motivation for change and alcoholism treatment. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 23(2), 86–92.