Denise (not her real name) is a 39-year-old Mexican immigrant in living in the US who was currently laid off from her job because the company she was working for was restructuring. She is married to 40-year-old Mark (not his real name) and the two have two daughters, Cate, 8 years, and Daniels, 4 years, they live in outskirts of Manhattan County. Her 40-year-old husband Mark presented to family services agency of Manhattan with a family problem complaint. The two have been married for 12 years and they have been experiencing several layoffs from their jobs, lately, Mark has been unemployed for quite a while now and he has been unable to provide for the family. Denise has been the bread winner for the family and she has been supporting her family of four with income from her job.
Lately, after losing her job, Denise has started drinking on weekends. Her husband has been complaining about the issue since she has increased the volume of liquor she drinks from a time when she started drinking. To her, it is not a problem because she only drinks on weekends so it doesn't affect her and her family because she's available throughout the week for them. However, according to Mark, Denise has been insensitive to family issues, neglecting her daughters while spending familys savings on weekend drinking sprees that sometimes goes up to Monday mornings. Sometimes her husband thought that she was slowly becoming addicted to alcohol and he confirmed his fears when he took her to Manhattan County Hospital one morning when she injured foot as a result of being tipsy while walking. The doctor on duty attended to her and she was cautioned that she should reduce the volume of alcohol she takes because she was already intoxicated, there was a lot of alcohol content in her blood.
Theories of Treatment
Ideally, treating a person who has the conditions presented in the case above requires different approaches. According to the doctor who attended to her, she has a lot of alcohol content in her blood thus there is a possibility that she is addicted to alcohol and if she is not then she must be about to be addicted to alcohol (Risendal et al, 2017). Having a look at her case in a wide perspective, there is a possibility that she is suffering from stress which might have been brought about as a result of losing her latest job as well as subsequent jobs thus leaving her jobless and frustrated.
On a second look, she must be suffering from stress because shes bearing a sole responsibility of providing for her family as a result of her husband layoff which came before hers. Treating such as person requires both medical and psychological treatment which will enable her to recover and accept the situation that shes currently in. In as far as medical treatment is concerned; she has to be treated for alcoholism, depression, and stress. In as far as alcoholism is concerned, alcoholism treatment theories shows that she may be suffering from Alcohol Use Disorder (AUD) which basically arises when a person consumes large volumes of liquor to the point that they become addicted and unwilling to forego alcohol (Anton et al, 2014). Additionally, AUD patients develop distress where they get distressed by small things and they, in turn, respond by causing physical and emotional harm to others.
Alcohol generally works as a depressant by making a person feel relaxed once they take large volumes of alcohol (Risendal et al, 2017). At the same time, the level of tolerance goes up, if a person used to take a bottle of alcohol they will instead take three or more until either they exhaust the stock or until someone stops them. Medically, such patients are treated by the use of the medicine called methadone where instead of taking alcohol they take a spoonful of methadone which will make them feel the way they feel when they take alcohol but it reduces the uncontrollable urge for alcohol over time until they will eventually have zero dependence on alcohol. The other treatment method is psychological counseling where the patient will book a date with the psychiatrist for counseling. Alcohol Use Disorder often results from the stress or depression that one develops as a result of what happens around them, it can be as a result of abuse, torture, financial distress, or emotional distress among others (Birkenmaier et al, 2015). In such circumstances, individuals develop deep thoughts and since they cannot do anything about their situation they slump into frustration and then depression as a result of continued stress. In order to address the issue of stress, a patient will have to be placed under a counseling plan that will take will last for close to a year depending on the level of depression that one is suffering from.
In other cases, when a patient has a more serious form of depression which often results from the damage to brain cells, they have to be under methadone for more than a year. In the case of Denise, her case is not a serious AUD case because it is not long since her addiction problem began and it can only be treated with methadone and counseling for a period not exceeding four months. In as far as counseling is concerned, her husband will have to be present because he will be the one to monitor her to ensure that she doesn't slip back into addiction rather while at the same time she has to be put under social services so that her worry of income can be alleviated. The treatment approach for this case is multifaceted and it entails various approaches, both medical and non-medical, which will go a long way in ensuring that the patient receives the best treatment that they can possibly obtain.
Process Excerpt
One process that will be applicable and perhaps most effective in treating Denise's case is the counseling psychology because of stress that resulted from job loss. In most cases, psychologically disturbed people or patients have their root cause in their daily lives and it always results from factors such as abuse, financial distress, emotional harm or even physical harm. In the case of Denise, her problem is not so serious because it has not graduated into a depression rather it is still considered to be a stress which if not addressed it will lead to depression in the future. The treatment process will be done on phases where she will have to report progress to the counselor from time to time with regards to her progress, at the same time Mark; her husband will have to be part of the treatment as a support since it will need someone she can be with while undertaking the whole treatment (Birkenmaier et al, 2015). The treatment will not involve the use of drugs and it will be purely undertaken through counseling sessions.
The first session will involve an interview of the patient and a close family member, who in this case it will be her husband, so as to establish when the problem started, the possible cause of the disease as well as identification of factors that might aggravate the situation. after the first session, the patient will be taken through various sessions some she may attend with her husband while others she may attend alone because progress will be recorded as accounted by the patient and the close family member, the husband. Finally, the patient will undergo the last session of counseling having been monitored all through the other sessions and the progress recorded while ensuring that eliminate factors that result in the worsening of the disease (Booth, 2015). A decision will then be made either to discharge the patient or to refer her to seek other means of treatment which may include a combination of both counseling and medicine or medicines alone. A decision will be made based on the outcome that will be recorded in the course of counseling.
Rationale
The rationale for using counseling as opposed to other means of treatment in the case of Denise is informed by various factors such as; the cause of the disease, the level of illness, the most effective approach or method that has worked in such cases among others. In the case of Denise, the cause of the disease is the most encompassing rationale which determines the process of treatment to a large extent (Literrel, 2014). Patients suffering from Alcohol Use Disorder (AUD) which is often referred to as addiction suffer develop the problem as a result of a problem that they are either going through or a problem that they had undergone in the past but it is still disturbing them. AUD mostly results from stressing factors which makes the patient nervous thus they resort to alcohol so as to cool their nerves and make them relax from the pressure that they are going through (Koob, 2015).
On the same note; the use of counseling is the most effective form of treatment that can be accorded to patients of Denises caliber since their drinking disease has not reached levels where it requires the use of medicine to treat, rather counseling is the best intervention because she is a person who recognizes the fact that her problem is becoming a problem to those who are close to her. Secondly, counseling seeks to address the root cause of the problem by interrogating the issues that led to the present condition, through interrogation, the causative issues can be well addressed and in the process, the patient will feel relieved of the problems that make them stressed of distressed (Holloway, 2014). Lastly, AUD cases are highly treatable owing to the fact that they result from environmental factors that can be addressed.
Process with the client
In as far as the client is concerned, she is a person whose problem is not serious to the point that it warrants one to be careless and a drunkard rather her problem can be addressed and she can lead a normal life (Risendal et al, 2017). I feel that counseling will be very impactful in her case and she will be able to heal and lead a normal life since she has a supportive family.
Clients Progress
In as far as counseling treatment is concerned, Denise's case ought to be addressed and be fully treated through the right application of the process. In most cases, the use of counseling in as far as AUD disease is concerned results in 80% success rates and 20% failures (Monsen et al, 2017). In the case of 20% failure, the patient is admitted to other programs such as the medical approach where they will be put under special tablets. In the case of Denise perhaps from the first counseling session to the last one, she will become fully treated because her case is not serious because the root cause of her problem can be identified and it can be rectified as well (Grinnell et al, 2015). It is the expectation of the counselor that in the first counseling session, the patient will be able to open up and perhaps explain the issues that she thinks stress her or trouble her.
After establishing the root cause that led to the disease the counselor is expected to seek various means of addressing the issues that are affecting the client while looking for various alternatives that the client is willing to pursue so as to address her issues. Therefore, in the course of counseling, the patient will be expected to have reached an agreement with regards to what she can do so as to address the issue that is affecting her. Lastly, at the end, the patient and the counselor will settle on the best means of addressing the issue through the support of close family member and then if everything goes well based on the progress of the counseling the counselor can call off counseling.
References
Anton, R. F., Schacht, J. P., & Book, S. W. (2014). Pharmacologic treatment of alcoholism. Handbook of clinical neurology, 125, 527-542.
Birkenmaier, J., Berg-Weger, M., & Dewees, M. P. (2014). The practice of generalist social work. Routledge.
Booth, R. (2014). Competency In Clinical Social Work. BookBaby.
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