PCN610 Alcohol Use Treatment Essay
PCN610 Alcohol Use Treatment Essay
Part 1: Using the revised treatment plan completed in Topic 7, complete a discharge summary for your client using the “Discharge Summary” template. This discharge summary should address the following:
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- What behaviors would indicate that the client is sustaining at a healthy baseline?
- How would you determine if Eliza met her treatment goals?
- What factors would determine if the treatment needed to be reevaluated, extended, or possibly referred to another clinician or setting?
- Based on your assessment of current symptomology, does your client, Eliza, need wraparound services, outpatient references, and/or step-down services? (Recommendations should be based on the information gathered for second mandatory evaluation).
- How would you encourage involvement in community-based resources?
Part 2: Write a 700-1,050-word summary statement about your client, Eliza.
Include or address the following in your summary statement:
- Demonstrate whether or not the client met the goals of the treatment plan.
- What specifically contributed to the success of the treatment plan or lack thereof?
- What language would you use to communicate the outcome to the client?
- How would you document the final session?
- Include at least three scholarly references in your paper.
PREVIOUS PAPERS/PLANS SUBMITTED AS WELL
A treatment plan should be considered a working document as it is developed around the problems that the client brings into therapy. As the counseling process develops and progresses, so does the client and with that can bring changes that may require counselors to reassess and update treatment plans to reflect those changes. Perkinson and Perkinson remind us “Treatment planning is a never-ending stream of therapeutic plans and interventions. It is always moving and changing” (Perkinson & Perkinson, 2017,p. 75). The following paper will analyze the recent changes with Eliza and update her treatment plan to reflect the appropriate changes.
Updates to Treatment Plan
Updates to Diagnosis
Recently Eliza was sent back in for a mandatory evaluation after another alcohol related incident where Eliza was found passed out in her dorm and smelling of alcohol. Due to this incident directly following the initial reason for seeking mental health treatment, which also involved alcohol, Eliza will be evaluated for an Alcohol Use Disorder. According to the Diagnostic and Statistics Manual, fifth edition (DSM-5) Alcohol use disorder is defined as a problematic pattern of alcohol use leading to clinically significant impairment or distress as manifested by at least two of the set criteria listed in the DSM occurring in the same year (American Psychiatric Association & American Psychiatric Publishing, 2014). Two symptoms met include “Recurrent alcohol use leading to failure to fulfill major role obligations at work, school, or home” and “Recurrent use of alcohol, despite having persistent or recurring social or interpersonal problems caused or worsened by alcohol” (American Psychiatric Association & American Psychiatric Publishing, 2014, p.491). At this time, the diagnosis for an AUD is listed as mild but without treatment or a commitment to abstain an update in severity could be made. The next step would be to further assess Eliza’s alcohol use, in order to do so I may use the Alcohol Dependency Scale.PCN610 Alcohol Use Treatment Essay
Changes to Treatment Plan
At this time, nothing was taken away from the original treatment plan, however, due to the recent changes in Eliza’s behavior and increased alcohol use two new goals were added along with new interventions. Eliza is at risk for a moderate to severe diagnosis of AUD if her alcohol consumption continues. In addition, Eliza is at risk of being removed from her student-housing situation and could put her academic status at risk as well if her behaviors continue. As Eliza has stated she does not want to leave her dorm or her school, a goal to maintain abstinence from alcohol has been added. To support her in this, the interventions suggested are to work with the counselor in her weekly session on identifying the negative consequences that continued alcohol use could lead to. It is suspected that the AUD may have developed as a coping strategy to the original Adjustment Disorder, Eliza and counselor will need to focus on developing new healthy coping strategies. To increase Eliza’s awareness of AUD and help build a support system it is recommended that she attend group meetings for AUD at the student center every two weeks on Wednesday evenings. With the recent changes, Eliza’s mood has worsened stating that she feels ‘worthless’ because of the mistakes she is making. A goal has been added to improve on her self-worth thr9ough confidence building exercises during her weekly individual counseling sessions. The changes made are both ethically and legally justified as they are in adherence to the current diagnostic standards and as Eliza is still considered a minor not of drinking age.
Potential Barriers to Treatment
With the recent changes in Eliza’s behavior she now has co-occurring disorders, which can be more difficult to treat, and particularly in that one of those is an AUD. In general AUD disorders can be more difficult as we now need to prioritize treating the symptoms of the AUD in order to keep Eliza safe and be able to progress successfully through treatment. However, this can prove difficult as the American Addiction Centers explains “Though the symptoms of one disorder may predate the other, both disorders tend to exacerbate one another, making it impossible to extricate the symptoms caused by one disorder from the other (American Addiction Centers, 2015). In addition, denial and resistance can become barriers with this type of diagnosis making treatment problematic if Eliza is not willing to commit.PCN610 Alcohol Use Treatment Essay
Referral Process
With the recent changes in Eliza’s need and diagnosis a referral could be made for alcohol abuse treatment. In order to make a referral that could work for Eliza I would need to take into consideration her financial means, transportation and current school commitments. Although her mental health is a priority I would be worried about putting more on her plate than she can handle or putting her in a situation where she must chose between attending class or a group. In communicating the need for the referral to Eliza I would explain my scope of practice and why I feel a referral is the best choice for her right now. Recommendations I would make would include a counselor with substance or alcohol abuse experience and group meetings.
References
American Addiction Centers. (2015, October). Co-Occurring Disorders Treatment Guide | American Addiction Centers. Retrieved from https://americanaddictioncenters.org/co-occurring-disorders/
American Psychiatric Association, & American Psychiatric Publishing. (2014). Diagnostic and statistical manual of mental disorders: DSM-5. Washington: American Psychiatric Publishing.
Perkinson, R. R., & Perkinson, R. R. (2017). Treatment Plan. In Chemical dependency counseling: A practical guide (p. 75). SAGE publications.
Treatment Plan
Based on the information collected in Week 4, complete the following treatment plan for your client Eliza. Be sure to include a description of the problem, goals, objectives, and interventions. Remember to incorporate the client’s strengths and support system in the treatment plan. Yellow is original treatment plan and updates have been highlighted green.PCN610 Alcohol Use Treatment Essay
Client: Eliza Doolittle Date: February 5, 2018 Age: 18 DOB: January 2, 2000PCN610 Alcohol Use Treatment Essay
| DSM Diagnosis | ICD Diagnosis |
| Adjustment Disorder (309.28) | F43.23 |
| Alcohol Use Disorder (305.00) Mild | F10.10 |
| Goals / Objectives: | Interventions: | Frequency: |
| □ Mood Stabilization | □ Psychotropic Medication Referral & Consultation □ Journaling
□ Cognitive Behavior Therapy □ Skill Training □ Emotion Recognition – Regulation Techniques |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Anxiety Reduction
Reduce anxiety and increase coping skills in responding to stress and anxiety |
□ Psychotropic Medication Referral & Consultation □ Journaling
□ Cognitive Behavior Therapy □ Skill Training □ Relaxation Techniques |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Reduce Obsessive Compulsive Behaviors | □ Psychotropic Medication Referral & Consultation □ Journaling
□ Cognitive Behavior Therapy □ Skill Training |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Decrease Sensitivity to Trauma Experiences | □ Verbalize Memories Triggers & Emotion
□ Desensitize Trauma Triggers and Memories □ Utilize Healing Model/Support (Mending the Soul) |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Establish and Maintain Eating Disorder Recovery | □ Overcome Denial □ Identify Negative Consequences
□ Menu Planning □ Nutrition Counseling □ Body Image Work □ Healthy Exercise □ Trigger Mngmt Recovery Plan □ CBT |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Maintain Abstinence from substances (Alcohol/Drugs)
Individual therapy for identifying negative consequences Bi-weekly group meetings for Alcoholism prevention/support |
□ Substance Use Assessment
□ Step work □ Overcome Denial □ Identify Negative Consequences □ Commitment to Recovery Program □ Attend Meetings □ Obtain Sponsor |
□ Weekly □ Bi Weekly
□ Monthly □ other: ____________________ □ Group □ Individual □ Family |
| □ Increase Coping Skills
Increase Eliza’s ability to identify every day problems and create solutions that can be accomplished |
□ DBT Skills Training
□ Problem Solving Techniques □ Emotion Recognition & Regulation □ Communication Skills |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Stabilize, Adjustment to New Life Circumstances
Teach Eliza to identify stress triggers and techniques to respond to them.
|
□ Alleviate Distress □ Cognitive Behavior Therapy
□ Stress Management □ Skills Training □ Improve Daily Functioning □ Develop Healthy Supports |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family
|
| □ Decrease/Eliminate Self Harmful Behaviors | □ Cognitive Behavior Therapy □ Skills Training
□ Develop and Utilize Support System |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Improve Relationships | □ Communication Skills
□ Active Listening □ Family Therapy □ Assertiveness □ Setting Healthy Boundaries |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Improve Self Worth | □ Affirmation Work □ Positive Self Talk □ Skills Training
□ Confidence Building Tasks |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Grief Reduction and Healing from Loss | □ Psychoeducation on Grief Process/ Stages
□ Process Feeling □ Emotion Regulation Techniques □ Reading/Writing Assignments □ Develop/Utilize Support |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |
| □ Develop Anger Management Skills | □ Decrease Anger Outbursts □ Emotion Regulation Techniques □ Cognitive Behavior Therapy
□ Increase Awareness/Self Control |
□ Weekly □ Bi Weekly □ Monthly
□ other: ____________________ □ Group □ Individual □ Family |