Laura is a very successful businesswoman in the high-stress high-powered world of corporate finance. She has been referred to you by the company’s employment assistance program. Laura presents herself as a no nonsense business professional. She is frank and honest about the events that has brought her to your office. Laura tells you that although she tells herself that she will only have one or two glasses with dinner, she usually finishes the whole bottle. “About five years ago I started having trouble sleeping and started to take a tranquilizer (5 mg Valium?) I normally take one or two pills every two to four times a week to help her sleep through the entire night.” In the morning, she drinks at least 3 to 4 cups of coffee daily, even on the weekends. She noticed that her sleeping problems developed around the same time her Dad died. He was only in his early 50’s and they were very close. His death hit her hard and she says she wanted to give in to a big depression. However, she fought it and lost herself in her work. She makes it a point to work out at least three times a week in the morning before going to work. In addition to the above medications, Laura is also prescribed Xanax? as needed for panic attacks and diet pills (amphetamine congeners) to control her weight, a problem she had since she was a child. Over the last year she has become more reclusive. She can barely make it to business dinners and after-work functions. Lately however, she has noticed that she has been steadily increasing her use of wine. Before, she would only have a few glasses with dinner but now “....more often than not I finish off the bottle before going to bed. I just can’t seem to stop. A lot of times I will come home and tell myself that I’ll only have one glass and no more but by the time I go to bed, the bottle is empty and I’m deciding whether I should open another or not. I never used to drink to excess or take anti-anxiety medication before. Now I can’t seem to stop drinking or taking these ‘downers’ at social events. I can’t seem to control when I take them and things are happening that I’m not too happy about. Of course, the alcohol adds to my weight problem which then causes me to take more of my Redux. Then I have to increase my Xanax to calm my nerves and also take my Valium to make sure I get a full night’s sleep. It has become a very vicious circle. All this has been going on for about a year but last week put the “cherry on the pie.” Laura tells you that last week she was to meet the firm's top client at a business luncheon. She could not get out of bed that morning. It took all her willpower to get up and get dressed. As it was, she was still 20 minutes late, "which is inexcusable." She was so nervous and sick she had to excuse herself in the middle of her presentation. In the bathroom, she took another Xanax? to calm her nerves. Then at the luncheon she could not stop herself from ordering several glasses of wine and had to be assisted to her car after the meeting was over. "My client spoke to my boss and staff and then canceled his account with me. The next day I met with my boss and he recommended (ordered) I make an appointment with our EAP program (or be terminated.) I’m really scared. Work is all I have. I can’t afford to blow it. Do you mind if I smoke?"Case Questions (provide a detailed response to each question based on the information provided and your reading of the text and film.1. What would your initial assessment of Laura be?2. What would you say Laura’s main drug of choice is and do you think she will need to be placed in a detoxification program to address this problem?3. Based on Laura’s emotional situation and the medications she is taking, what if any dangers do you need to be aware of?4. Based on the information Laura has given you who would you need to contact to advise them of Laura’s situation and what would you need from Laura to make these contacts?5. If Laura’s boss calls your office to find out how Laura is doing how would you respond to his inquiry? What are his rights to know if Laura did keep her appointment with you?6. What possible dual diagnosis issue(s) might Laura have and how would you do to confirm this possibility.7. Are there any other issues that you feel may need to be addressed in this case?

Respond to two of your colleague’s postings in one or more of the following ways:Ask a probing question.Share an insight gained from having read your colleague’s posting.Offer and support an opinion.Make a suggestion.Expand on your colleague’s postingUse Reference.DB 1—Akebia—Post a brief description of the disruptive behavior you selected, and explain one way your reactions might positively or negatively influence the development of a therapeutic relationship with that child or adolescent. Blaming adolescence. In the video, the client was blaming his parents and one of his schoolmates for his behavior. He took no accountability for the things he has done. According to American Psychiatric Association, disruptive, impulsive-control, and conduct disorders refer to a group of disorders that include oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania, and pyromania. These disorders can cause people to behave angrily or aggressively toward people or property and they may have difficulty controlling their emotions and behavior (American Psychiatric Association). When I heard the client blame other people for his behavior, the first thing came to thought is that he doesn't know better and my facial reaction was shocking. I think that my reaction to the client can bring on a negative therapeutic relationship. The client might think that I am being judgemental and that I am not there to help but to judge him for things he has done. Then, explain one way you might transform a negative reaction into an appropriate therapeutic response and how. Be specific and use examples.One way I can transform a negative reaction into an appropriate therapeutic response is by apologizing to the client and letting them know that I am here for them and that they can trust me throughout the process to deliver professional service. For example, if the client notices my negative reaction and reacts to it by becoming silent, I can reassure the client that whatever is said in this room is between the both of us and that my reaction from here on out will be appropriate. Natwick, (n.d), explains that negative feelings sometimes can be important information in the clinical conceptualization of the client and can be useful information for counselors in other ways. According to Natwick, (n.d), for instance, do they have a bias of which they were previously unaware, do they need further education and training, can this reaction help in forming a treatment plan that will better fit their client's needs? Natwick (n.d), also explains that counselors should periodically check in with themselves to examine all their feelings towards clients because these feelings can be useful signals to seek additional education or training. ReferencesNatwick, J. (n.d.). I don’t like my client: The ethics of handling negative ... Retrieved from https://www.counseling.org/docs/default-source/eth... American Psychiatric Association What Are Disruptive, Impulse-Control and Conduct Disorders? (2018, January). Retrieved from https://www.psychiatry.org/patients-families/disru...DB 2Crystal—Disruptive behaviors found in children and adolescents can be the result of various factors. Some experiences make children/adolescents more susceptible in developing disruptive behaviors such as exposure to violence, maltreatment, harsh/inconsistent parenting, or living with a caretaker who has mental health or substance abuse issues (Centers for Disease Control and Prevention, n.d). One disruptive behavior is anger. Anger or aggression in child has been linked to a history of spanking (Hamblin, 2017) and seeing media violence (Taggart, Eisen & Lillard, 2019). Excessive anger in children/adolescents can be accompanied by mental health issues. Some common disorders that go along with anger is oppositional defiant disorder (ODD), Conduct disorder (CD) and Disruptive mood dysregulation disorder (DMDD) (Yale Medicine, n.d).In working with angry children or adolescents, social workers need to watch how they respond. The anger that the client is displaying is not about the social workers and the social worker should not take the anger personally. Responding to the anger can negatively affect a therapeutic relationship. For example, if a client says, “I hate counselors and I am not going to talk to you,” a negative response would be “how can you hate me if you do not know me.” By responding to the client in this way, the social worker made the conversation about them and not the client. Instead, a social worker should validate the client’s feelings and be empathic to what the client is saying. Children who show disruptive behaviors are often only notice by their negative behaviors. A social worker can instead respond by saying, “yeah, I would have difficulty talking to someone I didn't know, but I am only here to help you. You don’t have to talk if you don’t want to, I wouldn't ask you to do something you didn't want to do…” The social worker can also bring up some positive attributes of the client, from what others have told the social worker. Bring up positive attributes, lets the client know that the social worker see more than just the negative behaviors which can positively affect the therapeutic relationship. ReferencesCenters for Disease Control and Prevention. (n.d). Children’s Mental Health. Behavior or Conduct Problems. Retrieved from https://www.cdc.gov/childrensmentalhealth/behavior...Hamblin, J. (2017, December 11). How spanking affects later relationships. The Atlantic. Retrieved from https://www.theatlantic.com/family/archive/2017/12...Taggart, J., Eisen, S., & Lillard, A. S. (2019). The current landscape of US children’s television: Violent, prosocial, educational, and fantastical content. Journal of Children and Media, 13(3), 276-294. https://doi-org.ezp.waldenulibrary.org/doi/full/10...Yale Medicine. (n.d). Anger, Irritability and Aggression in Kids. Retrieved from https://www.yalemedicine.org/conditions/anger-issues-in-children-and-teens#:~:text=One%20common%20trigger%20is%20frustration,compulsive%20disorder%2C%20and%20Tourette's%20syndrome.