Humanities
PCN610 Grand Canyon Week 8 Alcohol Use Treatment Plan Paper

PCN610

Grand Canyon University

Question Description

Details:

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:

  1. What behaviors would indicate that the client is sustaining at a healthy baseline?
  2. How would you determine if Eliza met her treatment goals?
  3. What factors would determine if the treatment needed to be reevaluated, extended, or possibly referred to another clinician or setting?
  4. 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).
  5. 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:

  1. Demonstrate whether or not the client met the goals of the treatment plan.
  2. What specifically contributed to the success of the treatment plan or lack thereof?
  3. What language would you use to communicate the outcome to the client?
  4. How would you document the final session?
  5. Include at least three scholarly references in your paper.

PREVIOUS PAPERS/PLANS SUBMITTED AS WELL

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Topic 8 Discharge Summary Template Directions: Complete the Discharge Summary form by addressing the fields below. Client Name: [Enter the client's name here] Date of Birth: [MM/DD/YYYY] Date of Admission: [MM/DD/YYYY] Date of Discharge: [MM/DD/YYYY] Presenting Problem Upon Admission: [State the client's presenting problem upon admission here.] Current Medication: [List the client's current medications here.] Reason for Discharge: Resources and Referrals: [State the client's reason for discharge here.] [List the client's resources and referrals here.] © 2017. Grand Canyon University. All Rights Reserved. Projected Prognosis: [State the client's projected prognosis here.] Eliza D 00/00/00 Client Signature & Date Case Manager Signature & Date © 2017. Grand Canyon University. All Rights Reserved. Running head: Treatment Plan 1 Updated Treatment Plan for Eliza Irais Quijada GCU PCN-610 February 5, 2018 Running head: Treatment Plan 2 Updating a Treatment Plan 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 Running head: Treatment Plan 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. 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 studenthousing 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 3 Running head: Treatment Plan 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. 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. 4 Running head: Treatment Plan 5 References American Addiction Centers. (2015, October). Co-Occurring Disorders Treatment Guide | American Addiction Centers. Retrieved from https://americanaddictioncenters.org/cooccurring-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. Running head: Treatment Plan 6 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. Client: Eliza Doolittle Date: February 5, 2018 Age: 18 DSM Diagnosis ICD Diagnosis Adjustment Disorder (309.28) F43.23 Alcohol Use Disorder (305.00) Mild F10.10 Goals / Objectives: □ Mood Stabilization □ Anxiety Reduction Reduce anxiety and increase coping skills in responding to stress and anxiety DOB: January 2, 2000 Interventions: Frequency: □ Psychotropic Medication Referral & Consultation □ Journaling □ Weekly □ Bi Weekly □ Monthly □ Cognitive Behavior Therapy □ Skill Training □ other: ____________________ □ Emotion Recognition – Regulation Techniques □ Group □ Individual □ Family □ Psychotropic Medication Referral & Consultation □ Journaling □ Weekly □ Bi Weekly □ Monthly □ Cognitive Behavior Therapy □ Skill Training □ other: ____________________ □ Relaxation Techniques □ Group □ Individual □ Family □ Reduce Obsessive Compulsive □ Psychotropic Medication Referral & Behaviors Consultation □ Journaling □ Cognitive Behavior Therapy □ Skill Training □ Weekly □ Bi Weekly □ Monthly □ other: ____________________ □ Group □ Individual □ Family □ Decrease Sensitivity to Trauma Experiences □ Verbalize Memories Triggers & Emotion □ Weekly □ Bi Weekly □ Monthly □ Desensitize Trauma Triggers and Memories □ other: ____________________ □ Utilize Healing Model/Support □ Group □ Individual □ Running head: Treatment Plan 7 (Mending the Soul) Family □ Overcome Denial □ Identify Negative Consequences □ Weekly □ Bi Weekly □ Monthly □ Menu Planning □ Nutrition Counseling □ Body Image Work □ other: ____________________ □ Healthy Exercise □ Trigger Mngmt Recovery Plan □ CBT □ Group □ Individual □ Family □ Maintain Abstinence from substances (Alcohol/Drugs) □ Substance Use Assessment □ Weekly □ Bi Weekly □ Step work □ Overcome Denial □ Monthly Individual therapy for identifying negative consequences □ Identify Negative Consequences □ other: ____________________ □ Establish and Maintain Eating Disorder Recovery Bi-weekly group meetings for Alcoholism prevention/support □ Increase Coping Skills □ Commitment to Recovery Program □ Attend Meetings □ Obtain Sponsor □ Family □ DBT Skills Training Increase Eliza’s ability to □ Problem Solving Techniques identify every day problems □ Emotion Recognition & Regulation and create solutions that can be □ Communication Skills accomplished □ Stabilize, Adjustment to New Life Circumstances Teach Eliza to identify stress triggers and techniques to respond to them. □ Decrease/Eliminate Self Harmful Behaviors □ Group □ Individual □ Alleviate Distress Behavior Therapy □ Cognitive □ Weekly □ Bi Weekly □ Monthly □ other: ____________________ □ Group □ Individual □ Family □ Weekly □ Bi Weekly □ Monthly □ Stress Management □ Skills Training □ other: ____________________ □ Improve Daily Functioning □ Develop Healthy Supports □ Group □ Individual □ Family □ Cognitive Behavior Therapy □ Skills Training □ Weekly □ Bi Weekly □ Monthly □ Develop and Utilize Support System □ other: ____________________ □ Group □ Individual □ Family □ Improve Relationships □ Communication Skills □ Active Listening □ Family Therapy □ Assertiveness □ Setting Healthy Boundaries □ Weekly □ Bi Weekly □ Monthly □ other: ____________________ □ Group □ Individual □ Running head: Treatment Plan 8 Family □ Improve Self Worth □ Affirmation Work □ Positive Self Talk □ Skills Training □ Weekly □ Bi Weekly □ Monthly □ Confidence Building Tasks □ other: ____________________ □ Group □ Individual □ Family □ Grief Reduction and Healing from Loss □ Develop Anger Management Skills □ Psychoeducation on Grief Process/ Stages □ Weekly □ Bi Weekly □ Monthly □ Process Feeling □ Emotion Regulation Techniques □ other: ____________________ □ Reading/Writing Assignments □ Develop/Utilize Support □ Group □ Individual □ Family □ Decrease Anger Outbursts □ Emotion Regulation Techniques □ Cognitive Behavior Therapy □ Weekly □ Bi Weekly □ Monthly □ Increase Awareness/Self Control □ other: ____________________ □ Group □ Individual □ Family Running head: TREATMENT PLAN 1 Treatment plan Name: Class: Tutor: Date: TREATMENT PLAN 2 Logic behind occurrence of changes The above changes in the initial treatment plan are driven by the fact that the client might have been adversely affected by the psychological problem; to the degree of exhibiting other manifestations that were not initially displayed. Other factors that might have led to these changes are the impact of the first initial proposed corrective measures for the problem that was affecting Eliza. Some of the proposed corrective technique might have failed to achieve the intended purpose (Osher, Kofoed 2006). The new environment in which the lady was exposed might have contributed to the emergency of other psycho-social problems that were not initially evident during the primary phase of treatment. The situation of the client seems to be deteriorating on daily basis. It is clear from the report from the university fraternity that the level of alcohol and other substance abuse have adversely affected her (Osher, Kofoed 2006). There are other healthy manifestations that are accompanying Eliza; substantiated by the fact that the level of drugs in her body system was too high. The conflicting situation at the university where Eliza is enrolled is wanting. The management team is concerned and is fully compelled to come up with the best effective and efficient contingency plans. It is the culture of prolonged and uncontrollable alcohol abuse that has caused changes to emerge in the plan to ensure that the situation is salvaged. Effectiveness of the treatment plan The proposed new plan is a holistic approach of addressing all psychological issues that were not initially identified in the primary treatment proposed plan. The plan is meant to address all important and key psychological deficiencies of the young lady. For example, key issues of concern such as depression management, anger management, adjusting to the new environment TREATMENT PLAN 3 and other key inclusions have been fully addressed. The frequency of applying the interventions of the set goals is designed in such as way that it is very flexible and complies with the special needs of the client (Osher, Kofoed 2006). Evidently, the plan is fully designed and tailored in a scientific and psychological angle of inclination; to address the issues of eminent substance and drug abuse at the university; where Eliza is a student. From the official report by the evaluation team, drug abuse is the major psychological problem that has had incapacitations to Eliza (McLellan et al. 2009). Plan adjustment As I have stated in the above paragraphs, alcohol abuse is a mega problem that is jeopardizing the peaceful academic and personality traits of the university student. The current treatment plan should be fully tailored to meet the special needs of substance abuse of Eliza. The plan should be focusing on key aspects of the client such as prevention, screening, actual assessment, diagnosis and final medical interventions to fully address the issue. The plan should be adjusted to include the aspects of work and motivation in order to create a sense of humanity in the university student; who is fighting the menace of drug and substance abuse (McLellan et al. 2009). Ethical and legal changes in the treatment plan Due to the change of events in the original proposed plan, there are some new issues that should be considered during the actual process of dealing with the issue of alcohol abuse of the client. Ethically, the treatment plan has to be confidential. This is due to the fact that the level of alcohol abuse in the client has sky-rocketed (Mclellan et al. 1980). Nothing should be exposed to irrelevant parties so that the client does not feel that her privacy has been compromised. TREATMENT PLAN 4 The plan is in full compliance with legal stipulations of the respecting the client’s self determination (Mclellan et al. 1980). The plan is not meant to compel her to issue information that is out of her beliefs. The process should be done in compliance with the informed consent, the duty of professional psychologists to care and application of the credential mechanisms in treating the state of alcohol abuse of the client. Obstacles to treatment plan Sometimes, the client might to be able to feel free to express herself on the exact problem forcing her to indulge in prolonged drug abuse. The inability to be transparency is likely to jeopardize the credible outcome of the proposed treatment plan. Finance can pose another huge problem to the current treatment plan (Mclellan et al. 1980). In the event that funds are not sufficient enough, the client might not be able to access specialized medical treatment. TREATMENT PLAN 5 References Fred C. Osher and Lial L. Kofoed (2006). Treatment of Patients with Psychiatric and Psychoactive Substance Abuse Disorders. Published online: April 01, 2006 https://doi.org/10.1176/ps.40.10.1025 Mclellan, A Thomas Ph.D.; Luborsky, Lester Ph.D.; Woody, George E. M.D.; O & Apos; Brien, Charles P. M.D., Ph.D. (1980). An Improved Diagnostic Evaluation Instrument for Substance Abuse Patients: The Addiction Severity Index. Journal of Nervous & Mental Disease: January 1980 Thomas McLellan, Isabelle O. Arndt David S. Metzger & George E. Woody Charles P. O'Brlen (2009). The Effects of Psychosocial Services in Substance Abuse Treatment. Pages 38-47 | published online: 12 Jul 2009. Running head: TREATMENT PLAN 1 Initial Treatment Plan: Eliza Irais Quijada GCU PCN-610 January 17, 2017 Running head: TREATMENT PLAN 2 Initial Treatment Planning: Eliza The following paper will look at an initial treatment plan for client, Eliza. Eliza is an 18-year-old student living on campus with roommates and has decided to seek out counseling due to anxiety, stress and low self-esteem. To better understand the process a client goes through when seeking out mental health services, the paper will focus on the intake, assessment, and treatment planning and referral procedures for Eliza. Intake Upon arrival Eliza was given an intake document to help with identifying information, presenting problems, immediate risks and brief family information. Eliza reports that she is seeking out counseling because she has to. At this time, her presenting problems do not present an immediate risk. Eliza reports having a ‘okay’ relationship with her mother, an elementary school teacher and a ‘good’ relationship with her father, who is a truck driver. Eliza reports no current life stressors or medications for mental health. The next step will be to conduct a more thorough assessment looking at biological, psychological and social factors that could help in understanding Eliza and her presenting problems. Biopsychosocial Assessment Using the biopsychosocial (BPS) framework and assessment helps to look at a client in a more holistic way; addressing areas such as their genetic information, the behavior and their cultural or familial backgrounds. In Eliza’s case the BPS model can be particularly beneficial as it has illustrated its importance in the treatment of disorders such as anxiety (Meyer, 2008), which is a presenting symptom of Eliza’s at this time. Running head: TREATMENT PLAN Identifying Information Eliza is a Caucasian female attending her freshman year of college as a engineering major. Her family resides in a town that is approximately two hours away. Presenting Problems Eliza is here because ‘she has to be’ due to an issue with residential advisor (RA) and her on campus living agreement (discussed further under substance use). She presents with substance use, anxiety, stress and low self-esteem concerns. Life Stressors Eliza denies feeling lonely but states it is difficult to make friends. She identifies school as a stressor as it has proven to much harder in high school and has difficulty with the increased study requirements. Substance Use and Abuse Eliza is presenting with substance use. She reports having to come to counseling because she lives in an alcohol-free campus dorm and was recently caught by her RA with alcohol in her room along with some friends who were intoxicated. Eliza states that she was “just buzzed” and drinking ...
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Running head: DISCHARGE SUMMARY STATEMENT

Discharge Summary Statement
Name
Institution

1

DISCHARGE SUMMARY STATEMENT

2

Discharge Summary Statement
The treatment plan for Eliza aimed to help her with the alcohol use tendencies that
provided trouble for her residing in the alcohol-free dorms on campus. Therefore, the treatment
plan initially aimed to help her limit alcohol use especially in the dorm deemed to have been
caused by her adjustment disorder. However, the plan further developed to include more goals
such as alcohol abstinence upon the realization that the alcoholism problem was getting worse
with time. The treatment plan was a good opportunity to interact with the client on a one-on-one
basis to understand and deal with the core issues she was facing. The sustainability of a healthy
baseline was the target of the interventions and the entire treatment plan. In the final session,
letting the client know that they did well by going through the treatment would boost their selfesteem and encourage further seeking help.
Eliza’s main problems included the adjustment to the campus environment and breaking
the alcohol use in dormitories. The change in behavior to indicate a healthy baseline would
mostly be through a recorded longer sobriety period, abstinence from alcohol; especially in the
campus dorms, and reported a feeling of ...

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