Case History 1
(Identifying information has been changed in order to maintain confidentiality.)
Identified Client: Robert, 66-year-old male, retired for the past 4 years. He is a husband, father,
grandfather, and friend.
Drug of Choice: Alcohol
Initial contact: Harriet, Robert's adult daughter, made the initial contact asking whether or not
Family Intervention might be an option in trying to get her father some help for his drinking
problem.
Because this family lives in a large city on the West Coast, the initial interview was done over
the phone.
Client History: "The drinking got worse after Robert retired, or maybe I started noticing it
more."
Robert has been married to Colleen for 44 years. They raised 2 daughters, numerous pets, and
have lived in the same house for the past 35 years. Some things have changed in their marriage
such as they now sleep in separate bedrooms; mostly because of Robert's drinking.
Robert would begin drinking in the late mornings just as soon as he could get his chores and
errands done.
Robert and Colleen began to have less and less to talk about as time went by. Colleen didn't want
to talk to Robert when he had been drinking and it began to seem like he was always drinking.
And Robert really didn't have much to say to Colleen. She was always coming and going and
when she did stick around it seemed as though she just had something negative to say about what
he was doing or not doing, "have you been drinking?" He felt like all she did was nag.
"The drinking got worse after Robert retired or maybe I started noticing it more" complained
Colleen. Robert began to go to bed earlier and earlier. "Now that I look back at it, I think he went
off to bed to be able to drink and not have me on his back."
Some health issues began to arise, complicated by years of drinking. Roberts' doctor was having
him get his blood tested every 3 months to monitor his diabetes and prostrate concerns. The
doctor had long ago told Robert to stop drinking.
Harriet (Robert's daughter) stated that others were concerned about her dads drinking as well.
(A more complete history, not included here, was gathered.)
Intervention Team members: During the course of the initial interview a list of possible
intervention participants were discussed over the phone (this is often the case where family
members live at a distance from each other). Harriet was asked to contact potential participants
and ask them to give the Interventionist a call so they might discuss their concerns and also to
see if they would be appropriate members of the intervention team.
Those that called and became part of the team included; older sister Marsha, older brother Franz
(living and calling from Sweden), younger brother Bill, wife Colleen, oldest daughter Harriet,
younger daughter Liz, nephew Mark, long-time co-worker/friend Arthur and friend Terry.
Interviews were conducted, and homework assignments given - to write a letter to Robert about
their concerns and feelings.
Treatment Program: A residential treatment program was contacted by Harriet. Arrangements
were made for admission should Robert agree to go to rehab.
Schedules were arranged, and dates set for the upcoming role-play followed the next day by the
Intervention.
The Role-Play: The day of the role-play arrived. The team members met at older sister Marsha's
house in the same city in which Robert and Colleen lived. We arrived at Marsha's at 1:30pm.
Over the next four hours we heard from everyone. There was a wide range of emotion and a lot
of anxiety about whether or not this would actually work.
Many agreed that Robert was most likely depressed. Some voiced concerns that there were
certainly more issues than just the alcohol to be dealt with. "Maybe if his marriage was better, he
wouldn't drink so much." Some were very worried that Robert might get up and walk out.
"Have you ever had someone just walk out?" someone asked. "Rarely" I responded. "But what
do we do if he does?" they asked. "What if he tells us all to get the heck out of his house?"
The team talked about the anxiety and solutions were discussed.
People read their letters aloud. Some cried. One person was very angry with Robert. We talked
and processed through the feelings and arrived at a shared group conclusion that Robert was
killing himself by continuing his drinking behavior. After years of having to be vigilant for her
children's safety, Harriet stated in her letter that if Robert was unwilling to accept the help being
offered through this Intervention and go to the treatment program that she would no longer allow
her father to be around his grandchildren. Some team members had strong reactions about her
feelings and decision. By the time the role-play was complete we had heard all the letters, team
members had received feedback from others about how their letters sounded, and some received
editing suggestions. We decided the order of who would go first to last. Everyone made the
decision to be firm with a willingness to hold the line with Love, Concern, and Respect: to
encourage Robert to say yes and go directly to the treatment program. We addressed all the
logistical questions again, making a plan for how Robert would physically get to the treatment
program and who would go with him. By the end of the role-play all team members agreed that
we had done our best. We were providing a plan that could succeed. We were collectively
offering Robert the opportunity and method to get his life back. We agreed on a time early the
following morning to meet at Robert's home and have the Intervention.
The Intervention: No one had mentioned to Robert that an Intervention was in the works. We
met just down the street from Robert and Colleen's home at 8:30 am. When we were assembled,
we walked to the house. We knocked and with Harriet in the lead we went directly in and got
seated in the living room. Robert was in the back of the house. By the time he made his way to
the living we were all in position. He looked at us, looked at his wife, and his daughters. I
introduce myself. "Hello Robert, my name is Jerry Wittman and I'm a counselor. I've been
consulted by your family and friends to help facilitate a family meeting. Everyone has some
things to talk with you about, please hear them out. We are going to start with your friend,
Arthur." One at a time, each read their letters. Tears were shed. Robert cried as well. When the
letters were complete, I briefly summarized the intention of the meeting and discussed where and
what the treatment program was and that what was being asked of him today was to agree to go
to treatment and begin the process of recovery. He said yes.
All congratulated him, gave hugs and prepared for departure to the program.
Within 45 minutes of completing the Intervention, Robert was on his way to Treatment.
Post-Intervention: After Robert had left the house the remaining team members and I sat down
and processed through the feelings and thoughts people were experiencing. Team members had
previously been given information about self-help (Alanon meetings) and therapist names in
their community to follow up with as needed. Immediately family members were encouraged to
attend the program's Family Program. We all agreed to do a check-in via phone in three days.
Since then, I have talked with all the participants. Every single one expressed their gratitude for
being part of this process. They've said that this has been a very powerful and important event in
their lives. Colleen (his wife) and I have talked several times. She says that this has been the
hardest and most important thing she has ever done in her life. She followed the
recommendations and is attending family week at the program.
2-2 Case Study Milestone One: Short Paper
Case Study on Addiction
Susanne Rose
Southern New Hampshire University
November 11, 2018
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2-2 Case Study Milestone One: Short Paper
Introduction
Addiction to prescription drugs affects the addict's body and brain. Prescription drugs cannot be
easily identified, but abusers of such drugs either use stimulants, opiates or tranquilizers. Drugseeking behaviors of individuals abusing prescription drugs include regular refills of the
medicines, visiting different doctors who treat their conditions and forging prescriptions from
their doctors (Rees & Day, 2014). Poor decision-making and depression are common symptoms
of people abusing prescription drugs. Therefore, the paper discusses case study three which
contains information of an addict who abused pain medication.
Case Study 3 Analysis
Katie is the identified client, and the presenting problem affecting Katie is an abuse of
prescription drugs, but sometimes she used Soma, a muscle relaxant drug. Lewis is Katie's
husband, and before he realized that his wife was an addict to pain meds, she had abused such
prescription drugs for over ten years because she started the abuse in her mid-20s. Prescription
drugs like pain pills used by Katie are expansive and have adverse side effects like depression.
As per Case Study 3, Katie is a woman aged thirty-five-years. Individuals addicted to abusing
pain medication are influenced by their deviant behavior to find all possible ways of getting the
pain medications (Rees & Day, 2014). Katie was introduced to pain medication after she
experienced a car accident to treat the low back pain. Therefore, Katie was addicted to drug
prescriptions which emulated ‘a good feeling' when she abused them.
When Katie lacks pain medication, she ventures to gambling which is another type of
addiction process. Gambling alters Katie’s mood and she remains depressed in her workplace
environment. The psychological and physical health of an individual is crippled when pain
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2-2 Case Study Milestone One: Short Paper
medication drugs are abused for an extended period (Rees & Day, 2014). Katie underwent
process addiction since the history of her obsession is traced back to her early 20s when she
began using pain pills to reduce the pain she experienced after she was engaged in an accident.
Before Lewis recognized the addiction, habit affecting his wife, Katie had visited a rehab three
years before. The abuse of pain addiction pushed Lewis' wife to enroll in a residential treatment
center. After the rehab program, Katie ignored counseling meetings because she believed she
had ceased from all addiction acts. However, her imaginations on the wonderful feelings from
the pain medication made Katie resume her deviant act of abusing pain pills. Therefore, Katie
thought of rational reasons to give her doctors to ensure anytime she met them, she was given a
prescription for. Katie claimed that the pain pills induced relaxation feelings, thus helping her
keep her mind free from the complications in her life resulting from interactions with family, coworkers, and neighbors.
The typical physical effects of prescription drugs when abused include overly fatigued,
dizziness and eventually, withdrawal symptoms when use ends abruptly (Martel &
Edwards, 2013). Pain medications, when abused, make the addict more depressed, and if using
while at work, may inhibit the individual’s coordination and cognitive skills. Katie as an addict
to prescription drugs, finds it hard to stop using the pain medication because they make her
relaxed, the feeling of stress fading away. Regarding family, Katie squandered their budget
because she used money set aside for food and other basic needs to purchase pain pills through
the internet. Her parents were worried about her because Lewis started vocalizing that her
addiction behavior could result in divorce if not thoroughly addressed. Therefore, Katie forced
her family members to incur extra costs needed as funding for better therapeutic interventions to
end her deviant behavior but persisted in her pain medication addiction. To society, Katie
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2-2 Case Study Milestone One: Short Paper
became unproductive because she failed to manage her responsibilities as a mother of two
children and a wife. Since Katie became unproductive in her profession, she could not help
society in a positive way until she decides to end her addiction. Katie’s act of buying pain
medication over the internet and visiting numerous doctors to obtain her prescription drugs
proved her incompetence to help her family, co-workers and the community. In addition, as a
result of Katie's addiction, consequences to her family include domestic violence and a lack of
funds her children's school fees and other basic needs. To co-workers in Katie's working
environment, workplace conflicts are frequent because she barely coordinates her role in life as a
result of addiction side effects. In Katie’s community, Katie will not be known for being a
positive role model and her children may suffer as a result. For example, parents may not allow
their children to visit or interact with Katie’s children.
Results
Katie relapsed after the treatment because she failed to avoid the use of pain medication
altogether. Pain pills make her feel relaxed but have several adverse health effects like nausea,
irritability, anxiety and hot and cold sweats (Addictions and Recovery, 2018). When Katie
skipped the use of pain pills, withdrawal symptoms persisted, and she remained depressed for a
length of time. Therefore, addiction can be compared to disease and youths should avoid
abusing drugs because they may end up in the criminal justice system and/or dying as a result of
health complications from the opioid abuse (Martel & Edwards, 2013). Drug abuse is a critical
issue in modern societies, and it is wise to counsel youths to ensure they avoid the deviant acts of
drug abuse.
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2-2 Case Study Milestone One: Short Paper
References
Addictions and Recovery. (2018, September 21). Opioids: Addiction, withdrawal and recovery.
Retrieved from https://www.addictionsandrecovery.org/opioid-opiate-recovery.htm
Martel, M., & Edwards, R. (2013). The impact of medication side effects on functional outcomes
among patients with chronic musculoskeletal pain. The Journal of Pain, 14(4), S1.
doi:10.1016/j.jpain.2013.01.015
Rees, G., & Day, E. (2014). Addiction to prescription drugs. Prescriber, 25(5), 5-6.
doi:10.1002/psb.1169
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4-2 Case Study Milestone Two: Short Paper
4-2 Case Study Milestone Two: Short Paper
Susanne Rose
Southern New Hampshire University
November 25, 2018
4-2 Case Study Milestone Two: Short Paper
Case Study Client Information and Presenting Problem
Identify the client (gender, age, race, profession)
The client is a 16-year-old adolescent of the Korean origin. He lives in the United States with
his mother and brother who resolved to move there four years ago. He is a student in one of the
schools in the country. His name is HC as referred to by Lee (2011).
Identify the addiction that this client presents with.
HC has an addition to internet games form the age of seven. He spends 3 to 5 hours during
weekdays and 13 hours during the weekend. This has led to his withdrawal from his friends, has
developed poor social relationships with his seniors including his parents and has developed a
negative attitude over anything.
Does he have a substance addiction, like alcohol, prescription drugs, or illicit drugs?
HC does not have an addition to any kind of illicit drugs, prescription of alcohol. His only
problem is that he indulges into a lot of internet gaming that has turned him into an introvert;
secluding himself from other people and spending most of his times alone.
Does he have a process addiction, like gambling, video gaming, or shopping?
Yes. HC has a process addiction towards internet gaming which is his main problem. He spends
most of his tome on gaming, a situation which worries his mother who says that the time he
4-2 Case Study Milestone Two: Short Paper
engages in this activity has been increasing rapidly recently. According to him, it is difficult to
control this addiction mostly during weekends.
Assessment
Identify the physiological procedure the client uses for administration of his addiction (oral,
injection, watching videos, phone calls).
HC, the client, indulges into continuous internet gaming activity. According to his mother, he
spends up to 5 hours on weekdays and 13 hours on weekends while playing internet games.
Describe the type of environment in which the client spends his time.
HC spends his time alone when indulging in the gaming activity. According to his mother, he
withdrew from his friends and now spends time alone. HC has also developed a negative
attitude from interactions with his seniors such as his father.
Is there support within the family?
Yes, his family is very supportive of HC and tries to help him overcome his condition. For
example, his father initially tried to indulge him into some activities that would shift his mind,
though he did not respond well. His mother, on the other hand, took him to a counseling
program.
Does the client hang around with friends who are using addictive substances?
No. In fact, HC does not hang around any of his friends. After coming to the US and having
difficulty learning English, he withdrew from all his friends and only spends time alone.
4-2 Case Study Milestone Two: Short Paper
Is the client working for a company where his addiction is encouraged?
No. HC is an adolescent and a student. Schools do not encourage internet gaming at all rather
they focus on developing concentration and focus on studies.
What is the client's philosophical stand about his addiction?
According to Lee (2011), HC feels that he needs to reduce his internet gaming behavior.
However, he felt that it is difficult to control it every time he tried.
1. What is his motivation level for getting help?
HC was very motivated in getting help. When he visited a counselor with his mother, he pledged
to reduce the time he spent on games by indulging into other activities which he did. He also
entered into a contract with his mother and the counselor to reduce internet gaming.
2. Is there a sense of hope or hopelessness?
HC is hopeful that he will soon stop this addiction. This can be evidenced by the continuous
participation in the treatment program and a reduction in gaming activities.
Addiction information
Provide the history of the addiction. (Is it a substance or process addiction?)
The addiction that HC faces is a process addiction involving video game addiction; internet
gaming. From the age of seven, he was addicted to internet games such that he withdrew from
4-2 Case Study Milestone Two: Short Paper
this friend and family members too, spending most of his times alone. The gaming times
increased rapidly and would indulge in the activity for 18 hours a week.
What is the history of the addiction? Remember, there are many types of addiction and not all
were defined around that time. For example, video game addiction was not officially defined
until 1995, while alcohol addiction was defined in 1941.
Differentiate between the physiological and psychological effects of the addiction.
Physiological effects of addiction are the changes in chemical response in the body of a human
being that affects the whole body or part of it. Usually, they result from a typical hormonal
imbalance in the human body and can be short term or long term. On the other hand,
Psychological effects are the changes in the functioning of the brain or mental capacity of a
human being that affects their mental health resulting to issues such as depression, anxiety,
paranoia among others.
Does the addiction physiologically affect the subject's behaviors and mental processes? If so,
how?
Yes. Addiction may affect the hormonal or chemical balance in the body of the addict which
results to his body or part of it acting in some type of way. For example, alcohol addiction
affects the functioning of the liver and may eventually lead to malfunctioning.
Does the addiction psychologically affect the subject's behaviors and mental processes? If so,
how?
4-2 Case Study Milestone Two: Short Paper
Yes, addiction affects the mental health and functioning of the addicted person. For example,
continuous addiction may lead to depression, paranoia and anxiety and which may lead to
exhaustion and eventual mental breakdown.
Results
Discuss the results of this case.
1. Did the client respond positively to the treatment?
Yes. HC responded positively to the treatment that he was receiving. For example, he would
wake up early, do his homework and exercise. Initially, the treatment session was meant to last
eight sessions but it took him five after which he had learned to take part in other activities such
as golfing. The treatment was very helpful to him.
4-2 Case Study Milestone Two: Short Paper
References
Lam, L (2014) Internet gaming addiction, problematic use of the internet, and sleep problems a
systematic review, Current Psychiatry Reports, 16: 444
Lee, E (2011) A case study of internet game addiction, Journal of addictions nursing, 22:208213
National Institute on Drug Abuse, Mental Health Effects, Retrieved from
https://www.drugabuse.gov/publications/health-consequences-drug-misuse/mentalhealth-effects
NCBI, Substance Abuse Treatment: Addressing the specific needs of women, Treatment
improvement protocol (TIP) Series, No. 51 Center for Substance Abuse Treatment,
Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK83244/
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