CED 322: Case Study In the case of the 46 year-old female client, I would begin my assessment of her by attempting to relieve her current state of anxiety. My first goal would be to allow her to feel safe and comfortable when she enters my office. I want her to know that my office is a safe haven from anything that causes her to relapse. In addition, by congratulating her decision to seek treatment I can make early strides in developing trust and rapport from the start.
Once the client and I spend some time reviewing her life story, I would ask her to complete the SASSI-3 to give me a well balanced perspective of her overall struggle with cocaine and heroin abuse. Although I’ve been given some background information on the client’s previous history of abuse, I feel that the SASSI-3 can give me some insight to habits and traits she developed from her family and lifestyle growing up. Since I have some information about her early use of alcohol, I would also administer a MAST which could give me some insight on her dependency with alcohol.
I would be able to better understand how alcohol plays a role in her use of heroin and cocaine. Once I can determine how they correlate I can then accurately diagnose her and lead to a more successful treatment strategy. From the current information I would diagnose this client with Cocaine and Opioid- Induced Mood Disorder (292. 84). The client reports that she relapses when she has a desire to feel “numb” which tells us her emotions and feelings are primary factors that influence her addictive behavior.
Also, her addiction is so severe that she claims that she uses at times for no reason at all. Since she is remorseful and fearful of her life, I feel that she is searching for the right treatment to rid herself of this life threatening addiction. She has the desire to change but is in need of the will to change. I would focus on her everyday routine, eliminating the parts of her day that involve thoughts or ideas that lead to using heroin and cocaine. I would recommend that she use the 12 step program and group therapy as new ways to guide her towards recovery.
Since she using these substances in private, I feel she could possibly benefit from others who know and feel the same struggles as she does. This would allow her to not feel alone in her recovery and bring a sense of accountability to prevent from relapse. I would monitor her progress in the 12 step program and encourage her to patiently complete each step. I’m basing my treatment strategy on trust. In order to eliminate her fear and anxiety along with her addiction through these screens and methods, she must be willing to trust herself at all times.