Client Name: Thomas
Date of Pre-intervention Score: 06 September 2019
Date of Post-Intervention Score: 04 October 2019
Length of Treatment: 4 weeks
Intervals of time on a scale: One Work Week (5 days)
Section 1: Introduction
The following Goal Attainment Scaling shall be instrumental in evaluating the follow-up guide for a client by the name Thomas. Thomas is a 26-year-old Caucasian who identifies as a heterosexual male who was born and raised in Bensalem, Pennsylvania. Thomas has experienced multiple cases of drug abuse from among relatives closest to him, for instance, his mother, biological and step-father. Moreover, he has experienced sexual abuse even though he does not vividly recall the events of that incident.
Thomas is currently at a drug and substance abuse rehabilitation center called Valley Forge Medical Center and has used various drugs like Oxycodone, crystal meth, marijuana, fentanyl, and heroin. His mother is a former drug addict that is in the process of rehabilitation, and they lack a working relationship because Thomas believes she could have prevented him from getting into drugs in the first place. The aim of this GAS is, therefore, to establish and track a connection between Thomas and his mother as a way of helping him heal and get off the hook of addiction. According to Verdoorna et al., (2018), the use of goal setting is instrumental because it helps in the prioritization of the most outstanding issues during clinical medication review. Moreover, it is a useful toon when it comes to the attainment of these goals.
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Research by Chan, (2019) posits that taking some time to think about the environment around which one operates and involving the mind in critical thinking strategies is an essential component that assists in shaping the outcomes of a person’s actions. This intervention plan is implemented between the counselor & Thomas himself during one-on-one therapy sessions that occur twice a week (Tuesdays and Fridays for duration of 4 weeks). Halim & Sabri, (2013) compile research that examines the relationship between styles of coping and mechanisms of defence among relapsing addicts and concluded that the kind of structure present in the life of a recovering addict formerly addicted to multiple hard drugs is essential in determining whether such a person will succeed in the journey towards recovery or if they will return to their addiction habits. Additional research by Rostamia, Zareib, Zamirinejad, & Larijanid (2010) examines the connection between childhood abuse and tendencies to turn to drug abuse as a means of escape. The study finds that events of child abuse and neglect during childhood are the perfect recipe for addiction during adulthood and understanding this assists in the creation of an appropriate GAS strategy specific to Thomas.
Section 2: Intervention
Use modeling, role-playing, and behavioral rehearsal to teach Thomas anger control techniques that include stop, think and act. The therapy session lasts 4 weeks and the date of the pre-intervention score begins on 06 September 2019 where that of the post-intervention score is on 04 October 2019. The four week period will give me the chance to collect follow up data in between the sessions for instance before and after scheduling meetings between Thomas and his mother. I will ask Thomas and his mother regarding their pattern of communication outside the clinical setting, the way they relate back at home and whether or not they get along. This information will enable me to gauge the effects of the therapy session.
At the culmination of the therapy session, the patient verbally reports amelioration in the therapy session and on occasions outside the therapy session. During the last week of the entire session, Thomas’ mother confirms that their communication has been less hostile with time. She attends the family fun day in the last week of the intervention plan and attends a therapy session with her son in the third week of the intervention plan.
The family is the closest unit of support that Thomas has around his life because he is having trouble with his girlfriend of six months. Thomas confessed to having witnessed a female friend overdose and die in a hotel room and showed little remorse doing so (Pietrzak et al., 1990). Therefore for this kind of case, it takes more than a person Thomas feels profoundly connected and intimate with to help him recover. Addiction is a treatable disorder that requires effort from the part of the addicted party and a reliable system of support. Becoming addicted to drugs is not a sign of weakness, and neither is it a flaw in character. From the story of Thomas, it can be seen that various factors have led him to his present situation. The very first step in the process of healing from addiction is the realization and the acknowledgment of the existence of a problem.
Section 3: Describe when and how you will collect follow up data.
The instruments of data collection can either be standard or the ones that the researcher may deem fir for that particular research. The initial step in the creation of the unique instrument for evaluation shall be the identification of the goal areas. This will entail the collection of data about the concerns of the client and making decisions about which of the areas are the most essential. The most essential areas shall then be selected as the areas to work with during the course of treatment. The selection will be done on a range of four areas of concern with the view of settling down on two key areas for measurement of the concerns. These areas shall include conflict between the client and his mother and taking responsibility for addiction.
Section 4: Data Presentation and Analysis
Based on the data analysis, the following calculations represent the GAS for Thomas. The starting point or the less than expected level of outcome is the one in which Thomas is unable to take responsibility for his own actions that have led to past or current conflict and this receives a score of (-1). The endpoint is where Thomas and his mother engage in a one on one family therapy session while in treatment where resentments are processed and this receives a score of (+1).
The overall GAS score is 50 and therefore this means that more attention needs to be paid to the original client assessment to ensure that the goals of treatment that are selected are relevant as well as desirable for both the client and the practitioner.
The initial score for each objective
| Objective 1 | -2 |
| Objective 2 | -2 |
| Total Follow-up Raw Score | -4 |
Follow-up score for each objective
| Objective 1 | +2 |
| Objective 2 | +2 |
| Total Follow-up Raw Score | 4 |
Both scores were successful
Both counts had a change of 4
Section 5: Conclusion
Based on these findings, the research found that both Thomas and his mother were intent on finding the solution to the problem. After seeing the solution, the next step would be to find the necessary tools for Thomas to use to heal, for instance, medication and boot camps. Although generally successful, the design had a limitation in the sense that the ratings were not entirely qualitative and it was not possible to tell the exclusive truth from untruth.
Thomas must be made to understand the consequences of his actions towards the people he loves, for example, the impact his rejection has on his mother. Thomas feels like the relationship between him and his mother is fractured because he feels like she should understand where he is coming from since she was once an addict. He needs to understand that perhaps his mother would love to see him recover too now that she is a recovering addict.
Overall, improved communication between Thomas and his mother are likely to have the best potential to be effective in this situation. In their article examining the widespread nature of addiction, Jamison Monroe & Huffington, (2016) posit that it is essential that the rest of the community or everyone must recognize that addiction is transient and can be seen everywhere. Therefore, it is vital for both the people seeking recovery and the addicts to speak about the situation to find a working solution openly. The article posits that it is essential for the people to sustain them of empathy and appreciation of everyone's contribution to the community.
References
Chan, Z. (2019). Nursing students' view of critical thinking as 'Own thinking, searching for truth, and cultural influences'. Nurse Education Today, 78 (1), 14-18.
Halim, A., & Sabri, F. (2013). Relationship Between Defense Mechanisms and Coping Styles Among Relapsing Addicts. Elsevier, 84 (1), 1829-1837.
Jamison Monroe, & Huffington, C. (2016). 'Addiction Is Everywhere, and It's Important for Us to Recognize That' . Retrieved from Huffington Post: https://www.huffpost.com/entry/addiction-is-everywhere_b_7139336
Palad, V., & Snyder, J. (2019). “We don’t want him worrying about how he will pay to save his life”: Using medical crowdfunding to explore lived experiences with addiction services in Canada. International Journal of Drug Policy, 1 (1), 73-77.
Pietrzak, J., Ramler, M., Renner, T., Ford, L. & Gilbert, N. (1990). Practical program evaluation: examples from child abuse prevention. (Chapter 5, Outcome evaluation: Client level, pp. 161 – 185). Newbury Park, CA. : Sage Publications, Inc.
Rostamia, R., Zareib, J., Zamirinejad, S., & Larijanid, R. (2010). Childhood abuse history among male addicts in comparison with the non-addict population. Elsevier, 1 (1), 738-740.
Verdoorna, S., Blom, J., Vogelzanga, T., Kwint, H.-F., Gusseklooc, J., & Bouvya, M. (2018). The use of goal attainment scaling during clinical medication review in older persons with polypharmacy. Research in Social and Administrative Pharmacy, 1 (2), 123-143
