The type of trauma that was first inflicted on Tim
Tim is a 29-year-old Caucasian man just released from prison. He has a problem of substance abuse and currently he is in drug court. The drug court plans to have him evaluated for residential treatment due to routinely testing positive for heroin or Suboxone. It is possible that Tim has trauma that he got from the time he was arrested and the time he spends in prison. After he had been released from the prison, he went into heavy substance abuse. The trauma he had while in jail could be the reason for the current addiction he is going through. The type of trauma that was first inflicted on Tim possibly is emotional abuse or psychological maltreatment. It might be the case the when Tim was arrested; he was subjected to racial discrimination by the fact that he was from the minority group which is Caucasian. Emotional abuse and psychological maltreatment directed to Tim because of his race are an act of commission against an individual because of his origin. Being from a minority group might have caused him to be imprisoned. The minority races were more probable to be arrested and imprisoned compared to the dominant races. It would thus result in emotional torture affecting an individual’s psychology. This type of trauma could have been made through verbal abuse and emotional abuse causing Tim to go through cognitive, affective and various mental disturbances that could result in trauma. An act of omission against Tim in this instance could have been emotional neglect and social deprivation causing him to experience conduct, cognitive, affective, or other mental disturbances (Drake, Mercer-McFadden, Mueser, McHugo & Bond, 1998).
1. Diagnostic summery
Based on the case study, it is clear that Tim was using drugs and had a problem in having to cope with his life on a daily basis. Tim grew up with her mother who was a crack user further, his maternal uncle for a long time struggled with the addiction problem. It is reported that Tim experiments with the drug at the age of 13 years. He began with a half a gram of marijuana during weekends then shifted to using alcohol. He gradually upgraded into using large quantities of all types of drugs and hallucinogens. He became a heavy user of narcotics when his brother died at the age 19. He went into using heroin and taking drugs intravenously. He stated that the longest period of sobriety he experienced was six months as a result of incarceration. Based on the urinalysis tests conducted, they all tested positive for heroin, Suboxone, fentanyl, or cocaine. As a drug addict, it would be important to come up with a treatment plan that would help address the addiction and enable him to live a healthy life free of drugs. The treatment plan will be suitable to help solve the problem that Tim is currently experiencing. The treatment plan developed for Tim will contribute to addressing drugs addiction and trauma. An appropriate intended task is to have Tim enter an outpatient drug treatment program for five months and be provided with a transitional home where he would stay for the entire period of therapy. Outpatient drug rehab is suitable in his case because it is less restrictive hence will allow him some freedom to associate with her children and move around. The program would be provided for 5 hours every week where Tim will have to visit the local treatment center (Drake et al., 1998).
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2. Problem list
Currently, Tim has become a heavy drug user that he cannot function properly without the use of substance
It was established that the continuous use of drugs substantially affected his mental and psychological status
3. Short term goals:
I. To be free of drug/alcohol use/abuse
II. Relief of symptoms of trauma
III. Restore relationships with previous friends
IV. Learn coping skills to work on adjust and adapt to his situation
4. Developing intervention
Model of individual therapy:
The primary individual therapy that would be used in this case is the motivational interviewing and group therapy. Making the treatment effective, the following steps are critical
1. Individual therapy is necessary and must be delivered approximately twice a week for five weeks. Tim would go through the therapy twice weekly until the time when the symptoms have shown reduction signs. Counselor and client will time after time establish the future course of the sessions.
2. Person Centered/Humanistic approach would be carried out where Tim would be required to open up with male therapists quickly
1. Therapist will have to refer Tim to the 12 step program that would target drugs addiction and trauma which will include: Narcotics Anonymous, crystal meth anonymous, marijuana anonymous and detox facility
Targeted interventions for specific presenting issues:
1. Medication management-
There would be the reevaluation prescriptions drugs that would be made with the medical doctor
2. Individual therapy-
This type of treatment will critically explore, process and the resolve different kinds of emotions that the clients might be going through and the coping skills
3. Family therapy-
This treatment will be directed at Tim’s family. It will help the family to clearly understand the dynamics, the negative patterns and possible problems within Tim’s family structure. It would encourage the family to learn and make use of effectively communication and conflict resolution skills to manage any condition within the family
4. Physical therapy-
This treatment is necessary to Tim since it will target any form of physical pain that he might be going through. Therefore, physical therapy will aim to reduce pain and make the client as comfortable and relaxed as possible
5. Increase parent’s and sibling’s ability to support & encourage
It would enable Tim to recover much quickly from addiction and trauma. It is clear that family support plays a greater role in helping the client to improve hence the need to encourage them to be supportive.
5. Evaluate effectiveness of treatment
The evaluation of the client would be conducted throughout the treatment plan. The treatment will be assessed by keeping a record of the patient changes in behavior, his feelings, and thoughts. This record would be used for reference to determine whether the client’s condition has improved or is getting worse.
6 review of treatment plan
The review will be conducted throughout the patient plan and regularly. The investigation would be carried out from the moment Tim was admitted to the program to the time he was discharged.
Goal 1: overarching goal- To be free of drug/alcohol use/abuse
Objective 1: Tim was free from drug by the end of the five weeks program, but there is the need for more treatment to ensure that he does not go back to drug use
Intervention 1: He should avoid going to places where drugs are easily available and cut the relationship with his old friends who uses drugs
Intervention 2 : he should engage in other social activities such as play football
Goal 2: Relief of symptoms of trauma
Objective 1: the trauma symptoms was reduced significantly by the end of week five but he had not recovered completely
Intervention 1: He should continue undergoing the trauma treatment to ensure that it is addressed thoroughly
Intervention 2: Tim should avoid at all cost any stress related activities that might worsen the signs of trauma
Goal 3: Restore relationships with previous friends
Objective 1 : Tim was able to restore a positive relation with some of his past friends within a period of three weeks
Intervention 1: Tim should be encouraged to visit social places but not those related to drugs where he would be able to meet some of his old and new friends
Intervention 2 : By accessing contacts of some of his old friends, this might be the easiest way to restore the previous relationships
Goal 4 : Learn coping skills to work on adjust and adapt to his situation
Objective 1: Tim acquired new coping skills that enabled to adjust and adapt to the situation by the end of week 5
Intervention 1: Tim should be introduced into thorough counseling sessions that would help her cope effectively
Intervention 2: It is important to provide him with an income earning activity that would keep him busy as he adjust to the and cope with his situation
Whether to treat trauma or the addiction
It might be more important to first treat trauma, and this may in later days be followed up by the treatment of Tim’s addiction. This is because trauma is the primary determinant of successful treatment of drug addiction. Studies have shown that when an individual experiences longer periods of stress and being subjected to traumatic events, then it is possible that this person might suffer severe damage to their health hence the need to first treat trauma (Drake et al., 1998). A prolong trauma might cause a worse situation of physiological response that might significantly affect the client. Therefore, it is important first of all to manage the trauma that Tim experience before moving forward to target addiction to ensure that the treatment becomes a success and meet the goals established. Addiction problem can wait until the client has fully recovered from the trauma (Drake et al., 1998). There are higher chances that an individual might go back to drug abuse when trauma has not been addressed. It is thus essential to begin by treating trauma to ensure that the client is at peace mental and psychology to make sure that she follows the addiction treatment appropriately.
Drake, R. E., Mercer-McFadden, C., Mueser, K. T., McHugo, G. J., & Bond, G. R. (1998). Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin , 24 (4), 589-608.