HSE-310 Module 5 Journal Reflection

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Southern New Hampshire University *

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HSE-310-T1

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Health Science

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Dec 6, 2023

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Module 5-1 Journal: Case Study Reflection Sarah Dobbs Human Services Department Southern New Hampshire University HSE-351 Substance Use: From Prevention Prof. Keenan November 21, 2023

Reflection: There are many things and factors that have changed in Penelope’s case between the time of part one and part two. In part one, Penelope wasn’t quite sure if she was ready to admit if she was, in fact, having a problem with drinking and substance abuse. She was a little worried and stated that she didn’t want to “turn out like my dad”. In part one, she seemed to minimize her drinking because she stated that she didn’t drink as much as her fellow college friends. She also seemed to justify her use of taking pills by saying that they were helping with her migraines because “Excedrin just doesn’t cut it”. Moving on to part two, Penelope’s situation seems to have escalated, and her alcohol and substance abuse have increased, and her life has become more unmanageable. She had started using her friend’s mother’s oxycontin, then eventually turned to snorting heroin. Penelope had gotten kicked out of college and her parents kicked her out of their home. She states that her siblings are there for her, but that they don’t understand her situation. She also lost her job. Penelope had tried outpatient treatment but felt that she was talked down to. At this point in Penelope’s case, she feels that if people would stop “nagging” her, then she wouldn’t have to turn to substances. Penelope also states that she would like to learn more about her Native American side of her family, and that culture. After assessing and discussing the diagnosis with Penelope, she begins attending in-house group therapy, individual counseling using CBT and motivational enhancement therapy, and is referred to educational therapy. She is also referred to an Introduction to 12 Step. It is also suggested that she attend a women’s group, and family intervention and counseling be implemented to address the family dynamics. Penelope starts to see how her view of her alcohol and substance abuse was distorted. In part two of her case, she finally starts to admit and see that

she has a problem. At first, she is making friends easily and is embracing her treatment, she expresses a desire to “make amends” with her parents and family, and in the future getting back to school and wanting to help other addicts. After a few days of dealing with withdrawal symptoms, and a few days after doing her group and individual therapy, Penelope states that she wants out of treatment. She had only been abstinent from alcohol and substances for 15 days at this point, but states that she is not “into” the AA/NA groups. She wants to meet to terminate treatment and discharge before attempting much of what was in her treatment plan. Referral for other services including community resources: I would most definitely refer Penelope for other treatment services. I would have first referred Penelope for medically managed withdrawal and detox services. I think that when it comes to alcohol use and opioid use, these two substances and getting off them require medical monitoring or management. Many times, it is the withdrawal and detox that will make a client want to leave. I would also refer Penelope for inpatient treatment as opposed to any outpatient, whether intensive or not. I agree with the referral to a primary care provider to address her migraines, so that they can be diagnosed and treated, so that there is no overlapping in services or missed treatment that could complicate her situation due to co-occurring medical conditions. I would also refer Penelope to a mental health professional. I feel that there are some mental health and emotional factors in Penelope's case that are undiagnosed, and upon diagnosis and treatment can help alleviate other factors contributing to her substance use. Penelope is very early and fresh in her path for treatment, so her risk of relapse is very high, especially if she leaves treatment. After treatment, if she were to stay and complete treatment, I would refer her to services for housing, getting back in school, and employment services. This will help her

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