Case Review : Alcohol Use Disorder, Severe

The idea of motivational interviewing builds on Rogers' theories about people having freedom of choice and changing through the process of self-actualisation (Davidson, 1994). Miller and Rollnik (1991) describe it as a technique in which the heath practitioner becomes a helper in the change process while expressing acceptance of their client. A central goal of motivational interviewing, says Geldard & Geldard (2012), is to help resolve the ambivalence which prevents clients from realising their personal goals and to facilitate positive change. Motivational interviewing is mostly utilised to counsel those troubled by addiction (not just substance, but also behaviours).

The DSM–5 incorporates the two DSM–IV syndromes, alcohol abuse and alcohol dependence, into one disorder - alcohol use disorder (AUD). AUD has sub-classifications of minor, moderate, and severe. A person who meets one or more of the criteria for abuse within a 12-month period would receive the “abuse” diagnosis. Anyone with three or more of the “dependence” criteria (see items 5 through 11) during the same 12-month period would receive a “dependence” diagnosis ( American

Alcohol abuse is growing rapidly throughout U.S. society. One in every twelve adults is being diagnosed with alcohol abuse (Barlow and Durand, 2006). All that are diagnosed with alcohol abuse must meet one or more of the following criteria within a twelve month period: he/ she must fail to accomplish major work, school or home

The choices he used to cope with his life events created his disorder. It almost seemed as inevitable for him to avoid this path because the cues that presented themselves were all just factors that amplified his poor mental health outcome. The biological indicator, the alcohol dependence for stress relief, and then the substance abuse that was evoked by the physicians were all measures that built on top of each other. The DSM-V categorizes substance use disorder as a combination of substance abuse and substance dependence. It is said that only two symptoms need to be apparent in order to be diagnosed with the disorder. Mark’s pharmacological effects of tolerance and withdraw of the pain medication are alone enough criteria for the diagnosis. In conclusion, Mark substance use disorder is a cluster oh his behavioral, cognitive, and physiological symptoms which resulted in his continue use of the substances despite the evident

Although, PO appears to be aware and understand how alcohol and drug use negatively impact him physically and mentally, he is not yet implementing recommended changes. Further family work, anger management, education about addiction, and abstinent from alcohol and all mind-altering substances therefore are required to increase PO's readiness to change.

Their relationship was strained, and oftentimes nonexistent, up until the point where Nic hit “rock bottom”, when he would call his parents and beg for help. While Nic was out alone struggling to rid himself of his inner demons, David and the rest of his family dealt with the realities of Nic’s drug and alcohol addiction directly. At first came the denial. The denial that there was even the remote possibility that their sweet, innocent Nic would become dependent on substance to keep him remotely functional. Rather than let his son waste away, David utilized his journalistic abilities and set off to research as much as he could about addiction. He set out to contact ULCA’s top methamphetamine researcher, Dr. Richard Rawson. As a researcher, Dr. Rawson has no agenda other than fact and truth. He is completely dedicated to the work he does for one sole reason, to help addicts (Sheff, 2008, p.277). Alongside research, Sheff also attends Alcoholics Anonymous and therapy sessions to better grasp what is going on with his son. In these sessions, he is continuously drilled of the three Cs, “you did not cause it, you cannot control it, and you cannot cure it”. Sheff has difficulties accepting all but one of the three Cs at the end of his memoir. He comes to realize that he cannot control, nor can he cure Nic’s addiction. After years of panic and worry over Nic’s wellbeing, numerous rehab treatments and therapy

In the stage, Precontemplation, people with a problem cannot see it. They have no way of understanding the need of change and continue to use. Contemplation is the next step and now the client can recognize there is a problem and entertains the thought, but nothing more. When a person is in denial, it is critical for the therapist to convince the client in denial to go from Precontemplation (no problem) to contemplation (recognizing a problem). In order to get Tonya to move to the next stage, the therapist clarifies the house hold problems occurring that are a byproduct of her drinking. Once the problem has been clarified, the therapist makes an initial recommendation for action based on her assessment. In this case, the therapist suggests that Tonya participates in three Alcoholics Anonymous (A.A.) classes in the next week. The therapist then strengthens the thought of action with a very simple, but affective question, “What would it hurt?” This simple question creates a deep thought for Tonya’s purpose for therapy. Tonya’s willingness to participate in a program that will help moves her towards the direction of the Determination/Preparation stage for quitting. They have made the decision and now Tonya needs further guidance in supporting the decision. The next stage is action and the client in denial has not yet reached this step but prior to her next meeting

Kim left the rehab center when her daughter got married. Kim brought along sober coach with her. However, she became so uncontrollable that her sober coach left. It was never determined if Kim was drunk, or high on drugs, but she said allegedly said horrible things to her daughter, her daughter’s husband and his family. She didn’t go back to the treatment center after that incident. Because of her drinking problem, she was fired from “Real Housewives of Beverly Hills.” Things continued to decline for Kim. On August 2, while shopping in Target, she shoplifted merchandise valued at $1,000. ET reported that she had three shopping carts full of things, but was charged for only

So how does an addicted individual escape addiction? Miller (1998) argues that there can be a sudden shift in how the person perceives the pros and cons of their behavior. This is often seen over time as the suffering directly attached to the addiction increases and the ratio of pros and cons shifts. Through motivational interviewing, Miller suggests that therapists and other helping professionals can lend clients another perspective, a mirror image of themselves, so as to increase the client's conception of the consequences and saliency of their

The Diagnostic and Statistical Manual V (DSM 5) describes the essential feature of a substance use disorder as a cluster of cognitive, behavioral and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. Specifically, the DSM V describes diagnostic criteria as a problematic pattern of alcohol use leading to clinically significant impairment or distress. Mr. Holliday manifested the following:

Drinking can cause a person to have a complete personality change and become violent or hostile after drinking. They may also become irritable or panicky during times when a drink is expected. An alcoholic may drink to the point of black out; this is where they don’t remember what they’ve done or said that happened during a bout of drinking. A definite red flag for alcoholism is when a person has to have to drink in the morning when they first wake up.

This section, using the DSM-5, has determined Frank has met the criteria for a moderate Alcohol Use Disorder (AUD). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2013) outlines anyone meeting any two of the 11 criteria’s under the DSM-5, within the same 12-month period would receive a diagnosis of AUD. The severity of an AUD, mild, moderate, or severe, is based on the number of criteria met (NIAAA, 2013). The presence of four to five symptoms would indicate a severity of moderate AUD (NIAAA, 2013). Based on Frank’s story shared in sessions, the therapist has determined that Frank has met five criteria’s of the DSM-5. Below are the specific DSM-5 criteria’s the therapist used to make this determination:

Group activities included learning about the distorted thinking patterns, how it impacts on the relapse process, and discussing how to work through stressful and difficult situations without engaging in criminal behavior. Mr. Taylor moderately participated. Stated “I try to keep a gratitude journal every day. When I get away from the habit, I tend to fall right back into a negative pattern. However, it doesn’t take long to get right back to where I should be once I pick it up again”. Mr. Taylor reported going to morning self-help meeting before treatment, and that he is doing well in treatment and recovery.

I was born in Shreveport, Louisiana, a city that is located exactly 327 miles away from New Orleans. I remained in Shreveport for the first six years of my life but due to my mothers excessive drug and alcohol abuse, I was put into the foster system. Due to overcrowding in the Shreveport foster homes, I was later sent to New Orleans where I would remain in the system until the age of fourteen. I orginally planned to leave NOLA and head out west, but that changed when I got sent to juvie. I spent six years behind bars for aggravated assault. Once out of prison, I ended up staying in New Orleans, gaining a GED and going to college.

The theme of the group discussion was the effects of changing thought processes, which enables people to alter the way they feel, and respond by through making behavioral changes. The Facilitator increased the patients’ awareness of this process, by engaging them in the discussion where patients reflected on situations that they responded both positively and negatively to, and identified ways in which they would be engaged in the process of changing their thinking in the future to manifest changes in their lives. An example provided included; an individual may have previously thought that being an alcoholic was rational reason for driving drunk. Through blaming being an alcoholic they continued to drive drunk without holding themselves accountable for this risky behavior. Through identifying this irrational thought, they recognize the need to change their thinking, and take responsibility for the action that followed that thought. The facilitator noted that the miracle of recovery is change, and the more time that lapses, the more clearly patients can reflect on their experiences. The facilitator divided the patients into groups based on the length of their sobriety to identify emerging themes. The groups included patients who were sober 1 through 15 days, 16 through 30 days, 31-45 days, and 76 days or more. The groups discussed five things they were thinking while they were using substances. Through this activity, patients identified and discussed the similarities