Case Study: Voluntary Request For Termination

The counselor met with the patient for her scheduled Addiction Severity Index assessment. The patient is a 54 year old black male. The patient states he is single with no children. He report currently lives with sister in law of his decease brother. The patient reports having a 14 years of education however no degree. The patient report receiving disability for mental health disorder. The patient reports he is currently not on probation. The patient reports he last use Cannabis 7/17/15 and started using at the age of 13 and smokes 3 to 4 times a week at least 2 joints. He also report using Alcohol 7/20/15 a 40oz beer and usually drank a couple a day. The patient denies any issues with HI/SI. Patient also reports he is taking his medication as prescribed. The patient appear to be in the pre-contemplation stage of change. The patient next scheduled individual session with the counselor is on Monday, July 27, 2015 at 02:30p

San Francisco has another wrongful termination suit in the news. A worker from Madera named Jason Pimentel claims that he was the victim of wrongful termination. Pimentel filed his complaint on June 13th against Velex, Inc., Nexius Solutions, Inc. Included in the complaint are a number of alleged violations. The complaint was filed in the U.S. District Court for the Northern District of California.

Counselor red flagged pt. and requested that he meet for brief TX intervention to discuss his current counseling non-compliance status and explaining the risk of discharge from the program if he fails to do an individual session by 1/22/17. AMS receptionist told this writer that pt. is asking why he needs to meet with this writer. This writer told him to inform him that if he fails to complete one hour individual session by 1/22/17 he will be subject for a TX discharge. Pt. refused to meet with this writer and he failed to schedule an individual session on the above date.

3. The patient had informed this writer initially of his goals of wanting to return back to the Hartford Dispensary due to the length of time he has been with the clinic and his positive rapport with his prior counselor at the other facility. The patient was compliant with his individual sessions with this writer and provided cancellation if unable to attend the session in the meantime while he awaits on the process of completion with his intake at Hartford Dispensary.

The client met with his counselor for his 1x1 session to completed his Exit plan. The client has completed and turned in his second step and has went over it with his counselor. the client seems to be interested staying clean and sober and appears to be seeking understand as to how to stay sober. The client has learned to let go of some of his resentment but needs to work in letting the resentment he has against himself. The client reported that he follow through with the King of Kings sober living stipulation as to having to attend three meeting a week there at there program to prove that he wants to go into their sober living program once an open becomes available. the client reported as well that he will be spending more time with his

Frankie Tilmon continues to be out of treatment compliance. Frankie has missed his last four appointments, 7/2/15, 7/9/15, 7/16/15, and 7/30/15. Frankie contacted this provider on 7/6 to apologize for missing his appointment on 7/2 and was reminded of his next appointment on 7/9, which he agreed to attend. On 7/15 Frankie contacted this provider to apologize for missing his treatment appointment on 7/9 and agreed to make his appointment the following day, which he failed to appear for. On 7/16 Frankie contacted this provider to again apologize for missing his appointment and wanted to confirm his next scheduled appointment day/time. I told Frankie that his appointment day and time has not changed; it was on Thursdays at 4pm. Frankie told

Pt. has been in the program for over 3 years and she is currently in Phase 0. Pt. has participated in the AMS of De methadone clinic, she has been able to achieve abstinence from illicit drugs but she is failing to comply with the mandatory counseling sessions. Pt. is now eligible to receive phase 1 take home privileges if she maintains satisfactory attendance and scheduled appointments. Pt. identified her children as a motivational factor to change and to reinforce the importance of remaining in recovery. Pt. was advised to obtain a sponsor and attend 12 Step meetings. Pt. has done in achieving her goal of maintaining financial compliance despite the holiday financial stress. Pt. seemed to accumulate a back balance, but normally pays for late account balance in full upon notice of an administrative taper.

Objectives/Progress: As the Pt. has participated in the AMS program since 8/24/16 and he has been able to maintain abstinence from all illicit drugs for 6 months straight t. Pt.'s UDS has shown no evidence of drug use or lapse/relapse. Pt. is currently in the action stage of change as indicated by reminding himself of how much progress he has made and ability to change his behavior and achieve goals during the past quarter. He has currently obtained a full-time job as a shelving installer. Patient reports as scheduled to receive maintenance medication services as instructed by AMS Doctor and attends all mandatory one therapy session once a month. He continues to share his understanding of being powerless and unmanageable over his addiction. During the next quarter sessions, Counselor will support a realistic view of change through small steps.

D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this

Pt. has been in the AMS program for 2 years. Pt. has had no positive UDS results for two years. Pt. is on a dose of 150 of methadone and he is responding as expected to his prescribed medication. Pt. demonstrated responsible attitude by attending monthly AMS groups faithfully. Pt. has discontinued all illicit drugs use and now he has used financial income in a more self-sustaining manner. Pt is effectively addressing this area by making regular payments as scheduled. Demonstrates treatment maturity and appropriately participating in medical treatment services. Pt. was taught calming strategies, such as relaxation and breathing techniques as indicated by previous counselor documentation. Pt. was assigned to this writer caseload and counselor

The patient was placed on HOLD to see the writer to address his non-compliance with treatment. The patient was reminded about his Step 3 of the patient engagement. According to the patient as the writer reviewed the patient case history of his no show for counseling, group attendance, and continuously AWOL, the patient only response was, " I, know." The writer then inquired of the patient efforts to engage in mental health services through ICRC. The patient admits that he haven't done the intake when the deadline was extended for the third time. The writer discussed with the patient about the risk of facing an intent to discharge due to his non-compliance and addressed alternatives such as suboxone and transferring to a clinic in Massachusetts to accommodate the work location. The patient declines the writer's suggestion as he wants to remain with HCRC-Hartford due to the positive treatment and said. " You guys really care....I do not want to be discharge.....I, mean what is the process of the intent of discharge?" The writer explained to the patient about the appeal process as his record will be reviewed by the Practice Manager to determine as to whether or not to forward with the discharge or the discharge to be overturn.

Patient is a 35 year old male presenting to the ED involuntarily as petitioned by his cousin due to threatening to shoot himself with a gun. At the time of assessment, patient denies feeling suicidal or having a plan. When confronted about admitting being suicidal and having a plan to nursing staff and TACT, Mr. Crowson stated "He is here because he is going through withdrawals and his mother is lying." The Mr. Crowson reports in the past year he has lost his father. Mr. Crowson reported wanting to receive Methadone from hospital to help with withdrawal symptoms. He expressed feeling body aches, stomach cramps, chills, irritability, angry, and verbally aggressive behavior. Patient refuses to finish full assessment.

The client met with his counselor to discuss the problem area's that he needed to work on to improve his life situation. The client is working on several assignments that are part of his treatment plan. The client at this time has turned in his first and second step and went over it with over it with his counselor. The client seems to be tired of being in the program and just waiting for its end. The client reported that he ready to go home. The client insists that he is willing going to AA meeting once he is released from the program, moreover client continues to talk about starting an AA meeting at this house. The client appears to ready to go home. The counselor will continue to meet with the client to discuss the problem areas that he needs

Pt. has been in the AMS of DE program for 5 months and 7 days. Pt. has submitted three negative UDS results and he is compliant with the AMS of DE monthly mandatory counseling session. Pt. stated that he pays his TX fees every Saturday, works on his TX plan and takes medication as instructed by AMS Doctor. Pt. attends faithfully to the Clinic for dosing without skipping or missing days. Pt. reported that he maintains a supportive relationship with his brother and younger daughter. Pt. reported that he has not experienced any recent triggers and no relapse in the past 60 days. Pt. stated that he is committed to storing his prescribed take home medications in a secured lock box and placed on the top shelf of his closet. Pt. is a disabled veteran

Thank you for letting me know that Friendly's wishes that the EOL part My Central to be terminated at the end the subscription term (31-JAN-2017). I will make sure to cancel the My Central subscription promptly on the January 31, 2017