Recovery Patient: A Case Study

D- This writer met with the patient about his request for a change of counselor. According to the patient, he reported that his assigned counselor, Cherron does not make himself available for schedule appointment or even at the exact time of the appointment as the patient tends to wait for a quite some time. In the beginning, as per patient, his assigned counselor was punctual but everything has changed since the patient made a compliant against the counselor for not informing the patient about the need to validate his Rx Scripts and the severity of the matter to avoid entering a detox treatment. Since then, the patient feels that his relationship with his counselor has changed and feels that Cherron tactics appeared to be vengenaceful whereas

D-Met with the patient to discuss her Aruba trips. This writer advised the patient that this writer is making contact with some staff members at the hospital, but was unable to speak to someone from the psychiatry department due to the hours as there is a 2 hour difference. The patient appeared to cheerful to learn that this writer is moving her host application forward. According to the patient, she apologized about her behavior yesterday and says, " Bobby was on me like why your counselor is not doing anything. My counselor did this and that.....it's frustrate me." This writer informed the patient that this clinic did not ignore her request whereas this writer was aware of it a month ago, but there was barriers to the patient dose as she

D- This writer met with the patient upon front desk specialist request as he was a minute late to his Orientation II. The patient provided an explanation that there was traffic and tried his best to get to the clinic. During the course of the session, this writer completed the Orientation II addressing what is methadone? How does it work? It's origin, clinic's policy regarding to dosing and medication validation and much more. The patient during the session asked appropriate questions about methadone. The patient provide some backgrounds of his drug history and his aspiration for his recovery process. The patient hopes to be counselor some day to help others with their addition. Lastly, the patient is employed and sales car parts.

The patient arrived on time for the counseling session. Reports feeling unstable on her dose and requested for a dose increase of 5mgs. Please note, the patient relapse last night and her relapse use listed above this header. According to the patient, she reported the following withdrawals: cramping in the stomach, backaches, feeling sick, chills. and sweats." This writer completed the HCRC internal form for a dose change and questioned the patient as to how long she has been dealing with the withdrawals and her response was, " Couple of days." This writer then says, " Edna, if you were feeling this way since last week, you need to report it immediately to avoid a relapse."

D-The patient arrived on time to attend the Women's Group. This writer advised the patient that the group session was cancelled due to low attendance; however, the patient agreed to meet with this writer for a 1:1 to get credit for attendance, This writer informed the patient about what to expect pertaining to topics of what will be discussed and then asked the patient about her expectation of the group session. Furthermore, this writer addressed with the patient about last week session regarding to patient #2570 comment. When asked by this writer as to how often she sees patient #2570, the patient response was, " Well, I am not trying to get anyone in trouble, but she drinks occasionally.....probably would have one to drink during special

D-The patient arrived late to her counseling session. Reported stability on her current dose and denies the need for a dose increase when offered by this writer. This writer addressed with the patient about her attitude about learning about her results yesterday as she appeared to be in a hurry and nonchalant about the result. According to the patient, he was affected by the news and says, " I had left over cocaine and threw it away.....I am done with that stuff." The patient updated this writer on her plans to change her mental health provider from CHR to the Hope Center as the patient dislike her psychiatrist at CHR. Furthermore, the patient reports, her CHR case manager will assist the patient referral to Chrysalis to be assigned with a

Pt. was readmitted to the program on 8/10/16 and he has shown good participating during therapy session. Pt. is currently encouraged to meet with the Primary Counselor to discuss and practice new behavior in order to progress to the Maintenance stage of change. As the Pt. has participated in the recovery program and has been able to achieve phase 5 of TX program and maintain 7 months of negative UDS results. Pt. remains in compliance with TX obligations by attending mandatory monthly counseling and making payments in advance despite recent hospitalization. Pt. was hospitalized due to a car accident in Lewes, DE. Pt. also indicated that he stills support his child financially. Pt. indicated that he is currently not working after having a facial

D-Met with the patient to address her request for a change of counselor. According to the patient, she expressed that her assigned counselor shows no empathy towards her personal issues when she attempts to discuss it with her assigned counselor. The patient then says, " With Cherron, every session is negative, nothing positive. No encouragement by him......I've through a lot. I broke up with the love my life 8 months as he left me for another woman....I was there for him when he was incarcerated for two years (the patient was emotional-in tears). I tried to talk to Cherron but he was not being understanding. I, know, I keep testing positive, but I am going through a lot, you know. I am the care taker of my parents. No social life." This writer reviewed the patient's case history as there has been numerous no shows and the patient is currently on a Step 3 for the no shows/ongoing illicit use. According to the patient, she continues to miss her session due to her feelings towards her counselor. When questioned as to why she did not mentioned this prior as to why it took 8 months. The patient says, " I did and was told that it will be entered in some green book.....I need a female counselor that can relate to me or even have empathy. I need guidance and Cherron is not helpful at all.....He tends to keep me in session for an hour whereas it was suppose to be a 1/2 hour session." Nevertheless, the patient is seeking to enrol in mental health services through Brownstone for treatment or IOL.

(S): Writer met with the consumer on Tuesday, 1/9/18 at 1:40pm at his home. The consumer report that the stress test went good. The consumer states that his heart rate was low and he was told to continue to take his medication. The consumer states that he is working on ways to handle stress. The writer discuss with the consumer about some coping skills which should help him to deal with the stress. The consumer is schedule for medication review appointment on Wednesday, 1/10/18 at 10:00am. The consumer denied any sleep and appetite problems.

The pt. informed the writer two days before attending his group appointment at SelfRefind he attend his psychologist at RVBH. The psychologist placed him on a new medication Seroquel. He took the medication before group, during group he was falling asleep. He stated they could not wake him up during group. After group he fell down and had to crawl to his vehicle. After his group he attended his psychologist office and inform him or her he was no longer going to take Seroquel. While speaking to him on the phone, he spoke very fast, hard time focusing on the writer’s questions. The writer had to redirect him back to the question.

D-The patient received his dose increase today from 35mgs to 40mgs. According to the patient he was doing okay at 35mgs, but feels 40 mgs will do better. The patient admits to using heroin last night, 2 bags by IV. This writer stated he did not use due to cravings, but to help him sleep as he going through withdrawals. The patient further believes with the new dose, he will be able to sleep better at night. This writer then asked the about the outcome of his blood works with Brownstone Clinic. The patient then admits that he hasn't follow up because he did not have any minutes on his phone, but will follow up today and update this writer during the next scheduled session. This writer then proceeded to discuss with the patient about his goals for his treatment during the remainder of the session.

“We were driving up the mountain and a boulder came rolling down and flipped over our car”

D: Group topic was focused on addressing Dim 2, 5, and 6. Client was provided basic information about some of the major health problems and the significance of insomnia in early recovery. Client learned the benefits of having a good sleeping pattern and improving physical well being. Client was attentive and participated in the group activity, stated “I try to be more structured. I also need to go to see my dentist because I haven’t in a while.”

As a voting member the RCC is require to review the documents on each case and provide their decisions to the WII Cell coordinator

On July 10, 2016, Cindy experienced increased fatigue and shortness of breath. She was admitted to the hospital and diagnosed with congestive heart failure. On 07/16/2016, Cindy went to the Hengsen Home operated by CARH, Inc. for a respite stay for recovery and medical follow up. Cindy remains at the Hengsen Home under a respite stay awaiting the conclusion of her medical recovery. It is Cindy’s personal goal to return to independent living in the community and employment. At the time of Cindy’s annual plan meeting, she was awaiting the outcome of a resent sleep study and pending appointment with the pulmonary specialist where it is believed the doctor will clear her of any medical restrictions. When Cindy receives medical clearance her team