12<\/p>\n
Comprehensive Clinical Assessment<\/p>\n
Part One: Background Information on Client<\/p>\n
Identifying Information<\/p>\n
Mr. Chiron Harris is a 28-year-old African American male who resides in a one-bedroom apartment in Landover, Maryland. In Mr. Harris’s earlier years, he resided in Florida public housing with his biological mother and attended Florida’s elementary, middle, and high school. Mr. Harris relocated to Landover, Maryland, for substance use disorder treatment.<\/p>\n
Mr. Harris reported living with his biological mother in Florida public housing program. Mr. Harris grew up in a high crime and drug traffic area. Mr. Harris is not aware of his biological father’s whereabouts. Mr. Harris is the only child of his biological mother. Mr. Harris reported his biological mother’s drug use. Mr. Harris’s biological mother used heroin and crack cocaine. Currently, Mr. Harris’s biological mother is seeking help from a drug treatment program in Florida for older adults. Mr. Harris’s childhood records show no drug use from his biological mother during infancy. Mr. Harris reported his relationship with his biological mother as challenging. Mr. Harris’s biological mother would request Mr. Harris to leave home, at which time Mr. Harris’s mother would use drugs with her friends. Mr. Harris’s biological mother would request Mr. Harris give her money to purchase her drugs. Mr. Harris’s biological mother would verbally attack him using words such as “stupid, faggot, ugly.” Often, Mr. Harris had to rely on local community support from Juan(neighbor) and Teresa (Juan’s girlfriend) for food, shelter, and clothing. Mr. Harris viewed Juan and Teresa as a strong support system. Juan and Teresa’s occupations are unknown; however, it is presumed that Juan sold drugs to Mr. Harris’s biological mother. Juan has since passed on, and Teresa continues to contact and support Mr. Harris if needed. <\/p>\n
Mr. Harris received his high school diploma from Atlanta Juvenile Detention Center. Mr. Harris reported leaving juvenile services at the age of 25. Mr. Harris had difficulty finding employment with limited work experience and negligible education; he found side jobs that paid under the table until he became employed at a warehouse. <\/p>\n
Mr. Harris does not have any children. Currently, Mr. Harris is not dating or expressed an interest in dating. Mr. Harris reported a consensual sexual incident with a peer of the same sex in high school. Mr. Harris reported this incident as his first time engaging in same-sex sexual activity. Mr. Harris believes he is attracted to the same sex. <\/p>\n
Religion and cultural factors were not addressed directly with the client. No legal proceedings are pending at the time of the interview.<\/p>\n
Reason for Referral\/Presenting Concern<\/p>\n
Mr. Harris is voluntarily seeking treatment services for alcohol and cocaine use.<\/p>\n
Summary of the Presenting Concern<\/p>\n
Mr. Harris denied any previous mental health problems. Mr. Harris completed all childhood milestones with no learning or intellectual disability history. Full IQ scale confirmed through Welcher Intelligence testing scores. According to Mr. Harris’s high school records, there were several attempts with counseling Mr. Harris for disruptive and physical altercations with peers. Mr. Harris was bullied, teased, harassed, and repeatedly called names like \u201cfaggot\u201d from peers and his biological mother. Mr. Harris reported his biological mother leaving him in the home with no food, hot water, or money, his mother’s whereabouts were unknown, and neglect incidents were not reported. Mr. Harris’s early education reports noted behaviors of isolation.<\/p>\n
At 16 years old, Mr. Harris attacked one of his peers in school by slamming a chair on his classmate’s back and neck. The fatal incident was the reason for Mr. Harris’ relocation to Atlanta, Georgia, Juvenile Detention Center. Mr. Harris was released from Georgia Juvenile Detention Center at 25. Mr. Harris struggled to maintain peer relationships. He used alcohol to cope with his inability to maintain a healthy relationship and his recurring dreams of the fatal physical altercation between him and his former classmate. Mr. Harris has had panic attacks for the last four years when thinking about the fatal incident. At 26, Mr. Harris started working at a warehouse in Atlanta, Georgia. Mr. Harris enjoyed working. However, he was terminated for excessive tardiness. Mr. Harris reported consuming 3 to 5 bottles a day, totaling 15 to 25 bottles of alcohol a week. He reported drinking daily and consuming over the legal limit. Mr. Harris stated he tends to drink alcohol when he thinks about his biological mother’s addiction, being bullied, and his former classmate’s death. Mr. Harris later found a job as an Uber driver. In 2018, Mr. Harris was involved in an automobile accident and sustained a few injuries. Mr. Harris’s automobile accident directly resulted from driving under the influence of alcohol. Mr. Harris was sentenced to a defensive driving course and two-years probation. While on probation, Mr. Harris had to test bi-weekly for alcohol. During this time, Mr. Harris started using cocaine. Mr. Harris reported using cocaine 3 to 4 times weekly. Mr. Harris said, “he is not a frequent cocaine user because he is aware of the effects of drugs like cocaine, and he does not want to end up like his biological mother. Mr. Harris has relocated to Landover, Maryland, to seek alcohol and cocaine use treatment.<\/p>\n
Mr. Harris seems alert, has clear speech, and has a neat appearance. Mr. Harris’s first attempt at treatment has no signs of distress or withdrawal. Mr. Harris admitted to consuming alcohol one day prior to the intake meeting. Mr. Harris reported using alcohol for the past three years and one year with cocaine use. Mr. Harris consumes alcohol by mouth and cocaine through the nasal pathway(snorting). Mr. Harris is not legally mandated to obtain treatment; Mr. Harris is seeking treatment voluntarily. <\/p>\n
Summary of Strengths and Resources<\/p>\n
Mr. Harris can work and find employment opportunities that match his work desires. Mr. Harris’s juvenile criminal records are sealed. He can acquire and maintain employment. In addition, he can benefit from higher education resources. Mr. Harris’s strong desire to work and participate in treatment is his strength. Treatment is a collaborative effort between client and practitioner. <\/p>\n
Impact of the Presenting Issues\/Challenge<\/p>\n
Mr. Harris is experiencing past trauma issues related to his sexual identity, childhood emotions, and early exposure to substance use. Mr. Harris is not coping with the demands of his sexuality and past relationships with his family. <\/p>\n
Family of Origin History\/Family of Choice History<\/p>\n
Mr. Harris biological mother raised him. Mr. Harris’s biological father’s whereabouts are unknown. Mr. Harris’s biological mother has a substance use disorder. Therefore, Mr. Harris has a challenging relationship with his biological mother and often will not visit or contact his mother. According to Mr. Harris, his biological mother used his son for money. She neglected to provide Mr. Harris with adequate shelter, food, and clothing. Mr. Harris and his mother resided in Florida public housing. Mr. Harris’s neighborhood friend, Juan, occasionally provided him with food and shelter.<\/p>\n
Relevant Developmental History<\/p>\n
Mr. Harris was born full term. No history of developmental delays. Mr. Harris reached all childhood milestones. As a child, Mr. Harris was withdrawn and shy. Mr. Harris did not engage in age-appropriate activities with his peers. <\/p>\n
Family of Creation History<\/p>\n
Mr. Harris is not married and has no history of past marriages. Mr. Harris’s biological mother was never married, and his biological father’s whereabouts are unknown. Maternal grandparents’ whereabouts unknown, presumably deceased.<\/p>\n
Educational and Occupational History<\/p>\n
Mr. Harris satisfied his General Education requirements at Atlanta Juvenile Detention Center. Mr. Harris has limited work experience. Currently, Mr. Harris is using his savings to maintain his current lifestyle. <\/p>\n
Religious (Spiritual) Development<\/p>\n
Mr. Harris does not have a declared religion. When asked about history with the traditional 12 step model, Mr. Harris was unaware of the 12-step approach model.<\/p>\n
Social Relationships<\/p>\n
Mr. Harris can sustain relationships. However, Mr. Harris should evaluate the benefits of his relationship with others and proceed with mutually beneficial relationships.<\/p>\n
Dating\/Marital\/Sexual Relations<\/p>\n
Mr. Harris recalled a consensual sexual encounter with a peer of the same sex. Mr. Harris struggles with identifying his sexuality and coping with trauma surrounding his sexual identity. <\/p>\n
Medical\/Psychological Health<\/p>\n
Mr. Harris reported excessive alcohol and occasional cocaine use. Mr. Harris grew up in a household with repeated drug use and abuse. According to Mr. Harris, his biological mother often used crack cocaine and heroin. It was reported that Mr. Harris’s male mentor, Juan sold drugs to Mr. Harris’s biological mother and other community members. To date, it appears Mr. Harris is not showing signs of mental distress. However, a mental health assessment and CAGE screening tool is appropriate in this case. <\/p>\n
Legal<\/p>\n
At 16, Mr. Harris was found guilty of manslaughter and sentenced to Atlanta Juvenile Detention Center. Mr. Harris was released from the Atlanta detention center at 25. Due to an automobile incident involving excessive alcohol use, Mr. Harris had to complete a defensive driving course and bi-weekly alcohol testing. <\/p>\n
Environmental Conditions<\/p>\n
Currently, Mr. Harris resides in a suburban community. He lives alone in a one-bedroom apartment in Landover, Maryland. No cases of evictions and or pending evictions.<\/p>\n
Social, Community, or Recreational Activities<\/p>\n
Mr. Harris stated that he is not involved in illegal drug activity. Mr. Harris spends most of his time commuting to Florida to visit his biological mother and friend, Teresa.<\/p>\n
Social Policy Impact <\/p>\n
Mr. Harris’s early childhood living conditions with his biological mother may have impacted his life. Freeman (2002) found that housing is the most significant expenditure for most households. Housing affordability has the potential to affect all domains of life. High rent rates leave low-income families with little money for food, doctor’s visits, or other necessities. Therefore, households lacking affordable housing are vulnerable to diseases and illnesses associated with malnutrition and inadequate health care. As a substantial body of research attests, these types of psychological stressors can harm health (p.710). Therefore, Mr. Harris’s early poor living conditions have impacted his health and sobriety. Working towards social injustice is an ethical requirement for social workers. Urban communities are the most vulnerable communities; advocating for urban communities is expected under the NASW code of ethics. Although Mr. Harris appears to live well independently, he has placed some distance between himself and his relatives in Florida. Mr. Harris’s inability to adjust to his childhood environment has led him to withdraw from his relatives and his previous life in Florida. <\/p>\n
Clinical Summary and Recommendations<\/p>\n
Mr. Harris reported symptoms of substance use, recurrent dreams of traumatic events in early childhood home and social environment, inability to cope with life stressors, and inability to identify sexual preference. It appears Mr. Harris’s symptoms and signs are related to 309.81(F43.10) Posttraumatic Stress Disorder (PTSD), 303.90(F10.20) Alcohol Substance Use Disorders, Moderate, and 292.9 (F14.99) Unspecified Stimulant Related Disorder, cocaine. Mr. Harris will benefit from psychodynamic therapy practice. Assuming Mr. Harris is interested in therapy, psychodynamic practice will allow Mr. Harris the opportunity to discuss deep-rooted issues with his past and address the emotional attachment trauma behind his problems.<\/p>\n
Part Two: Summary of Diagnosis, Treatment Recommendation<\/p>\n
Assessment Summary<\/p>\n
Mr. Harris appears to be an active participant in treatment. Although Mr. Harris has a history of avoiding family and peer relationships, he feels comfortable initiating treatment. Mr. Harris provisional diagnosis of 309.81(F43.10) posttraumatic stress disorder (PTSD), 303.90(F10.20) Alcohol Substance Use Disorders, Moderate, and 292.9 (F14.99) Unspecified Stimulant Related Disorder, cocaine was based on his presenting sign and symptoms. For example, Mr. Harris met the criteria for posttraumatic stress disorder because he was exposed to a significant life event, such as the death of his classmate. He has recurrent and intrusive distressing memories of the event; dissociative reactions tend to avoid distressing memories of his childhood, and the distress duration lasts longer than one month. Therefore, Mr. Harris meets the full criteria for posttraumatic stress disorder.<\/p>\n
In addition, Mr. Harris met the criteria for moderate alcohol substance use disorder because Mr. Harris is not displaying signs of withdrawal. He presents five symptoms: excessive alcohol consumption, recurrent alcohol use, and failure to fulfill significant role obligations at work, school, or home. Alcohol use continues despite having a persistent or recurrent physical, psychological problem that is likely to have been caused by alcohol and recurrent use of alcohol in physically hazardous situations. In addition to alcohol, Mr. Harris is using stimulants such as cocaine. Based on the information provided, it appears Mr. Harris meets the criteria unspecified stimulant-related use disorder because he uses cocaine to abstain from alcohol. This category applies in which symptoms characteristic of a stimulant-related disorder that cause distress in social, occupational, or other tasks do not meet the full criteria for any specific stimulant-related disorder. <\/p>\n
Treatment Plan<\/p>\n
Presenting Problem: Seeking treatment for alcohol and cocaine use following an automobile incident. <\/p>\n
Long Term Goals<\/p>\n
Short Term Goals<\/p>\n
Intervention\/Tasks<\/p>\n
Maintain abstinence from alcohol and other drug-related substances. MAT treatment for cocaine use.<\/p>\n
Improve Alcohol Craving Questionnaire score within six weeks.<\/p>\n
Attend monthly drug abuse classes at recreational centers, libraries, and schools within three months<\/p>\n
Individualize counseling.<\/p>\n
Family counseling.<\/p>\n
Mutual support groups.<\/p>\n
Psychoeducation sessions.<\/p>\n
Maintain contact with biological mother.<\/p>\n
Contact and visit with mother quarterly.<\/p>\n
Call monthly and complete in-person visits quarterly. <\/p>\n
Continue to seek treatment from rehabilitation centers.<\/p>\n
Attend at least one sober support in his personal life that he can talk to when feeling the urge to drink.<\/p>\n
Weekly visits to AA 12 step program <\/p>\n
NA 12 step program<\/p>\n
Al-Anon 12 step programs<\/p>\n
Na-Anon programs<\/p>\n
No criminal or legal involvement.<\/p>\n
Follow all probation guidelines for two years. <\/p>\n
Complete bi-weekly check-ins. Complete bi-weekly alcohol urine testing. <\/p>\n
The treatment plan listed above will help Mr. Harris work on his long-term sobriety goals while addressing past issues with his biological mother. Many childhood trauma and experiences play a role in Mr. Harris’s substance use. Using screening tools such as CAGE can show Mr. Harris that he depends on alcohol. The Alcohol Craving Questionnaire tool will help Mr. Harris better understand his emotions and impulsiveness for alcohol. In addition to using screening tools, developing a therapeutic technique that will enhance Mr. Harris’s progress with treatment is essential. <\/p>\n
Theoretical Framework<\/p>\n
In Social Work, theories and models of practice help practitioners better understand and address social problems for clients. One theory that can help better understand Mr. Harris’s problems with alcohol is the psychodynamic theory. According to Payne (2016), psychodynamic theory seeks explanation and understanding of the person’s feelings and unconscious factors (p.111). Using the psychodynamic approach with Mr. Harris’s practitioners will understand the presenting problem and the range of antecedent factors that led to the client’s decision to seek treatment. Also, psychodynamic theory helps practitioners better understand how Mr. Harris deals with his environment and his psychological defenses of avoiding people and repressing (defense mechanism) childhood trauma by using alcohol. Time spent with Mr. Harris should help him address his emotions and examine how he deals with external threats and difficulties. I firmly believe Brandell\u2019s four elements of psychodynamic, social work theory will help work for Mr. Harris. <\/p>\n
Cultural Issues and Influences<\/p>\n
It is vital for practitioners working with Mr. Harris to have background cultural knowledge on African American men and sexual identity. Mr. Harris is a 28-year-old African American male struggling to cope with his sexuality, past trauma, and substance use. According to Irwin and Morgenstern (2005), African American men reported more drinks per drinking day than other ethnic groups. Everyday use of alcohol is used among MSM (men who have sex with men). The National Drug and Alcoholism Treatment Unit Survey indicates that about 40% of those who receive substance-abuse treatment have disorders related to alcohol and drug abuse (p.131). Therefore, it is essential to know the correlation between alcohol use for African American men and men who identify sexually with the same sex. <\/p>\n
Treatment Center Recommendations<\/p>\n
Below is a list of treatment centers available to Mr. Harris in Prince George\u2019s County. All centers have alcohol dependency counseling services, and recommendations were based on online reviews. <\/p>\n
Insight Treatment Centers are located in Camp Springs, MD. https:\/\/insighttreatmentcenters.net\/ <\/p>\n
Serenity Outpatient Services located in Upper Marlboro https:\/\/www.serenityoutpatient.com\/. <\/p>\n
IAFF Center of Excellence for Behavioral Health Treatment and Recovery located in Upper Marlboro, MD.<\/p>\n
https:\/\/www.iaffrecoverycenter.com\/?utm_source=google&utm_medium=organic&utm_campaign=gmbwebsite. <\/p>\n
References<\/p>\n
Irwin, T.W., and Morgenstern, J. (2005). Drug-Use Patterns Among Men Who Have Sex with Men Presenting for Alcohol treatment: Differences in Ethnic and Sexual Identity.\u00a0J Urban Health,\u00a082, p.127\u2013133. https:\/\/doi.org\/10.1093\/jurban\/jti032. <\/p>\n
Freeman L. (2002). America’s Affordable Housing Crisis: A Contract Unfulfilled.\u00a0American Journal of Public Health,\u00a092(5), 709\u2013712. https:\/\/doi.org\/10.2105\/ajph.92.5.709. <\/p>\n
Payne, M. (2016). Modern Social Work Theory (4th ed.). Chicago, IL: Oxford University Press.<\/p>\n","protected":false},"excerpt":{"rendered":"
12 Comprehensive Clinical Assessment Part One: Background Information on Client Identifying Information Mr. Chiron Harris is a 28-year-old African American male who resides in a one-bedroom apartment in Landover, Maryland. In Mr. Harris’s earlier years, he resided in Florida public housing with his biological mother and attended Florida’s elementary, middle, and high school. Mr. Harris […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[10],"class_list":["post-106943","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing","tag-writing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/106943","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=106943"}],"version-history":[{"count":0,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/106943\/revisions"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=106943"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=106943"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=106943"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}