Substance-Seeking Behaviors

Instructions

Read the assigned case study

11: Xanax-Seeking Client

You are seeing a new client but have completed the majority of the initial interview. As you wrap up, you will move through some psychotherapy utilizing motivational interviewing to collect the remainder of the data.

Motivational interviewing (MI) practitioners are similar to guides; that is, someone who does not choose the destination but offers information about the paths the client might choose. The evoking (immediacy) phase of MI focuses on recognizing and reinforcing change talk and eliciting and strengthening change talk. It utilizes techniques for rolling with resistance. This week, you will be introduced to question-asking techniques that will elicit and clarify change talk using the OARS and DARN-CAT techniques.

You will be applying these techniques in the video recording this week and will discuss them in your peer and self-reflection.

Case Study

Because a patient, 36-year-old Hispanic-American male, Kevin, has been showing signs of addiction to Xanax, the primary care provider decides to discontinue the patient’s Xanax prescription and refer for psychotherapy. The patient responds with anger, pleading that he can’t function without the medication.

As you move through the initial assessment, the patient states that he had a back injury on the job. He works for a concrete company and fell into a prepped basement area before the concrete was poured. He had some pain meds during recovery and was given Xanax for increased anxiety. He states he enjoys his job very much and that he cannot lose it as he is the sole provider for his family.

He lives with his wife and twin boys, age eight. He stresses again that he works hard for his family and can’t afford to miss work due to anxiety so he needs the Xanax to function. He denies any substance abuse or past medical history other than the back injury eight months prior. He has no legal history and no military history. His extended family lives near, and he reports a pleasant childhood with continued support even still.

Vitals:BP 138/90HR 76R 20T 97.2O2 99%Pain 5 on 0–10 scale (back pain)

Contact Your Partner

• Identify a time that both of you can meet online to record your video. Allot about 60 minutes for discussion with your partner and the recording of the video.
• Your partner groups are assigned in the first few weeks of the course. You will keep the same partner group throughout the entire semester. During the video session, you will both practice the assigned skills for this week, which are based on your readings, handouts, and other weekly materials.

During Your Meeting with Your Partner

• Each session should include the skills you used in prior weeks in the current video; don’t forget the skills you previously learned.
• In your practice session, role play the case study with your partner using empathy and other skills you have reviewed this week. Your partner becomes the client. You play the role of the therapist.
• Each partner will record a 15-minute video for each week using Zoom (see the instructional video on how to record a video at the beginning of the course). Provide a brief description (verbally) of the patient situation at the beginning of the video.
• Then complete the SOAP Note and Reflection Template (Word) and turn it in to the assignment dropbox.