substance-use-disorders-diagnostic-activity-1

Can you help me finish those problem within 10 mins? Thank you so much.

Problem 1:Kai is a 17-year-old who lives with his mother and his brother. His dad is a sales rep and is on the road during the week. He meets with you to talk through some of his issues and explains the following:

“Yeah, when my dad is home, he just drinks and watches TV. When he gets drunk he yells at me and my mom and throws stuff around the house. Mom also drinks. Watch out when they both get smashed. Man, it’s an ugly show. We’ve had the cops come out several times. I just take off when they start getting into it. Then there’s my brother, a complete nerd. Always gotten good grades, never been in trouble; responsible, dependable, healthy, and clean. He’s a parent’s dream and I’m his evil twin brother.

I started drinking and smoking when I was 13, in the eighth grade. School was a total drag. All the kids would talk about was high school and the classes they were going to take, and me, I was just trying to figure out where I was going to get money for my next pack of cigarettes.

Now I smoke about a pack of cigarettes a day, plus a couple of joints too. At night I’ll drink 3 or 4 beers plus a few shots of vodka. On the weekends is when I really get down to partying. I’ve played around with lots of stuff. I’ve tried pot, coke, mescaline, molly, mushrooms. I’ve even shot up a few times. When I’m partying, I like to mix things up a bit. If I drink too much I black out. It’s not a big deal though.“

What in Kai’s family history might lead you to suspect that there may be a genetic component to his substance abuse problems?

Problem 2:What in Kai’s environment might lead you to believe that environmental factors may also play a role in his substance use?

Problem 3:Laura is a very successful businesswoman in the high-stress world of corporate finance. She has been referred to you by the company’s employee assistance program. Laura is frank and honest about the events that have brought her to your office. Laura explains that although she tells herself that she will only have one or two glasses of wine with dinner, she usually finishes the whole bottle. In addition to drinking alcohol, Laura reports that about five years ago, she started having trouble sleeping and started to take Valium. She states that she normally takes one or two pills two to four times a week to help her sleep. In the morning she drinks at least 5 to 6 cups of coffee daily, even on the weekends.

Laura tells you that last week she met with the firm’s top client at a business luncheon. She could not get out of bed that morning. It took all her willpower to get up and get dressed. As it was, she was still 20 minutes late, which is “inexcusable” in the eyes of her boss. She was so nervous and sick she had to excuse herself in the middle of her presentation. In the bathroom she took a Xanax to calm her nerves. Then at the luncheon she could not stop herself from ordering several glasses of wine and had to be assisted to her car after the meeting was over. According to Laura, her client spoke to her boss and then canceled his account with Laura.

If you were working with Laura, what would be the first issue you would address and why?

Thank you so much.