Treatment plan: Substance abuse
Dylan is a sixteen year old adolescent and is having problems with substance abuse. Dylan began smoking at a tender age of 11. One of the factors that have contributed to Dylan’s condition is the ongoing conflict with her mother and her father. His father thinks Dylan is lazy but her mother usually supports him. Dylan attempts to seek treatment have been affected by the lack of his family involvement. This paper examines how the cognitive-behavioral approach can be used to treat Dylan’s condition.
The available literature indicates that when adolescents become witnesses of conflicts in a family environment they externalized behavior problems. The available literature also concurs that inter-parental conflicts are detrimental to children’s well-being.
According to the DSM of mental disorders, for one to be diagnosed with substance abuse of the following conditions should exist. Firstly, there must be recurrent substance resulting in a failure of the victim to fulfil major role obligations. Secondly, the victim uses substances recurrently and in a hazardous manner. Thirdly, there must be recurrent substance-related legal problems. Lastly, the victim continues to abuse drugs despite persistent or recurrent social or interpersonal problems.
In this case, there is a recurrent substance-related legal problems. Dylan has on several occasions been in trouble with the law reinforcers. The current situation is not only worrying to people around him but also his probation officer. The probation officer is afraid that if Dylan continues like that, he is likely to end up in a detention center. In order to correct Dylan’s problem, Corey (2008) feels that the involvement of his family is important. According to Corey (2008) family involvement encourages the patient to become involved too, while lowering the patients’ rates of attrition. Corey’s (2008) view is supported Marlatt and Gordon (1985) who argue that family treatment approaches are more effective than individual or group-only approaches. Based on Dylan’s history and the above discussion, his family needs to be involved and that is why the treatment plan will be based on the cognitive-behavioral approach, which is one of the approaches of the family therapy models.
Dylan will attend, 90 minute sessions twice a week.
During the first session the following activities will be carried out:
Dylan will be introduced to the work plan, rules and norms that will guide the therapy
Dylan will be taught how to replace substance abuse related thoughts with positive thoughts. During this session Dylan will also be educated about the negative consequences of substance abuse
This session will be dedicated to developing problem solving strategies. The problem solving session will several steps. First, the problem will clearly be defined. Secondly, brainstorming will be used to identify possible solutions. At this point, Dylan’s family will be involved in order to support him to go through the therapy sessions. Thirdly, the advantages and disadvatges of each solution identified will be assessed. Fourthly, the best hypothetical solution is chosen.
In the subsequent sessions, social skills training will be carried out. Social skills training includes psysosocial education, modelling, reinforcement, behavioral rehearsal, role playing and feedback. These techniques will help him to to communicate effectively. Communication skills will help him to respond to risk situations that are likely to lead to substance abuse. Most important, social skills training will help Dylan to deal with any forms ofabusee frombeing hiss father. Presently, Dylan lacks interpersonal competencies and as such he will also be taught a more specialized form of social skills training known as assertiveness training. Assertiveness training is suitable for patients who have had difficulty expressing anger or irritation and people who allow others to take advantage of them . In this case, Dylan father is taking advantage of him and is only fair that Dylan is taught how to behave assertively in such situations. Assertion training will also increase his behavioral repertoire and replace maladaptive behavior (Witkiewitz & Marlatt, 2004).
During this session, Dylan’s family situation is also addressed. At this point, Dylan’s parents will be summoned. They will be informed about how the family environment has contributed to Dylan’s present condition. The family will provide Dylan with the necessary social support network
During the subsequent sessions, Dylan will als about relaxation techniques,
Relaxation training will help Dylan to deal with any potential stresses within the family environment. Dylan will be taught basic of relaxation techniques and will be required to exercise these techniques at home and under the guidance of the counselor. Relaxation training will cure 4 to 8 hours of instruction. Some of the skills that Dylan will learn include deep and regular breathing, and how to relax arms muscles, followed by head, neck, shoulders, back , abdomen, thorax and lower limb muscles (Robinson et. al., 2011).
In This case, the therapy will utilize the eye movement desensitization and reprocessing. This technique has found to be useful for treating patients with a diction problem. The technique was developed by Franice Sparrow and it entails the use of imaginal flooding, cognitive restructuring and the use of rapid, rhythmic eye movements (Rosenheck, & Desai, 2011). Is technique has found to be used in the treatment of patients suffering from PTSD, anxiety, phobias a depression and addictions.
The last session will address issues related to relapse prevention. Relapse is seen as a transactional process whereby a series of events lead an individual back to the initial pattern of behavior (Marlatt, & Donovan, 2005).. The three common relapse factors are negative emotional states, in personal conflicts and social pressure. In this case, Dylan will talk how these factors contribute to his condition and how to maintain abstinence from substance abuse.
Dylan’s social environment is one of the maintaining factors behind his present condition. The cognitive behavioral approach can be used to deal with the problem. The therapist will use social training sessions, relaxation session, behavioral modification sessions, and problem solving strategies to address the Dylan’s condition. However, for this approach to work, Dylan needs a social support network that will help him to deal with teh problem. In this regard, his family will prove helpful in maintaining a conducive environment which will help Dylan recover successful.
Corey, G. (2008). Theory and practice of groupCounseling (7th Ed.). belmont, ca: brooks
Marlatt, G.A. & Gordon, J.R. (1985). Relapse Prevention. Guilford Press.
Marlatt, G.A. & Donovan, D.M. (2005). Relapse Prevention: maintenance strategies in the
Treatment of addictive behaviors. New York: Guilford Press.
Rosenheck, R, & Desai, R. (2011). Substance use comorbidity among veterans with posttraumatic stress disorder and other psychiatric illness. Am J Addict, 20(3), 185-9.
Robinson, J., Sareen J, Cox BJ, & Bolton JM.(2011). Role of Self-medication in the Development of Comorbid Anxiety and Substance Use Disorders: A Longitudinal Investigation. Arch Gen Psychiatry, 68(8), 800-7.
Vijayakumar, L. (2011). Substance use and suicide. Current Opinion in Psychiatry, 24(3), 197-202.
Witkiewitz, K. & Marlatt, G.A. (2004) Relapse prevention for alcohol and drug problems.
American Psychologist, 59, 224-235.