Assessment and Intervention in Addiction - Essay Example

Assessment and Intervention in Addiction Number Introduction Briddon, Baguley and Webber (2008) observe that according to the American Psychological Association, also known as the APA, a far much larger population of the world is beset by mental illnesses or psychologically relevant sicknesses, contrary to average opinion. This is to the effect that there many who need mental or psychological therapy than is commonly thought. When administering psychological or mental treatment, it is important that proper intervention plan is determined and drawn. In turn, it is important and inevitable that the intervention plan be based upon proper diagnosis of the patient and accurate outcome data for the intervention that has been chosen. This is because, proper diagnosis of the patient and accurate outcome data for the intervention will determine the suitability of medical intervention that will be chosen and administered on the patient. The import of the standpoint immediately above is underscored in the ensuing discourse. The Chosen Treatment Plan Among the many treatment plans available, the bio-psychosocial theory has been chosen as the most tenable and effective approach to treating Paul’s problem. This is because, Paul is not only a bio-psychosocial entity but his problems have strong underpinnings and causes which are specifically and strongly founded in bio-psychosocial factors also (Kasiram, and Harilall, 2011). Develop an Intervention Plan It is important to develop a bio-psychosocial plan which will take care of the dangers of recidivism on the side of Paul. However, before the plan is drawn, it is very important that proper diagnosis is made, so as to gain insight into the extent of Paul’s mental illness. In this case, the best way of reading into Paul’s psychological instability is the APA Diagnostic Classification method, also known as DSM-IV-TR. This is because DSM-IV-TR caters for conditions such as motor skills disorders, attention-deficit and disruptive behavior disorders, pervasive developmental disorders (covers childhood disintegrative disorder), chronic motor and vocal TIC disorders, delirium, substance-induced psychological illnesses and general medication-induced disorders such as catatonic disorder and personality change. All these conditions are consistent with Paul’s conditions (Adams & Grieder, 2005 and Ministry of Health 1994). In this case, it will be important to divide DSM-IV-TR diagnoses into five categories: Axis I to Axis V. Axis I deals with clinical syndromes and analyses psychological illnesses and conditions such as social phobia, depression and schizophrenia. The second step that Paul is to be taken through is the Axis II: developmental disorder and personality disorder diagnoses. In this case, Paul is to be checked against personality and developmental disorders or conditions such as paranoia, borderline personality disorder and antisocial disorder that may have resulted from his neglect (Smith & Seymour, 2001). Axis III looks into the physical conditions which may have played a role in Paul’s development or arrested development, continuation, or exacerbated factors in Axes I and II. Paul’s brain injury that was caused by the motorcycle accident will be considered at this stage. Paul is to be taken to Axis IV which looks into the severity of psychological stressors. At this point, Paul is to have the events in his life (such as the absence of Paul’s family members and the failure to access education, employment or other factors in Axes I and II. According to Briddon, Baguley & Webber (2008), Axis V is analyses the highest level of functioning. In this final axis, the clinician is to rate Paul’s level of functioning at the present time and the optimal level of functioning in the previous year. This will help the Alcohol and Drug Assessment Service and its clinicians determine the manner and extent to which the four aforementioned axes are affecting the patient and the type of adjustments or changes that are to be therefore expected (Sellman, 2009). It is most obvious from the case or scenario that has been provided that Paul’s vulnerability to recidivism has its underpinnings in social factors. The social factors in this case include: his social circle and networks that habitually use drugs and have a penchant for criminal activities; and Paul’s inability to work. Just as Velasquez, Maurer, Crouch & DiClemente (2001) observe, because of the expediency of the social network and social factors that Paul draws from, it is important that Paul’s social needs are tackled. In this respect, it will be important that the local Alcohol and Drug Assessment Service establishes all the factors that determine Paul’s socioeconomic status and pull him back to drugs and criminality. In this respect, it is important to consider Paul’s livelihood during and after the rehabilitation or treatment. In this case, it will be important that the local Alcohol and Drug Assessment Service considers according Paul with ways of earning his livelihood. This may involve getting Paul a job to start with, or assisting him get a job by recommending and/or directing him to an organization or supporting Paul’s financial needs until he is able to fend for his needs. According to Miller and Rollnick (2002), the need for the local Alcohol and Drug Assessment Service to take the course above is underscored by the fact that after the motorcycle accident, Paul was left unable to work. Equally, Paul’s resultant inability to control his impulses and to concentrate for long further eroded his ability to work. Definitely, with the inability to work, it is most likely that Paul can resort to crime and his destructive social circle that engaged in drugs. In this case, failing to take care of Paul’s socioeconomic needs will not only expose him to criminal recidivism, but to drugs abuse also. This is because, his friends are engaging in drugs abuse and substance abuse and crime (Petry, 2005). Conversely, it is important for the local Alcohol and Drug Assessment Service to ensure that Paul is provided with biological treatment. In this case, the failure to treat Paul of Hepatitis C may leave the virus to permanently destroy his liver. Before prescribing the drugs that should be used in the antiretroviral therapy for Hepatitis C, it is of utmost importance to assure Paul that his condition with Hepatitis C is treatable. This will speed up Paul’s recovery. Secondly, in the accordance of the biological treatment or therapy to Paul, it will be important to attend to the brain injury which he sustained from the motorcycle accident. In this case, it will be expedient that the local Alcohol and Drug Assessment Service examines the part of the brain that was injured, the extent of the injury and the manner of the injury. This will be instrumental not only in treating Paul’s injury, but also in treating his problems with impulse control, memory impairment and poor concentration. This step is important since it can positively catalyze the patient’s ability to work and earn a decent living. The case above is to be followed with physical exercises. The physical exercises are to help Paul gain a greater degree of control on his impulses. The same feat is to be followed with mental exercises to help strengthen Paul’s cognitive abilities. This will help Paul regain and enhance his degree of concentration and the strength of his memorization. As a side note, the local Alcohol and Drug Assessment Service should ensure that the physical exercises are sustained throughout so that they run concurrently with the prescribed mental exercises. The import of this is to catalyze Paul’s mental and cognitive recovery since mental wellbeing and cognitive strength are heavily dependent upon physical exercises and physical wellbeing. In this regard, the recommended form of physical exercise for Paul is the GP Exercise Referral Programme. This is a 12-week programme that is scheduled for 12 weeks as is always the custom and is meant to help Paul regain the operations of his mental faculties more effectively. This will necessitate the input of qualified coordinators and availability of proper facilities and space. The import of this is that the GP Exercise Referral Programme is bound to help Paul: improve his mental health and emotional predisposition; lessen the risks of cardiovascular illnesses; strengthen his motor impulses; and remain alert. Therefore, a well-crafted exercise programme will help catalyse the recover faster and better. In light of the foregoing, Paul is to be engaged in physical activity for at least half-an-hour. However, at this activity’s initial-most point, Paul will be exposed to shorter bouts of physical activity. The length of the physical activities will then be elongated gradually. The coordinator will help the local Alcohol and Drug Assessment Service establish the best physical exercises and routines that can best help Paul. In a closely related wavelength, Paul’s diet is to be prescribed in a manner that would aid his mental recovery. Paul is to take at least 8 glasses of water a day so as to help him get rid of the traces of drugs in his body and ultimately purify his body. Again, Paul is to recover better and faster with this amount of water intake, since more than 60% of the brain is water. Paul is to also take a whole grain of granola bar, a fruit and yoghurt for breakfast. Paul’s lunch should also comprise vegetables, fish, whole grains and fruits. The import of this is that those who take this diet have chances less than 30% likely to sustain depression (Thompson, 2002). Paul’s diet should be also inclusive of vitamin D, folic acid and omega-3 fatty acids. Omega-3 fatty acids have a mood-stabilising effect and greatly reduce the risks of brain cancer and brain illnesses. Vitamin D will help Paul develop strong bones and also boost his immune system. Folic acids will help Paul’s system produce white and red blood cells and thereby helping him recover faster and better. After administering the biological treatments above, it will be important to attend to Paul’s emotional and psychological person. This, according to Manthei (2000) is because, to a very large extent, Paul’s wanting psychosocial misconduct is largely underpinned by his interaction with the dysfunctional environment and forces of socialization and acculturation. This will demand strongly, the use of able and professionally competent counseling services. The gravity of the counseling services is that it is to help Paul change his mind set about his loveless background and to assure him of the possibility of making his life a success and a source of inspiration to others in a similar or worse predicament to his. The accordance of these counseling services is to be administered as part of the more comprehensive psychotherapy treatment due to Paul (Geldard and Geldard, 2005). In the course of inculcating the virtue of love, it may be important that the local Alcohol and Drug Assessment Service uses the family inclusive practice approach. This is because this approach is cognizant of the role of the family in social cohesion and harmony and the decline of the family and a general breakdown of social order. Again, as is shown by statistics, drugs and substance abuse treatments and rehabilitative exercises which involve the family have consistently exhibited a higher level of abstinence for patients or clients. This is because of the love, support and sense of accountability that comes with the presence and support of the family (DiClemente, 2003 and Donovan & Marlatt, 2005). In light of the immediately foregoing, the Alcohol and Drug Assessment Service will have to contact Paul’s remaining family members- whether these family members are nuclear or extend, that notwithstanding. Again, the presence of the family members will help: foster reconciliation between Paul and the family; Paul appreciate his distraught past; the patient know that because he is loved, he has a reason to reform since there are those who are interested in the perpetuation of his welfare. Again, the presence and support of Paul’s family will help neutralize the link that connects Paul and his friends who are a negative source of influence. According to McRory (2012) and Thompson (2002), as part of the psychotherapy treatment that is to be accorded to Paul, the patient is to be subjected to anger treatment and management. The need for this is informed by Paul’s proneness to rage and contemplation of murder-suicide. According to Rollnick, Mason and Butler (1999), while administering these steps, it is very necessary that the local Alcohol and Drug Assessment Service does so with a deep and professional touch of love and care, since the patient had never experienced these. Again, the patient has not only not experienced love and care in his childhood, but he also sought them in the wrong quarters (in drugs and negative influence), while the failure to access them is one of the underpinnings of the patient’s psychosocial problems also. In this light, extending the patient (Paul) may greatly unlock the key into Paul’s emotional and psychological world and thereby making his treatment speedier and more effective. It is at the point above that measures must be taken to address Paul’s source of anger. The crux of the matter herein is that this will help significantly abate Paul’s proclivity to crime. It must be appreciated that after sustaining the motorcycle accident, Paul took on an angrier and more irritable mien. It is also true that Paul’s loveless childhood and inability to interact with his family or his parents must also serve as the anteceding source of this anger. The motorcycle accident must have merely served as the triggering or magnifying factor. The extent of Paul’s anger is accurately captured in his remote-but-possible will to one day engage in murder-suicide. Apart from the love that had been previously mentioned, it will be important for the local Alcohol and Drug Assessment Service to give Paul hope and to remind that all is not lost and he is young enough to turn his life around for the better (Hyman, 2007 and Keane, 2002). According to Blume (2005) and Fisher & Harrison (2009) and Hamilton, Kellehear & Rumbold (1998), it must be noted that the entire exercise is to be administered in isolation: Paul is to be excluded from his outside world and social circle, in the local Alcohol and Drug Assessment Service’s rehabilitative centers or premises. The essence of the use of confined rehabilitative approach is threefold: to ward off the chances for recidivism; to allay the effects of the drugs and substances (such as cannabis and alcohol, benzodiazepines and polydrug) that Paul had been using in Paul’s body; and to make the entire treatment and rehabilitative processes more effective. As for psychological treatment, it is important that the results that the diagnosis produced are used as the guidelines for the professional intervention. This is to ensure that the prescribed form of treatment deals with the most fundamental problems of Paul’s mental and psychological problems, in lieu of merely treating symptoms (O’Shea, Moss and McKenzie, 2007). Rationale for Choosing the Treatment/ Intervention Approach As previously stated, the bio-psychosocial theory or approach has been chosen as the most tenable and effective approach to treating Paul’s problem because, Paul is not only a bio-psychosocial entity but his problems have strong underpinnings and causes which are specifically and strongly founded in bio-psychosocial factors also. Again, it is important to appreciate these factors as being closely interlinked. In this case, it is will be very ineffective to treat one problem or aspect of Paul’s mental health while negating the others. For instance, treating Paul’s drug addiction without treating his mental illness and establishing his socioeconomic wellbeing is setting Paul for rehabilitative failure (Kahn, 1997). Conclusion The foregoing clearly underlines the importance of taking an all-inclusive approach in psychosocial therapy. The same underscores the reality of the complex nature of the human person, yet it is the bio-psychosocial approach to psychological treatment that captures this reality. Just as has been in the case of Paul, social and economic factors can extensively affect man’s emotional and mental or psychological health and vice versa. The application of the bio-psychosocial approach is consenting to the complex nature of man and the needs that arise from this complexity. Any other method of treatment parallel to the bio-psychosocial approach fails to capture the complex nature of man and the multiple aspects behind a psychological or emotional illness or complication. References Adams, N. & Grieder, (2005). Treatment Planning for Person-Centred Car: The road to mental health and addiction recovery. Elsevier Academic Press. London. Adams, P. (2008). Fragmented Intimacy: Addiction in a social world. Springer: New York. Blume, A.W. (2005). Treating Drug Problems. New York: Wiley Press. 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