Treating a Dual Diagnosis Client - Research Paper Example

Treating a Dual Diagnosis Client Abstract This paper presents as case of Dual-Diagnosis client. David who is diagnosed with depression and alcohol addiction is assessed in accordance with the ethical standards and values of mental health care. The diagnosis process is described within the paper within the application of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV) model and David’s symptoms to come up with a conclusive diagnosis. A treatment plan is designed within this paper which includes detoxification and application of dual treatment approach in a rehabilitative phase in which individual and group therapy sessions are employed in the treatment of David’s co-morbid condition. Introduction Dual-diagnosis is used in psychology to refer to state of a patient which is characterized by coexistence of a psychological disorder and a substance abuse and addiction problem (Phillips, Olive and Tom 32). Patients with a dual-diagnosis are faced with a significant challenge or problem in dealing with both the psychological illness and a drug problem. It is in this sense that effective assessment approach, diagnosis and treatment which employs an appropriate model is required for dual-diagnosis patients. This paper is based on a case study of David who at 21 years of age is presenting with abnormal behavior which indicates a dual-diagnosis of a psychological disorder and a drug abuse and addiction problem. David is referred for psychological assessment, diagnosis and treatment by his advisor who is concerned about his change of behavior. This paper therefore gives a presentation of effective psychological assessment for David including the ethical considerations during the process of assessing the patient. The paper also describes the process and justification of the diagnosis for David’s co-morbid condition with an illustration of the etiology and the appropriate explanatory model for the diagnosis. Finally, the paper presents an appropriate treatment plan and approach for David which is based on the conclusive diagnosis that is reached during the psychological health care process. Psychological Assessment The psychological assessment for David will be achieved through a comprehensive medical history. This history is gathered by the psychologist in line with the ethics and standards of mental health care. The history involves an attempt to understand David both in the context of the psychological disorder and the drug addiction problem. Therefore David will be assessed through a psychological interviewing process where the psychologist will inquire about the drugs that he would be taking. The assessment for drug abuse will be achieved through a guarantee that David is given about the confidentiality of the information that he would provide as provided by the ethics of health care practice. In addition, David will be assured that the information that he would provide will only be used for making his life better by solving the problems that he would be facing at school or home. In the assessment process, the family history for drug use would be obtained from David. More importantly, the first time of drug use and the duration of substance abuse will be inquired by the psychologist to aid in the diagnosis of his drug problem. In the assessment of David’s psychological disorder, the psychologist will seek to determine when the symptoms of the disorder began to show. This will be achieved through inquiry about David’s childhood life. This should be described by David himself during the interviewing process and used by the psychologist to achieve an accurate assessment of his psychological disorder. By determining the time of onset of psychological symptoms, psychologists are able to determine the duration of a psychological disorder so that an accurate assessment is achieved on the impact of the illness on the social and personal life of the client (Antoni 1005). Therefore the assessment process in David’s case will involve asking him to describe his relationship with peers, friends, educators and parents. The family relationships will be traced from David’s childhood because it would be the cause of his current psychological illness. The assessment of David’s condition by the psychologist will be used to determine how his psychological illness and mental problem interact into a dual diagnosis. Diagnosis Etiologically, individuals abuse drugs because they need to feel better or good (Timko 613). This means that there is an underlying psychological problem which makes these people to seek self-medication through the used and abuse of drugs so that they would alleviate bad feelings (Phillips, Olive and Tom 41). Psychologists and psychiatrists have revealed that the intent of patients to self-medicate in drug abuse emanates from emotional pain which results from personality problems such as depression, low self-esteem, agitation and anxiety (Schulte, Petra and John 64). With continued use of drugs as a way of elevating emotional pain, the self-medication of drugs becomes more harmful or damaging than beneficial, a state which is referred to as a co-morbid condition of drug addiction and personality disorder (Antoni 1007). David’s psychological and drug problems will be diagnosed through the use of Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV). This model of duo diagnosis will appropriately be used in David’s co-morbid condition because it provides psychologists and psychiatrists with an elaborate diagnostic criteria and process for both drug addiction and personality or mental disorders (Schulte, Petra and John 67). More importantly, DSM-IV allows clinicians to draw a distinction between the causal or etiological factors for both disorders within the co-morbid condition (Timko 620). In the Diagnosis of David’s condition, the DSM-IV model will be applied in line with his symptoms in order to reach a conclusive diagnosis. The fact that David is enthusiastic and energetic in the morning regardless of initially being a slow starter indicates alcohol use and abuse. This is also justified by the fact that David stopped turning his assignments in for assessment. In this sense, a clinician’s diagnosis for one of the co-morbid conditions is alcohol abuse. On the other hand, David stays up late and wakes up early. This is an indication of depression. This diagnosis is further demonstrated by irritability which he expresses when asked about the computer program which he claims that he wants to develop. Furthermore, David admits that he neither has a girlfriend or male friends. The application of DSM-IV in dual-diagnosis process will describe David’s antisocial behavior as the cause of his depression. In the light of the assessment of David’s behavior and application of the DSM-IV diagnostic model, a dual-diagnosis of depression and alcohol addiction id reached by the clinician as the basis for the treatment plan and therapy for the co-morbid condition. Treatment Plan A dual treatment approach is effective for the treatment of dual-diagnosis clients (Antoni 1008). This means that the treatment approach for David’s co-morbid condition will involve simultaneous treatment of both the underlying conditions. The goal of David’s treatment will be to treat the alcohol addiction and depression simultaneously. This will however depend on the severity of David’s condition. In this regard, the clinician will design a treatment plan through an outpatient or outpatient program as determined by the seriousness of David’s symptoms and condition. Detoxification will be the first step of therapy for David’s dual-diagnosis condition. Detoxification as part of David’s treatment plan will involve cleansing of his body of alcohol over a specified time period. The duration for David’s detoxification will range between a few days and few weeks depending on how severe his condition is found to be. When David’s body will be determined to have been cleansed of all alcohol, a dual treatment will begin. The initiation of the dual treatment will have a goal of rehabilitating the patient. A dual treatment approach for dual diagnosis conditions is designed to rehabilitate patients by helping them to overcome both the drug problem and the symptoms of the mental illness which they suffer from (Phillips, Olive and Tom 38). In the rehabilitative phase, both group and individual psychotherapy sessions will be used as effective approaches to David’s treatment. These forms of behavioral therapies will involve a treatment plan in which David will be involved in activities such as educative sessions about the negative implications of alcohol abuse, proper nutrition, physical exercise and participation in the specific recovery programs. If necessary, drugs will be prescribed for David in order to alleviate possible withdrawal symptoms. Conclusion David has a dual-diagnosis of depression and alcohol abuse. This is a co-morbid condition which is diagnosed after an effective psychological assessment in which relevant history is gathered by the clinician to aid the diagnostic process. Ethical values and standards of practice are adhered to during the assessment of the patient. The diagnosis of David’s condition is achieved through the understanding of the etiology of his condition and the application of Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV) model for the diagnosis of co-morbid conditions. The conclusive diagnosis for David is then applied in design and application of a treatment plan. David’s treatment involved detoxification and application of the dual treatment approach and behavioral therapy approaches such as individual and group therapy sessions within the rehabilitative phase. Works cited Antoni, Bulbena. "Psychiatric Co-Morbidity and Substance Use Disorders: Treatment in Parallel Systems or In One Integrated System?" Substance Use & Misuse 47.8/9 (2012): 1005-1014. Academic Search Premier. Web. 11 Oct. 2012. Phillips, Peter, Olive McKeown, and Tom Sandford. Dual Diagnosis: Practice in Context. Chichester: John Wiley & Sons, 2009. Schulte, Sabrina J., Petra S. Meier, and John Stirling. "Dual Diagnosis Clients' Treatment Satisfaction - A Systematic Review." BMC Psychiatry 11.1 (2011): 64-75. Academic Search Premier. Web. 11 Oct. 2012. Timko, Christine, Anne Sutkowi, and Rudolf Moos. "Patients with Dual Diagnoses or Substance Use Disorders Only: 12-Step Group Participation and 1-Year Outcomes." Substance Use & Misuse 45.4 (2010): 613-627. Academic Search Premier. Web. 11 Oct. 2012. Read More