Completing a Clinical Risk Assessment and Implementing a Harm Reduction Plan - Case Study Example

Completing a Clinical Risk Assessment and Implementing a Harm Reduction Plan of Abstract In this paper, a clinical risk assessment and harm reduction strategies have presented for the case of Ken who is suffering from co-occurring disorder. Ken is the first born in a family of four where his parents are alcoholics. After his mother is admitted for surgery, his father abscond his responsibilities and therefore Ken has to take care of his siblings. However, due to stress emanating from the new responsibilities, he ends up with the problem of alcoholism. The risk assessment has identified the consequences of these disorders to Ken and other and based on these risks; harm reduction strategies have been proposed. The harm reduction strategies are based on principles for caring of patients with co-occurring conditions. Completing a Clinical Risk Assessment and Implementing a Harm Reduction Plan Introduction This paper will revolve around the case study of Ken. Ken is the oldest son in a family of four children is raised up by parents having alcoholism problems. At one point, Ken’s mother was hospitalized for heart surgery but his father abscond his responsibilities. Consequently, Ken assumed the responsibilities of his father and mother among his younger siblings. Due to pressure resulting from these responsibilities, he starts feeling unsecure and uneasy leading him to engage in alcoholism. Initially, alcohol was able to give Ken a tranquilizing feeling but with time, he began feeling restless and became easily distracted, which are signs of addiction. Moreover, Ken would easily pick up fights at school and had learning difficulties. The psychiatrist helping Ken out recognized that he gets little sleep, acts in a combative manner and eat very little food. In this paper, a clinical risk assessment of Ken will be presented and then a harm reduction plan will be developed. Clinical Risk Assessment In the case of Ken, the hypothesis during his treatment is that the primary course of his drinking and the associated behavior resulted from the psychological problems that he was going through due to mental problems. Alcoholism is a secondary problem that resulted from an attempt of Ken to deal with the mental problem. The type of psychological problem that Ken is going through is known as co-occurring disorders. According to Phillips, McKeown, and Sandford (2010), the risks factors that led to the type of problem that Ken is experiencing include lack of social skills, negative moods and lack of the sense of self-efficacy and self-control. The other factor that drove Ken to become alcoholic is poor performance in the new roles since he cannot adequately fit to play the roles of his parents while still schooling. Low self-esteem is another cause for the condition that Ken is going through (Phillips, McKeown, and Sandford, 2010). Given that Ken was brought up by parents having drinking problems and his father is not even able to play his role in the family after the hospitalization of his wife; Ken may get a feeling that his classmates despises him leading to a high degree of irritability. Consequently, to deal with this problem, he becomes easily irritable and can pick a fight easily. Failure to receive social support from other people is another cause of Ken’s condition. Lastly, lack of coping strategies to deal with the pressure that Ken is exposed to is the other cause for his current condition (Miller and Rollnick, 2002). The risk assessment will involve a systematic process of gathering information to establish the extent to which the co-occurring disorders can cause harm to Ken and others (Phillips, McKeown and Sandford, 2010). Clinical risk assessment is one of the organizational processes targeting to enhance the quality of care offered and its primary concern is creation and maintenance of safe processes of care. Risk assessment should be done as an ongoing component during provision of mental health care. Risk assessment should be conducted once a patient starts to receive care, during admission to the hospital, when the patient is being seen by a multidisciplinary team and when the patient is about to be discharged (Finnell, 2003). During the first encounter with a psychiatrist, the clinical assessment will involve looking at all the risk factors that drove Ken to get the co-occurring disorder. Moreover, the psychologist will look at the history of the patient and his mental state. In the risk clinical assessment, the psychologist will begin with an identification of whether Ken is overindulging in alcohol abuse. Overindulgence in alcohol can lead to alcoholism where one becomes dependent on alcohol, sleeplessness and failure to eat (Miller and Rollnick, 2002). Overindulgence in the uptake of alcohol also leads to social problems and loss of a sense of judgment. After the psychologists has identified whether Ken overindulges in taking alcohol, the next stage of the clinical risk assessment is to outline all behavioral and health effects of such a trend (Drake, Mueser, and Brunette, 2007). Short-term effects of alcoholism are loss of judgment, loss of control leading to accidents and emotional instability. The other behavioral consequence is that Ken’s performance at school will be affected. The long-term health problems of alcohol abuse include damage to the heart, hypertension, liver disease, sexual impotency, brain damage and low concentration and memory problems. Clinical risk assessment of the co-occurring disorders in the case of Ken will also involve identifying the effects this disorder can have on others. The current state of Ken is risky to his siblings, parents, teachers and schoolmates (Finnell, 2003). At home, Ken is supposed to take over all the responsibilities of his parents and take care of his younger siblings but he will be unable to attend to those responsibilities and therefore the children may become neglected. Since Ken currently becomes easily irritable, he can beat up his siblings. Considering that Ken’s mother has gone through a heart surgery, her recovery process could be negatively affected in case she learns that her son is also engaging in alcoholism. In school, Ken’s condition is risky given that he will be consistently engaged in fights with his schoolmates. Furthermore, teachers would have a rough time controlling Ken (Drake, Mueser, and Brunette, 2007). A Harm Reduction Strategy The harm reduction strategy developed when treating Ken will be based on the principles that characterize an effective process for caring of individuals with co-occurring disorders. One of the principles that the psychologist should uphold is recovery and optimism. The psychologist should be optimist that Ken will recover and during the counseling sessions, it is important to show Ken that his parents can also change. Additionally, the psychologists should work to restore self-esteem, pride, dignity and self-worth of Ken. The other principle that will form an effective harm reduction strategy when treating Ken is to have him accepted by both at school and at home. The psychologist should be culturally sensitive, empathic and welcoming. It is also important to engage any person who may be unwilling to work with Ken such as his schoolmates and teachers. By ensuring that Ken is accepted, he will have someone to lean on in case live seems unbearable. Ken should also be placed in a rehabilitation center. The rehabilitation center should be accessible to patient throughout. This means that the patient should not be restricted to get to the rehabilitation center. Care given to Ken should be provided in an integrate setting where he will be able to receive care for both disorders coordinated by one clinician. In addition, the care given should be specific and its intensity must take into account the complications that result from the co-occurring disorders. The setting for provision of treatment and counseling should be offered in an individualized setting. The treatment process should be provided in a phased approach based on the principle of continuity. The first phase is to ensure that Ken behaviors become stabilized, that is, he does not heavily rely on alcohol. The other stage is to engage him and motivate him that there is hope for the future. After treatment, it is important to ensure Ken does not relapse back to alcoholism. Following fully recovery, the clinician should teach Ken strategies to manage problems such as talking with others. This strategy ensures that the treatment maybe sustained over a long period. Conclusion Ken is experiencing co-occurring disorders where pressure from new responsibilities led him to get alcoholic. The factors that caused Ken to be engaged in alcoholism include low self-esteem, lack of social skills and negative moods. Furthermore, lack of self-control and social support also led him to alcoholism. From the clinical assessment conducted, these disorders have various effects to Ken and other people. To Ken, alcoholism could lead to irresponsibility, becoming highly irritable and loss of a sense of judgment. Alcoholism also poses numerous long-term health risks to the patient such as cirrhosis, impotency, and hypertension. Alcoholism could also lead to impacts to other people that Ken interacts with and therefore it is important to develop strategies to reduce those harms. The harm reduction strategy will be based on various principles. The treatment should be individualized, integrated and accessible. The treatment should be continuous and the psychologist should be optimist. Reference Drake, R., Mueser, K., and Brunette, M. (2007). Management of persons with co-occurring severe mental illness and substance use disorder: program implications. World Psychiatry, Vol. 6 (3): 131-136. Finnell, D. S. (2003). Use of the transtheoretical model for individuals with co-occurring disorders. Community Mental Health Journal, 39(1), 3-15. Retrieved from http://search.proquest.com/docview/228309467?accountid=45049 Phillips, P., McKeown, O., and Sandford, T. (2010). Dual diagnosis: Practice in context. Chichester, West Sussex, U.K: Wiley-Blackwell Miller, W. R., and Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd Ed.). New York: Guilford Press. Read More