Elise is using alcohol to self-medicate. She suffers from debilitating depression, but since adolescence she has turned to alcohol and street drugs to alleviate the symptoms of this depression rather than take her medication. Her reasons for doing so are that the medication is too expensive, coming in every time she needs a prescription is “a pain,” and she can go to the liquor store and buy cheap liquor without the inconvenience. Lately, she seems to be thinking that maybe using alcohol is not the best idea, but she is defensive about why she has used alcohol in the past. 

(a) What are some interviewing techniques you can use at this point to help Elise? 

(b) Does the case manager have an obligation to explain the negative effects of alcohol on depression or is there a way to get Elise to describe these? How would you get Elise to do that?

Looking at the techniques you learned in this chapter, decide what techniques and skills would be best to use in each of these situations.