Case Study

Juan is a 35-year-old man with schizophrenia who talks about seeing pink elephants in therapy and tends to speak of this among family and friends. However, his counselor anticipates that in the room at AA meetings, Juan may be ridiculed by other members and scapegoated by the group, and thus not benefit from the healing effects of the group. Essentially, having schizophrenia is part of a unique culture that is not common to the AA group in general. Juan's therapist has advised him to talk about the pink elephants in individual therapy but to be silent about them in AA meetings. Juan continues to make progress with both his mental illness and SUDs, but with different therapeutic modalities for each.

An individual such as Juan, who has not been coached by his counselor ahead of time to keep quiet about the hallucinations during the AA meeting, runs the risk of being ostracized by the group. Such an incident is unfortunate and avoidable with proper preparation for AA group participation. Helping a recovering alcoholic, including one with schizophrenia, to stay in an AA group will allow that person to address the problem of alcoholism as well as to benefit from the curative factor that Yalom (in Corey, 2001) refers to as "universality," even though the group itself does not address the schizophrenia. The schizophrenia issues can be dealt with in another format, such as individual therapy or another group specifically geared to these issues.

1. Disease/medical Model?

2. How does this model explain the client's problems?

3. What issues does the model not explain?

4. What could they do as a support worker or paraprofessional counsellor to help this client?

5. What treatment suggestions would you consider?