Case Vignette Client's Information Thomas Halowen is a client who was referred by his substance abuse counselor from Substance Abuse and Research Treatment Center in Norfolk, Virginia. He is a 40-year-old man living in the Northern Virginia area in Woodbridge. He has been a resident of Virginia all his life and has been staying with his parents. He is of white ethnicity and identifies himself as a male. He is about 5'9 inches tall and weighs 220 lbs. His hair is fully grey and has green eyes. He has never had any major health problems in the past. Thomas has never been married and does not have any long-term relationships. He also does not have any children of his own. Thomas has been struggling with addiction to the prescription painkiller Oxycodone for 5 years now. Thomas previously worked as a construction worker but lost his job due to his addiction to the prescribed painkiller Oxycodone. He started having problems in his relationships with loved ones, and even fall back on illegal means to obtain the drug. However, he is currently unemployed and has limited financial resources so he has been arrested multiple times for obtaining oxycodone illegally. He is currently on probation and responsible for letting his probation officer know of any drug intake. Thomas has not been diagnosed with any other mental health conditions. He stated that he feels alone and has limited support from friends and family due to the consequences of his addiction. Family History Thomas was raised in a religious home where his dad was a pastor and his mom was the first lady of the church. He considers his family as well comfortable but doesn't like to use the word, middle class. He is the third child and only son of his parent with three sisters. Years after the church collapsed due to unresolved issues by other church members at his dad's church, his dad was depressed but was never diagnosed. Although his father has a history of alcohol abuse, his mother has been diagnosed with depression. However, she hasn't been showing any signs of loss of interest in the things she likes doing or any sadness. Thomas has reported that he has never experienced any sort of abuse or trauma from his parents or siblings. Even though his parent were going through hard times and battling for their health and safety. Substance Use/Addiction History Thomas has been using oxycodone prescription orally on a daily basis for his pains for 5 years now. This all started after he was injured at his workplace but he has not used any other substances outside of the prescribed painkiller. He quickly became dependent on the drug to manage his chronic pain. He stated that he was prescribed 20 milligrams 2 times per day. Instead, he would double the doses and take them 8 times per day or sometimes more depending on how he feels. Over time, his use of Oxycodone increased, which is leading him to negative consequences in his personal and professional working life. He didn't realize his addiction had gotten out of hand until when he started asking for more refills and he was denied due to his insurance since he lost his job. So, he started asking people who had been selling their prescribed drugs illegally and was end up arrested with the drugs. Treatment Goals The focus of treatment for Thomas is his addiction to oxycodone which was prescribed for his pains but over time misused. And for him to continue meeting with his counselor in order to build up his relationship with his loved ones, secure a job, learn to be responsible again, and take care of himself along with keeping his record clean.

Research Supported Treatment Plan

Using a minimum of 5 peer reviewed articles, students will identify evidence based research that supports and proposes interventions and theoretical approaches to support their case vignette. In completing this assignment, please be sure to include and address the following components:

a) Client Information:

____ Client Name

____ Gender

____ Date of Birth

____ Race

____ Address

____ Phone Number

____ Date of Assessment

____ Date of Treatment Plan

____ Referral Source

b) Presenting Problem:

____ Why is the client seeing you for services?

____ What is the client's insight into their needs?

____ What is the client's motivation level? Are supports available?

____ What is the legal status of the client?

___ A brief summary of the current SA usage of the client. (e.g. drug of choice, frequency of usage, method of usage, amount of usage)

a) Short Term Goals and Objectives

____ Student develops three treatment goals

____ For each identified goal, student identifies 2-3 objectives

Ex: Goal: Sally will understand the impact her ongoing substance use will have on her unborn baby Obj 1: Sally will obtain a primary care physician and begin to receive obstetrics/gynecology care Obj 2: HS professional will continue to educate Sally on the negative outcomes her continued substance abuse will have on her ability to parent her child after birth Obj 3: HS professional will refer Sally to parenting classes

b) Plan for Relapse:

____ If the client were to relapse while in services, what is the agreed upon plan?

c) Research:

____ Student incorporated a minimum of 4 articles that were no more than 7 years old

____ What does the research say about the cause/trigger for addiction for your client? (One article should address the specific cause for addiction with your client, ex. trauma, physical injury, child abuse, peer influence etc.)

____ What does the research say about the behaviors that are a result of your client's addiction? (E.g. identify one article that discusses your client's displayed behavior of either lying, stealing, manipulation, drug dealing, prostitution, poor parenting etc.)

____ Identify at least two risk and two protective factors that supports their addiction (risk factors) or supports their sobriety (protective) in your scenario? After you identify these, support your answer with a minimum of one research article for each area (one article for a risk factor, one article for a protective factor).

Example Risk factors:

a) Family history of addiction

b) Lack of housing, food, basic needs

c) Suicidal history

d) Unstable living arrangements

e) History of failed attempts

f) Enabling family/friends

g) History of overdose

h) Mental illness

i) Denial of addiction

Example of Protective factors

1. Children they wish to care for

2. Supportive family member

3. Acceptance of their addiction and a desire to recovery

4. Limited or no income to support their addiction.

5. Meaningful relationships

d) Psychotherapeutic Approaches and Evidence Based Practices

_____ Then identify one psychotherapeutic approach that would be appropriate to address and treat your client's addiction.

_____ Justify your chosen approach with at least one research article that has utilized this intervention with cases that are similar to your client. What was the result of this study?