Derek is a 30-year-old Puerto Rican homosexual male. He graduated from law school two years ago and feels fortunate to have a job as a law clerk in a prestigious law firm in Miami. His job demands long hours so it is not unusual for him to go several days with little sleep. His partner, William, is familiar with pushing the limits to get established in a career so he suggested that they both take time to get away.

While on vacation, William was hoping to enjoy some downtime. In contrast, Derek seemed particularly keyed up the first few days. Rather than relaxing on the beach, Derek paced and seemed out of place among the happy vacationers. William made excuses for Derek's agitated behavior noting that it was difficult for many people to wind down after pushing so hard at work. The fourth night at dinner, Derek began berating the waiter who made a mistake in his order to the point of being uncharacteristically rude suggesting that the waiter wasn't worth his time of day and abruptly left the restaurant. William paid the bill and returned to the hotel only to find Derek out on the balcony of their room screaming, "Do you know who I am?!" at other guests. Becoming truly alarmed, William coxed Derek back into the room and convinced Derek to take a walk to cool down. While he was gone, William wondered if Derek was "on something" and went through Derek's luggage and found a small baggie of white powder he recognized as methamphetamine. He immediately called Derek's brother, Angel.

Angel was not shocked by William' description of Derek's explosive behavior. Angel recalled Derek being in trouble in college for similar behavior and that Derek had seen some kind of doctor as part of an agreement for him to remain in school. According to Angel, the incident blew over and the family attributed it to the stress of applying to law schools. When Angel went to visit Derek afterward, Derek seemed down on himself and in a low mood in general. Taking a risk to share an alternate explanation, William admitted that he had seen Derek meet some friends at a club that were into meth, but didn't think much of it until now. The more Angel and William compared notes; the more concerned they became. While William tried to convince himself that Derek had surely just got mixed up with the wrong people and "a little meth" in his attempt to keep up at work, Angel was more skeptical and insisted this sounded very similar to what his parents vaguely called "Derek's episode". Their debate was interrupted by another phone call. Derek was in a local Hospital Emergency Room (ER) being treated for injuries after he took a swing at someone in a nightclub. He missed and hit a wall injuring his hand. William debated whether he should tell the ER staff about his fears of Derek abusing meth or Angel's description of the story from law school. He didn't have to debate long as the ER physician concluded that a full assessment was warranted based upon Derek's insistence that he was the best lawyer in Miami and the ER doctor better not "screw up" the best shot he'd ever have to get out of that "crummy little hospital". The ER physician referred Derek to the crisis worker on call.

Analyzes the selected tools' applicability to diverse populations including a clear rationale for the selected tools." Research how well each assessment selected in the preceding section performs with relevant diverse populations. When it exists, scholarly literature that addresses how well the assessment tool performs with the specific diversity presented in the case should be cited.

Describe the differential diagnostic approach for a mental health disorder co-occurring with substance use with strong support from scholarly sources." This section should address the relevant diagnostic information to rule out closely related diagnoses for the selected case. You may find the American Psychiatric Association (2014) Differential Diagnosis by the Trees to be helpful.

Analyzes the advantages and disadvantages of a family systems approach for a substance use disorder or gambling assessment." Review scholarly literature to describe how the addiction impacts those closest to the individual meeting criterion for a substance use or other addictive disorder. Avoid sweeping generalizations that could apply to any addiction. An accurate description requires support from current scholarly literature to be specific and relevant.