focuses on vignette analysis and direct application of course concepts to the persons and situations presented in the vignette for each question. All discussions must take into account the legal and ethical considerations, as well as issues of culture and human diversity t Culture and Legal/Ethical issues can be found in the course text, but you are encouraged to use outside sources in culture and ethics integrate the material presented in the text and DSM-5-TR.

Case of Larry

Larry is a 51-year-old African American man who has bounced around between homelessness/unemployment and a few part-time jobs while living in a shelter or occasionally on his own via renting a room. Living on the streets, Larry has been exposed toviolence, both as an observer and recipient.Larry has a long-term 30+ year history of relatively consistent heroin use. He reports two prior instances of abstinence when admitted into inpatient treatment, but both times he ceased treatment and returned to substances within three weeks' time due to feeling "awful and crazy" when not taking heroin. Heroin Use History Larry began using heroin in his early 20's after being stabbed in a gang related incident in which he also suffered a head injury. Hequickly became addicted to heroin and continued using ever since. Larry reports using heroin multiple times per day, but varying in actual number. He disclosed experiences which indicate he has likely developed tolerance to the substance including that he still uses because it offers some effect, though not as intense as he used to experience in his earlier years.

Larry has had two recent failed treatment episodes. His first-ever attempt at treatment was two years ago when he was living temporarily with a friend. Larry attended a 28-day inpatient program at a local medical center. Approximately three weeks into treatment, Larry began sensing he was seeing "shadowy figures" out of his peripheral vision. He also recalled feeling very confused, disoriented, on-edge and paranoid. Larry was discharged from treatment because he had overheard his clinician was holding a staff meeting and Larry was convinced they were discussing him. He barged into the meeting and accused the staff of unethical behavior. He had to be escorted to the ER by medical center security. Larry was discharged from the program after receiving a "clean bill of health" from the ER doctors. Larry recalls them saying that he was deemed simply "not ready for treatment."

Larry next tried treatment four weeks ago when he was admitted into a residential therapeutic community (TC)where he was diagnosed as HIV/AIDS positive along with Hepatitis C. He was given a referral to a physician, which he declined.After four weeks of being heroin-free, Larry began demonstrating odd behavior that included hearing voices, confused regarding his surroundings, and overwhelming experiences of paranoia. Larry describes feeling as if certain important TC staff were watching him and waiting to trap him; however, Larry could not elaborate on what the "trap" might be or why they would feel a need to snare him in a trap. Larry's Presentation In your initial session with Larry, he is convinced that session is being recorded.

Textbook Morgan, K. (2017). Substance use disorders and addiction.. SAGE Publications. ISBN 9781483370569

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Book American Psychiatric Association (2022).Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-5-TR). ISBN-13:978-0890425763

Book American Psychological Association (2020). Publication manual of the American Psychological Association. (7th ed.). ISBN:978-1-4338-3216-1

File DSM-5-TR (American Psychiatric Association (2022), p. 482 Diagnoses associated with substance use disordersDownload Diagnoses associated with substance use disorders

File Sample Vignette PSY 7534_SampleVignette.docx Download PSY 7534_SampleVignette.docx

SAMHSA Mental and Substance Use Disorder Treatment for People With Physical and Cognitive Disabilities https://store.samhsa.gov/sites/default/files/d7/priv/pep19-02-00-002_508_022620.pdfLinks to an external site.