Read the case study of Bernie. Answer these questions:

1. List Bernie's problems. (Hint: Keep in mind these problems become the basis for what to put in a treatment plan.)
2. What are Bernie's strengths, needs, abilities, and preferences?

Case Study - Bernie

40-year-old Bernie, has been using cocaine in some capacity or another for the last 12 years. Bernie was always a very good pubic speaker and he would go out on the road and train others in the new technology that his company had to offer. The more he was on the road the more bored he became and using coke filled his time. 2 years ago, his use of cocaine and alcohol led him to passing out or blacking out on most weekends. His drinking began in college when he was living in a fraternity. He was always a friend to all and would be available to help out friends whenever he was needed. He says that back then everyone was drinking all the time and he thought nothing of it. In fact, when he drank he found it helped calm all the racing thoughts he had experienced his entire life. When drinking he could think without ruminating about things over and over again in his head. He also found that his checking behaviors stopped. He was no longer locking and unlocking the front door in succession or going over to the stove on a constant basis to make sure he had turned it off. Although he was getting positive benefits from drinking, he and his fianc were constantly arguing about how much he drank. Along with their arguing, he had been experiencing pains in his side and decided to go see the doctor. The doctor told him his liver enzymes were high and that his liver was enlarged. This scared Bernie enough that he followed the doctor's advice and decided to go 12 step meetings to stop using and drinking. Once he was able to "get a handle" on the substances his pains subsided and he was feeling better. He decided he no longer needed "those" meetings and stopped attending.

Ironically, once Bernie stopped drinking and using coke his job performance began to suffer and he was having trouble completing his assignments and making deadlines. Public speaking became harder because much of his time was taken up at the office checking his work over and over again or turning his computer off and on to make sure it was going to work again. Although he was always a hard worker and was a valued employee, 6 months after he stopped drinking and using cocaine he was fired due not being able to keep up with the demands of his job.

Currently he is out of work and has started drinking and using again figuring "I need to find a job and get back to work". Bernie's logic is that since he was able to stop drinking and using before, this time he would be able to control it. He says his game plan is to use the alcohol to help him with his racing thoughts and compulsive behaviors so he can find a job and the cocaine will give him the energy he needs to stay up at night browsing websites for work.

His fianc has decided that although she still loves him she is not going to put up with the drinking or using again, and has broken off their engagement. She told Bernie that if he did not get help for his addictions and checking behaviors she would never be able to marry him. Bernie would prefer she stay around to support him rather than always nagging and picking at him. He says he needs her to be more understanding as he is having a very hard time since losing his job.