Tania is a 19-year-old single woman, sent for assessment and diagnosis of a possible substance-related disorder by her college counseling center. She was arrested by campus police for resisting arrest approximately one month prior to the time of the assessment. Tania reported that she and three friends were celebrating the end of the college semester by partying for three straight days. Tania used cocaine continuously; she did not sleep through the entire binge. On the third day of use, Tania began to experience thoughts that she was a vampire, that others identified her as such, and that they meant to do her harm. She was running through the campus when spotted by the police. In an attempt to escape, she ran into the college bookstore, frightened some of the customers, and the police apprehended her. She resisted arrest and the police report indicated that Tania was speaking incoherently and was clearly "out of touch with reality." In the interview, Tania reported a history of cocaine use starting at 16 years of age. She uses cocaine by snorting, usually only on the weekends. The incident leading to the arrest was the only time she used in a binge manner. Tania began using alcohol at age 14, getting intoxicated nearly every weekend. She does not use alcohol much except to help her sleep after using cocaine. Tania smokes one to two packs of cigarettes per day. She is in college with a B to C average but feels she could do better if she tried. She reported no previous psychiatric treatment and no prior symptoms like those experienced on the day of the arrest. There was no reported history of a family substance use problem or of psychiatric treatment. Tania did not present with any bizarre or unusual behavior and was completely free of psychotic or other psychiatric symptoms since a day or so after the arrest. She does not feel that she has a severe substance use problem but does appear distressed by the arrest and subsequent problems related to her education (her college was notified about the arrest because it occurred on campus, and she was placed on probation). Her family was notified about the arrest.

Questions:

1. Identify which phase Tania would be in and why you believe she is in this phase (Prodromal, Crucial, Chronic).

2. Identify the primary problem areas and issues that need to be assessed and which assessment tools/methods might you use to get more information? Explain thoroughly how the tools/methods will help you.

3. What social characteristics did you identify?

4. Family characteristics?

5. Do you believe that there will be a dual diagnosis? What mental health diagnosis is possible with Tania? Support your responses.

6. Would you consider a diagnosis of substance abuse disorder? Why? To which substances?