Smith Case Study: John is a 42-year-old white male who was treated for a severe alcohol use disorder. John was reluctant to enter treatment but was urged by his spouse and had recently been arrested for driving while intoxicated, and he knew he would have to address his legal issues. John had a long history of drinking. Most recently, he was drinking nearly every day, drinking very heavy on the weekends. He maintained his job as an insurance salesman. He had not been in any trouble at his job. He had experienced blackouts at times and did experience mild to moderate withdrawal symptoms, which did lead him to occasionally drink in the mornings to stabilize the symptoms. During treatment, John began to understand that he had a serious problem and was willing to commit to abstinence and ongoing recovery. He started going to Alcoholics Anonymous meetings but had not obtained a sponsor. He was willing to change some of his social habits to avoid situations where drinking was encouraged. John’s father was an alcoholic and passed away 5 years ago. John’s mother is still alive but does not live in the area.
Margaret is John’s wife. They have been married for 17 years. Margaret works herself and has also been the primary parent for their two children. Margaret drinks on occasion and she and John used to drink together socially when they first were married. Margaret began getting very angry at John and began to try and coerce him into treatment. She was successful after John was arrested. Margaret’s father was an alcoholic, and, currently, he is sober and no longer drinking. Margaret experiences signs of depression and anxiety. She has, in the past, seen a counselor and is currently on Zoloft. Margaret was reluctant to participate in treatment as she believed that it was his problem. She does understand the concept of enabling and understands that she must stop to help John. She is still quite angry at all the problems his drinking has caused. She has attended a few Al-Anon meetings but does not feel they are helpful. She believes that John just needs to stay sober and things will get better.
Robert is their 15-year-old son. He excels in school and athletics and is a high achiever. He has participated a little in treatment but lacks the full understanding of the issue his father is dealing with. He knows that his father has a problem with alcohol but does not fully understand the comprehensive nature of the issue. Robert is very close with his father and has tended to make excuses for him and has covered up for him at times. He was quick to rationalize his father’s behavior and attributed to his stressful job. Robert and his mother have a pleasant but not close relationship.
Tina is the 12-year-old daughter. She struggles in school and has done so since 3rd grade. She has had some behavioral issues in school and at home. She tends to become very oppositional and angry, especially with her mother. She gets into verbal confrontations with her brother. She does not understand much about her father’s alcohol problem but understands that her mother does not like it when he drinks. She tests boundaries and limits and engages in arguments to try to get her way. She feels that she is unwanted by her mother and does not feel that she is treated fairly.
The family has become separated and segregated. John and his son would do a lot of things recreationally although this has diminished greatly over the last few years. John does not talk much to his daughter. Tina and Margaret do things together but also fight a lot. Members do not share their emotions easily and anger seems to be the dominant emotion. Tina believes she is blamed for a lot of the stress in the home. Robert tends to be the peacemaker and does not like conflict. During primary treatment, the focus was to help family members understand John’s issue and begin to learn better communication skills.
SMITH FAMILY CASE STUDY
I. SMITH FAMILY
A. Smith family history; mental health and substance abuse
B. Family dynamics; hierarchy, roles
C. Presenting problem
D. Biographical data
II. INTERVENTION
A. Outline four intervention programs
1. Process
2. Outcomes
3. Evidence practice
B. Process and outcomes
1. Identify the problems and concerns
2. Factor related to the concerns
C. Family goals
1. Intervention steps
2. Individual client and family roles/goals in treatment
3. Goals and objective for the family
4. Ritual/rules/relapse and coping skills to try and abide by
5. Improved interpersonal relationships
III. TREATMENT
1. Therapeutic Approach to Apply
A. Theory to apply to treatment/Therapeutic interventions
B. Including for the individuals
C. Specific therapeutic approaches for individuals/family
2. Support Groups
A. 12-Step Programs
B. Al-Anon
C. Family Support Groups
IV. DISCHARGE
A. Coping skills/rituals/rules to abide
1. Relapse prevention
2. Respond to John when concerned about his sobriety
3. Social planning
B. Maintaining recovery
1. Continued Support Group
2. Follow up individual therapy
3. Continue Al-Anon
4. Continue family therapy
review the Smith family case study, research discharge/treatment plan options, and provide the details for a treatment/discharge plan for the Smith family.
Write a 1,500-2,000-word paper, describing the typical characteristics, rules and roles of the Smith family as well as the details you would include as the therapist in a discharge/treatment plan for the family. Include the following in your paper:
1. Describe some of the treatment issues that the Smith family may be facing in their recovery.
2. Describe at least four interventions that might be indicated for the Smith family as they move forward in their treatment.
3. Details for a discharge/treatment plan for the family that includes the following:
• Social planning
• Support groups
• Goals and objectives for the family
• Rituals and rules to try to abide by
• Relapse prevention strategies and how the family can respond to John when they are concerned about his sobriety
