You will view a film approved by the instructor that depicts the development of a substance use disorder as it occurs in an individual or a group of individuals. The depiction will include a character in a story who encounters significant difficulty in dealing with a psychoactive substance or gambling and may be suffering from co-occurring mental and physical disorders. The film Ray by Hackford (2004), a biopic regarding the life of musician Ray Charles, is an example of a film that includes such a portrayal.
After viewing the film, you will develop a clinical formulation for the character(s) in the film who is/are affected by a substance use disorder and create a treatment plan using the format described in the Explanation of DO A CLIENT MAP section.
An effective way to create comprehensive treatment plans is to follow the acronym DO A CLIENT MAP (Seligman, 2004). Each letter of the acronym serves as a topic heading for the treatment plan narrative. You will write a minimum of one paragraph for each section, providing a strong rationale for your clinical decisions. You may utilize the textbook, lectures, and supplemental materials to support your formulation and treatment choices.
Explanation of DO A CLIENT MAP:
- Diagnosis (D): Determine a diagnosis (or diagnoses) and the differential diagnoses of substance use disorder and any co-occurring mental disorders (if applicable), utilizing the criteria specified in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).
- Objectives (O): After determining the diagnosis (or diagnoses), select the short-term, midterm, and long-term objectives (i.e., what the client will do) that will be addressed during treatment. These should be geared toward helping the client move from problematic substance use toward recovery, as well as address other areas that will help the client remain in remission from substance use disorder or other addictions. These objectives and goals should be specific, measurable, attainable, realistic, and time-limited (SMART).
- Assessment (A): Consider multiple methods and modalities to obtain a good picture of what is happening with the person suffering from the disorders. This will include informal techniques (screening assessments and interviews with family members and friends) and formal techniques (test instruments, such as the Addiction Severity Index [ASI], that clients can take with pen and paper or on a computer).
- Clinician (C): Match the ideal counselor for the client. There are certain characteristics that may better fit the client’s needs. Answer these questions: If you were able to create the perfect counselor for your client, what would you choose? What would be the ideal gender, age, ethnicity, and theoretical orientation of the counselor? Also, provide a clear rationale for why you selected these particular characteristics.
- Location (L): Identify the appropriate locus or level of care for the client according to diagnostic data and other assessment data.
- Interventions (I): Now that the location has been chosen, how will you approach treatment? Interventions begin by picking the most effective treatment model to address the concerns that the client brings to treatment. Then, you need to decide the focus of interventions, be it a past, present, or future orientation, and how much time will be spent on developing appropriate coping skills. You also need to decide what those skills would be.
- Emphasis (E): This is where you determine how the chosen treatment model will be adapted to the individual client. This decision will be based on the client’s level of motivation (high or low), how the client entered treatment (voluntarily or at the request of someone else), and his or her current stage of change.
- Number of People (N) or Modality: Identify the modalities that will be employed to apply the interventions and emphasis that you have chosen. Keep in mind the location and whether or not these modalities occur in those facilities. Which counseling modality will be employed? More than one modality is the norm, and remember to provide a rationale for your chosen modality in the clinical formulation. Counseling modalities include the following:
- Individual counseling
- Couple’s counseling
- Family counseling
- Group counseling
- Timing (T): For each chosen counseling modality, how long would each session be? How frequently would the sessions occur? How many sessions of each modality should be provided? And how would the sessions be sequenced, for example, will you start with group counseling and then move on to individual counseling, followed by couple’s counseling in the future? The following are some examples:
- Length of Sessions: For example, 1-hour individual counseling sessions and 2-hour group counseling sessions
- Frequency of Sessions: For example, one individual counseling session per week and five group counseling sessions per week
- Number of Sessions: For example, four individual counseling sessions and 20 group counseling sessions
- Pacing and Sequence: For example, individual counseling sessions held on Fridays, decreasing to one every other week after the first four weeks
- Medication (M): Determine whether a medication evaluation (i.e., a referral to a psychiatrist) is appropriate or not. This might be worthwhile if the drug of dependence has characteristics of physical dependence or if there is a comorbid psychiatric concern.
- Adjunct Services (A): In addition to the treatment that you are providing, what other areas of the client’s life need attention? Is the client homeless, is he or she in financial trouble, does he or she have a legal record, is the client seeking spiritual direction, or is the client physically challenged?
- Prognosis (P): This is the likelihood that the objectives will be reached (i.e., the client will get better). This judgment is based on several things:
- In what course of the disorder is the client, for example, is the client at the beginning of his or her disorder and, therefore, with increased denial?
- Are coexisting disorders (process addictions, psychiatric disorders, or medical conditions) present that will complicate treatment?
- Does the client have any strong support systems (or no support systems at all)? If yes, then which of these would lead to a better prognosis?
- Are the client’s expectations for success high or low? How realistic are those expectations?
- In which stage of readiness for change is the client—precontemplative or maintenance?
Terms to use: On the basis of the answers to the above questions, the client’s prognosis is:
- Excellent
- Very good
- Good
- Fair
- Poor
- Guarded
Your final product will be a Microsoft Word document written in APA style, including a title page, a running head, and references, and be approximately 5–6 pages in length (not including the title and reference pages). Your document should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punctuation.
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