Discussion 1: Substance Abuse and Comorbidity

Unfortunately, individuals living with a co-occurring mental disorder are more likely to abuse drugs or alcohol. One population that has struggled with substance abuse and comorbidity is veterans returning from the wars in Iraq and Afghanistan. Their returning to society after witnessing traumatic events and not always having the appropriate resources or treatment has contributed to substance abuse-related disorders. Understanding the prevalence of comorbidity of substance abuse and addiction with certain mental health diagnoses is important for clinical practice.

For this Discussion, review the Levy Family video. Then read the articles on your reading list for this week, including Jake’s case. Finally, identify the presenting problem for Jake Levy.

· Post a clinical diagnosis of Jake using the DSM-5 criteria, ICD-10-CM and the information presented in the Levy Family video and case. 

· Describe how you arrived at this diagnosis and what behaviors and/or symptoms met the criteria for this diagnosis. 

· Be sure to use the inputs from Other Conditions That May Be a Focus of Clinical Attention. 

· Analyze your diagnosis and the comorbidity of substance use and other disorders that exist in this case study. What would be your first area of focus in treating Jake?

References (use 3 or more)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

· “Substance-Related and Addictive Disorders” (pp. 481–590)

Muthén, B. (2006). Should substance use disorders be considered as categorical or dimensional? Addiction, 101, 6–16.

Nash, D., Wilkinson, J., Paradis, B., Kelley, S., Naseem, A., & Grant, K. (2011). Trauma and substance use disorders in rural and urban veterans. The Journal of Rural Health, 27(2), 151–158.

Nunes, E. V., & Rounsaville, B. J. (2006). Comorbidity of substance use with depression and other mental disorders: From Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to DSM-V. Addiction, 101, 86–96.

Plummer, S.-B., Makris, S., Brocksen S. (Eds.). (2014). Sessions: Case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

· “The Levy Family”

Room, R. (2006). Taking account of cultural and societal influences on substance use diagnoses and criteria. Addiction, 101, 31–39.

Sheidow, A. J., McCart, M., Zajac, K., & Davis, M. (2012). Prevalence and impact of substance use among emerging adults with serious mental health conditions. Psychiatric Rehabilitation Journal, 35(3), 235–243. doi:10.2975/35.3

Discussion 2:
Policy Implementation Challenges

When a policy is launched, its success is dependent on a variety of stakeholders. As the politics of decision makers, executives, staff, clients, and social workers begin to influence the implementation process, their beliefs—and subsequent actions—determine the fate of the policy.

Often a social worker must step out of the comfort of his or her social service world and may find himself or herself making difficult decisions about ethical issues and/or may find himself or herself involved in implementing policies that he or she feels is against his or her social work values. How does a social worker handle the intricacies and challenges of policy implementation on both a personal and professional level?

In this Discussion, you explore policy implementation and the challenges faced by social workers during policy implementation.

· Post your thoughts on whether social workers might try to undermine the implementation of specific policies. What ethical issues might they confront? Discuss how social workers can implement policies that they feel may be against their social work values. Discuss a specific policy’s impact that you would try to mitigate in the implementation phase. Provide an experience you have had with a policy you had difficulty implementing or a policy you are aware of that you would have serious qualms about implementing.

References (use 3 or more)

Jansson, B. S. (2018). Becoming an effective policy advocate: From policy practice to social justice (8th ed.). Pacific Grove, CA: Brooks/Cole Cengage Learning Series.

Chapter 13, “Troubleshooting the Implementation of Policies in Task 7” (pp. 460-487)

Lane, S. R., & Humphreys, N. A. (2011). Social workers in politics: A national survey of social work candidates and elected officials. Journal of Policy Practice, 10(3), 225–244. doi:10.1080/15588742.2011.582809.

 Case 15: Borderline Personality Disorder in Gorenstein and Comer (2014), and Borderline Personality Disorder in Sneed et al., . (2012). Please also read the Rizvi, et al. (2013), “An Overview of Dialectical Behavior Therapy for Professional Psychologists,” Harned, et al.  (2013), “Treatment Preference Among Suicidal and Self-Injuring Women with Borderline Personality Disorder and PTSD,” Miller (2006), “Telehealth Issues in Consulting Psychology Practice,”  and Luxton, et al. (2011), “mHealth for Mental Health: Integrating Smartphone Technology in Behavioral Healthcare” articles.

Assess the evidence-based practices implemented in this case study. In your paper, include the following.

· Explain the connection between each theoretical orientation used by Dr. Bank’s and the interventions utilized in the case.

· Describe the concept of dialectical behavior therapy, being sure to include the six main points of this type of treatment.

· Explain Dr. Banks’s primary goal during the pre-treatment stage and how Dr. Banks related this to Karen in her initial therapy sessions.

· Describe the two formats that Dr. Banks told Karen would be part of her treatment program.

· Describe the focus of the second and third stages of treatment.

· Assume the role of a consulting clinical or counseling psychologist on this case, and recommend at least one technology-based e-therapy tool that would be useful. Explain liability issues related to delivering e-therapy consultation, supporting your response with information from the Miller (2006), “Telehealth Issues in Consulting Psychology Practice” article.

· Evaluate the effectiveness of the treatment interventions implemented by Dr. Banks supporting your statements with information from the case and two to three peer-reviewed articles from the Ashford University Library, in addition to those required for this week.

· Recommend three additional treatment interventions that would be appropriate in this case. Use information from the Sneed, Fertuck, Kanellopoulos, and Culang-Reinlieb (2012), “Borderline Personality Disorder” article to help support your recommendations. Justify your selections with information from the case.

The Case Analysis – Treatment Format

Must be 4 to 5 double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.)Links to an external site..

Must use at least two peer-reviewed sources from the Ashford University Library in addition to the article required for this week.

Must document all sources in APA style as outlined in the Ashford Writing Center.

PSY650 Week Four Treatment Plan

Behaviorally Defined Symptoms: Karen displays extreme emotional reactions at the hint of perceived abandonment in a relationship. There is a history of unstable and intense interpersonal relationships, impulsive behaviors, and recurrent suicidal gestures.

Diagnostic Impression: Borderline Personality Disorder

Long-Term Goal: Terminate self-harming behaviors (substance abuse, cutting, and suicidal behaviors).

Short-Term Goal: Reduce the frequency of maladaptive behaviors, thoughts, and feelings.

Intervention 1: Dr. Banks will outline the process of Dialectical Behavioral Therapy.

Intervention 2: Karen will commit to attending group behavioral skills training and individual psychotherapy.

Intervention 3: Karen will participate in imaginal exposure to trauma, until the memories no longer cause marked distressed.

For additional information regarding Karen’s case history and the outcome of the treatment interventions, please see Dr. Bank’s session notes under Case 15 in Gorenstein and Comer’s (2015), Case Studies in Abnormal Psychology

References: (Should be utilized)

Gorenstein, E. E., & Comer, R. J. (2015). Case studies in abnormal psychology (2nd ed.). New York, NY: Worth Publishers.

· Case 15: Borderline Personality Disorder

Sneed, J. R., Fertuck, E. A., Kanellopoulos, D., & Culang-Reinlieb, M. E. (2012). Borderline personality disorder. In P. Sturmey & M. Hersen (Series Eds.), Handbook of evidence-based practice in clinical psychology: Vol. 2. Adult disorders. (pp. 507-529) [E-book]. Hoboken, N.J.: John Wiley & Sons.

Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of dialectical behavior therapy for professional psychologists. Professional Psychology: Research and Practice, 44(2), 73-80. doi:10.1037/a0029808

Harned, M. S., Tkachuck, M. A., & Youngberg, K. A. (2013). Treatment preference among suicidal and self-injuring women with borderline personality disorder and PTSD. Journal of Clinical Psychology, 69(7), 749-761. doi:10.1002/jclp.21943

Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42(6), 505-512. doi:10.1037/a0024485

Miller, T. W. (2006). Telehealth issues in consulting psychology practice. Consulting Psychology Journal: Practice and Research, 58(2), 82-90. doi:10.1037/1065-9293.58.2.82