Assignment
Jose is a 47-year-old Hispanic male. He appears well oriented to time, place, and person. His intelligence appears to be in the normal range and he lists lifelong alcoholism as his therapeutic problem. His court mandated that he complete DUI education, and attend counseling for a period of one year. He reports one marriage, to Maria, which ended in divorce two years ago. The couple has three teenage children. He reports a history of verbal and physical abuse at the hands of his father.
He has witnessed a great deal of abuse by his father upon other members of the family mainly his mother. Alcohol use was prevalent in his home of origin. His father died at age 45 from cirrhosis of the liver. His brother was recently hospitalized for pancreatitis. Jose reported that he argued a lot with his ex-wife and children when he was under the influence, but "never abused them." He reported that his ex-wife and children do not drink or use drugs. As a consequence of his substance abuse, Jose has experienced problems with the law -- two DUIs and an assault charge after a fight in a bar. He is currently on probation and does not have a driver's license.
He worked in manual labor as a bricklayer until two years ago when he sustained a back injury. He can't work now because of the chronic back injury and is questioning how he will work in the future and support his children. His current workman's compensation ends in one more year.
His drinking started at age 12 and consisted, primarily, of drinking beer, but in strikingly large quantities (as much as 48 beers a day at its peak). At one point, he was spending as much as $500 a week on alcohol, marijuana, and pain medications. He has now been sober for eleven months, after an eight-month stay in a residential facility.
Case Notes:
He explained that his drinking led to the use of other drugs, mainly marijuana and prescription pain medications following his back injury two years ago. He claims that he never let his drinking interfere with his work and that he was a hard worker. He stated that he only drank on the job after hours with his buddies. He stated that his buddies don't come around anymore since he went away to the residential facility. Maria cited Jose's drinking and the subsequent financial problems as the reasons for the divorce. Since leaving the treatment facility, Jose has been consistently attending the weekend visits with his three children. He reports he has bought into the AA model, but still does not have a sponsor after three months. He attends one AA meeting a week. He has not attended an NA meeting since his release from the residential facility. He says that he has been successful in abstinence, although he occasionally thinks about having a beer. He stated that last weekend, he went to a bar, but claims that he did not drink alcohol.
Include the following in your essay:
1. Discuss the biological, psychological, and social factors that need to be considered; how does the biopsychosocial model inform your recommendations for treatment.
2. Explain the sociocultural factors needing to be considered and integrated into your counseling approach and conceptualization of Jose's presenting issues.
3. Provide a DSM-5-TR diagnosis for Jose and discuss/support your choice of a diagnosis (i.e., differential diagnosis).
4. Describe the CBT and the other counseling theories and treatment approaches discussed thus far in the that you would recommend for Jose. Explain your rationale.
5. Include a minimum of four well developed examples to illustrate the different treatment theories you would recommend for this client. Make sure to support your choices with the use of at least 4 current journal articles.
6. Identify and explain what legal and ethical issues you must consider in this case. Refer to relevant standards and principles in the NAADAC/NCC APA Code of Ethics.