Client Description/Presenting Symptoms
The client is Kristopher, who is a 19-year-old male who was in the military and was deployed to Iraq. He comes into counseling with these presenting symptoms: Binge drinking, violent episodes, experienced paranoia of possible threats, random triggers, and suicide attempts/ideation.
Key Issues
The key issues in the case study are: Helping Kristopher cope with his experience of being deployed, addressing Kristopher’s drinking, and addressing his violent outbursts. The learner would want to use the SASSI (Substance Abuse Subtle Screening Inventory) as an assessment to get a clinical picture of his drinking patterns. It is also important to assess the severity and frequency of Kristopher’s violent episodes. The learner would want to issue a suicide assessment to see where Kristopher currently is at regarding suicidal ideation.
Short-Term Goals
The learner would want to make a goal of trying to lessen his drinking short-term (ex. From 4 drinks in 1 setting to 2). Another goal would be to develop better coping strategies for Kristopher’s triggers. The other goal is to lessen suicidal ideation.
Long-Term Goals
A long-term goal would be to eliminate Kristopher’s binge drinking. Another goal would be to manage violent outbursts by helping him develop better coping mechanisms. For example, when Kristopher hears a remark that triggers him, he can call a family member or a friend that moment.
Treatment Approach
The learner would utilize cognitive-behavioral therapy (CBT) for PTSD. Nolen-Hoeksema (2014) states that CBT is effective to treat PTSD (Nolen-Hoeksema, 2014). CBT is an excellent approach because it focuses on changing faulty cognitions that contributes to the questionable behavior/symptoms. CBT could help address any survivors guilt that Kristopher might be experiencing.
Interventions
Ford, Russo, & Mallon (2007) says that a useful intervention would be to teach Kristopher cognitive skills to help develop his strengths (Ford, Russo, & Mallon, 2007). This is an empowering approach that can be helpful. CBT would use systematic desensitization to help clients work through situations that would create anxiety. The third intervention would be stress-inoculation therapy. Nolen-Hoeksema (2014) says that this method can help clients overcome different issues that they face (Nolen-Hoeksema, 2014).
Systemic Considerations
Close family and friends should be included whenever possible to provide needed support. It might be more difficult for the client if they are isolated. Even if they present with no support system, the clinician can collaborate with the client to help create a support system.
References:
Ford, J., & Russo, E., & Mallon, S. (2007). Integrating treatment of posttraumatic stress disorder and substance use disorder. Assessment & Diagnosis. Retrieved from: Capella
Nolen-Hoeksema, S. (2014). Abnormal Psychology. (6th ed.). New York, NY: McGraw-Hill
