For this assignment, refer to the ASAM Level of Care Case Study document. Utilize the resources below to assist you.
Make a recommendation for the proper level of care for each client using the ASAM Patient Placement Criteria for Substance Related Disorders. Remember that a clinical justification provides a summary of the evidence that justifies the recommendation. You are responsible for writing clear, concise and clinically defensible justifications for your recommendation as well as advocating for the services of the person on your caseload.
MAJ 6614 Week 3: ASAM Level of Care Case Study
Your goal for this assignment is to make a recommendation for the proper level of care for each client using the ASAM Patient Placement Criteria for Substance Related Disorders. Remember that a clinical justification provides a summary of the evidence that justifies the recommendation. You are responsible for writing clear, concise and clinically defensible justifications for your recommendation as well as advocating for the services of the person on your caseload.
CASE STUDY 1: Ann
Ann, a 32-year-old divorced female, came in for assessment for the first time ever. She has been abstinent for 48 hours from alcohol and reports that she has remained so far up to 72 hours during the past three months. When she has done this she states she has experienced sweats, internal tremors and nausea, but has never hallucinated, experienced D.T.’s or seizures. She states she is in good health except for alcoholic hepatitis for which she was just released from the hospital one week ago. Her doctor referred her for assessment. She smokes up to 3 or 4 joints a day, but stopped yesterday. In addition to the above, Ann describes two past suicide attempts using sleeping pills, but the most recent attempt was three years ago and she sees a psychiatrist once a month for review of her medication. She takes Prozac for the depression and doesn’t report abuse of her medication.
Ann reported that she lives in a rented apartment and has very few friends since moving away after her divorce a year ago. She is currently unemployed after being laid off when the supermarket she worked at closed. She has worked as a waitress, check-out person and sales person before and says she has never lost job due to addiction.
Ann appears slightly anxious, but is not flushed. She speaks calmly and is cooperative. Ann shows awareness of her consequences from chemical use, but tends to minimize it and blame others including her ex-husband who left her without warning. She doesn’t know much about alcoholism/chemical dependency, but wants to learn more. She has one son, age 11, who doesn’t see any problems with her drinking and doesn’t know about her marijuana use.
CASE STUDY 2: Matt
Matt is a forty-two year old man. He reports completing the eleventh grade and obtaining his GED. Matt indicates he is married and has two children. He is currently incarcerated on the charge of Theft by Unlawful Taking. Matt reports first drinking alcohol when he was 15 years old. Matt indicates he began to drink excessively at about 30 years old. He confirms drinking has been a problem in the past and describes drinking “sun up to sun down,” going to bars and after-hours clubs. He states that he continues to drink alcohol but only drinks one or two times per month, and has approximately two or three drinks at a time. Matt indicates he has been to AA meetings in the past, but doubts he has ever applied their principles to his life. Matt reports his first use of marijuana at age 13. He describes marijuana as his drug of choice, and second to that he prefers to drink rum and cokes. Matt reports first using cocaine at age 27. He indicates only using cocaine three times in his life. He said he first used methamphetamine at age 30. Matt said his last use of alcohol and drugs as six months ago before being incarcerated.
Matt said he has never completed a Drug/Alcohol Treatment Program in his lifetime. Motivational enhancement for treatment could include focusing on how his substance use has affected his family, employment, and his physical health. Matt could benefit from a Cognitive Restructuring Class to increase self-awareness of the relationship between his thoughts and actions. A Twelve Step Program may also be effective for Matt in order to begin living with more principles. Matt has a lengthy legal history including Possession of Marijuana (4 times), driving under the Influence (3 times), Driving Under Suspension (4 times, 15 year. Suspension), Possession of Controlled Substance- Meth (18-36 Months).
CASE STUDY 3: Carl
Carl is a 15 y.o. male who you suspect meets DSM criteria for Alcohol and Cannabis Use Disorder, with occasional cocaine (crack) use on weekends. He reports no withdrawal symptoms, but then he really doesn’t think he has a problem and you are basing your tentative diagnosis on reports from the school, probation officer, and older sister. Carl has been arrested three times in the past eighteen months for petty theft/shoplifting offenses. Each time he has been acting intoxicated but says he has not been using any drugs. The school reports acting up behavior, declining grades and erratic attendance, but no evidence of alcohol/drug use directly. They know he is part of a crowd that uses drugs frequently. Yolanda, Carl’s 24 y.o. sister, has custody of Carl following his mother’s death from a car accident eighteen months ago. She is single, employed by the telephone company as a secretary, and has a three y.o. daughter she cares for. She reports that Carl stays out all night on weekends and refuses to obey her or follow her rules. On two occasions she has observed Carl drunk. On both occasions he has been verbally aggressive and has broken furniture. A search of his room produced evidence of marijuana and crack which Carl claims he is holding for a friend.
CASE STUDY 4: Sierra
A 16-year-old young woman is brought into the emergency room of an acute care hospital. She had gotten into an argument with her parents and ended up throwing a chair. There was some indication that she was intoxicated at the time and her parents have been concerned about her coming home late and mixing with the wrong crowd. There has been a lot of family discord and there is mutual anger and frustration between the teen and especially her father. No previous psychiatric or addiction treatment.
The parents are both present at the ER, but the police who had been called by her mother brought her. The ER physician and nurse from the psychiatric unit who came from the unit to evaluate the teen, both feel she needs to be in hospital given the animosity at home, the violent behavior and the question of intoxication.
Last Completed Projects
| topic title | academic level | Writer | delivered |
|---|
