Reference no: EM133681381

Assignment:

We last "visited" Maria C., a 16 year old Latina female who is 5'7" tall about 3 months ago. She has continued to lose weight and has gone from 140 lbs., to 125 lbs and appears to have lost more weight. Her marijuana use has progressed from smoking once or twice per week to smoking daily, both before school and on school grounds; Maria has been skipping school "every once in awhile" to spend time with her boyfriend. She smokes a 1/2 a pack of cigarettes (about 10) per day and continues to drink alcohol on the weekends, usually consuming 3 - 4 beers per episode. Until recently Maria has been a steady B+ student, however, her grades have suffered to the point where she is likely to have below average grades in several courses.

At a recent visit to Planned Parenthood Maria found out that she has been infected with genital Herpes and is terrified her parents will find out. Otherwise healthy, her doctor is concerned about her weight loss, as are her parents and the few friends she continues to see. She denies having sex with anyone other than her boyfriend who is several years older, but is afraid to tell him about the Herpes because she thinks he will break up with her. They continue to use cocaine together, sometimes as much as 3 - 4 times over the weekend. She has recently taken to staying out late without calling her parents because she is tired of the arguments they have regarding her curfew, her increaslingly defiant behavior, and her unwillingness to talk to them. When she is home, she stays in her room and either sleeps or watches television.

Maria has always talked about attending college upon high school graduation, however, she is now considering "taking some time off" after high school and no longer talking about a desire to become a paralegal, nor does she have other ideas about what she would like to do. She continues to live with her parents and her younger brother Roberto, age 13, with whom she now rarely talks to despite the fact that they have been very close in the past. Maria's parents are concerned and angry about her marijuana use (they once found marijuana in her room) and suspect that she is using other drugs and that she is depressed.

Whenever her parents attempt to talk to her about their concerns, heated arguments ensue. They still have not met Maria's boyfriend and continue to insist that she bring him over so they can meet him; she has so far refused to do so and her parents remain unaware of the age differences between them. They are now insisting that she go to a drug treatment center and a mental health counselor. She wishes they would "mind their own business" and she does not see her alcohol or other drug (AOD) use, truancy, weight loss or how her parents perceive her behaviors. However, to get her parents off her back, she has agreed to see a counselor for assessment.

Note: from earlier learning activities you have already 1) identified key developmental issues related to Maria and her substance use 2) Used DSM 5 diagnostic criteria for substance use disorders to determine if she meets one of these conditions? 3) Considered how well the DSM 5 criteria applies to Maria? and 4 ) identified any symptoms of mental health disorder from her history and description, along with symptoms to further evaluate. Now you will take this case to a final step.

Assignment Questions:

1. What key developmental issues did you identify or would you consider as concerns related to Maria and her substance use?
2. Using the DSM-V diagnostic criteria for substance use disorders which of the criteria clearly apply to Maria? If you find that some criteria applies, what level of severity would you assign? Note: be sure you can support any criteria you assign with evidence from the case, rather than from speculation or future expectation of what might occur. Does Maria meet the criteria for classification for a) substance intoxication? or b) substance withdrawal? or c) substance -induced mental disorder? Be sure to support your response with evidence.
3. How well does the adult-based criteria apply to Maria?
4. What symptoms of mental health disorder, if any, appear from her history and description? What symptoms would you want a health or mental health professional to further evaluate?
5. What techniques would you suggest to engage Maria to talk with you? What methods would you use to engage and form an alliance with her parents? Explain your reasoning.
6. From reviewing the four different methods (MI, CBT, SFT, Reality Therapy) which specific approach do you think would be most effective with Maria? Which specific techniques would you use from that method? Explain why.
7. Using one of the other three approaches, what counseling techniques from that approach would you also want to consider using? (For example, if you used CBT for Item 6, and decided to also use Reality Therapy and MI, what specific techniques would you use?). How would you integrate these methods into working with Maria?
8. What are areas regarding Maria's behavior where you could use a harm/ risk reduction approach? What specific techniques would you discuss with Maria regarding risk reduction?
9. What other strategies might you suggest to work with Maria and her parents/family?