Reference no: EM133520282

Addictions Services of Sudbury and District (fictitious name)

Your organization offers addictions screening and assessment, one-on-one time-limited counselling, and group counselling sessions, has dedicated beds at a local detox centre, helps with referral to rehabilitation services (both private and subsidized), and has an innovative peer support program in which people who have been in a significant period of recovery provide informal counselling and support to clients, often engaging clients into 12-step programs. Your organization's mandate is to work from a trauma-informed and harm-reduction approach to problematic substance use and problem gambling. It is funded by the Ontario Ministry of Health and Long-Term Care, and therefore there are no fees for services.

One of you is the intake worker. Your 3:00 pm appointment arrives, Dwayne, for his initial appointment. He states:
"Can we get to this right away? I've been through these things before, and they are so stupid. Just ask me the questions so I can get on with my day. I have a life, you know? Like they expect me to do all this crap and I had to take the afternoon off work, and I still have to get back in time to pick up my kid because my wife is working the night shift."

You ask him if he'd like water or maybe a coffee. He accepts a coffee and tells you the following:
"I am only here because of the court order. I don't need any of this but I have to come do this so I can get my charges dropped and to get my wife off my back."
In this half-hour appointment, you learn that:

· Dwayne received an impaired charge 3-months ago. This was his second offense, so he has been mandated into addiction counselling before he returns to court for his final appearance.
· Dwayne says he only drinks to "blow off steam" because he has a stressful job. His wife has been asking him to change his drinking for years, and now is threatening to leave him with their child because she believes he has a drinking problem and has anger control problems. He thinks if he just does a couple of counselling here at ASDS, he can get his charges stayed and his wife will be placated enough to "drop it".
· He has been taking anti-depressants for the past year, prescribed by his GP, for what he refers to as a sometimes-severe depression. He tells you that before the meds, he was having a hard time being motivated to go to work, would sleep a lot, and was thinking about ending his life. He says the medication isn't working like it used to, and that he has been drinking more as a result in order to deal with the stress it causes in his marriage.
· He says he does not have an anger control problem. He "might get into fights" with his wife when he has a few drinks, but he doesn't have problems day-to-day and gets along well with everyone else in his life.
Used with permission for the exclusive purposes of Concurrent Disorders II LDS1010 Cambrian College by Bryan Dalla Rosa (author).

You thank him for coming in, confirm that you think that the organization will have some services that will benefit him, but that you need more time to assess his needs, and ask him to book another appointment with you as the intake worker for more screening/assessment before being referred on to the other services in the organization. He resists a bit, stating it was wasting his time and he just wanted to get a few counselling sessions" right away. You explain that this isn't how it works, but that you will try your best to get him the services he needs as quickly as possible. You book a second session for the following week, this time for 2 hours. He seems satisfied with that and shows up for the appointment.

Part 1

What are your immediate thoughts about this individual's presenting problems? Do you suspect a Concurrent Disorder? Why or why not? If so, what disorders or problems are potentially co-occurring?

*be sure to cite information from your outside sources .

Part 2:

Pretend you are either a Case Manager or Family Supporter.

• Case Manager: Responsible for coordinating all community and clinical services, but also providing one-on-one direct support regarding the practical needs of the client (e.g., housing, ODSP or employment), goal setting and recovery planning.

• Family Supporter: Providing supportive counselling; coordination of services; goal setting and recovery planning.

What considerations are you making as to how you are going to proceed? What principles of practice are important to consider? How can you best demonstrate a Trauma-informed, harm-reduction, and integrated approach to this client/family?

Create a plan: How will you support this client/family in the short-term and in the long term? To whom do you need to turn for support (interdisciplinary team)?