Reference no: EM133452848

Alisa is 20 years old and has been using drugs since the age of 11.

Stimulants like amphetamines and crack were easy to find on the reserve in Northern BC where she lived with her parents and five other siblings- and numerous other relatives-in the same tiny house. Both of her parents experienced severe problems with alcohol and were largely unavailable to her. In fact, her mother drank heavily while she was pregnant with Alisa.
Alisa was only 6 years old when her 12-year-old cousin, who was drunk, forced her to have sex. That was her first experience of violence -but not the last. At 14 years of age, Alisa left the reserve and eventually found herself living on the street in Vancouver. She, like many others, became entrenched in the streets-sleeping in shelters, with very little support and facing a daily struggle just to survive. It was during this time that she first tried injecting drugs. The opiates helped her by numbing her psychological pain and helping her to forget all that had happened to her. Crack helped her to stay alert -something a person living on the streets needs to be.
Now, at age 20, Alisa is living in a Single Room Occupancy (SROp)-a windowless, sparsely furnished room -in Vancouver's Downtown Eastside.
She makes her living in the sex trade, mostly to finance her drug use (survival sex). Abuse and suffering remain as daily occurrences in her life, together with nightmares and flashbacks. And yet, despite all this, she continues to have hope that somehow things might change for the better in her life.

1. What stage/phase of change is Alyssa in - please explain.

2. Is there evidence of a stress-substance use cycle? Explain your answer.

3. What do you think would create meaningful change for Alyssa?

4. Identify Alyssa's strengths.

5. What are Alyssa's protective factors?

6. Identify ten questions that you think should be included on a questionnaire screening for concurrent disorders.