NIU Motivational Interviewing ASAM Case Study
ANSWER
To answer these questions effectively, we will need to analyze the provided case study (Preston) and apply principles from the ASAM criteria, stages of change, cultural/environmental factors, assessments, and a bio-psychosocial perspective. Let’s address each question:
Question 1: ASAM Ratings and Level of Care Placement (60 Points)
To generate ASAM ratings and make a level of care placement recommendation for Preston, we will assess him across the six ASAM dimensions:
- Acute Intoxication and Withdrawal Potential: Assess Preston’s risk of acute intoxication or withdrawal. Given his history of cocaine use and current alcohol use, there is a moderate risk. We might rate this dimension as a 2.
- Biomedical Conditions and Complications: Preston has hepatitis C, which requires ongoing medical attention. We would rate this dimension as a 3.
- Emotional, Behavioral, or Cognitive Conditions and Complications: Preston shows signs of depression and anxiety, suggesting moderate impairment. We might rate this dimension as a 2.
- Readiness to Change: Based on his expressed negativity towards treatment, Preston may be at a Precontemplation or Contemplation stage. We would rate this dimension as a 2.
- Relapse, Continued Use, or Continued Problem Potential: Given his history of relapse and ongoing alcohol use, there is a high risk of relapse. We might rate this dimension as a 3.
- Recovery Environment: Preston’s environment includes a roommate who uses substances and a lack of support from his family. This dimension might be rated as a 3.
Overall, considering these ratings, Preston may be best suited for a higher level of care, possibly Residential Treatment (Level 3.3). This level provides more intensive medical and psychiatric care, which Preston needs due to his hepatitis C and emotional issues. However, Preston’s negative perception of treatment may be a barrier.
If Preston balks at this recommendation, alternatives could include Intensive Outpatient Treatment (Level 2.1) with additional support from a therapist or counselor who specializes in motivational interviewing and engagement strategies. Specific treatment activities could focus on building motivation, addressing negative perceptions, and developing coping skills to manage cravings and negative emotions.
Question 2: Stage of Change and Barriers (10 Points)
Preston appears to be in the Precontemplation or Contemplation stage. He is not actively seeking help and has a negative perception of treatment. Potential barriers to engagement include his lack of motivation, fear of AA groups, and skepticism about the effectiveness of treatment. To address these barriers, a motivational interviewing approach can be used to explore his ambivalence, build motivation, and address concerns about AA groups. Providing information about alternative treatment options and emphasizing his autonomy in making choices can be beneficial.
Question 3: Cultural, Environmental, and Developmental Factors (10 Points)
Cultural factors: Preston’s cultural background and beliefs may affect his perception of addiction and treatment. Understanding his cultural context can help tailor interventions and address potential cultural barriers.
Environmental factors: Living with a substance-using roommate and lacking family support are significant environmental risk factors. Identifying ways to change or cope with these factors is crucial for his recovery.
Developmental factors: Preston’s age and life stage may impact his substance use and recovery. For example, if he is a young adult, peer influences and identity development could be relevant factors.
Protective factors: Identifying any protective factors, such as supportive friends or personal strengths, can be incorporated into his treatment plan to enhance his recovery.
Question 4: Assessments (10 Points)
For a comprehensive assessment, the following tools and considerations can be utilized:
- DSM-5 Criteria: Assess whether Preston meets criteria for Substance Use Disorder based on his reported symptoms and drug of choice (cocaine and alcohol).
- AUDIT and DAST-10: Use the Alcohol Use Disorders Identification Test (AUDIT) and Drug Abuse Screening Test (DAST-10) to screen for the severity of alcohol and drug use.
- PHQ-9 and GAD-7: Administer the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to assess the severity of depression and anxiety.
- Hepatitis C Assessment: Assess the current status of Preston’s hepatitis C and the need for medical treatment.
- Motivation Assessment: Use a validated motivation assessment tool to gauge Preston’s readiness for change and motivation to engage in treatment.
Question 5: Bio-Psychosocial Perspective (10 Points)
To effectively intervene, additional information is needed:
- Biological: Detailed medical history and lab results related to hepatitis C. Information on Preston’s overall physical health.
- Psychological: A comprehensive assessment of Preston’s mental health, including any past trauma or co-occurring mental health disorders.
- Social: More insight into his social support network, relationships, and the dynamics with his substance-using roommate.
- Cultural: A cultural assessment to understand how his cultural background influences his beliefs and values regarding addiction and recovery.
- Environmental: A thorough evaluation of his living environment, including housing stability and potential stressors.
- Developmental: Information on his developmental stage, including any life transitions or challenges he may be facing.
In conclusion, a comprehensive assessment, considering ASAM criteria, stage of change, cultural/environmental factors, and appropriate assessments, is crucial to inform an effective intervention plan for Preston’s substance use disorder.
QUESTION
Description
- INSTRUCTIONS:
- This test will stress critical thinking skills. For some questions there may be multiple “right” answers that are all reasonable if grounded in the course reading and lecture material. Grading will focus on both your ability to manipulate and apply the content that you learned in the readings.
- Questions have different point totals for a reason. Although this is not a failsafe prescription, I think that 10 point questions could be answered in a few paragraphs (<= one page), and that the two 30 point questions may take up to two pages of text for your responses to be well- developed. Writing this much, however, is no guarantee that you will get full points if there is a lot of filler content. It is important that your responses have high quality content, as evidenced by your knowledge of the subject and critical appraisal of the content.
- you will need to use the attached mock case (Preston). This is a case Dr. Smith developed for training in an MI intervention.
- ASAM lecture 1 https://mediaspace.illinois.edu/media/t/1_9bclmnho
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- ASAM lecture 2 https://mediaspace.illinois.edu/media/t/1_cx05taah
- ASAM lecture 3 https://mediaspace.illinois.edu/media/t/1_pxlzl6i9
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- Questions to be answered:
- Note that your treatment options in your
community for both outpatient and intensive outpatient mainly involve generic group therapy
that focus on processes of addiction and recovery that are common to all people suffering
substance use disorders. During the interview, the client expresses a very negative perception
of treatment, thinking that you will refer him for AA self-help groups. Please generate ASAM
ratings for the 6 ASAM dimensions, and make an overall level of care placement
recommendation. Justify your placement using the assessment information, lecture notes on
ASAM criteria, and any other information you research on what treatment he may need.
Discuss alternatives to your selected level of care that may be viable if the client balks at what
you recommend. Be sure to mention what types of specific problems should be targeted in
treatment or specific treatment activities that you think may benefit this client. (60 Points) - What stage of change is the individual in? What barriers to engagement might you
encounter? How will you address them? (10 points) - What cultural, environmental, and developmental factors may be impacting the
individual’s substance use? Consider both protective and risk factors. How may this
impact their recovery? (10 points) - What assessment(s) would you utilize? Consider the individual’s characteristics, DSM V
criteria including groupings of symptoms, the drug of choice, and the evidence-base for
the assessment. (10 points) - Using a bio-psychosocial perspective, what additional information do you need for you
to effectively intervene that is not present in the case study? (10 points)
- Note that your treatment options in your
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