Case Presentation, Case Study Example

Demographic and Background Information:

John is a 52-year-old single Caucasian male with two children. He has been a client with Probation since December 2011. He was admitted to Mountain Crest in February for two weeks. Upon release, he moved with his daughter for 4months and then moved in with his son where he is at currently. John is easily over stimulated. He usually presents as anxious, irritable and impulsive. He has a history of ADD and is diagnosed with schizoaffective disorder. John’s symptoms usually display as fixed delusions; paranoia about CM talking to father, needing surgery for a phantom injury, owning land in SC.  John also has a Poly-substance abuse diagnosis. He has a history of IV use. John is currently struggling to refrain from drug and substance abuse. John has an extensive criminal history with multiple assaults, violating restraining orders and felony drug charges.  He is on probation for the second assault on a Peace Officer. Per John’s report, his mother passed away in 2008, and he had a half-sister that died at a young age. He currently has a tumultuous relationship with his father. This is because his father, as a young boy, sexually abused him.

Presenting Issue

His son can no longer keep him at his home because of his violent outburst and drug usage. He expresses some interest in getting into a residential drug treatment program. John is not consistent in taking his psychotropic medications and is actively using heroin, amphetamines and crack cocaine that are psycho pharmaceutical and affect the central nervous system. I know this because of his six positive UA`s. John receives SSI as income ($694/month) and has his daughter to assist him in managing his money. However, he gets extremely angry when she puts limits on his spending since it is court ordered to probation. John’s assaultive and threatening behavior limits progress that can be made during case management sessions.  As does his obsessive thoughts on delusional content. John currently needs case management to probation sessions are set up for access housing, substance abuse treatment, and manage behavioral and psychiatric symptoms in order to comply with court orders.

Person in Environment Assessment

The current substance abuse treatment facilities refuse John due to his mental state, access individual diagnosis treatment centers poses a problem. This is because at times he does not observe his prescription and even neglects the usual medical check up. The scarcity of low-income housing mixed with John’s criminal history is making it difficult to assist John in finding housing. John refuses to move from his son`s apartment yet people in the apartment are complaining of insecurity and the abusive language that he uses to address them. Without him being treated, it is likely that John is to face serous living conditions that include hostility from the other tenants.

Interventions

The client has undergone various medical treatments and interventions. This is because of overcoming substance and drug abuse. He has been under medication in the medical nursing home for mental treatment and drug effects for a short period. The following were the interventions made to the client:

• Advocating for the client to be accepted into low income housing, pending -Behavioral contracts
• End session if threats made, only allowed at clinic certain times – Ongoing assessment of mental status and if ‘hold able’ contacting Mobile Crisis for Hospitalization should be reported for being unlawful
• Advocate on regular guidance and counseling to the client
• Advocate on “booster” telephone calls to offer medical services or incase of any drug alternation. This is to make emergencies with the client met since he can communicate fast to the medical organization
• Increase UA monitoring
• Writing noncompliance reports to court, which then prompt for additional probation time is added
• Verbal threats from the client would be corrected through neglecting them and not paying attention to him-guidance and counseling is also to be imposed
• Advice the client on self report of drug use through drawing a similar case that I had handled earlier to enable the client build self-esteem
• Advocate for in-treatment for drug and substance abuse. This will eliminate his access to the drugs

However, the client has responded negatively to the medical interventions. He usually presents as anxious, irritable and impulsive. This is evident with the fact that he has a turbulent relationship with his father. Through John being irritable to his father, it is quite clear that he has not responded to the medications and interventions prescribed. Thus, to curb this John is to be regularly checked and advised on medication intake.

Questions

I choose the particular case since the substance abuse and drug interventions are extremely common and need attention. As a Deputy Probation Officer for adult and mental health, I have observed many cases in the present society who along have issues regarding substance abuse. John`s issue thus will be one of those interesting issues to handle since I got the background information. The client also poses a situation that I am well skilled. This particular case is fascinating because being a Deputy probation Officer in medical health; I will love to handle it with all my experience. It is significant to note that John`s case has housing and substance use is of significance. The housing problem regards his conduct in the treatment facilities because of the mental state and his criminal history. He also refuses to move into an assisted living facility.

I have several questions;

• Is it possible that we may have omitted something relevant regard the client`s intervention on substance abuse? If so, what is it?
• Do you have any alternative interventions to the client apart from in-treatment medication?
• Is there something in the intervention I suggested that could control John`s substance and drug abuse?
• Is there any other place that the client can receive medical interventions besides the being in for an in-treatment program?
• Is it possible that diagnosis to the client could not work out without guidance and counseling?
• Could the client`s criminal history and the death of his family members be as a reason to his move into drug and substance abuse including his history of being sexually abused by his father?
• How can verbal threats by the client be contained?
• What are the major effects that the client is suffering from apart from drug abuse?
• What are the various procedures that should be taken into account to enable John stick to the prescribed medication?
• Should the nursing home consider John`s situation? If yes? Why?