Childhood Substance Abuse, Case Study Example

Adolescence and youth substance abuse largely go untreated in the United States. Not only is the subject not mention in child psychology, but there is a stigmatization related with admitting that the adolescent has a problem. It can affect the individual socially, psychologically, physically, and mentally. This case study is presented to provide an example on a significant problem that is increasing among the young population. Erik has had several behavioral problems that have affected his ability to participate in class, or do the school work. He has moved to a new school after being sent to live his father and his new family. He was recently caught shoplifting for the first time, and found with a bag of traces of marijuana. The cops that are colleagues with his father set the proposal that he seek treatment or risk going to juvenile.

Background Information

Erik is a twelve year old male student at Parker Middle School. Currently Erik is in the seventh grade, which is the appropriate level of education. He is an average size for his age, and has dark brown hair and green eyes. He appears to be having trouble interacting with his peers, and avoids eye contact with his teachers.  He has been noticeably withdrawn from school activities and his schoolwork in the past months, and has become less interested in his appearance. His grades have declined in a short period of time, which has been a cause of concern with his teachers. He has become pessimistic about his future, he has become quiet, and moody. Erik has a troubled family life, as his parents were divorced when he was 5 years old. As a young child, he split time between his mother and father’s homes. However, as a child, time with his father, a police officer, had been limited because his father was preoccupied with his other family.  Erik’s mother remarried also, and she is mostly preoccupied with his younger siblings as a stay at home mother. Due to the lack of attention, he would act out at school and have behavioral problems at school, hanging out with delinquents, and being truant. He was noncompliant with his mother, and although she said tried to pay him more attention, she was overwhelmed with the younger kids. Erik’s mother a few months ago, decided to send him to stay with his father for a while, so he can work out some of his behavioral problems. Shortly after his stay he got into several altercations with his step-mother, and has had trouble adapting to his new school. His father has threatened him several times to send him back to his mother, but it has not deterred Erik’s behavior. When he is at home, he stays in his room with the door closed, only to come out to eat.

Erik has been experiencing the same behavioral problems as before. He has befriended some delinquent youths to hang with, and has withdrawn from his family. Erik has been getting into trouble at school, and his become noncompliant with his father, while having limited contact with his mother, only a few times a week, and the calls are short. With the passage of time, his behavioral problems have grown worse. Indeed, within a few months he has experienced a number of stressors which includes, the lack of attention at home from his mother, being sent away to live with his father and his family, which he does not have a relationship with. Has gotten into altercations with his stepmom, and has not adapted well with his new school. He has been suspended recently, for skipping school, and was picked up by police for shoplifting at the local store. When the cops apprehended Erik, they found a small bag in his jacket pocket with traces of marijuana. Since the cops knew his father, they did not arrest him. They negotiated with Erik’s father that he seek treatment for his drug use and behavioral problems, instead of taking him to the local jail.

Diagnosis

At the time of his intake assessment, Erik admitted to smoking marijuana, tobacco, and consuming alcohol however, he did not view these as a problem.  Having collected the necessary background information for his parents and fellow teacher, I asked his parents to describe the possible circumstances around his behavior. It is significant to have an accurate picture of Erik’s substance abuse and emotional state. The increased and negative changes in his life suggest that something serious has developed. Is he using marijuana and other substances to attempt to cope with problems at school? Problems at home? Or the lack of attention that he is receiving from both parents? Substance abuse can occur because of self-medication when adolescents lacks the proper coping skills, which leads to an addictive habit. When interviewing his parents, they informed me of that they both were not aware of his drug use. His mother was overwhelmed by the situation, and both parents felt it was their faults.

Speaking with Erik, he conveyed that he is having difficulty at home interacting with his stepmom whom he would often argue with, and does not feel a connection with his father, who is hardly around. He feels abandoned by his mother that he barely speaks to, and does not like his new school where he feels the teachers do not like him. He often skips to hang out with a group of teenagers at the mall, because they make him feel like family. When there he smokes cigarettes, and marijuana, while consuming beer. When at home he sneaks out to hang with the delinquents almost every night to smoke and drink. Erik informs me that drinking alcohol and smoking tobacco and marijuana helps him cope with problems of feeling neglected by his parents.

Erik is diagnosed with having a substance abuse problems, he abuses the substances in order to cope with his feelings of neglect and abandonment from his parents. While also engaging in criminal behavior to fit in with his new “family.” His behavioral misconduct is a due to his forced upheaval from his school and friends, to a new surrounding with a father he did not have a real relationship with. New environmental stressors consisted of his adjustment to his new school, lack of parental supervision, stress that contributed to the coercive interactions with his stepmom, and lack of interest in his school work. His noncompliance with his father is due to the lack of appropriate consequences (e.g., due chores, grounding, taking away his things, positive reinforcement, and regular talks about his problems) for his inappropriate behavior (e.g., arguing with his stepmother, truancy, decline in grades, and not listening to his teachers). In addition, his lack of parental oversight and engagement in his life to positively encourage and reinforce attention and love, encouraged him to seek other habits that conduce good feelings, and frequent substance abuse.

Developing a Treatment Plan

Using the Brief Strategic Family Therapy approach for drug users, in a 1 year, two hour intervention program, which will help in his treatment for substance abuse, but other behavioral problems, and impaired family functioning. Erik’s goals for treatment were determined during the last baseline session, where his parents and Erik were asked separately what they wanted to accomplish from this treatment. This is appropriate therapy, as the underlying problems of his substance abuse is what is going on in the family system. Treatment will be practical and targeted to change the patterns of interaction with family and other problems associated with Erik’s substance abuse. Following a social learning and interpersonal model, the focus was placed on getting Erik to open up more on what he wanted. Both of his parents agreed they wanted Erik to abstain from all substances, associated with better peers, and make better grades. Erik while initially agreeing with his parents, wanted them to be more involved in his life. He felt that was his main goal was for to get his parents’ attention before he stopped caring. He was asked the most important issues he is facing, and while he did not see the problem in him smoking and drinking, he understood that it was not appropriate for him to engage in, and did not want to end up in jail.  Erik’s primary treatment goals were abstinence from substances, and have a fundamental relationship with his parents. Included in his treatment would include assessments on substance problems, routing screening.

Questions would be asked on his usage, if he has ever been abused, left alone, or other underlying problems that could be affecting his behavior. In order to build more trust and repertoire with Erik, we engage in several activities that included board games to get him to open up, and interacting with figures to show how his family communicates. In the sessions, Erik helped to determined several methods to achieve these goals which included, reaching out to his parents and step-families which has proven to be a positive impact on the individual, as well as help in a preventative strategy. Incorporating cognitive techniques of restructuring such as recognizing and correcting negative thoughts. Provide psychoeducation for the family and Erik. This will encourage good communications between the families and Erik, and encourage social skills by getting motivating Erik to get into school activities to make good friends.  Erik was asked to write down the list of activities he would like to do with his father. Encourage his father and mother to schedule sessions separately with Erik, to work on their relationship.  The observance of behavioral changes, familial interactions, and positive drug screening will help Erik achieve his goals, as he is still young and developing, so he still has the opportunity to excel in school and life. The recommendations are for a routine drug screening, encouragement in school activities, and more family involvement.  Follow empirically research treatment and intervention plans, when treating substance abusing adolescents. Establish realistic goals and be conscious of cultural or sensitive backgrounds that could affect their overall treatment.