Make a Co-occuring diagnostic practice on the case below; Presenting the problem, Diagnostic rational Identification of stages of changes Identificate of stage of IDDT and treatment recommentdation Catherine is a 38-year old married Native American female with no children who lives in rural New Mexico. She was court-ordered to attend outpatient mental health and substance use treatment after spending 6 weeks in a city jail. She does not have any history of being in treatment for or diagnosed with mental health or substance use disorders, but the judge suspected that support would be more helpful than punishment and is offering her treatment instead of jail time. Catherine’s attitude about the judge’s offer is mixed. On the one hand, she is glad she is not in jail for the next 10 months. On the other hand, she is confused about the judge thinking she’s “crazy”. She reports, “how can I have a diagnosis? I have a job and friends. I’m not some homeless druggie on the street” and “you gotta do what you gotta do to stay out of jail; you get it, right?.” Two months ago, Catherine’s husband charged her with assault after she stabbed him in the shoulder with a steak knife during an argument at a local restaurant. She then left the scene and drove her car while under the influence of cannabis and methamphetamine. Catherine reports that she has no memory of the event. Her husband has filed for legal separation but has stated that he is open to reuniting with her if she gets help. Catherine is in generally good physical health and reports that she is in regular contact with her family physician. She has kept a full time job at the post office for the past 15 years where she works as a mail sorter and occasionally as a deliverer. Catherine reports she has had irritable “up and down” moods for most of her adult life. She describes extended periods of time when she becomes “hyperactive” and easily annoyed by people around her. Catherine says that she has “incredible energy” at those times and “gets a lot done.” At those times, she likes delivering the mail, working out at the local recreation center, eating out in restaurants, and shopping. She also reports that she has a strong relationship with spirits during this time and that they speak to her about the future, which is a gift she enjoys. She rests primarily with “short naps” during her energy bursts. Catherine uses cannabis regularly and in large amounts to help her sleep. She reports she may need to take “several puffs” from her high-THC vape pen to get rest. She makes no apologies for her use, stating, “it’s the only thing that helps”. Upon further questioning, she admits that she only uses cannabis when she is in a “high energy” phase. Otherwise she abstains. Catherine reports that she “wears herself out” after about a month of this hyperactivity, becoming “shaky and disoriented” from lack of sleep. This causes her to lose her temper and argue with “almost anyone” who gets in the way of her activities. She reports that during these times, she gets into physical fights, often with her husband, and sees this as acceptable behavior. Despite her erratic behaviors, she is “accepted for who I am” in her rural community. She has a small group of friends and she reports that they spend time “smoking pot and doing puzzles” together. Catherine explains that when she is “worn out”, it is difficult to get out of bed in the mornings. She often wants to sleep for days and weeks. Because she cannot afford to lose her job during the extended periods of time in which she struggles to get out of bed and go to work, she relies on methamphetamine use to regulate her moods. She reports that she sometimes sees spirits who talk to her about the future when she is under the influence, and she reports that she likes this. She reports that “one puff gets me out the door” and describes methamphetamine as a positive influence in her life. She later described it as a problematic influence because it sometimes makes it difficult for her to sleep for days at a time; she also recalled having “bad episodes” where she saw demons that instructed to harm her spouse. She attributes this to a “bad batch”. Reference: case study is adapted from Corcoran, J. & Walsh, J. (2014). Mental health in Social Work: A Casebook in Diagnosis and Strengths-based Assessment (2nd edition). New Jersey: Pearson Education
Make a Co-occuring diagnostic practice on the case below;
Presenting the problem,
Diagnostic rational
Identification of stages of changes
Identificate of stage of IDDT and treatment recommentdation
Catherine is a 38-year old married Native American female with no children who lives in rural New
Mexico. She was court-ordered to attend outpatient mental health and substance use treatment after
spending 6 weeks in a city jail. She does not have any history of being in treatment for or diagnosed with
mental health or substance use disorders, but the judge suspected that support would be more helpful
than punishment and is offering her treatment instead of jail time. Catherine’s attitude about the
judge’s offer is mixed. On the one hand, she is glad she is not in jail for the next 10 months. On the other
hand, she is confused about the judge thinking she’s “crazy”. She reports, “how can I have a diagnosis? I
have a job and friends. I’m not some homeless druggie on the street” and “you gotta do what you gotta
do to stay out of jail; you get it, right?.”
Two months ago, Catherine’s husband charged her with assault after she stabbed him in the shoulder
with a steak knife during an argument at a local restaurant. She then left the scene and drove her car
while under the influence of cannabis and methamphetamine. Catherine reports that she has no
memory of the event. Her husband has filed for legal separation but has stated that he is open to
reuniting with her if she gets help.
Catherine is in generally good physical health and reports that she is in regular contact with her family
physician. She has kept a full time job at the post office for the past 15 years where she works as a mail
sorter and occasionally as a deliverer.
Catherine reports she has had irritable “up and down” moods for most of her adult life. She describes
extended periods of time when she becomes “hyperactive” and easily annoyed by people around her.
Catherine says that she has “incredible energy” at those times and “gets a lot done.” At those times, she
likes delivering the mail, working out at the local recreation center, eating out in restaurants, and
shopping. She also reports that she has a strong relationship with spirits during this time and that they
speak to her about the future, which is a gift she enjoys. She rests primarily with “short naps” during her
energy bursts. Catherine uses cannabis regularly and in large amounts to help her sleep. She reports she
may need to take “several puffs” from her high-THC vape pen to get rest. She makes no apologies for
her use, stating, “it’s the only thing that helps”. Upon further questioning, she admits that she only uses
cannabis when she is in a “high energy” phase. Otherwise she abstains.
Catherine reports that she “wears herself out” after about a month of this hyperactivity, becoming
“shaky and disoriented” from lack of sleep. This causes her to lose her temper and argue with “almost
anyone” who gets in the way of her activities. She reports that during these times, she gets into physical
fights, often with her husband, and sees this as acceptable behavior. Despite her erratic behaviors, she is
“accepted for who I am” in her rural community. She has a small group of friends and she reports that
they spend time “smoking pot and doing puzzles” together.
Catherine explains that when she is “worn out”, it is difficult to get out of bed in the mornings. She often
wants to sleep for days and weeks. Because she cannot afford to lose her job during the extended
periods of time in which she struggles to get out of bed and go to work, she relies on methamphetamine
use to regulate her moods. She reports that she sometimes sees spirits who talk to her about the future
when she is under the influence, and she reports that she likes this. She reports that “one puff gets me
out the door” and describes methamphetamine as a positive influence in her life. She later described it
as a problematic influence because it sometimes makes it difficult for her to sleep for days at a time; she
also recalled having “bad episodes” where she saw demons that instructed to harm her spouse. She
attributes this to a “bad batch”.
Reference: case study is adapted from Corcoran, J. & Walsh, J. (2014). Mental health in Social Work: A
Casebook in Diagnosis and Strengths-based Assessment (2nd edition). New Jersey: Pearson Education
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