Carl Case Study copy PDF

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Written response to the carl case study helper studio assignment which includes my mock response to the video and answers to the 3 questions. I used this to read as a script while recording my responses....

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CARL CASE STUDY Carl: -

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Middle-aged, single White female Currently living with brother and family Heroin user accused of stealing On the verge of being homeless “someone told me you could help me” “I wasn’t always like this” “I had an accident, it wasn’t my fault- someone hit me. They didn’t have insurance. Dr put me on painkillers” o Blaming doctors for addiction Wife left him o Blaming her too * blaming everyone else for his problems o Wife leaving him, guy without insurance hitting him, dr putting him on painkillers n taking him off too soon “so he wouldn’t get sick” Started stealing from family to afford his habit > claims he was remorseful but he got caught again Only came to treatment bc his family told him get help or move out

Mock Response First and foremost, Carl, I am so sorry that you’ve had such a tough time battling your addiction to heroin. Thank you for sharing all of that with me, I’m sure it must have been difficult. From what I understand, you were dealing with a difficult set of circumstances before you were even prescribed the painkillers with your wife leaving you and dealing with the aftermath of your accident. That must have been a really challenging time for you. Am I understanding this correctly? I could imagine that the opiates provided you some sort of solace from all of the pain you were enduring, so it makes sense why you had such a hard time after your doctor pulled your prescription. I imagine it must have been hard to try to cope naturally again. I want you to understand that you are not alone in this battle and you are not weak for struggling or seeking help. There are millions of people fighting addictions and getting sober is not easy, as you know, but this is an admirable, significant step in the right direction. Your family seems to really care about you or else they wouldn’t keep giving you chances, forgiveness, and encouraging you to seek help. I do have to ask you, though, what you want to come out of this. You need to be doing this for you, not to appease your family. I am here to work through this with you, but we need to start by being honest with one another and ourselves. Our success together depends on the choices we make together and our responsibility of upholding out plans. I couldn’t help but notice the emphasis you put on your wife, the circumstances of your accident, and your doctor’s role in

apparently causing your addiction. How do those factors continue to perpetuate your drug use today?

1. Using a trauma-informed care perspective, how would you begin to explore Carl’s problems? I would want to begin by rebuilding his self-esteem by discussing his strengths at length. I recognize that he has probably spent the course of his addiction being shamed for his struggles, leaving him feeling powerless. We won’t get anywhere if he feels like he has no control. With that, using a patient empowerment strategy would be appropriate. I would emphasize that the outcome of his treatment is entirely in his hands because his choices, whether it be course of treatment or how he utilizes the strategies we come up with to help him reach his goals outside of treatment, and his dedication to the process, will determine the outcome of our work together. I will make sure we discuss any and all resources available to him so we can come up with the best treatment plan possible for him. I want him to fully understand that he will be supported from all angles. In terms of applying a “what happened to you” as opposed to a “what’s wrong with you” approach, I would address the events he mentioned prior to being prescribed painkillers. Carl implicitly blames his wife and his accident for his addiction, so at some point, I would want to explore how those events affected him and what he was going through emotionally before his addiction started.

2. Which stage of change is Carl in? Carl is in the contemplation stage of change. While he definitely recognizes that his addiction is a problem, he repeatedly places the blame on various external factors with a tone of bitterness which makes me feel like he isn’t taking any responsibility. He basically said the only reason he is in treatment is because his family will kick him out if he doesn’t comply with their wishes. Carl is ambivalent throughout his whole narrative. Even though he says he wants to change, he hasn’t really done anything about it and probably still wouldn’t if he wasn’t given an ultimatum. Even after getting caught stealing by his family, he says he was “all remorseful,” which didn’t sound genuine in the slightest, and he ended up stealing again. Carl is in the contemplation stage of change because he is not seeking treatment because he wants to, but because he would be homeless if he didn’t.

3. What barriers to goal accomplishment do you think might present themselves in working with Carl?

If the goal is to stop doing heroin, his addiction in itself is going to be a huge barrier. On top of that, the fact that he is not seeking help on his own convictions as his family is has forced him into counseling takes away most of, if not all, of the drive that Carl has in achieving his goal because getting clean is not his true goal. While he expresses that he doesn’t enjoy heroin anymore, he hasn’t necessarily done much on his own to stop. My cousin was an addict for almost 12 years and it wasn’t until he got to the point that he had absolutely nothing and realized himself that he couldn’t do it anymore and he put himself in rehab. I believe that because HE is the one that chose to seek treatment, without anybody else forcing him, that is why he got clean....