Description of Client and Presenting Problem
CH is a 45-year-old Korean accountant. He is married and has seven children. CH has alcohol addiction, which poses a challenge to his health, as well as his family life. His addiction has resulted in his family relationship’s malfunction. The family members can no longer trust the subject of the study, as he has become irresponsible and violent in relation to his family members. CH was brought to the treatment facility two weeks ago, and I scheduled an aversion therapy program. We have tested and treated alcohol symptoms. Apart from increased alcoholic consumption, CH has problems with his anger management. At his age, he is most likely to be susceptible to alcohol-related brain damage and cognitive deficits. Moreover, alcohol has impaired his memory and learning abilities.
I began holding sessions with CH three times a week, engaging him in outdoor activities such as playing football, meeting friends, discussing political and economic matters, and visiting those affected by drug addiction at a hospital. During these activities, I continued to make observations and record his thoughts on various issues. Another present problem appeared to be hangovers. CH is constantly in a state of a hangover due to heavy and prolonged drinking. He experiences headaches and feelings of dizziness, vomiting and nausea, muscle pain, weakness, and sweating. We also visited several clubs twice on Fridays, limiting alcohol intake with 2 bottles of beer. I have noted that CH is experiencing constant blackouts and cannot remember events that happened while he was drinking, implying he is a binge drinker.
Target Problems, Goals, Objectives, and Tasks
The main goal of this intervention is to ensure that the health of CH is restored and that he can normally function. After the assessment, I have outlined the following three functions to address the above-stated problems.
1. To help CH and clinicians distinguish shared treatment objectives and create treatment arrangements. Different patients require proper methodologies, as every patient is unique. Any hidden problems ought to be distinguished regardless of the possibility that the causal relationship is indistinct. The treatment arrangement ought to be founded on the best intervention for CH, not simply on the sort of treatment regularly provided by the facility. CH ought to be educated about the scope of alternatives for locally accessible intercession and helped to settle on a contemplated choice as to which intervention is most suitable for his needs.
2. To develop a strong connection with the patient during the treatment is a great opportunity for both the clinician and CH to create compatibility. If I showed CH compassion and affability and gave a feeling of trust and faith, he would be less inclined to take a defensive position in the meeting and resist changes. My input would urge him to evaluate his circumstance from another point of view.
3. To persuade CH to change drinking habits and related ways of conduct. CH’s impression of a gap between his objectives and this present state may enhance inspiration for changes. It is vital to highlight the availability of the open door for changes. This requires the clinician to have a definite and reasonable methodology and a rational comprehension of the ramifications of progress for the patient.
The objective of the present study is to guarantee that CH avoids and abstains from taking alcohol. It is the most reasonable drinking goal for patients with heavy alcohol reliance and those showing related issues. Accomplishing forbearance will be accompanied by a danger of withdrawal alcohol disorder. I will deal with the withdrawals before accomplishing longer-term restraint or decreased drinking.
The assignment of the research is to create a proper treatment arrangement. Any treatment mechanism must address the issue under consideration. The exhibiting problem is regularly alcohol-related (for instance, liver ailment, sorrow, aggressive behavior at home), thus, it will be significant to address CH’s alcohol consumption, keeping in mind the end goal of considerable longer-term change. Immediate needs often control the grouping of intercessions.
Indicator of Target Problems, Data Source, and Data Collection Procedures
Biological indicators of excessive alcohol use incorporate direct measures of alcohol (for instance, alcohol in breath or blood) and scope of backhanded records, i.e. liver chemicals movement, the level of sugar insufficient exchanging, attributes of blood erythrocytes (e.g. mean corpuscular volume), etc. High mean cell volume (MCV), serum gamma-glutamyl transferase (GGT), and sugar deficit transfer are the indicators of substantial drinking a few weeks before the testing. To define the accuracy of surveying poses a challenge, as indicative tests have recorded self-reported consumption to be the highest, yet in some cases, a natural indicator may be more precise than a self-report (Gast & Ledford, 2010).
GGT and MCV often witness false-positive results due to various reasons. False-positive MCV can occur as a consequence of vitamin B12 inadequacy, corrosive folic insufficiency, thyroid sickness, or incessant liver ailment. False positives with GGT are recorded to happen due to liver sickness or chemical instigation including a few medications. CDT is typical in mellow liver infection. The case might be related to a serious liver infection however generally giving false-positive analysis results. On the off chance rising due to the alcohol, it stays hoisted for a few weeks after consumption has diminished. It will not distinguish late backslide. CDT may be a more precise indicator of extremely later (past two weeks) drinking than GGT (Richards, Taylor, & Ramasamy, 1999).
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As CDT estimation may not be accessible, it is suggested to decipher a typical or an abnormal GGT or other liver test outcomes in case of clinical trouble. Organic tests are considered to be of a lower quality than self-reports for screening with the aim of intercession. They play their most significant part in case CH has the purpose of minimizing (or, less generally, overstating) his consumption. It is also important for observing CH’s progress in decreasing his drinking. Despite the fact that these tests have restricted affectability and specificity, in the case of the patient under consideration, they may persuade CH to lessen drinking and are helpful in observing the changes in consumption.
The Intervention and the Rationale Underlying It
The intervention I chose to handle CH’s alcoholism is through assessment, engagement, and building of trust. I became my patient’s best friend thus guiding him through the healing process. We spent time together while I taught him the benefits of staying healthy and keeping fit. I made him realize the risks he was putting his family to and what he could do to change. I also made him acquire a new vision of his children and proposed to engage in investments (as he is a prosperous man). I opted for the socialization therapy to introduce him to the most affluent member of the community and make him see the difference between his life and their life.
We watched videos about close and loving families, as well as the worst family movies. He manages to see the difference and introduces his own position as a family man. I allowed him to explain to me what his ideal family model is and to reflect on the topic. I was also told about the problems which according to CH were driving him into alcohol. We developed step by step procedures to help him solve these problems. I also discussed with his wife some of these issues and asked her to ensure CH was improving on a regular basis.
Literature Regarding the Client, the Target Problem, or the Intervention
Various studies have analyzed the effect of alcohol on savagery; however, only a small number have addressed differences elicited by different levels of alcohol. Since alcohol promptly crosses the blood-cerebrum obstruction, the centralization of alcohol in mind parallels the focus built up in the blood. For sporadic consumers, apparent inebriation happens at BACs of 50 – 150 mg/dL. Side effects shift especially with the rate of drinking and may incorporate happiness, incoordination, ataxia, sleepiness, glibness, melancholy, and pugnacity. With expanding BACs, immediate depressant impacts of alcohol prevail and patients may encounter laziness, bradycardia, hypotension, and respiratory despondency. Sometimes it is confused with retching and pneumonic yearning. As BACs increase further, the impacts of alcohol are evident with the loss of memory, respiratory acidosis, and hypotension. The average deadly BAC is roughly 450 mg/dL (Kratochwill, 2010)
While for many people the withdrawal alcohol disorder is fleeting and immaterial, in others its seriousness increases within 48 to 72 hours of forbearance. CH turns out to be exceptionally helpless against mental and physiological anxiety during this time. According to Richards, Taylor & Ramasamy (1999), psychiatric indications of alcohol withdrawal including dysphoria, rest aggravation, and nervousness regularly take a few weeks in the wake of drinking discontinuance.
Experimental confirmation emphatically underpins the perspective that brief intercessions adequately lessen the levels of alcohol admission in individuals who drink above prescribed levels and are in danger of creating alcohol-related issues. Unfortunately, they are not looking for treatment. From the observations by Gat and Ledford (2010), various meta-analyses have inspected the adequacy of brief interventions in the populaces. Results from these meta-investigations have been steady in proposing that pioneering brief interventions, contrasted with no intercession, viably diminishes the levels of alcohol use (Janosky, 2010).
The evaluation design I use in this experiment is the ABA evaluation design. I managed to receive data from the clinician on the status of CH’s liver, blood system, as well as the extent at which he had been affected by alcohol. Continuous interaction with him is important in enabling me to understand his behavior. This design was easy to use as I was able to manage the withdrawal symptoms of CH. The clinical advice is useful in deciding the dietary regime to employ. I ensured that he took a lot of water and ate enough vegetables and fruit. Choosing the friends to meet and inspire him was not difficult, as most of them were willing to help him change. The treatment was conducive to an evaluation of the program and CH’s development as I was able to focus intensively on CH’s behavior and generate results that are unique to him. I managed to discover causal relationships by manipulating the use of alcohol as a key independent variable.
The evaluation design I used is precise enough. I can measure the outcomes, such as the number of times CH takes alcohol and the reduction in a number of bottles. This allows me to have an accurate assessment of my efficiency in behavioral therapy. It facilitates empowerment. I do not want to control CH but inspire him to reach the goal – living free of alcohol. CH is able to exert more control and power over his environment and behavior, which helps him attain his goals as a family man. I clarify the choices available for CH and teach him independent life skills. He is able to acquire personal management skills that will assist him in the future.
The appendix shows a graph derived to show CH’s performance for the standard 30 session period. I did not just ask him to stop drinking but remained systematic. Firstly, I allowed him to take two bottles of beer a day instead of five as he used to do; secondly, I allowed him to take four bottles a week as opposed to seven days. We narrowed the consumption to one bottle a week and he finally managed to stay without drinking for the entire week. CH’s position as shown on the graph stood at less than 20% (can be defined as chronic), but the change remained steady throughout the process.
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The data collected from this client was both qualitative and quantitative; hence, there was a need to use various intervention tools. Dealing with behavioral matters requires a wider understanding of the issues affecting the client, while no particular approach is known to be perfect. After terming the behavior as negative reinforcement, I was able to remove the unpleasant stimuli and, therefore, CH could not easily repeat or relapse to drinking. I removed the behavior completely by saying positive words and encouraging him to talk openly about his problems.
I would make a follow-up with CH for the next six months and keep engaging him in my investment plan. I have recommended a guiding and counseling team to assist him in handling his marital issues, which was one of the reasons why he was constantly drinking.