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Case Study: Mid-Twenties Client Admitted for Medical Detox

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The client was a 26-year-old African American female that entered treatment with Destination Hope for medical detoxification. Before admission, the client had been abusing Xanax, Adderall, Heroin, and Methamphetamine. The client began using substances in adolescence and had continued for ten years. As a result of her substance use, the client lost legal custody of her toddler, overdosed four times unintentionally, was incarcerated multiple times, on legal probation, and her relationship with her adoptive family deteriorated. Although the client was initially admitted to medically assisted detox, she decided to stay in treatment for all levels of care to improve her addiction and mental health.  The client was dual diagnosed with Bipolar II disorder, major depressive disorder, generalized anxiety, ADHD, and PTSD.

Throughout treatment, the client processed her history of multiple suicidal attempts. Sharing that she tried to take her own life because she thought “it just wasn’t worth all the pain anymore.” She also worked through her unresolved grief, mourning the death of her biological mother and brother while repairing her relationship with her adoptive mother and family. The client’s adoptive mother participated in weekly clinical updates via phone and in-person family sessions and the family intensive weekend program in person.

During the client’s treatment, she developed practical coping skills to manage her cravings to use, depression, PTSD, and anxiety while remaining medication compliant. The client’s treatment included periods of improvement and regression. The client would feel overwhelmed, verbally lashing out at both staff and peers, even attempting to leave treatment ACA (against clinical advice.) The client’s therapist used various therapeutic modalities with the client, including CBT (cognitive behavioral therapy) which teaches clients how thoughts and feelings affect behaviors, as well as MI (motivational interviewing) which helps clients identify their true motivation for wanting to get well and succeeding in achieving both their clinical and personal goals.

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While at the IOP (intensive outpatient) & OP (outpatient) levels of care, the client resided in Destination Hope’s structured living facility, allowing clients to reintegrate into society with the support of clinical staff slowly. The client gained employment, resolved one of her legal issues, obtained a Narcotics Anonymous sponsor, and developed a sober support system for women as part of her relapse prevention plan. Before discharge from Destination Hope, the client achieved 198 days of continuous sobriety, which she stated: “is the longest amount of clean time I’ve had in years.”

At discharge, case management set the client up with a sober living facility in her local area, with referrals to a psychiatrist and LMHC (licensed mental health counselor) for the client to continue with medication management and therapeutic services.

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