Case Study: Middle Aged Female with Co-Occurring Disorders
A middle-aged female arrived at Destination Hope’s residential level of care voluntarily due to mental health diagnoses of Bipolar Disorder, PTSD, and Generalized Anxiety Disorder with alcohol and cocaine abuse in remission. The client had spent time in recovery prior to her admission, reporting to residential level of care due to her inability to manage her severe mental health symptoms – sharing with staff members “I didn’t relapse, things just got really bad for me, and I want to just nip it in the bud”. The client arrived to treatment from her halfway house expressing to the therapist: “I took some advice to get some help, that’s why I came here, I didn’t relapse.” The client demonstrated motivation at both Residential and PHP levels of care to address her underlying mental health symptoms, gain coping skills, and participate in the therapeutic process. The client also presented with secondary emotional / psychological symptoms of unresolved grief, anger and resentment, and unresolved feelings of guilt. Lastly, poor stress management and lack of balance in her life became important focuses of her treatment as well.
The Treatment Process
Clinical interventions of psycho-education and narrative therapy resulted in a re-organization of symptoms to address past events. The client’s anxiety and PTSD both had their source in negative or unresolved family interactions. The client relayed to the therapist a history of unprocessed grief and loss related to the death of her mother, father, and husband who died of cancer not long before her admission to treatment.
The client’s strong feelings of guilt were related to negative self-statements such as “I could’ve done more to save him,” referring to her husband who died of cancer. The therapist and patient worked through feelings of unjustified guilt and letting go of feelings of anger and resentment as part of the therapeutic process. These interventions assisted the patient with letting go of years of pent-up pain and frustration and were vital to her healing process. In addition, medication compliance was crucial to the client’s ability to reduce her anxiety levels to a degree where she could develop coping skills to manage them independently on a daily basis. As the clients mental and emotional health became more stable, she accepted the suggestion of clinical staff to obtain a sponsor and begin the process of seeking employment once she transitioned to IOP level of care.
As part of her aftercare plan, the client put effort into learning how to balance employment with recovery related objectives such as attending 12 step meetings, following through with self-care issues, and completing step work with her sponsor. Because of her lack of family support, aftercare objectives also include involvement with DH alumni and building her sober support network. Eventually, the client returned to the halfway house where she was residing prior to admission to Destination Hope and where she has support from staff.