Case Study: Stress, Trauma and Substance Abuse
Client came to Destination Hope in her mid-twenties from the southern United States where she worked in customer service. She self-reports that the primary factor resulting in her mental health decompensation is due to the combination of stress and trauma. With a history of daily marijuana use, client presented with denial and poor insight into how the drug contributes to her current state of mental health. Other contributing factors leading to treatment included medication non-compliance, poor impulse control, poor judgment, problems within the family as well as interpersonal problems, inability to function, employment problems, relationship problems, and anxiety.
The Treatment Program
Working with the clinicians daily, the client evaluated her current state of mood, energy level, control over racing thoughts, and sleep pattern. The medical team designed a medication regime to stabilize her mood to ensure sustainable recovery. In the medication group facilitated by the nursing staff, she began to understand how drug and alcohol use can have adverse effects on the medication that was used as part of her overall treatment. During groups like “Living Mentally Well” client began to gain insight into her mental health diagnosis and learn how to practice having healthier judgement. Accountability groups helped the client clearly identify the impulsive behaviors she had been engaging in that had created chaos and negative results in her life. Through repetition of activities of daily living client learned to perform and function normal, everyday chores, personal care, and tasks. As she gained more clarity and worked with her therapist in individual sessions, client processed a tenuous relationship she had with a family member that allowed her to let go of anger and resentment. Her family member attended therapy with her, and this allowed the client to work toward forgiveness. The client’s family was referred to Al-Anon and NAMI so they could learn about mental health and recovery.
As her healing and recovery progressed, she began to learn new and effective ways to cope with the depression and anxiety. One of her first homework assignments from her therapist was to maintain an anxiety thought record identifying 3 episodes of high anxiety and the circumstance in which they occurred. This supported her in identifying her personal triggers and the origin of the increased anxiety she experienced. During Mindfulness group, the client was taught relaxation skills such as guided imagery, meditation, and diaphragmatic breathing and learned how to apply these skills to her daily life.
With weeks of a stabilized medication regime and both individual therapy and group therapy, the client was ready to be guided into the next phase of her recovery which was to plan her aftercare. Working with her case manager she was referred to vocational services where she was taught skills that would help her become gainfully employed. To create a support network, client was introduced to NAMI and given an extensive list of meetings in the area she would reside in. Client would go on to attend out-patient treatment while she lived with her supportive family.