Client is a 27-year-old female admitted to Destination Hope residential program for substance use and mental health problems. During her pre-admission, client reported having suicidal ideations and partaking in risky behaviors such as, driving under the influence and using substances in front of her children. Client stated she has been married for 5 years but reports instability in their relationship due to her substance use and mental health. Client stated she has two children with her husband. Client reported drinking alcohol and abusing substances daily. Client stated negative consequences resulting from her substance use include unhealthy interpersonal and familial relationships, isolation, and was required to have supervised custody of her children due to inability to maintain their safety. Client reported history of medication non-compliance. Client reported a history of traumatic experiences.
From the beginning, client presented as very guarded and unable to share past trauma. Through the unconditional positive regard of her therapist, client was able to open up more and more in individual sessions. Client learned coping skills to effectively manage her anxiety such as deep breathing, grounding, and reality testing. For a while, client continued to struggle with her anger and irritability. Client would lash out at staff and her peers when frustrated. Client would report not wanting to act in these ways but not knowing how to control her anger. Therapist assisted client by providing alternative options to release the anger such as, deep breathing, walking away, and processing in group/session later on. During group and individual therapy sessions, client learned more about her mental health diagnoses and how they impact her life and substance use.
Client was able to identify the negative consequences resulting from her substance use. By using the strengths-based perspective, client’s therapist was able to help client feel more empowered and capable of maintaining her recovery. Therapist had client do inner child work to address her low self-esteem, trauma reactions, and destructive behaviors. Client was able to gain insight which helped her release the damaging beliefs she had about herself and the world.
Client willingly completed the homework assignment that her therapist provided. To prepare her for returning home, client was asked to journal about potential triggers that may arise back home and how she would approach each one. At this point, client had done a lot of self-reflection and built the confidence to make her decisions based on what is best for her and her recovery. Client appeared confident in her abilities and excited to see her children, strengthen the relationship with her mother, and mend the relationship with her husband. Client spoke with both her mother and husband who agreed to attend therapy with her.
Towards the end of treatment, client was able to identify her strengths, which is something she could not in the beginning. Client stated, “I like helping others. I’m loving and caring. I’m a good mother. I’m confident and loyal. I’m determined and compassionate.” Client was able to identify her progress since arriving at DH. Client stated, “My personality is coming back. I’m not seeing as much hatred towards others as I used to. I’m better at communicating effectively. I’m learning how to be a better version of myself. I’m also getting the patience thing down”.
Client also was able to share vulnerably in a group which is something she struggled with in the beginning. Client was discharged and returned home to live with her mother and continue IOP locally.
