SHS 255-Co-Occurring Disorders-----------Case Study #1, Nov. 2, 2010

Read the case study and respond to the questions below.  Please word process your paper using 12 pt. font and double space.  Practice professional writing skills, e.g.  use correct grammar and punctuation, use objective and descriptive language and write concisely.

1.  Write 2-3 sentences describing the client demographically.  For example, "Client is a _____ year old white female, single with two children.  She is referred by DSHS following a CPS report." (4 points)
2.  Identify the key signs and symptoms of mental disorder/substance-related disorder the client is experiencing.  (10 points)
3.  Identify the strengths and resources the client has.  (10 points)
4.  Identify any imminent crisis or safety issue that must be addressed immediately.  (8 points)
5.  What are three assessment questions you would like to ask the client or a collateral source to more fully understand him/her? (8 points)

William arrives at the counseling office appearing tired and smelling like alcohol.  He is 24 years old and of Philipino and African American background.  He is seeking help as a result of a warning from his father, with whom he lives, that he is on his last chance.  Next time he messes up, he'll be looking for a new place to live.  His boss, too, has given him his last warning.  His boss is happy with his work but he's unhappy with William's habit of showing up late at least once a week.  His boss has also wondered if William has gotten high at lunchtime. 

William graduated from high school and has attended college classes a couple of times but felt it was a bad match.  He wants to go into the trades but has had a hard time committing to anything.  He acknowledges, too, that it's difficult to get a good job without a clean drug test.  He says he'd like to stop smoking long enough to get a clean test and he's pretty sure he can do it on his own, without treatment.  He just needs to be motivated enough to tell his friends "no" when they come around with a blunt to smoke.

As you talk with William about his teen years, he tells you about the intense anxiety he experienced.   It actually began in elementary school, when he had a period of time during which he was afraid to go to school, afraid to sleep in his own room, afraid when his parents went out, etc.  He was never quite able to just let go of his worries, although they decreased over time and he functioned pretty well throughout middle and high school.

William is a good natured, friendly and likable young man.  He seems pretty open and honest when you ask him how much he drinks, smokes and whether or not he uses other drugs.  He drinks 3-4 days a week, sometimes just 2-3 beers, other times to the point of getting "really drunk."  He smokes marijuana "not that often just every once in a while," usually when someone else suggests it.  He's fairly healthy, which is a good thing since he has no health insurance.  He likes his dad and has a pretty good relationship, except when his dad gets mad about his drinking and smoking.  William has a few good friends that he's had since high school.