Take-Home Portion
Unless otherwise instructed, write as though you’re talking TO the client
Loren is a 33-year-old Caucasian man mandated for substance treatment after he was arrested for possession of methamphetamines, public intoxication, and disturbing the peace. (He had been doing methamphetamines and drinking with friends, and he started singing loudly while walking home at 3 a.m.) Loren lives in an apartment with his current girlfriend and her younger sister. He works at the counter of a deli 30 hours per week. He says he can’t get more hours at his store, and he doesn’t feel up to having two jobs. He sometimes does some basic handyman work on the side. He says that he has no reason to stop using meth or drinking, and he is irritated about being mandated to come to treatment. He says that half of the people he knows use more than him, and that there’s no harm in using once per week for fun. He said he does not use any other drugs, and he rarely drinks alcohol.
- How do you respond? (Write what you would initially say to him. Write about a paragraph. You do not have to persuade him to stop using or even commit to treatment in this answer. Write it as you would say it TO HIM.)
He says that he doesn’t want to stop using drugs and very strongly says he has no reason to try since he only uses for fun. He is adamant that he doesn’t have a problem and that meth doesn’t cause him any problems. You want him to commit to treatment and try to think of reasons he might want to commit.
- What might you tell him to help him realize that he can benefit by coming to treatment and working toward abstinence, even if he doesn’t think he has a problem? (Hint: Why/how was her referred?)
He arrives the following week and says that he did not use any meth or any other drug that week. His urine comes back positive for meth and cocaine.
- What do you say? (Be sure to include all the important components.)
Later in the session, he says that his sister is getting mad because he has not been paying his share of the bills. He says he dreads seeing her because she keeps harping at him.
- What are some MI techniques you might use? (Give the NAMES of two)
- Give AN EXAMPLE of what you might say incorporating both of the above. (Write it as though you’re saying it TO him.)
He appears to be thinking about stopping, but he doesn’t seem to be as motivated as you would like him to be.
- List a MI strategy you might use to increase motivation (OTHER than the OARS).
- Give an example of what you would say.
He now also admits that he also drinks “about 4 drinks a day.”
- What would you ask to find more details about those drinks? (There are two things you especially need to know)
He shows up a couple of weeks in a row without doing any of the home practice.
- What would you say to him? (1-2 paragraphs; be sure to include all of the important components)
A few weeks later, he has been abstinent for 7 days. (Woo Hoo.) However, he is upset because he has started experiencing stronger urges and cravings.
- Write a couple of paragraphs about what you would say and do to help him cope with the cravings (based on CBT).
He appears to be having problems having people offer meth; he has difficulty not using when it is offered.
- What might you do/say (based on CBT)? Be specific. (Describe what you would do – not necessarily how you would say it to him. Go into a lot of detail. Be sure to read the addendum as well as the CBT manual.)
You’ve finally come to the end of your time with the client.
- What does CBT say is important to do for termination?
