Question by : Alexia entered the inpatient treatment program where you are a chemical dependency counselor. She stated that?
Alexia entered the inpatient treatment program where you are a chemical dependency counselor. She stated that she needs help for drug addiction and possibly alcoholism. She is a 32-year-old, divorced, Caucasian woman, employed as an administrative assistant at a local human services program. She lives with her 11-year-old daughter, Christine, in an apartment located near her job. Although she makes a relatively low salary, Alexia has managed to support herself and her daughter without financial support from Christine’s father. Alexia was married briefly to Christine’s father when she was 20, but left him after he became physically and sexually abusive toward her. He was also an alcoholic. Until recently, she had almost no contact with him for many years. Her widowed mother is a strong support for Alexia and Christine, as are two cousins, Denise and Moira. Alexia reports growing up in a “normal middle class family” and states that her childhood was “good” despite her father’s occasional drinking binges. She is the youngest of five children and the only girl. Alexia reports having little pleasure in life and feeling tired and “dragging” all of the time. She tells you that her difficulty in standing up for herself with her boss at work is a constant stress orShe reports to having tried AA two years ago, but wasn’t able to stay sober for more than six months. She began drinking regularly (several times a week) around the age of 13. She recalls having felt depressed around the same time that she began drinking heavily, although she states she has very few clear memories of that time in her life. Alexia’s drinking became progressively worse over the years, although she did not begin to see it as a problem until after she began using crack cocaine, at around age 28. She reports feeling depressed over much of her adult life; however, her depression got much worse after she began using crack daily. She feels hopeless about her ability to put her life together, and is doubtful that she can achieve sobriety. alexis was recently raped by her drug dealer and his friend, which resulted in a broken jaw and one month’s absence from work. she tell you that she “only got what she deserved” for being in the wrong place with the wrong people at the wrong time. her ex-husband is trying to gain custody of her daughter now that he has been sober for two years. alexis hopes to get sober so she can fight this custody battle, and “be the mother her daughter deserves”.1) i want to know what is actually happening in this client’s life. 2) what must be addressed to improve the situation. 3) how would you asses this client and why. 4)what diagnosis would you give this client and what criteria are you basing this diagnosis on. 5) what treatment options would you recommend for this client and why? 6) what is your working hypothesis about this client’s problems with alcohol and drug issues
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Answer by nickipettis
in no particular order

i suspect she was physically abused in childhood and sexually abused in puberty, 13 and later.
she has worked hard to not remember that.

I have NO idea how she can afford alcohol and drugs and support herself and her daughter on a “relatively low salary.” you should investigate whether she has been prostituting herself for drug money, or paying for her drugs with sex.

Anyone who says “they only got what they deserved” is being emotionally abused, even if there are no other factors. her drug dealer is keeping her dependent not just on drugs, but is lowering her self worth.

She may have started using drugs more seriously at 28?, when her daughter was 7 or 8. this may have triggered memories of her own abuse.

i think the first thing that has to be addressed is that she doesn’t think she CAN get sober.
If she doesn’t think she can get sober, then she certainly can not.

What do you think? Answer below!