Assignment 3 Case History When Conducting An Evaluation

Assignment 3 Case Historywhen Conducting An Evaluation It Is Also Im

Construct a detailed case history for a person with an addiction that clearly traces contributing factors, including demographics, family background, education, employment, history of chemical use, description of the current problem, and previous treatment, if any. Additionally, analyze potential ethical issues related to working with this client, including considerations of multiculturalism, duty to report/warn, and confidentiality, especially in the context of family dynamics or other sensitive information. The report should be 3–4 pages, adhere to APA standards, and include supported references. Do not include identifying information or details of any mental illness that would constitute a dual diagnosis.

Paper For Above instruction

Substance addiction remains a complex phenomenon intertwined with various personal, familial, social, and cultural factors. Analyzing these elements through a comprehensive case history provides crucial insights into the multifaceted nature of addiction, informing both assessment and intervention strategies. In this paper, I present a detailed case history of a hypothetical client, emphasizing contributing factors such as demographics, background, and previous treatment, alongside a discussion of potential ethical issues inherent in working with such a client.

Case History

The client is a 34-year-old male of Hispanic ethnicity residing in an urban area. He belongs to a working-class socioeconomic status, employed as a factory worker. The client is single, with no children, and lives alone in an apartment in a densely populated neighborhood. His religious affiliation is Catholic; however, his attendance at religious services is sporadic.

His family background reveals a history of substance use; his father was an alcoholic who eventually died due to liver cirrhosis. His mother, although supportive, struggled with her own mental health issues. The client reports growing up in a household marked by economic instability and occasional domestic conflicts. He was a decent student but dropped out of high school at age 16 due to family financial difficulties, which interrupted his education early. Subsequently, he entered the workforce but lacked stable employment for long periods.

The client’s employment history is sporadic, with periods of unemployment linked to stress and substance use. His chemical use started in his late teens, initially involving alcohol and marijuana to cope with stress. Over time, his substance use escalated to include prescription painkillers and eventually heroin, largely driven by peer influence and the desire to escape emotional pain. He reports using heroin approximately four to five times weekly over the past two years, with occasional binges that last several days.

The current problem is his inability to maintain stable employment and relationships, accompanied by increasing health issues and declining physical condition. He reports feelings of guilt, shame, and hopelessness regarding his addiction. Despite multiple attempts to quit, he has relapsed several times. His previous treatment efforts include detoxification programs and outpatient counseling, but he has struggled to maintain sobriety long-term.

Ethical Considerations

When working with this client, several ethical issues could arise. Confidentiality is paramount; however, if the client’s substance use or behavior poses a risk to himself or others, the clinician may be obligated to breach confidentiality under the duty to warn or protect. For example, if the client’s drug use endangers his life or the safety of others, the mental health professional must consider legal and ethical mandates to report or disclose information.

Multicultural competence is essential, given the client's Hispanic background. The clinician must be sensitive to cultural values, beliefs about substance use, and potential stigma that might influence the client’s openness and engagement in treatment. Recognizing cultural influences can facilitate trust and improve treatment outcomes.

Furthermore, the client may have children or be in situations where reporting is legally required. If applicable, the duty to report child abuse or neglect would specifically come into play. The clinician must understand local laws and ethical guidelines to navigate reporting obligations while maintaining the client’s dignity and trust.

Supporting Ethical Practice and Cultural Sensitivity

Supporting ethical practice involves balancing respect for client autonomy with the responsibility to prevent harm. Clear communication about confidentiality limits, including situations requiring reporting, is essential. Additionally, applying culturally responsive approaches—such as incorporating culturally relevant resources or involving family members—can enhance engagement and effectiveness of interventions (Sue & Sue, 2012).

In conclusion, a thorough case history that delineates contributing factors provides valuable context for understanding addiction. Simultaneously, awareness of ethical considerations, including confidentiality, duty to warn, and multicultural factors, is critical for responsible and effective clinical practice. Incorporating ethical standards and cultural competence enhances the overall quality of care and aligns with professional guidelines set forth by organizations such as the American Counseling Association and the American Psychological Association.

References

• American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf
• American Psychological Association. (2020). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
• Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
• Sue, D. W., & Sue, D. (2012). Counseling the culturally diverse: Theory and practice (6th ed.). Wiley.
• Hansen, H. (2019). Cultural competence in addiction treatment: A review of concepts and practices. Journal of Substance Abuse Treatment, 103, 50-58.
• Johnston, L. D., et al. (2018). Substance use and related factors among Hispanic youth: A review. Journal of Ethnic & Cultural Diversity in Social Work, 27(1), 1-19.
• Hayes, S. C., et al. (2019). Acceptance and commitment therapy and the management of substance use disorders. Clinical Psychology Review, 69, 1-11.
• Hart, C. L., & Ksir, C. (2019). Drugs, society, and human behavior (17th ed.). McGraw-Hill Education.
• Fischer, B., et al. (2018). Legal and ethical considerations in addiction treatment. Drug and Alcohol Review, 37(7), 853-859.
• Schmidt, L. R., et al. (2017). Ethical issues in substance use disorder treatment: Balancing confidentiality and duty. Professional Psychology: Research and Practice, 48(4), 263-271.