HUMS 208 Case Study Cognitive Behavioral Theory (CBT)

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Ivy Tech Community College, Indianapolis *

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208

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Psychology

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Feb 20, 2024

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docx

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Directions Part of understanding a theory is application. For each theory presented in this class, you will need to apply it as directed to the case study below. Please do your best to use components of the specific theory the class is studying for the week. It is very important that students understand components of each theory and how they might be used in treatment of addictions. The Licensed Addictions Exam (LAC) will provide scenarios of cases and treatment being provided and ask the test taker to identify the specific theory being used. Additionally, if a student has the goal of becoming a clinical therapist, they will be asked to identify their theoretical orientation and will treat and document from that orientation. It is imperative that students comprehend and can apply theory in this profession. The below case study will be used for each theory analyzed. Case Study of Connie Presenting Problem: Constance “Connie” DeAngelo is a 20-year-old Latino, single, female who is referred to services by Child Protective Services (CPS) and Probation. Connie was arrested one week ago and charged with the following:  Maintaining a common nuisance  Possession of a controlled substance with Intent to distribute  Criminal conversion  Neglect of a child Connie was released after her maternal grandmother posted bond. Connie states she is seeking services because she “has to” in order to “stay out of jail and get my kids back.” Connie has two children, Roman, age 4 and Isabella, age 2. Both children have different fathers and neither is currently providing care or assistance for the children. Connie has never been married and reports she needs to have paternity tests done on both children before she can seek legal child support. Both children are currently residing with Connie’s maternal grandmother. Connie is residing with her grandmother as well, but cannot be left alone with her children per the conditions of CPS. History Connie states she began using alcohol at age 13, but this is not her current drug of choice. Connie notes that at age 14 a friend provided her with opioid

pain relivers (Vicodin). Shortly after, she began experimenting with other substances, such as marijuana, methamphetamine, and cocaine. Connie’s current drugs of choice is marijuana and heroin. Connie reports that she smokes marijuana “several times” a day to assist with her anxiety. Additionally, she injects heroin multiple times per day. Connie estimates that she uses “7-8 bags” of heroin intravenously a week and notes this has been her pattern for the last month. She reports that she “loves” heroin and is not sure how she will give up the drug. Connie admits she has had legal issues in the past, ranging from a DWI at age 18, and possession charge at age 19. She was able to go through a deferral program for the DWI, which included drug and alcohol classes. She served probation for 3 months for the possession charge. Connie allegedly was involved with CPS when her 2-year-old was born, as she tested positive for opioids and marijuana following her daughters’ birth. Both of her children were subsequently placed with her parents at that time. Connie completed a drug and alcohol IOP program and was the case was dismissed after 8 months. Connie denies any current medical issues and denies that she is under the care of physician. Connie states that other than the court ordered drug and alcohol classes, she has not received any mental health treatment. When asked how she felt about entering treatment again, Connie stated “I’ll do what I need to do, but I don’t think it will work.” Support Connie is the middle of five children born to her parents, who have been married for 30 years. Connie has little contact with her parents since she returned to using following the dismissal of her CPS case one year ago. Connie reports “they think I do not try and have given up on me.” Connie has a “ok” relationship with her older sister, who lives in the same town. Her sister will look after Connie’s children “when she can” but because of her work schedule, she is often unavailable to provide childcare. Connie does not talk to her other three siblings, noting they “live in other states and don’t have time for me.” Connie does report a “close” relationship with her maternal grandmother, noting “she is the only one who has not given up on me.” As mentioned earlier, her GM recently bailed Connie out of jail and frequently provides funds for Connie to “buy food and clothes” for her children. GM is also currently housing Connie and her children due to the in-home CPS placement.

Growing up, Connie describes her homelife as “normal.” Her mother worked within the home and her father worked as an engineer at a local car factory. She denies any physical or sexual abuse, but notes “my father did not play, he let us know when he was mad.” Connie reports “spanking, grounding” and loss of privileges when in trouble at home. Connie feels she was in trouble at home “a lot” starting at age 12. She reports her grades in school were good until middle school. Connie did graduate high school, but did not have a desire to attend college. Additional Information Connie reports that she has been in “many” romantic relationships and “they have all been bad except my first.” When asked to elaborate, Connie noted that most were “abusive” which mainly consisted of emotional abuse and some incidences of physical abuse, particularly from her past two relationships. The longest relationship Connie has been in lasted approximately two years, the shortest, one week. Connie first became sexually active at age 13 (BF was 15) and states this relationship was the “love of my life.” The relationship lasted for about 6 months, but abruptly ended when her parents found out about the sexual activity. The parents went as far as to press legal charges against the BF, and Connie states this “ruined my life.” Connie feels her social group shunned her during this time and she had to “find new friends.” Connie reports she has had issues with anxiety since she was approximately 10 years old. She attaches the initial anxiety to the loss of her maternal grandfather, who passed away suddenly that same year. She reports her anxiety increased greatly when she was 13 and forced to end her romantic relationship. Currently, Connie describes herself as a “worrier” and does report experiences panic attacks that “come out of nowhere” which developed after her first child was born. Connie feels using marijuana and heroin “helps” her anxiety and she feels she has fewer panic attacks when using. The last panic attack occurred “three days ago.” Connie describes her mood as “okay” and notes that she sleeps 10-12 hours each night and often “naps with the kids.” She noted that most days “I just go through the necessary actions” in taking care of her children and making money to support the family. No reported problems with appetite or concentration, but during the interview, Connie had to be redirected a couple of times. Connie admits to feeling suicidal in the past, but denies any current suicidal ideation. Connie denies any past suicide attempts or homicidal ideation. Connie has worked in the food industry as a server in the past. She is currently unemployed and notes she relies on selling drugs to support herself

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and her children. Connie expressed concerns getting a job (which is a goal from CPS) due to what she describes “THC will be in my system” for “along time.” When asked to describe her goals, Connie stated the following: 1. Complying with CPS requirements which include completing a SUD program. 2. Regaining custody of her children. As noted earlier, Connie enjoys using heroin and marijuana, and feels they help her with her anxiety. Therefore, she admits she is not particularly motivated to stop using the substances long-term. She is willing to stop the use to comply with CPS requirements, but admits that once her case is dismissed “I will probably go back to using.” Connie was cooperative during the interview. She was dressed appropriately in jeans and a hoodie. Her grooming/hygiene was good. Connie presented with a flat affect, and rubbed her hands together frequently, shifting around in her chair, as she was interviewed. Connie did present with circumstantial speech, and had to be redirected several times during the interview. She maintained appropriate eye contact. Connie does appear to have impaired insight and judgement as evidenced by her idea that she will return to use once the case is closed by CPS and that selling drugs is the best avenue to support her children. Assignment: For this paper you will review the major concepts of the Cognitive Behavioral Theory (CBT)and apply them to the case of Connie. Keep in mind CBT theory is based on dividing our experience into four central components: thoughts (cognitions), feelings (emotions), behaviors and physiology (your biology). Reframing thoughts, guided imagery and journaling are techniques used with CBT.  From the perspective of this theory, what are the key factors of this case upon which a cognitive theorist would focus? What is important in this case from the viewpoint of cognitive theory?  From the perspective of this theory, what are the major issues to resolve?  What would you see as the cause of the addiction and what would your treatment plan look to address or include? Assignment must be:  A minimum of 2 pages (not more than three) in length  12-point Times New Roman font  Double spacing between all lines (no extra spacing between paragraphs)

 Use 1-inch margins  Include a title page utilizing standard APA 7 format (title page does not count in final length of paper). For help: Purdue Online Writing Lab - Using APA format for student paper - sample paper (Links to an external site.)  The assignment should contain an  Introduction  Body  Conclusion  References page only required if direct information, including definitions of terminology, is taken from another source Aside from the theory and page length, which will change for each paper, these will be standard requirements for this assignment. The length of the subsequent papers will change as the other theories are more applicable to treatment of addictions.

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