Final Case study- Chris (1)

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7-3 Final Project: Client History & Therapy Plan Mackenzie Connell PSY-315 Counseling Process/Techniques Southern New Hampshire University December 8, 2023

Client History/Development Chris, a 26-year-old Asian male from Utah, lives intermittently with his adoptive parents, having been adopted at the age of 4. His adoptive parents are well-educated and financially secure; his father was a neurosurgeon, and his mother worked as a registered nurse at a children's hospital. In contrast, his biological parents, both high school dropouts with criminal records, stand in stark contrast. Chris himself has a high school diploma and some college education. Over the past year, he has worked inconsistently as a technician after being let go from his previous position as a medical technician due to his addiction to opiates. He faces many challenges, including the loss of shared custody of his 2-year-old daughter and the risk of losing his job due to punctuality issues. Chris has three siblings: one older and two younger. Despite his tough circumstances, he has received support from his adoptive family, who are aware of his biological family background and current struggles. This support has taken various forms, such as providing shelter and financial assistance. While his adoptive family is sympathetic and supportive, they find themselves at a crossroads. They want to help Chris but are unsure of how to do so without perpetuating his dependency. Chris faced a challenging upbringing from the very beginning, born addicted to heroin and other drugs. Child Protective Services intervened shortly after his birth, leading him to live with his biological father's family for a year. However, his parents' relapse into drug addiction rendered them incapable of caring for him, forcing him into foster care for the next three years. Fortunately, he was adopted at the age of 4. During his childhood, Chris thrived until he reached the age of 13 when he befriended a troubled teen. This friendship led him down a destructive path, involving marijuana use and wandering the streets beyond curfew. His situation worsened at 15 when he committed firearm

theft, landing him in a juvenile detention center until he turned 16. Upon release, he discovered his biological parents' ongoing addiction, fueling his anger and prompting a return to substance abuse, now involving cocaine and opiates. His criminal record expanded further, including drug distribution charges. Chris always felt like an outsider in his adoptive family because he was not of the same race. His adoptive parents, who were white, treated him differently, often comparing him unfavorably to their biological children, who excelled academically. While he was financially supported, he lacked emotional understanding and a loving home environment. Despite having no diagnosed mental disorders, Chris struggled in his romantic relationships. He tended to fall in love quickly, but when problems arose, he resorted to criminal behavior and emotional abuse, causing further turmoil in his life. Presenting Problems Over the past four months, Chris has experienced a relapse, intensifying his drug usage to nearly double its previous level. During this period, he has undergone a substantial weight loss of around 25 pounds and has been grappling with an escalating sense of depression. Chris has communicated a pervasive feeling of abandonment from his family, perceiving their recent frustrations with him. Additionally, his ex-partner is preventing him from seeing their daughter, adding to his emotional distress. In a desperate attempt to sustain his drug addiction, Chris has resorted to stealing valuable items from his adoptive parents' home. This criminal behavior reflects the dire financial situation he finds himself in due to the increasing necessity of drugs in his life. Unless Chris changes his destructive path, it is likely that he will face estrangement from his adoptive family soon.

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Diagnoses According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Chris exhibits indications of Substance Related Disorders, falling under both abuse and dependence categories within this classification. The DSM-5 outlines 10 classes of substances, including alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics or anxiolytics, stimulants, tobacco, and other or unknown substances. Chris satisfies seven out of 10 criteria in criterion A for Substance Related Disorders: Consumption of the substance in larger amounts or over a more extended period than initially intended, Persistent desire to reduce or regulate use, with unsuccessful attempts to do so, Devoting a substantial amount of time to obtaining, using, and recovering from the effects of the substance, Experiencing intense cravings, especially when exposed to triggers associated with substance use, Social impairment resulting from substance use, Neglecting major role obligations at work, school, or home due to substance use, Continued use despite adverse consequences, such as health problems or damaged relationships. Chris's manifestation of this criteria suggests a substantial and concerning pattern of substance-related behavior that aligns with the diagnostic framework outlined in the DSM-5. Cognitive Behavioral Therapy (CBT) Chris has a few additional concerns that require attention, which include abuse, addiction, family issues, and emotional problems. Therefore, I would initiate therapy for Chris by employing cognitive behavior therapy, a method that primarily targets his drug addiction. Additionally, it's crucial to address and modify certain behaviors, such as engaging in criminal activities. I recommend that Chris participates in a support group specifically designed for individuals adopted from the foster care system. This step can help him confront his feelings of

isolation within his adoptive family, which might be exacerbated by his adoption and racial differences. Furthermore, it's essential to explore the root cause of his sense of detachment, possibly stemming from his adoption and racial background. Chris also needs assistance in coping with the trauma related to discovering his biological past. I suggest enrolling him in anger management courses and rehabilitation programs. If his violent tendencies persist despite anger management efforts, cognitive behavior therapy could be a valuable resource in addressing this issue. Goals Chris must address and modify various behaviors, including engaging in different criminal acts. To support his rehabilitation, I recommend his participation in an addiction counseling program. Additionally, it is crucial for Chris to explore and resolve issues related to his familial relationships, especially concerning feelings of isolation, potentially stemming from his adoption. The emotional impact of discovering his adopted status appears to be a source of trauma that requires attention. Despite prior participation in anger management courses, which he completed as directed, these interventions did not effectively curb his behavior. Considering this, cognitive behavior therapy is suggested as an alternative approach to address the underlying issues contributing to his actions. This therapeutic method aims to delve into the cognitive patterns influencing behavior, with the hope of fostering more constructive coping mechanisms and reducing the likelihood of future violent tendencies.

Resources Walker, J. S., & Bright, J. A. (2009). Cognitive therapy for violence: Reaching the parts that angermanagement doesn't reach. Journal of Forensic Psychiatry & Psychology, 20(2), 174- 201.doi:10.1080/14789940701656832 Case StudyHodges, S. (2006). Cognitive behaviour therapy. In J. Kenrick, C. Lindsey, L. Tollemache, J. Kenrick, C.Lindsey, L. Tollemache (Eds.), Creating new families: Therapeutic approaches to fostering, adoption, andkinship care (pp. 84-94). London, England: Karnac Books.

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