Nicks DAP Note

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Southern New Hampshire University *

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640

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Sociology

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Jan 9, 2024

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COU 640 DAP Draft Nicks DAP Note Southern New Hampshire University

COU 640 DAP Draft Nicks DAP Note Description I. Introduction A. Summery In the case it is reported that Nick is a 17-year white male who lived in East St Louis Illinois, with his mother who works three jobs, it was also reported that his father was not in the picture according to his mother his father got into some bad stuff and had to leave town never getting to meet Nick. So, Nick had no male role model in his life. Its also reported that growing up in East St Louis Illinois was difficult due to being a dangerous nabrohood robberies, mugging, drug dealings and murders. Nick reported being threated and beaten up few times and had his shoes and his coat. It is reported at the age of 10 Nick Joined a gang because he realized that it was only way for him to be protected. His role in the in gang was to help deliver drugs however the rule was they could not take drugs to it would make them sloppy and they get caught or killed. It is reported that Nick consumed alcohol when he started at age of 10, he drinking one or two beers or shots at age of 12 he was drinking 40 -ounces or multiple shots and by the age of 14 he and his peers were drinking full bottles. At the age of 17 Nick was expelled after being caught with being with alcohol at school. After being expelled Nick spent most of his time with gang consuming alcohol and beginning to dabble with drugs. After a few mouths Nick realized he wanted change so he reached out to substance abuse hotline. Nick reported wanting change but felt like he had no support II. Biopsychosocial Summery A. Problem

COU 640 DAP Draft Nick grew up in East St Louis Illinois a city that has a crime filled reputation. Nick not much guidance or support due to his mother working three jobs and not having his father in picture and being threatened and robbed. Nick joined a gang so he be safe, joining the gang meant delivering drugs with in the nabrohood. Nick consumed alcohol with his peers with in the gang starting at the age of 10 and increasing as he got older .Nick was expelled from school at the age of 17 after continually brining and being caught with a flask of alcohol to school .Since Nicks he has counited to spend more time with the gang and consuming alcohol and starting to dabble with drugs. B. Symptoms Nicks tendency to consume increasing amounts of alcohol and engaged in drug use are behavioral symptoms. Cognitive symptoms are attached to lack of guidance Nick experienced as a kid which prompted to join the gang to protect himself. Nicks emotional symptoms might be attached to strained relationship between him and his mother due to his mother working three jobs and negative impacts of socializing with in the gang. Nick has not reported phycological symptoms of his alcohol use and drug use. C. Environmental Factors Nicks environment plays role his crime filled nabrohood provoked him to join a gang to feel safe. Nick also has no outside support from family or friends other then potentially his peers and mother if given the time and tools needed to understand what nick is going through. Nick was negatively influenced by his peers to bring alcohol to school but also Nick was caught several times in school with Alcohol and he likely faced consiques like detention and getting yelled at but no tried to help or make feel like he could ask help. Nick felt he didn’t have support from his

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COU 640 DAP Draft parents and school system. So, Nick stayed with gang and was influenced by actions and behavior. Then he realized he wanted change and he reached out to the substance abuse hotline. Now we can work together on finding him recourses and building support systems. D. Harmful Behaviors In Nicks case there is no evidence of aggressive behavior. The ability to harm others exists others with in nicks alcohol and drug use and also with in nicks work in the gang nick delivers drugs and the gang is involved in crime. Being apart of a gang and crime is also high risk as it was reported that they could get caught or even killed if work wasn’t done properly. Nicks Peers from the gang influenced him to act impulsively in take alcohol to school. E. Family history It is reported that Nick is an only child who lives with his mother who works three jobs. Nick has reported he never met his father. According to Nicks mother Nick father got into some bad stuff and had to leave town. In Nicks case there was no substance abuse or psychiatric history of family members. Nick didn’t have a male role modal so Nick might look to members of the gang as role modal .Nick mom has not been there for him due her working three jobs trying to provide for them . F. Evidence Based Research In looking at the client Nicks though Erickson’s eight stages of phycological development Nick at the age of 10 years would have been in stage of Industry vs. Inferiority the goal in stage is learning new skills or competence. How a child preforms in school is important if is not supported children can develop a sense of Inferiority. Nick was not given support for the skills might have been survival in an unsafe environment and being threated, robbed and, beaten up

COU 640 DAP Draft might mean that nick given the opportunity to master his own world or have his efforts blocked, these unsuccessful experiences lead to a sense of inferiority, or lack of worthiness (Salkind, 2005). This might explain why Nick choose to join a gang he did not feel he could keep himself safe and there was no one supporting or guiding him. Nick seemed to contuntiue to struggle through the next stage of Erickson’s eight stages of phycological development this is the stage Nick is currently in, as it from 12 and 18 years old. In this stage the child becomes an adolescent and starts to figure who they are what there and how they identify however if they are blocked from figuring who they are and what different parts of identity are they can develop role a sense of not knowing or role confusion. Nick was not supported at home or at school from when it came him trying to figure out his world he was punished instead of supported or given guidance this could by why he stops caring about school and spends most of his time with the gang and starts to dabble with drugs might have been confused and with support and guidance doing makes him feel safe in the gang community that accepts him. G. Cultural Characteristics The client Nick is 17 years old in 2023 would be in Generation Z “Called Generation Z or “zoomers,” spanning ages 10 to 26 as of 2023, the young adult members of this group have become a powerful force in recent elections and with 8.3 million Gen Zeers turning 18 since the November 2000 election, all signs indicate their strength will continue to grow” (The Annie E. Casey Foundation, 2020). There are no developmental disabilities stated in Nicks case and there are no physical or other disabilities mentioned in Nicks case as well. There is no statement of religion or spirituality in the client Nick case. Nick identifies as a white male. From what we know in that Nick lives in East St. Louis, Illinois which is full of crime Nick’s mother works three jobs so Nick might be of lower socioeconomic status. There is no mention of Indigenous

COU 640 DAP Draft heritage in Nicks case. Nick is American and he didn’t identify a sexual orientation but he does identify as a male. H. Client Identifies Nick identifies as 17-year-old American white male who became a gang member for protection due his possible low socioeconomic status. The most important to Nick is his identify as gang member as that is where he seems to feel safe and useful. Next that low socioeconomic status in that one of the reasons he maybe joined the gang to make money or to take care of him self so maybe his mom wouldn’t have to worry about it. As client has not mentioned anything about sexual orerantion religiose, spitural or racial identity those are least important to Nick. Assessment III. Co-occurring Disorders A. Co-occurring Disorders Nick seems to be anxious as he joined the gang to protect him from harm of being bullied threated or robed. Nick can be diagnosed with An Alcohol use disorder that co-occurs with generalized anxiety disorder. Nick may also be diagnosed with one or multiple drug substance use disorders that as the drugs or substances were not mentioned it was mentioned that Nick started to dabble with drugs . B. DSM Diagnosis The DSM-5-TR identifies Alcohol Use Disorder by a group of physical and behavioral symptoms such as withdrawal ,craving ,and tolerance .According to the DSM 5-TR at least two of the 11 criteria need to be met within a 12 month period . Nick meets the first criteria in that

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COU 640 DAP Draft the amount of Alcohol he takes increases over time Nick was also expelled from school due to his continued alcohol use which is the fifth criteria in that he is unable to fulfill the obligations of being a student. According to the DSM-5-TR first criteria for generalized anxiety is Excessive anxiety and worry that occur more days than not for at least six months Nick lived in a bad nabrohood were was bullied, and robbed and beat up on more than one occasion. This happened was the reason nick joined a the gang in first place so anxiety seemed to existed before the alcohol and drug use begin which is criteria D that anxiety is not induced by substance or medication. Nick grew up in a unstable household and with his mother working three jobs trying to provide keep them safe significant destress. A substance/medication induced anxiety disorder can be ruled due because the substance use is not directly affecting Nicks anxiety levels .one thing to consider is the information we have currently on client is limited so there is a lot of possibly to be able to better understand and diagnose the client more thourohly for example if we knew what drugs he was perfectly starting to dabble in there could be more defined substance use diagnosis. IV. Addiction Assessments Both the CAGE -AID and the National Institute on Alcohol Abuse and Alcoholism Alcohol screening and Brief Intervention for Youth age 9-18 were admistered virtually through a video call meeting. B. Scoring The CAGE -AID assessment is four yes or no questions about the clients drinking and drug use. The assessment is scored between 1 and 4 yes and a score of 2 or more is clinically significant. Nick Answered all four questions with yes so, he scored a 4 out of 4 is considered clinically

COU 640 DAP Draft significant. The Institute on Alcohol Abuse and Alcoholism Alcohol screening and Brief Intervention for Youth age 9-18 assessment asks two questions the first about client’s alcohol use “in the past year on how many days in the past year have you had more than a few sips of beer wine or any drink containing alcohol” Nicks response was “everyday”. The second question was about his friends and or peers’ alcohol use “If your friends drink how many drinks do, they usually have on an occasion? Nick responds “multiple a couple or shots or sometimes a six pack of beer.” The next step was to assess risk because Nick stated he drank everyday at his age of 17 drinking 24- 52+ days he is at the highest risk level so I asked a follow up question what’s most you had at time and he said at least six pack of beer. Next, I provided brief motivational interview which is just supporting the client or if client is resistance acknowledged were they are with support and understanding, I acknowledged Nicks ability to make the choice to reach out for help. Then is was time to set a goal the first choice was 4 – week abstinence challenge which nick was hesitant to but he was willing to try cut down from a 6 pack of beer to just 3 beers or 3 shots a day .so that was our gtoal for the follow up last step is to would to see how he did with follow up was he successful and what if any challenges came up. C. Results The results in both the CAGE AID and the Institute on Alcohol Abuse and Alcoholism Alcohol screening and Brief Intervention for Youth age 9-18 assessment were both significant. From these results its clear that Nick is and has been consuming a harmful amount of Alcohol and possibly drugs for his age. It is also clear fom Nicks hesitancy that he is feeling unsure either about his ability to commit to change or about what change he wants to see within himself. But it also seen that he willing to work at in trying to cut down his alcohol consption. Plan

COU 640 DAP Draft V. Recommendations Recovery The first thing doing following up with Nick either within 4-week period that was set or I also do think that Nick should advised that if feels needs more support he can reach out to the counselor at any time before the 4-week period. At follow up appointment the counselor would check in on client’s progress if the goal was met or if there challenges and what factors, if anything made it more or less difficult. This can help in identifying skills and resources that will be helpful to client. Nick might benefit from Brief Alcohol Interventions “BAIs can use universal, selective, or indicated prevention strategies, as well as a variety of program modalities. The most common BAI program modalities involve cognitive behavioral/skills training, motivational enhancement, and/or psychoeducational therapy. Cognitive behavioral/skills training modalities focus on how individuals’ cognitions affect their actions, and might involve, for instance, teaching and practicing skills for identifying and dealing with risky drinking situations” (Hennessy & Tanner- Smith, 2015). Relapse prevention Once goals are Identified the client the next step is plan around what happens if Nick is unable to reach his goals or dose have a relapse much like we do fire drills to prepare for an emergency like a fire or an earthquake . “ The same logic applies in the case of relapse prevention. Why not have a 'relapse drill' as a prevention strategy to be included as part of an ongoing treatment programme? Learning precise prevention skills and related cognitive ideologies would seem to offer more help to the client than relying on vague constructs such as 'willpower' or attempting to adhere to the advice embedded in various prophetic slogans such as,

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COU 640 DAP Draft 'You are only one drink away from a drunk” (Marlatt & George, 1984). Working on identifying high risk situations and environments and other triggers becoming aware of them will be key in helping Nick avoid a protentional relapse Resources one resource that a counselor could give to Nick is the Recovery Village website offers types of treatment centers for Alcohol and drug in East St. Louis use as well different types of meeting like Alcohol Anonymous SMART meetings in East St. Louis.

COU 640 DAP Draft

Nicks DAP Note

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