Introduction
Allan’s case conceptualization incorporates the cognitive-behavioral theory (CBT) and social learning theory (SLT). The recovery and prevention plan strategies integrate action models, such as interventions and therapeutic strategies. Allan’s negative social and environmental risk factors may deteriorate his treatment plans. For instance, his inability to share his feelings with others is a risk factor for mental treatment. The evaluation and application of a relapse prevention plan through the introduction of positive support welfares, educational resources, and necessary case conceptualization is the key to improving patients’ health and safety in cases of post-traumatic stress disorder (PTSD) and such comorbidities as a substance-use disorder.
Diagnostic Impression
Allan, a 25-year-old African American man, presents as frustrated, easily angered, and embarrassed. Allan has financial issues because of his incapacity to take care of his family, having waited for a long time for his veteran disability benefits. The effect of this may result in Allan engaging in other negative social activities, such as robbery. He presents with family problems because of how he feels about his wife’s state of not comprehending his physical and emotional pain. He has substance-abuse disorder as indicated by his behavior of drinking.
Social Learning Theory
SLT assimilates the behavior and social factors, thoughts, and emotional factors and offers a structured education for self-control. SLT outlines the outcome of the cognitive belief process of the mind and emphasizes goal-oriented behaviors. In Allan’s case, SLT considers his ethnicity and culture (African-American), gender, perception of the social surroundings, and social interactions. Using SLT, Allan will use positive behaviors to enable him to recover quickly. For instance, the SLT will address his societal and communal issues from excessive drinking, his readiness for treatment by presenting himself to Veteran Hospital, and his counseling needs by unlocking his family and personal issues.
Biological and Social Factors
The biological and social factors underscore Allan’s mode of action towards his family and social interactions. Biological factors play a psychological role in human behavior and aggression. For instance, Allan’s indication of aggression is attributed to genetic factors. According to Bartholow (2018), the neurotransmitter serotonin in the brain is an essential factor in the regulation of reactive rage and petulance. Furthermore, Bartholow (2018) posits that bad temper and violence may be a developing brain property towards such activities as “social behavior network,” thus dictating social interaction as witnessed in Allan’s preserved behavior towards society. In this case, Allan’s unstable emotions and poor interpersonal relationships may be a result of poor interaction, a social factor derived from his genetic factor.
Physical & Social Effects
The physical and social effects of substance abuse are composed of several negative life challenges. In physical effects, the feeling of stimulation or relaxation from the abuse of drugs causes health-related issues, such as variations in the heart rhythm, breathing, and deviations of body temperature, muscle feebleness, and nausea. According to Parrott and Eckhardt (2018), the physical effects of drinking alcohol result in alcohol-facilitated aggression, which may lead to other physical harm from other people offended by such aggressive behaviors. Moreover, recurrent actions of substance abuse make the brain develop a hallucinating effect such as pleasure, leading to addiction. Allan’s social effects from substance-related addiction may have led to poor group interaction, which may be the cause of his unemployment. Therefore, Allan’s help-seeking move to the Veteran hospital may be an attempt to resolve these negative social consequences.
Treatment Modalities and Options
Inpatient Rehabilitation
Allan has been abusing alcohol to relieve the pain from his family issues, unemployment, and thoughts of the delayed veteran benefits. Detoxification through inpatient rehabilitation is an essential care procedure in most substance-abuse disorders (Zhu & Wu, 2018). The rehabilitation phase is important as it ensures chemical substance cleansing of the body, followed by therapeutic management, such as individual counseling using CBT. For this to be successful, such triggers as thoughts of events of wars in Iraq and the feelings of his wife not caring about his pain should be removed.
Family Counseling
Allan has a strained family relationship with the wife because of several family-related problems. Counseling Allan’s wife will be an imperative move in ensuring that Allan’s trust towards his spouse is regained. Counseling Allan and his partner is also essential in making them understand the substance effects and maintenance of sobriety. Besides, treating the patient without involving his wife as a family proxy during Mental Capacity consent presents legal implications. (Evans et al., 2020). The policy of the Mental Capacity Act requires that a close family should be part of the treatment of individuals with substance disorder and mental illness in cases of consent formulation. Therefore, the participation of his wife will help them develop ways to handle situations that may arise due to potential relapses for Allan.
Allan’s Recovery, Relapse Prevention Plan, and Strategies
The recovery and relapse prevention plan provides consistent evidence that will help Allan to control his risk of falls and challenges. Using suitable approaches to conserve his lifelong recovery process, it is indispensable to formulate a plan which ascertains quick recovery with minimum relapse rates and reduced healthcare challenges. The worksheet below provides a treatment plan as applied in Allan’s case of substance-use disorder and addictive disorder.
Treatment Plan
The first problem to be addressed in the case of Allan is alcohol abuse. The main goal in the care plan for this problem involves total body detoxification through the formulation of the first objective, the inpatient rehabilitation. Therefore, the care plan intervention in Allan’s case encompasses a multidisciplinary team. In this case, healthcare providers, such as social care workers, can be used by the nurse to help identify and locate appropriate rehabilitation facilities that are nearer to Allan’s place of residence.
According to Oviedo Ramirez (2018), the healthcare givers should consider the language and race to which the special group population (Allan’s alcoholism) belongs and provide a nurse with the same identities. In this case, an African American nurse can be delegated the duty of taking care of Allan at the inpatient rehabilitation settings. Moreover, the location is important in maintaining close contact with the rehabilitation facility to meet his urgent needs. Therefore, the healthcare provider’s role ensures that the rehabilitation center caters to maintain relapse-related challenges.
The second objective for this particular care plan uses the SMART Recovery strategy. The intervention for SMART recovery involves assisting patients in learning how to control their alcohol addiction and risk activators through recovery training with the 4-Point Program (Zemore et al., 2018). In this case, the nurse may involve educators and counselors in providing training, which ensures that Mr. Allan is updated on all available programs to guarantee quality recovery.
A better relationship with himself and his wife forms the second goal for the care plan. In this case, the first objective is to perform an individual counseling/therapy that addresses all the risks of falls and challenges. The intervention involves meeting with Mr. Allan twice a week or as often as possible and support him with what elicits his alcohol abuse through one-on-one meetings, journaling, the transmission of feelings, and free relationship. Lifestyle modifications and precautionary measures to preserve his sobriety will also be deliberated upon. The second objective to achieve the goal of bettering the family relationship is performing family therapy. The intervention starts with a therapy process with Mr. Allan and his wife. Establish face-to-face interviews with him first, followed by a one-on-one meeting with his wife, and lastly, perform sessions with the whole family combined.
Moreover, it is essential to educate Mr. Allan and his family about alcohol addiction, recovery processes, and care strategies, which are within the treatment modalities formulated. The attending nurse can involve the community in the care plan. Andersen et al. (2020) highlight the application of the Community Reinforcement Approach (CRA) which demonstrates the significance of including patient’s problems to certain community members.
For instance, local organizations or businesses may provide employment opportunities to Allan. During this time, the nurse can also help in addressing such challenges as the identification of local schools to take up the role of educating Allan’s son. In addition, the healthcare giver can ensure such challenges as patient advocacy by the local state legislation is addressed through VA mental health services. In this case, the advocacy helps in assisting the veteran war soldiers by providing employment, easy access to disability benefits, and family care intervention upon returning from war countries.
Conclusion
In conclusion, the case conceptualization and application of recovery and relapse prevention plan is an important aspect of managing patients with PTSD and substance-use disorders. The strategies exploited in Allan’s recovery and relapse prevention plan provided the patient with training on addiction management, which is an evidence-based practice. The various interventions discussed will help Allan to learn the essential approaches to cope with the risk of falls and challenges to ensure completion of the recovery process. Therefore, if Allan applies these coping interventions at the first signal of a relapse, he will certainly resist the triggers and warning signs that may prevent it.
References
Andersen, K., Behrendt, S., Bilberg, R., Bogenschutz, M. P., Braun, B., Buehringer, G., Ekstrøm, C. T., Mejldal, A., Petersen, A. H., & Nielsen, A. S. (2020). Evaluation of adding the community reinforcement approach to motivational enhancement therapy for adults aged 60 years and older with DSM‐5 alcohol use disorder: A randomized controlled trial. Addiction, 115(1), 69−81. Web.
Bartholow, B. D. (2018). The aggressive brain: Insights from neuroscience. Current Opinion in Psychology, 19(1), 60−64. Web.
Evans, C. J., Yorganci, E., Lewis, P., Koffman, J., Stone, K., Tunnard, I., Wee, B., Bernal, W., Hotopf, M., & Higginson, I. J. (2020). Processes of consent in research for adults with impaired mental capacity nearing the end of life: Systematic review and transparent expert consultation (MORECare_Capacity statement). BMC Medicine, 18, 1−55. Web.
Oviedo Ramirez, S., Alvarez, M. J., Field, C., Morera, O. F., Cherpitel, C., & Woolard, R. (2018). Brief intervention among Mexican-origin young adults in the emergency department at the USA–Mexico border: Examining the role of patient’s preferred language of intervention in predicting drinking outcomes. Alcohol and Alcoholism, 53(6), 728−734. Web.
Parrott, D. J., & Eckhardt, C. I. (2018). Effects of alcohol on human aggression. Current Opinion in Psychology, 19(1), 1−5. Web.
Zemore, S. E., Lui, C., Mericle, A., Hemberg, J., & Kaskutas, L. A. (2018). A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD. Journal of Substance Abuse Treatment, 88, 18−26. Web.
Zhu, H., & Wu, L.-T. (2018). National trends and characteristics of inpatient detoxification for drug use disorders in the United States. BMC Public Health, 18, 1−14. Web.