Substance abuse
Using an integrative approach, identify and describe how more than one theory or evidenced based treatment strategy can help explain and treat the substance abuse in following case scenario:
Sally is 16 years old and lives with her mother and 8-year-old brother in the “projects” in Cleveland, Ohio. She started smoking cigarettes at age 12 by stealing from her mother. She took her first drink of alcohol when offered by a teenage babysitter at age 10 and started drinking regularly with peers at age 12. Her father is in and out of her life due to an addiction to heroin. Her mother works long hours at a local dry-cleaner and Sally frequently provides after school daycare for her brother which she “hates.” Sally feels trapped and forgotten by both parents and overwhelmed by the demands of her coursework and caregiving. In addition, she makes meals and does the housekeeping at home. Consequently, her grades have dropped and she may have to repeat her sophomore year of high school. Sally recently tried cocaine and found it extremely pleasant. She has since used cocaine at every opportunity offered her and is beginning to do “favors” for friends to get access to the drug. When Sally’s mother caught Sally drinking alcohol, she told Sally that she was “just like her father.”
Sample Solution
Sally's case highlights the complex interplay of social, psychological, and biological factors that contribute to substance abuse. Here's how multiple theories and evidence-based treatments can be integrated to address her situation:
1. Social Learning Theory and Multisystemic Therapy (MST):
- Social Learning Theory: Sally's exposure to her father's addiction and peer pressure normalized substance use. She may have learned to cope with stress and negative emotions through substance use.
- Multisystemic Therapy (MST): This family-based therapy focuses on improving communication, parenting skills, and conflict resolution within the family. It can help Sally's mother understand Sally's struggles and develop a more supportive environment. MST can also address the chaotic home situation and its contribution to Sally's stress.
Full Answer Section
Psychodynamic Theory and Cognitive Behavioral Therapy (CBT):- Psychodynamic Theory: Sally's resentment towards her parents and feelings of abandonment could be contributing to her substance use as a way of self-soothing or acting out.
- Cognitive Behavioral Therapy (CBT): CBT can help Sally identify and challenge negative thought patterns that fuel her substance use. It can teach her coping mechanisms for dealing with stress, overwhelm, and feelings of anger or resentment.
- Motivational Interviewing (MI):
- Motivational Interviewing (MI): This approach focuses on helping Sally explore her own motivations for wanting to change her behavior. MI can help her develop a sense of ownership over her recovery and build intrinsic motivation to stay away from drugs.
- Trauma-Informed Care:
- Trauma-Informed Care: Sally's experiences of neglect and feeling trapped might indicate underlying trauma. Trauma-informed care ensures a safe and supportive environment where she can address past experiences without judgment.
- Addressing Social Determinants of Health:
- Social Determinants of Health: Living in poverty in a challenging environment like the "projects" creates significant stress. Addressing these factors is crucial. Advocacy for affordable housing, after-school programs for Sally's brother, and potentially connecting Sally's mother with resources to reduce work hours could lessen some of the burdens contributing to her substance use.
- Substance Abuse Treatment: Depending on the severity of Sally's cocaine use, a combination of medication-assisted treatment (MAT) and behavioral therapy might be necessary.
- Peer Support Groups: Connecting Sally with support groups for teenagers struggling with substance use can provide her with a sense of belonging and connection with others facing similar challenges.