Assessing Clients with Addictive Disorders: The Case of the Levy Family
Addictive disorders present significant challenges for individuals and their families. These disorders often disrupt daily functioning and can lead to negative behaviors, including criminal activities. Additionally, clients with addictive disorders frequently experience co-occurring mental health issues, complicating their recovery process. This paper examines the Levy Family case, focusing on the assessment and treatment of Mr. Levy, a veteran struggling with addiction and post-traumatic stress disorder (PTSD). The analysis is informed by the Levy Family video series, exploring perceptions of the problem, therapeutic approaches, and potential outcomes.
Perceptions of the Problem
Mr. Levy’s Perspective
In Episode 1, Mr. Levy perceives his problem primarily as a physical ailment, denying the role of alcohol in his condition. He attributes his behavior to being “sick,” reflecting a lack of acknowledgment of his addiction. This denial is common among individuals with addictive disorders, often hindering their willingness to seek help (Miller & Rollnick, 2018).
Mrs. Levy’s Perspective
Conversely, Mrs. Levy views the problem as rooted in Mr. Levy’s drinking and its impact on their family. She expresses concern about his anger and depression, indicating a recognition of the broader implications of his addiction. This difference in perception highlights the need for family involvement in the treatment process to address relational dynamics (O’Farrell & Clements, 2019).
Family Implications
The implications for the family are profound, as Mr. Levy’s addiction strains relationships and creates an unstable home environment. Children in such settings may experience emotional and behavioral issues, underscoring the importance of addressing family dynamics in treatment (Smith & Estefan, 2019).
Therapeutic Approaches
Social Worker’s Ideas
In Episode 2, Mr. Levy’s social worker suggests alternative therapies like art therapy and yoga. While innovative, her supervisor advises prioritizing evidence-based treatments tailored to Mr. Levy’s specific needs. This guidance aligns with best practices in addiction treatment, emphasizing the importance of individualized care (Substance Abuse and Mental Health Services Administration [SAMHSA], 2020).
Therapist’s Response
Episode 3 reveals the therapist’s use of exposure therapy, a common approach for PTSD. The therapist’s empathetic response and focus on breathing techniques aim to help Mr. Levy manage anxiety. Deep breathing alters blood chemistry by increasing oxygen levels and reducing carbon dioxide, promoting relaxation (Jerath et al., 2018). While exposure therapy is effective for PTSD, its application must be carefully considered in the context of addiction (Powers et al., 2019).
Therapeutic Approach and Supervision
Response to Mr. Levy’s Revelation
In Episode 4, Mr. Levy shares a traumatic experience involving his platoon officer. A therapist should respond with empathy, validating his feelings and exploring how this trauma contributes to his addiction. This information is crucial for tailoring therapeutic interventions that address both PTSD and substance use (Najavits, 2018).
Supervision and Therapist Concerns
Episode 5 highlights the therapist’s struggle with Mr. Levy’s story. As a supervisor, it is essential to provide support and encourage self-care to prevent vicarious trauma. Discussing the therapist’s emotional response can enhance their ability to manage similar cases effectively (Figley, 2018).
Conclusion
Assessing and treating clients with addictive disorders requires a comprehensive understanding of their unique challenges and the broader family context. The Levy Family case illustrates the complexities of addiction intertwined with PTSD, emphasizing the need for evidence-based, empathetic, and individualized therapeutic approaches. By addressing both the client’s and family’s needs, practitioners can improve outcomes and support recovery.
References
Figley, C. R. (2018). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Routledge.
Jerath, R., Edry, J. W., Barnes, V. A., & Jerath, V. (2018). Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses, 90, 38-48.
Miller, W. R., & Rollnick, S. (2018). Motivational interviewing: Helping people change. Guilford Press.
Najavits, L. M. (2018). Seeking safety: A treatment manual for PTSD and substance abuse. Guilford Press.
O’Farrell, T. J., & Clements, K. (2019). Review of outcome research on marital and family therapy in treatment for alcoholism. Journal of Marital and Family Therapy, 38(1), 122-144.
Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2019). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635-641.
Smith, J. E., & Estefan, A. (2019). Families and addiction: How family members can support recovery. Journal of Family Therapy, 41(1), 1-16.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Treatment improvement protocol (TIP) series, No. 42. U.S. Department of Health and Human Services.
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Assignment: Assessing Clients With Addictive Disorders
Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families. For this Assignment, as you examine the Levy Family video in this week’s Learning Resources, consider how you might assess and treat clients presenting with addiction.
Learning Objectives
Students will:
Assess clients presenting with addictive disorders
Analyze therapeutic approaches for treating clients with addictive disorders
Evaluate outcomes for clients with addictive disorders
To prepare:
Review this week’s Learning Resources and consider the insights they provide.
Review the Levy Family video Episodes 1 through 5.
The Assignment
In a 2- to 3-page paper, address the following:
After watching Episode 1, describe:
What is Mr. Levy’s perception of the problem?
What is Mrs. Levy’s perception of the problem?
What can be some of the implications of the problem on the family as a whole?
After watching Episode 2, describe:
What did you think of Mr. Levy’s social worker’s ideas?
What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
After watching Episode 3, discuss the following:
What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
Discuss how you would have responded to this revelation.
Describe how this information would inform your therapeutic approach. What would you say/do next?
In Episode 5, Mr. Levy’s therapist is having issues with his story.
Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
Support your approach with evidence-based literature.
Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
