Building a treatment plan
Josie was born in Sault Ste. Marie amphetamine-dependent. She was a tiny baby (3.5lbs) and stayed in the NICU for weeks after her birth. Once she was strong enough for discharge she was placed in foster care. Her mother was told by Child Protective Services that she would need to complete treatment prior to being assessed as able to provide care for her child. Josie’s mom completed treatment and was able to provide a safe home for Josie from the age of 1-6 years.
Josie’s mom relapsed after 6 years of recovery. She was using crack and cannabis in the home for the next 5 years. Josie was a victim of neglect and sexual abuse during that time. She was raped by two men before she was 12. She struggled in school but didn’t tell her teachers why she was having a hard time paying attention in class. She was given some extra time to complete tasks but was struggling to comprehend the materials presented to the class.
Josie first used cannabis at age 10 with her friends; her mom knew about her drug use but didn’t consider it out of the ordinary. She provided Josie with her first dose of cocaine at age 12. She told her it would help her focus and get her school work done. Again, mom didn’t think this was out of the ordinary.
When Josie first came into the office at age 21 to ask for help, she said that she was using heroin daily by IV. She had found out she was 16 weeks pregnant and wanted to do something that was healthier for her baby. She was living on a couch at the house of someone she barely knew and there were often many people in the home using drugs. She was unsure who the baby’s father was. She was not sure what to do next and was looking for any kind of help to make life easier for her baby.
Josie was on Ontario Works. She hadn’t graduated from high school. Josie had no contact with her mother; she hadn’t seen her in 3 years. They stopped talking after Josie assaulted her mother during an argument they had about money. Josie was charged and sentenced to probation. She has 3 previous assault charges, one solicitation charge and two possession charges.
Josie describes feeling anxious all the time. She has had a few “sober” days in the past 3 years but states she was withdrawing “so hard” that she doesn’t recall them. She
reports that her decisions are always impulsive, emotionally charged and poorly thought out. Today though, in your office she states that she has been giving a lot of thought to changing her lifestyle. She has been involved with the criminal justice system, but has never accessed addiction support before. You are assigned to her as an addiction counsellor to help assess her needs and build a treatment plan.
1.Which stage of change is this client currently in? How did you come to that assessment of their Stage of Change?
2.What level of treatment would you recommend to build the treatment plan? How does their diagnosis of Fetal Alcohol Spectrum Disorder(FASD) affect your treatment planning?
3.What steps would you take as a counsellor? What would be the next steps for the client? What barriers exist for this client?
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