Monique Is a 24-Year-Old Law Student Who

Monique is a 24-year-old law student who appears normal on the surface, but struggles with substance abuse issues. She has been drinking since she was 14 years old and regularly consumes a large number of drinks when she goes out with her friends, in addition to consuming alcohol each evening at home. Her drinking interferes with her normal life, as hangovers prevent her from attending morning classes on occasion, and she sometimes blacks out while drinking. In addition, Monique smokes marijuana. She recently attempted to stop smoking marijuana due to concerns that she has a drug problem, but found herself unable to stop. She does not think that she has a drinking problem because she does not drink in the morning, but her family and friends are concerned about her drinking (Butcher et al., 2012, p.6).

Some of the information that would be important to collect during the initial assessment process to make a diagnosis would include personality factors. In other words, I would need to determine whether there were personality traits or behaviors that predispose Monique to behaving in a particular way. Substance abuse is a complex disease with a myriad of different causes. Therefore, it is important to examine personality factors when looking at possible causes of and treatments for Monique's substance abuse. Some personality factors cause people to act in overtly deviant manner, and introduce them to drug usage. The fact that she attempted to stop smoking marijuana, a drug that is generally not considered physically addictive, but was unable to do so may be indicative of personality traits that encourage drug abuse, but are not necessarily indicative of alcoholism or drug abuse problems as they are viewed in a conventional context.

It would also be important to examine family factors. Alcoholism and substance abuse are often transmitted from generation-to-generation in a family. Whether this intergenerational dynamic is the result of biological predisposition to substance abuse or whether substance abuse is learned behavior is not as important as knowing that, if there are family members with substance abuse problems, Monique is predisposed to being a substance abuser as well. In addition, understanding the family dynamic and the family approach to substance abuse treatment can be critical in helping develop an intervention and prevention strategy for Monique. The case notes indicate that Monique's family has concerns about her substance usage, but does not indicate if those family members who are concerned also suffer with addiction disorders. If they do, then they are not an appropriate support network for Monique as she becomes sober.

Furthermore, it is important to look into the cultural context of Monique's life. Attorneys have one of the highest alcoholism rates of any profession, and the law school environment supports binge drinking in many ways. Is Monique's drinking maladaptive to her environment or an expected adaptation to the law school environment? If her drinking is not so different from that of her peers in law school, then it will be difficult to treat Monique. In fact, if that level of drinking is considered pro-social, or at least not considered anti-social, by law students and attorneys, then Monique's perceptions that her behavior is not a problem will be reinforced by her social environment.

It would also be important to examine Monique's physical well-being. Chronic binge drinking, as described in Monique's case study, can be linked to a wide variety of health problems, including, but not limited to liver damage. Her frequent black-outs could be linked to promiscuous sexual behavior or put her at risk for sexual assaults; therefore, she would be considered high risk for a sexually transmitted disease and/or unintended pregnancies. As a result, it would be important to assess her physical condition prior to beginning any treatment regime.