Addiction case study of Lionel Dawson in Small Fish

Drug Abuse Case Study

The Movie: Small Fish- a synopsis

An evaluation of the case

The substance abuse model for my client

The disease model of addiction

The physical dependency model

The positive reinforcement model of drug addiction

The best intervention

In this paper be present an addiction case study on the basis of the Australian movie 'Small Fish'. I chose to work with the character Lionel Dawson, who is a junkie and a former football champion. I provide an assessment as a well as a formulation of the case for the client. I evaluate his psychological need as well as his use of heroine. I then briefly describe the substance abuse counseling model you I draw on and its usefulness for the client. I also describe how I would work with the client as well as the likely outcomes, using published research on client outcomes in the drug and alcohol field of research. Finally, I the challenges the client would face and identify the supports for recovery in his social context.

Introduction

Drug addiction is defined as a chronic relapsing disorder that is characterized by a persistent urge and behavior to seek drugs as well as take them (Feltenstein,2008). The American Society of Addiction Medicine defined addiction by describing the condition as a primary and chronic disease that acts via brain reward, memory, motivation as well as other related circuitry (ASAM,2011). In this paper we seek to review a case of a movie character, Lionel Dawson in the Australian movie titled 'Small Fish'. Before proceeding, I would like to offer a synopsis of the movie in order to bring the case in view.

The psychological needs of my client-Lionel Dawson

A review of the psychological needs of the client indicates that he is ready to quit but the level of addiction and depends in quite high. His psychological need to remain 'high' has made him defenseless against the heroin addiction. The patient is also not able to stop his homosexual relationship with the retired criminal boss, Bradley. The client is withdrawn and is forced to stay in the woods when he has a very nice house that he leaves to Tracy and her mother as evident in his will.

The substance abuse model for my client

In order to understand the most suitable drug addiction model for my client, it is worth reviewing the three theories of drug addiction. The work of McKim (1997) provided a description of the three models of drug addiction. They include;

1. Disease model of addiction

2. The physical dependency model as well as

3. The positive reinforcement model

The disease model of addiction

The disease model of drug addiction described drug addiction as a disease (lifelong) that involves biologic as well as environmental sources as its origin (Gorski,1996). The more traditional model of disease needs that only the abnormal conditions be presented as the major causes of dysfunction, discomfort as well as distress on the affected individual. However, the current medical model attributed drug addiction to be partly be as a result of the changes in the victims' mesolimbic pathway (Leshner,1997).This medical model take a lot of considerations that the disease may be due to sociologic, psychologic as well as biologic entities.

The physical dependency model

A prolonged exposure to some drugs leads to the exhibition of withdrawal symptoms ahould they be discontinued. The effects of heroin addiction as well as the corresponding withdrawal symptoms include; euphoria and dysphoria, constipation and diarrhea, relaxation and agitation.

The withdrawal symptoms are the compensatory reactions to the withdrawal from the drugs and they tend to oppose the primary effects of being addicted to the drug.

The withdrawal effects are the rather unpleasant effects and their reduction would subsequently lead to negative reinforcement.

The concentration on the role of effects of physical withdrawal at the expense of the psychological factors subsequently led to the failure in recognizing cocaine's addictive properties. It is therefore worth noting that a general reduction in the level of withdrawal symptoms is never an explanation of the reasons as to why people engaged themselves in drug consumption.

The positive reinforcement model of drug addiction

The positive reinforcing properties of various drugs are thought to be one of the main reasons as to why drug addiction takes place. Carlson (2001) pointed out that addictive drugs are very god positive reinforces. Positive reinforcement has been indicated to result on completely new responses as well as the maintenance of the currently existing behaviors. This therefore means that the behaviors that are associated with the consumption of the addictive drugs will automatically increase the probability.

In regard to out case, it is probable that the client, Mr. Lionel Dawson is addicted to heroin as explained by the physical dependency model (since he was very unsuccessful in quitting ) as well as the positive reinforcement model (due to his urge to remain 'high' and euphoric).

The best intervention

The fact that Lionel Dawson appeared like a very emotional person when he cried in the arms of her supervisor, Tracy means that motivational interviewing can be employed in helping him achieve a behavioral change.

Motivational interviewing is a client-centered style of counseling used in the solicitation of behavioral change by means of assisting the client to effectively explore as well as resolve their ambivalence as pointed out by Wagner & Conners (1999). Ambivalence in this case is defined as the simultaneous as well as contradictory feelings and attitudes (such as repulsion and attraction) towards a given object, action or person. In my client's case it is towards heroin. Due to the fact that this approach as a therapy is goal-oriented as well as focused, the resolution of ambivalence towards heroin is important.

The concept of motivational interviewing was pioneered by Miller & Rollnick (1991). A review of the case indicates that my client Lionel Dawson is willing to change. The willingness to change is pointed out by Miller & Rollnick (1991) to be a prerequisite for motivational interviewing. In case my client never had the willingness to change by exhibiting characteristics of belief that they have no problem at all, a positive reinforcement program must be initiated. This must be continued until a relapse occurs. It is therefore my responsibility to give advice to my client as well as motivate him as pointed out by Miller & Rollnick (1991).

In order to assist my client, I will use the main principles of motivational thinking. The first principle I will use is the avoidance of argumentation. This means that I will avoid any form of argument with my client. As indicated by Miller & Rollnick (1991), confronting a client might leave them with a feeling of being under attack. This may then reduce their urge of being treated. Zweben, Miller, Rychtarik, DiClemente (1992) indicated that most people would resist the advice of a counselor by constantly reacting as well as acting in the opposite manner to what the counselor wants them to act.

The other principle of motivational thinking requires the counselor to express some form of empathy. This is indicated by Miller & Rollnick (1991) to be an essential as well as defining characteristic of motivational therapy. Through this process, the therapist should seek to comprehend the client's feelings as well as see things through their eyes. This would make the client to trust the counselor/therapist. The client would also be more open in the entire process of therapy. The principle of empathy basically involves seeing the situation through the eyes of the client. DiClemente, Miller, Rychtarik, Zweben (1992) pointed out that this principle is very crucial for the accurate understanding of the feelings and experiences of the client by the counselor.

The other important principle is the one for self-efficacy. Self-efficacy is a term used to the belief of a person in their ability to execute certain tasks.

Conclusion

I believe that an application of these principles would effectively help in ensuring that my client, Lionel Dawson succeeds dropping his addiction to heroin. Should this principle fail, then I would use an integrated approach that involves other effective techniques.