Substance Abuse Treatment Planning and Youth Relapse Barriers
This paper addresses substance abuse counseling in two parts. The first part presents a treatment plan for a client (Milo) exhibiting alcohol use disorder with comorbid social anxiety, covering the assessment process, ethical and legal considerations, and evidence-based treatment techniques including short-term inpatient care, pharmacological interventions, and mindfulness strategies. The second part critiques a qualitative study by Gonzales et al. (2012) on youth perceptions of substance use relapse barriers, evaluating its major strengths, methodological weaknesses, and implications for substance abuse counseling practice.
- Assessment Process: Diagnosing Milo's alcohol use disorder using DSM criteria
- Ethical and Legal Considerations: Confidentiality and ethical duties in Milo's case
- Evidence-Based Treatment Techniques: Short- and long-term treatment goals and interventions
- Article Summary and Introduction: Overview of Gonzales et al. (2012) youth relapse study
- Major Strengths and Weaknesses of the Study: Methodological evaluation of the Gonzales et al. article
- Implications for Substance Abuse Counseling and Conclusion: Practice relevance and personal reflection on relapse complexity
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What makes this paper effective
- The paper integrates both practical clinical application and critical academic analysis, demonstrating the student's ability to move between case-based reasoning and scholarly evaluation.
- The treatment plan for Milo is well-grounded, connecting DSM diagnostic criteria to specific short- and long-term goals and naming concrete pharmacological and behavioral interventions.
- The article critique follows a clear evaluative structure, honestly acknowledging both strengths and methodological limitations such as convenience sampling and the absence of longitudinal data.
Key academic technique demonstrated
The paper demonstrates applied clinical reasoning: the student translates diagnostic criteria and theoretical frameworks (harm reduction, motivational interviewing) into a concrete, individualized treatment plan, then shifts registers to evaluate empirical research methodology. This dual-mode writing — practitioner reasoning alongside academic critique — is a core competency in counseling and social work graduate programs.
Structure breakdown
Part 1 is organized into three subsections (Assessment, Ethics, Treatment) that follow a logical clinical sequence from identification through intervention. Part 2 mirrors a standard article-critique format: summary, strengths, weaknesses, practice implications, and personal reflection. Each section is concise and purposeful, making the paper a solid model for structured professional writing in a counseling context.
Assessment Process
Assessing for substance abuse can be challenging, given the client's potential for denial, their perception of social stigma related to substance abuse, and even the therapist's own biases. Structured interviews and collateral interviews therefore offer "a more complete picture of both the user and the impact they are having on others in their environment" (Chapter 5, Slide 4). A diagnostic interview will yield information pertinent to a DSM diagnosis.
Milo clearly has a history of substance use behaviors that make this case easier to diagnose. The DSM-IV offers clear guidelines for diagnosis. Diagnostic criteria for substance abuse include a "maladaptive pattern" over a twelve-month period, including recurrent situations that lead to failure to fulfill obligations at school, work, or home, as well as physically hazardous situations. Milo's case reveals hazardous situations (blackouts while driving) and a building tolerance to alcohol, along with withdrawal symptoms. Milo also has comorbidity with social anxiety, one of the commonly associated problems linked with substance abuse.
Ethical and Legal Considerations
Milo's case should be treated with sensitivity and the same ethical considerations afforded to any other client, meaning that confidentiality must be maintained. The therapist should not, for example, divulge information about Milo's history of driving while intoxicated. Although he did strike an animal, Milo did not directly harm a human being, and therefore there is no grounds to disclose this information. Additional screenings and assessments might also help address any underlying or comorbid issues such as depression. Finally, the therapist may need to collaborate with other healthcare providers to address Milo's tendency to experience seizures.
References
Rose, S. (2017). Notes on Chapter 5: Assessment and Diagnosis.
Waldron, H. B., & Turner, C. W. (2008). Evidence-based psychosocial treatments for adolescent substance abuse. Journal of Clinical Child and Adolescent Psychology, 37(1), 238–261.
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