This presentation was based on a graduate level Addictions class requirement. The assignment asked students to chose a movie or television show as a group that illustrates the theme of addiction through one of the main characters. First the students will determine a diagnosis of one of the characters in the movie. In addition, students will be required to provide a treatment plan. The group presentation should (1) include a detailed client description, including the issues of concern. It should be evident that a mental status exam was completed, (2) reflect a thorough understanding of the client’s bio/psycho/social profile, (3) reflect any culturally relevant information that may impact the course of treatment and addiction, (4) provide some psychoeducation on the client’s drug of choice, and (5) develop an effective treatment plan for the addiction. Your chosen treatment plan and interventions should be reflective of best practice and be empirically supported.

1. Addictions: Diagnosis and
Treatment Plan
Vanessa Migliorini, Kristen Anderson, Shanika Torres, and Kelsie Wells

2. Meet Jim...

3. Client Description
●
The client is a 16 year old caucasian male,
by the name of Jim Carroll.
●
Jim is an only child and was raised by his single mother,
Lorraine Bracco.
●
●
●
●
Jim does not have a known male role model present in his life.
Jim and his mother reside in a low income community in New York.
Jim attended an all boys Catholic school, but quit after he was kicked off
the basketball team.
Jim has a history of drug abuse and was recently incarcerated for drug
possession and theft.

4. Presenting Concerns
● Jim recently lost his best friend Bobby, to Leukemia.
● Jim stated that he was sexully harrassed by his basketball
coach and that he began stealing and performing sexual
acts, to feed his drug addictions.
● Drugs of choice include: smoking cigarettes, drinking
alcohol, snorting cocaine, and
shooting up heroin.
● Jim states that he is an addict
and is depressed.

5. DSM-IV-TR Diagnosis
Axis I:
304.0 Opioid Dependence
292.84 Opioid-Induced Mood Disorder (With Mixed Features)
312.82 Conduct Disorder (Adolescent-Onset Type; Severe)
V61.20 Parent-Child Relational Problem
V61.21 Sexual Abuse of a Child (Victim)
Axis II: 799.90 Diagnosis Deferred
Axis III: None
Axis IV: Addicted to Heroin, poor social support, negative peer
influence, possible criminal charges pending,parent-child relational
problems, victim of sexual abuse by an adult.
Axis V: GAF 38

6. Bio-Psycho-Social

7. Bio-Psycho-Social Profile
●
●
●
•
Client is a high school student growing up in an lower socio-economic
neighborhood with his single mother. Drug use is apparent among civilians,
as is prostitution.
His father is absent and he does not have a prominent male figure present in
his life. His basketball coach displays signs of pedophilia. He does have
one older male friend whom he has an on-going game of bball with, and who
shows concern for his well-being
Client’s support system seems to be his teammates/friends. His best friend
becomes sick with cancer and dies. After his best friend’s death client’s
behaviors become more impulsive and risky

8. Bio-Psycho-Social Profile
●
●
●
Despite Catholic Schooling, client does not appear to have a particularly
strong spiritual/religious affiliation or respect for his Priest/teacher
Client appears to be extroverted in nature, but expresses himself through his
poetry—which he keeps private.
Initial drug use appears to be social, and then becomes alluring as a coping
mechanism to numb pain of loss

9. Cultural Implications

10. Cultural Implications - Negative
● Son of a single mother, no father figure present
● Lives in a lower socioeconomic status neighborhood
● Goes to a catholic school in which authority figures are
abusive
● Friends find drugs and alcohol as fun and a way to fix
problems
● Oppression by those outside of his neighborhood lead
to feelings of : hopelessness, and low self esteem

11. Cultural Implications - Positive
● Strong mother to provide support
● Adult friend who supported him and saved
his life

12. Psychoeducation

13. Psychoeducation-Inhalants
●
●
●
●
●
●
●
Four types: volatile solvents, gases, aerosol sprays,
and nitrates
Used multiple ways that are all very harmful to the
body
Cheap, can be purchased legally
Effects of “high” last only a few minutes
Common household products often used as
inhalants
Can result in brain damage
Death can occur after using inhalants just once
Retrieved from: http://kidshealth.org/teen/drug_alcohol/drugs/inhalants.html

14. Psychoeducation-Cocaine
●
●
●
●
●
●
●
Extracted from the leaves of the coca plant
Used: Snorting or Smoked “Crack Cocaine”
Increases heart rate, blood pressure, and body temperature, nasal scabs
Overstimulates the bodies natural reward system
Uses may experience temporary states of paranoid psychosis
Creates a feeling of being “wired”
Prolonged use can result in cardiac arrest or
seizures
Retrieved from:http://www.abovetheinfluence.com/facts/drugscocaine

15. Psychoeducation-Heroin

16. Psychoeducation-Heroin
●
●
●
●
●
●
●
●
Heroin is a highly addictive drug
Derived from the seed of poppy plant
Used: Injection, Snorting, or Smoking
Most begin using in teens or early 20s
Tolerance happens quickly
Multiple health risks associated with its use
Withdrawal can happen within just a few hours
Heroin cravings can persist years after drug use stops
Retrieved from: http://www.dosomething.org/tipsandtools/11-facts-about-heroin

17. Intervention and Treatment
Retrieved from:http://arlington.alcoholdrugtreatmenthelp.com/

18. Intervention-Strength Based
● Drawing on client’s talent/interest in poetry allow the client to work
through his feelings of loss/abandonment through that medium.
Write a poem about his best friend, or to his best friend.
● Enlisting in a support group for heroin addicts as well as abstaining
from future use. Client is in need of a support system of individuals
who are also clean, and can be empathetic

19. Intervention-Behavioral Therapy
● Motivational Interviewing
● Skills building to resist drug use
● Identifying psychological and social factors that could
trigger relapse
● Family therapy
● Group therapy
● Peer Support/Sponsor
Retrieved from: Van Wormer, K and Davis, D (2013). Addiction Treatment: A strengths perspective. p.419-442

20. Intervention-Pharmaceutical
Cocaine-Gama vinyl-GABA (GVG) blocks production of
dopamine produced in conjuction with cocaine use.
Heroin-Methadone is a synthetic form of heroin that is
legally provided for persons with heroin addiction to keep
them stabilized and from having withdrawl symptoms.
Retrieved from: Van Wormer, K and Davis, D (2013). Addiction Treatment: A strengths perspective. p.185-186

21. Treatment Plan
● Recommended treatment for client entails a 90 day
stay at a methadone treatment clinic due to drug type,
duration, and underlying issues of concern.
● Treatment would include a combination of behavioral
therapy and pharmacologic intervention.

22. References
●
●
●
American Psychiatric Association: Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric
Association, 2013.
Heroin Addictions, Abuse, and Recovery - Complete Heroin Resources.
Retreived November 6, 2013, from http: heroin.net
Kalvert, S. (Director). (1995). BasketballDiaries[MotionPicture].
United States. Palm Pictures, LLC.
●
Miller, Geri. (2010). Learning The Language of Addiction Counseling (3rd
edition).Hoboken, New Jersey. John Wiley & Sons, Inc.

23. References
●
●
National Youth Anti- drug Media Campaign. Retrieved November 6, 2013,
from http://www.abovetheinfluence.com/facts/drugscocaine
Teens Health 1995 - 2013. Retrieved November 6, 2013, from
http://kidshealth.org/teen/drug_alcohol/drugs/inhalants.html
●
Wormer, K. A. & Davis, D.R. (2013). Addiction Treatment: a strengths
based perspective (3rd edition). Belmount, CA. Brooks/Cole.