Case Study – Dual Diagnosis Treatment, Court Ordered

Case Study – Dual Diagnosis Treatment, Court Ordered

By In Case Studies
Posted June 18, 2021

A Male client in his twenties and of Native-American descent presented for six months of court-ordered substance abuse and dual-diagnosis treatment after a full year of court-ordered inpatient psychiatric stabilization at a state hospital. The client presented with a history of extensive legal issues stemming from his struggles with a wide range of both substance abuse disorders and untreated mental health diagnoses. The client also reported a history of suicidal ideations, including one suicide attempt. The client reported a history of mental health issues in his family, as well as a history of criminal activity and incarceration. The client arrived to treatment with violent tendencies, avoidant thought process, and a multitude of other conditioned responses resulting not only from his drug addiction, but also from his tribal background and associated skeptical view toward modern medicine. His judgement was poor, insight severely lacking, and motivation for treatment primarily external. The client was fully transparent about the fact that he didn’t plan on changing and that his sole reason for admitting to treatment was to comply with court.

The Treatment Process

Initially arriving to Destination Hope with no intention to change, this client gradually became more and more open minded through the use of a variety of therapeutic interventions.  He attended a full day of treatment every day of the week for six full months while under the full supervision of and receiving individualized treatment planning and support from the clinical department, medical department, case management department, and behavioral health technician team.  

His treatment planning was designed to address his substance abuse diagnoses, schizoaffective diagnosis, depression diagnosis, criminal thinking, and trauma.  He began learning to apply new coping skills in his life. As his self-esteem grew, he began contemplating change for the first time in his life. He stopped counting the days left in treatment and began making the most of each of his remaining days. The client began practicing honesty while participating in therapy, allowing him to receive valuable feedback and take a look at the common themes in his life’s circular pattern of drugs and institutions. Over the course of six months, the client made tremendous, life-changing progress in his outlook and level of self-acceptance.

Results of the Therapeutic Process

Upon completion of treatment, the client fulfilled his end of the legal bargain. He was no longer required to follow treatment recommendations. For the first time in almost a decade of this client’s life, he had the opportunity to make decisions without having to consider pending legal issues and obligations placed upon him by drug court, probation, or parole. It was at this time that it became clear that the client’s thinking had been awakened. He could have chosen to go directly back to his old ways, but instead he decided to accept assistance with sober living placement and coordination of ongoing therapy in the outpatient setting. This client was referred to a nationally certified local sober living program and set-up with a local outpatient psychiatry and mental health counseling provider. 

When contacted by our Alumni department in the weeks, months, and years following treatment, the client reported significant progress and continued growth. He mentioned ongoing residency in the same sober living facility, maintained medication compliance, active participation in his local chapter of Alcoholics Anonymous, renewed family relationships, and plans to enroll in local community college to begin pursuing a career in addiction counseling.

This client arrived at treatment with significant, seemingly impossible barriers to change. Nudged into treatment by the criminal justice system for the umpteenth time, this client could have gone through the motions and continued with his same destructive cycles; however, this time, he was motivated to change and possessed the tools to do so. Against all odds, this client changed everything to change everything.

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