Case Study: Middle Aged Female with Cooccurring Substance Abuse & Mental Illness

By In Case Studies
Posted April 5, 2021

Client was a middle-aged female of Middle Eastern descent who presented with mental health symptoms and a history of substance abuse. The client struggled to engage in treatment initially, after being given an ultimatum by her family to admit into the Destination Hope treatment program. The client presented with mental health symptoms related to depression, anxiety, guilt and shame. She had developed an unhealthy attachment to her children which was largely based on shame she experienced from neglecting her children while involved in her active addiction. Initially, the client presented with a tendency to isolate from others. However, she gradually learned the value of “allowing others in” and building a sober support network. Challenges the client faced related to maintaining mental health stability and sobriety included refraining from minimizing her mental health symptoms, maintaining medication management, and following through with 12-step recommendations.

The Treatment Plan

Therapeutic interventions involved Cognitive Behavioral Therapy (CBT), Motivational interviewing and challenging negative thinking while addressing mental health symptoms of depression/anxiety, with a special emphasis on coping with client’s feelings of shame and guilt.

Coping skills involved identifying the value of self-forgiveness to release feelings of shame and guilt related to neglecting her children during her addiction. The client also identified experiencing grief and loss related to “not being there” for her children and “feeling like a burden” to others due to her need for her parents to take care of her children while she was in treatment. The client’s motivation to get better have served her well however, she at times demonstrated resistance to obtaining a sponsor and displayed fluctuating motivation to be more involved with the 12-step process. With the encouragement of her therapist, the client learned to place a strong value on utilizing her support network, although she was distracted by her feelings of anxiety related to her children. Mental health problems that need ongoing treatment include the client’s moderate to severe level of anxiety, which was strongly related to her inability to remain “in the here and now.”

Treatment Outcome

The client made significant progress while in treatment as evidenced by her decreased sense of depression and feeling “ready” to return home. The client’s family has been consistently involved and supportive in her recovery, attending family night while she was in treatment. The client’s aftercare plans involved moving back to her parents’ home where she can reunite with her children, attend intensive outpatient treatment with Destination Hope, continue medication management with frequent psychiatrist follow-up, participate in 12-step meetings, obtain a sponsor and attend support group meetings to address mental health.

An important aspect of the client’s recovery will involve maintaining balance in her life given that prior to her admission to treatment, she was experiencing feelings of being overwhelmed due to working multiple jobs.

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