Case Study: Survivor’s Guilt & Trauma

Case Study: Survivor’s Guilt & Trauma

By In Case Studies
Posted July 2, 2021

The subject of our case study was a client in her late 20s hailing from the mid-west. She presented to treatment for alcohol use disorder, depression, trauma, eating disorder, abandonment issues due to her parents getting divorced at a young age and anxiety. Client reported abusing alcohol at the young age of 15. Client’s trauma stems from a severe car accident a few years prior to admitting to treatment due to driving drunk where she fractured several bones. Due to this car accident, she dealt with severe survivor’s guilt, and shame over the fact that she was drunk, and caused her family much pain and anguish. Client also reports two different sexual trauma events in her life. Client also struggled with severe unjustified guilt over being abused sexually due to her being drunk “and putting myself into that situation.” Client also struggled having a healthy relationship with her father due to client stating that he had hit her in the past and treated her the worst out of her other siblings. 

Client reports her alcohol getting severe enough that she experienced DT’S, and hallucinations. Client reported a habit of alcohol poisoning, and blackouts reporting that she was hospitalized for this. Client reports that the last time when she went to the hospital her BAC was 0.4, reporting that this is common for her. Client has been in three detox programs in her life; however, she has never received treatment for her problem areas. Client was employed with plans to return to her same neighborhood, and job. 

Treatment Progression

When client first arrived at the PHP level of care, she struggled with opening up, and allowing herself to be vulnerable. Client was extremely superficial, did not participate during groups, very guarded, and resistant to the treatment process and sharing anything trauma related. Client initially was planning on returning back home to her family where she would continue treatment. Client’s mindset was focused on leaving after 45 total days of treatment. Therapy was focused on how this client functions internally, and how she has been dealing with his emotions externally causing her to have negative consequences. Client was able to get honest about her mental health, specifically her trauma, and how this has affected her having any healthy relationships. After several weeks of rapport building, education, and intervention techniques she allowed herself to open up, and begin sharing honestly. However, client struggled through a significant part of her treatment by engaging in risky behaviors that were distracting her, relapsing while at the IOP level of care where she blew a .49, went to the hospital, and made the decision to return back to treatment. At this point she was fully committed to staying abstinent. 

Outcomes of Treatment

Client was able to complete all levels of care from residential to OP. Client became a positive role-model and peer leader in her community. Client eventually transferred to the cottages, became employed, and obtained her vehicle which was a tremendous fear of hers due to the car accident. Client was able to identify as a survivor rather than a victim by the time she completed treatment. Through this process therapist utilized CBT, motivational interviewing, trauma timeline, trauma narrative and staff interventions that were necessary for client to improve including client’s father coming for a family session, and family night. Client then moved out of the cottages into a local sober living where she continued to engage in the alumni program, has a home group, a sponsor, and reports “I have the best relationship with my dad now because he understands me.” 

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