Does Laura need to be referred to a physician to be assessed for possible medical detoxification/stabilization and if so provide an explanation as to why?

Feb 15, 2024

Does Laura need to be referred to a physician to be assessed for possible medical detoxification/stabilization and if so provide an explanation as to why?

Read the following case and answer all questions.Laura is a Hispanic woman in her late-forties. Laura is married and has two daughters aged 15and 17. She works in the high-stress, high-powered world of corporate finance. Laura presentsherself as a no nonsense business professional. She has come to the clinic that you arepresently working in as a social worker for an assessment because her husband and twoteenage children are very concerned about her drinking. Her husband has insisted that she seekprofessional help.Laura tells you that although she promises herself that she will only have one or two glasses ofwine per day, she routinely finds herself finishing the whole bottle and sometimes half or moreof a second bottle. Laura reports that it seems to take more wine these days to help her feelrelaxed at the end of a stressful day. She does not see this as a problem but she has missed afew important business meetings lately. This has made her feel quite upset with herself andguilty because she has lied to her boss about the reason for her absences.About three years ago, Laura began to have trouble sleeping and the doctor prescribed themedication Xanax (an anti-anxiety drug and central nervous system depressant). Her fatherdied about one year ago and her use of alcohol and Xanax has steadily increased since thattime. She often takes five or six times the prescribed dose of Xanax. When her physicianpresented his concerns about the amount of Xanax she was taking on a regular basis she beganto search for other physicians in order to obtain more prescriptions for Xanax. She now takesXanax during the day as well as at night when she is feeling stressed.112020/2021Laura notices that her mind is quite fuzzy in the mornings and she cannot remember certainthings from the evening before. Of major concern to her family is that she recently totaled hercar in a crash on the way to work on a morning that she had a very bad hangover fromdrinking the night before. Laura states “I guess I am really lucky to have walked awayunharmed”. Her children told her that they are beginning to feel embarrassed by her slurredspeech and staggering gait in the evenings when they bring their friends home. Laura admitsthat she felt ashamed and guilty when her children told her that they felt embarrassed by herbehavior. Laura’s husband has told her the car accident terrified him and he wants her to gethelp.a) What are your initial impressions of Laura?b) Describe your approach and engagement of Laura and include professional andethical considerations in working with Laura.c) Provide an assessment and DSM-5 diagnosis with a rationale for choosing thespecific diagnosis for Laura.d) Does Laura need to be referred to a physician to be assessed for possible medicaldetoxification/stabilization and if so provide an explanation as to why?e) Provide a treatment plan including models or treatment used and interventions.f) Should Laura’s family be involved in her treatment? If family involvement isindicated outline the rationale for including Laura’s family in hertreatment plan.

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