26 Dec CLINICAL SUPERVISION

Clinical Supervision

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For the purpose of this discussion, the client that shall be selected is a 36-year-old man that is married and with 3 children. At the time of the initial meeting, this client was living alone because the wife had left him and she had full custody of the children. At this time, he was not able to provide for the family because he was not in employment because he was fired. He used to work as a manager in a retail store. This client presented to the clinic because he said that he needed help with his alcohol addiction. This had to be properly diagnosed. According to the DSM-5, in order to diagnose alcohol use disorder, at least two symptoms from the list that is provided in the manual should have been experienced for the same period of 12 months. In this case, the client reported a number of symptoms that he experienced for more than a year. He takes alcohol in large amounts for periods which are longer than it was initially intended. He has tried to stop taking alcohol without any success. He reported of having a strong urge to drink and this makes him compromise his health and social life. He has lost 4 jobs in the last 4 years and this has been a breaking point for him. He intends to be better in order to have his family back. Alcohol use disorder is an addictive disorder that is known to negatively affect social and occupational aspects of life (Nadkarni et al., 2017).

The client had to be started on cognitive behavioral therapy. This is one of the most effective psychotherapeutic interventions for persons that suffer from alcohol use disorder. It should be noted that cognitive behavioral therapy is the most effective empirical intervention for this disorder (Carroll & Kiluk, 2017). This therapy was meant to help the client to understand the relationship between thoughts, emotions and behavior. The client was given an option of using medications as part of the therapy as well but he had a preference for an intervention that did not involve the use of pharmacotherapeutic interventions. During the 6th session, the client started to report improvements such as the fact that he did not have urges as strong as before. However, he reported that the fact that his wife and kids left him put him in a very difficult emotional state.

During days when he feels very sad about being left by his family, he uses alcohol to help him to overcome the sad thoughts. He reported that he was constantly sad but he did not report having depressed mood. On further interview, it was established that he did not meet the criteria for major depressive disorder. However, the sadness and feeling of emptiness after being left by his wife and kids affected the progresses of his recovery. Even though CBT was used in this case, it is safe to conclude that the sad thoughts came out as significant obstacles to his recovery.

The client at this point has not yet finished his sessions. He still has a long way to go. CBT is a very effective intervention and this should continue to be used. He should be able, eventually, to overcome the sad thoughts and cope in a manner that is not destructive. This client needs to understand that being able to overcome the thoughts is going to be very important to his recovery. The use of medications to help in reducing the urge to drink should also be considered in this case. However, respecting the preferences of the client is going to be very important.

References

Carroll, K. M., & Kiluk, B. D. (2017). Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again. Psychology of addictive behaviors, 31(8), 847

Nadkarni, A., Weobong, B., Weiss, H. A., McCambridge, J., Bhat, B., Katti, B., … & Wilson, G. T. (2017). Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial. The Lancet, 389(10065), 186-195.