University Psychology Report: Family and Substance Abuse Management

This psychology report presents a case study focusing on the management of excessive drinking and drug use within a family. The report begins with an executive summary outlining the diagnosis, case formulation, and treatment plan for a man named George, diagnosed with Alcohol Use Disorder (AUD) based on DSM-5 criteria, and his wife, diagnosed with stress and anxiety. The diagnosis section details the specific criteria met by each individual. The case formulation explores the biological, psychological, and family-related causes of George's AUD, as well as the social and work-related stressors contributing to Sandra's anxiety. The report highlights the potential negative impacts on their children. Finally, the treatment plan outlines goals for both George and Sandra, including medication, therapies like CBT and MET for George, and stress management techniques and counseling for Sandra. The report also discusses the potential dangers for the children if help is not provided immediately and the consequences of not seeking help.

Running head: PSYCHOLOGY
The management of excessive drinking and drug taking in the family
Name of the Student
Name of the University
Author Note

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Executive summary
This report deals with a case study of ‘The management of excessive drinking and drug
taking on the family’, its analysis is done in three broad headings mainly comprising of the
diagnosis, case formulation, and treatment plan. In the diagnosis section following the
diagnostic criteria of DSM-5 George is diagnosed of having Substance Abuse Disorder or to
be more specific from the symptoms and that of the criteria in DSM-5 it can be said that he is
having Alcohol Use Disorders (AUD). On the other hand, his wife is diagnosed of suffering
from stress and anxiety after referring the criteria list of DSM-5. In the case formulation
section the causes of AUD for George is identified to be biological, psychological or effects
of family. Whereas, Sandra his wife’s cause of stress is assumed to be from social or work
pressure. It was also highlighted that if immediate help is not provided their children are also
in the danger of getting negatively affected. Finally, in the treatment plan the goals of the
treatment for both George and Sandra are identified and outlined. George needs treatment,
which will include medications as well as therapies whereas; his wife will need to learn few
techniques to deal with stress and anxiety along with counseling sessions.

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Table of Contents
Introduction................................................................................................................................3
DSM-V Diagnosis......................................................................................................................3
Case Formulation.......................................................................................................................5
Treatment Goal and Planning.....................................................................................................7
Conclusion................................................................................................................................10
References................................................................................................................................12

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Introduction
It is known to everyone that if any individual in a family who is into excessive
drinking or into drugs then it will in turn effect the whole family because they will try to help
the member but will get themselves pulled down to the bog. However, for a couple it is not
easy to be with a partner, who is into excessive drinking and drug use because the
relationship will get into conflicts, blaming one another and finally became a burden without
love. The partner of the addicted often is hurt, afraid, and ashamed or suffers from a sense of
failure. Family members mainly try to cover up the mess and often are found taking more
responsibilities and fighting the lost battle with their dear ones (Orford et al., 2013). Heavy
drinking and drug use can not only affect the family but also can heavily affect career, health
and other aspect of a person’s life. Consuming drug or alcohol also equally affects not only
men but also women, as alcohol is more absorbent in a women’s bloodstream, as they are
lacking enzyme which alcohol dehydrogenate in the stomach, where as in men the alcohol is
broken down before it gets absorbed. Substance abuse mainly includes the persistent use of
both alcohol and drugs. In this report, a case study of ‘The management of excessive drinking
and drug taking on the family’ is analyzed in three broad headings mainly comprising of the
diagnosis, case formulation and treatment plan.
DSM-V Diagnosis
George from the case study has been diagnosed with Substance use disorders.
According to DSM-V substance use disorders mainly results from the use of separate classes
of drugs like alcohol, cannabis, caffeine, hallucinogens, opioids, sedatives, inhalants, tobacco
and many more such substances. However, in case of George in this case study he has been
addicted to alcohol for the last 5years. As per DSM-V George, falls mainly under Alcohol
related disorder because as the diagnostic criteria suggest that a person should have at least

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two of the issues that must have occurred within a period of 12 months (American Psychiatric
Association, 2013). Therefore, in case of George the points, which are matching with that of
DSM-V criteria, are that alcohol is consumed excessively or over longer time periods,
repeated alcohol consumption is hindering to complete the role at work, school or home,
recurrent use of alcohol despite of falling sick. Followed by continuing alcohol consumption
despite having issues in the social as well interpersonal relations, important occupational
activities are given up or have decreased because of alcohol consumption and lastly, alcohol
consumption is continued even knowing that there will be a physical or psychological issue
that have chances to take place due to excessive drinking (American Psychiatric Association,
2013).
On the other hand, living with a husband like George his wife named Sandra is
ongoing extreme stress that George will lose his job because of his excess alcohol
consumption, which is troubling his career along with having a deteriorated relationship with
her husband. She has been found facing a sense of fear as well as apprehension, nausea along
with an irregular heart beating in few occasions (Spielberger, 2013). Therefore, Sandra is
diagnosed with stress and anxiety. As per DSM-5 that are used to diagnose Anxiety disorders,
Sandra has been found to worry excessively about her husband’s health as well as financial
matters but not more than 6 months. Along with it as per DSM-5 criteria, the individual
suffering from anxiety can also experience symptoms like sweating, nausea or diarrhea.
Sandra has been encountered with nausea (American Psychiatric Association, 2013).
However, as Sandra in few occasions has been found having feelings of fear and irregular
heartbeats thus, she is anxiety attacks which is according to DSM-5 called the panic attack
which is the sudden onset of fear or may be discomfort and reaches the peak which any 4
symptoms of the DSM-5 list of criteria. However, Sandra’s symptoms that are matching with

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DSM-5 criteria of panic attack are pounding heart rate, nausea, fear of losing control or going
crazy and discomfort (American Psychiatric Association, 2013).
Case Formulation
Causes of George’s mental health issue
According to the researches, it has been proved that there has been a close association
between alcoholism and biological factors mainly genetics and physiology. There are certain
chemicals in the brain that can make an individual susceptible to alcohol abuse. According to
the scientists, alcohol dependence may be associated with up to 51 genes in different
chromosome regions (Enoch, 2012). Therefore, if these genes are passed generation after
generation then family members get more prone in acquiring irregular drinking habits. Some
can limit the amount of alcohol they consume while others feel a strong impulse of getting
drunk. Repetitive behaviors make a person more vulnerable to become alcoholic (Kissin,
2013). Alcoholism is frequently seemed as a trait of broken families. If any member in the
family is alcoholic then it disrupts the healthy and normal family dynamics, creating many
issues that ultimately lead to dysfunction. The spouse of an alcoholic often fined doubting his
or her partners, but alcoholism is a disease not a fault of anyone. Children of parents who
were alcoholic can fall into various unhealthy roles (Jayne, Valentine & Gould, 2012). Thus,
biological factors as well as family can be a cause of George’s mental health issue.
There are various psychological factors as well which can increase the chances of
heavy drinking. Every individual has their unique ways to handle situations and therefore, the
way one cope with these feelings actually influences certain behavioral traits. For instance,
those who have high stress, anxiety, depression or any other mental condition are more prone
to develop alcoholism. In these situations, alcohol mainly withholds feelings and replaces the
symptoms of psychological disorders. However, with time drinking becomes a habit and

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guides to Alcohol use disorder. The more one uses alcohol to ease their feelings of pain, the
more their body becomes tolerant to alcohol and relies on its effects. Alcohol abuse can
further co-occur with depression, bipolar and schizophrenia and can further cause serious side
effects (Heinz et al., 2013).
Cause of Sandra’s Stress
Social causes can enhance stress like living in an area where the place is too crowded,
pollution, crime or even noises can create chronic stress for an individual. Along with other
social causes like not having enough money to cover the expenses, loneliness, any kind of
discrimination or sexual orientation can add stress to one’s life (Patki et al., 2013). However,
for Sandra she is always stressed that her husband will lose his job that will lead to financial
crisis as they have three children. Moreover, she is also getting isolated from her husband,
which is making her lonely. Therefore, social cause is there which is affecting Sandra. The
job structure or unemployment can also bring stress to someone. However, Sandra is working
as Manager in a large insurance company, which means that she has high workload as well as
work pressure. As she is an office manager thus, she has huge responsibilities, which
increases her already existing stress about her husband, his career as well as their relationship
(Khamisa et al., 2015).
Possible dangers of the children getting affected-
The three children of George and Sandra can get severely affected growing up with an
alcoholic parent because psychologically they can suffer from guilt, anxiety, embarrassment,
confusion, anger and depression. In their own adulthood, they might also face risks of mental
health trauma or substance abuse. Moreover, their children can adapt to antisocial behavior
and may have difficulty in forming relationships (Lander, Howsare & Byrne, 2013). Children
growing up with an alcoholic parent means to have a traumatic childhood experience. The

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children can often feel neglected and thus, are more prone of getting emotionally, physically
or sexually abused. Their children can further become secretive and may stay away from
friends because of being ashamed (Velleman & Orford, 2013).
Consequences if help is not provided to them-
If immediate help is not provided to them then it will affect George, Sandra and their
children immensely. For George, alcohol will have short-term as well as long-term effects
along with few side effects like depression, liver damage, and cancer as well as reduced
sexual performance. Further excess alcohol consumption can cause death of the brain,
cirrhosis, pancreatitis, tolerance or lastly alcohol dependence (Lieber, 2012). Then for
Sandra, her stress and anxiety can have negative effect on her physical health as well mental,
emotional and even on her social life. Not only her immune system will get affected due to
stress and anxiety but it will also affect her digestive, cardiovascular, musculoskeletal as well
as well reproductive system along with other physical problems (Cooper & Marshall, 2013).
Lastly, growing up with alcoholic father and mother with stress and anxiety will have
negative effect on the kids as well which is not only make them feel neglected but also make
their childhood traumatic. This will further be reflected in their adult life. Therefore, they are
all in need for immediate help before it is too late.
Treatment Goal and Planning
Treatment for George-
Depending of the need of the clients the treatment for alcohol use disorder can vary.
However, George’s treatment may include a brief intervention in the beginning followed by
individual counseling, an output patient program or a residential inpatient stay. Nevertheless,
currently the treatment plan for George may begin with a detoxification or Detox which is

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withdrawal that is managed medically. It takes two to seven days. George may need sedating
medications so that the withdrawal symptoms can be prevented (Stephens et al., 2014).
Counseling as well as therapies are very much helpful for better understanding the problem of
George and support recovery from his psychological aspect of alcohol use. Therapies like
behavioral therapies along with CBT therapy, motivational enhancement therapy(MET) can
be very much affective to people suffering from substance use because CBT will help George
to think in an alternative way and avoid behaviors that are harmful for him and MET will self
motivate and educate him about health risks from alcohol addiction.(Dermatis & Egelko,
2014). Moreover, marital and family counseling is also helpful because it will help improving
the family relationships as well as repair and enhance his relationship with his wife. Drug like
disulfiram (Antabuse) can be prescribed to George to prevent him from drinking. However,
this medicine cannot completely cure alcohol use or wipe out the compulsion to drink but if
this medicine is taken then this drug will produce a physical reaction, which in turn will
produce flushing, nausea, vomiting and headaches. Another drug called naltrexone (Revia)
can prevent heavy drinking and lower the urge to drink as it obstructs the good feelings
alcohol produces. Acamprosate (Campral) can also be helpful in this case, as it will help
George to combat alcohol cravings once he stops drinking (Froehlich, Hausauer&
Rasmussen, 2013). Lastly, medical treatment should be continued because health will
definitely improve if George stops drinking but few health conditions will remain and will be
needing treatment and follow-ups.
Treatment for Sandra-
Sandra’s treatment plan will exclude those drugs containing stimulants as can make her
conditions worse thus Sandra should avoid that along with regular use of caffeine related
drinks. Along with she must also avoid medicines like diet pills, asthma inhalers and thyroid
medications. Then she will need techniques for managing daily stress and anxieties, as it is

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very normal that stress and anxiety will occur from time to time. Sandra needs to pay little
attention to know that how her body and mind responds to the stressful situation so that the
next time in a similar stressful situation she can anticipate her reactions and it gets less
troublesome. She should also eat balanced diet, get enough sleep, meditate, practice deep
breathing and talk to friends (Sharma & Rush, 2014).CBT therapy can be helpful to Sandra as
this therapy is very much effective for managing anxiety. This therapy will further teach
Sandra how she can recognize anxious thoughts as well as behaviors and modify them into
ones that are more positive (Arch et al., 2012). Counseling, this will be effective for Sandra to
fight with stress and anxiety because this is the best-known talking therapy that she can easily
avail. Counseling may be of 6-12 sessions each about an hour long. Sandra can talk to her
counselor with confidence and he/she can help her think about her situations. Counseling is
the best help for those who are healthy but need little help to cope up with their present crisis.
In Sandra’s case, relational counseling will also be effective because her husband’s alcohol
use has ruined their relationship, which is also an important cause of her stress and anxiety.
Thus, relationship counseling can also help her if both the partners talk in confidence to the
counselor/therapist to discover what exactly has been wrong in their relationship and how
together they can make things better. This will further help Sandra and George to learn about
each other’s needs and will enhance their communication (Petch et al., 2014).
Treatment Goal for George-
By following this treatment plan slowly and steadily George’s excessive alcohol
consumption can be brought under control. Further, after this treatment his physical and
mental health conditions will also improve. Moreover, if his alcohol consumption is
controlled then his social and personal life will become hassle free. Therefore, he can
continue to lead a healthy and peaceful life without frequently falling sick or without the fear

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of losing his job. Thus, the main goal is to control George’s drinking habit and improve his
mental as well as physical health as of now.
Treatment goal for Sandra-
If the treatment plan of Sandra is followed appropriately then definitely she will be
able to control her level of stress and anxiety that she faces now. Controlling her stress and
anxiety level will definitely save her from many long-term mental and physical illnesses.
Thus, implementing the treatment for Sandra in a successful way will surely give her the
power to manage stressful situations as well as her relationship with her children and
husband.
Conclusion
To conclude this report, it can be said that from the case study provided George who
is 42years of age and is a Postman by his profession is drinking excessively over the past five
years. The habit of his excess drinking is now interfering with his professional as well as
personal relationships because he is regularly falling sick or is suspected as intoxicated at his
workplace and is send home. Whereas, drinking is making his mood irritable, being rude or
quiet or reserved at times. Thus, his wife and children are isolating themselves from him. On
the other hand, his wife Sandra who is 39years old and works as an office manager for a large
insurance company is experiencing symptoms like worries, fear, nauseous and irregular
heartbeats. According DSM-5 George is diagnosed with Substance abuse disorder, mainly
alcohol use disorder and his wife Sandra is diagnosed with stress and anxiety. In the case
formulation, it has been seen that George’s mental health problem can cause due to
biological, family or psychological effects whereas Sandra’s causes can be social or work
related. However, as mentioned in the case study that they have three children, who can also
get negatively affected if immediate help is not provided to them. Therefore, appropriate

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treatment plan is followed with the goal to control George’s drinking habits and help Sandra
to manage her stress and anxiety. Thus, for both counseling are a common factor other than
that both will need different types to medications as well as therapies.

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