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Essay Instructions: II. Treatment Plan and Termination Summary
Students will be provided with a scenario of a client who comes in for counseling who is struggling with an addiction and other co-occurring disorders. Students will then type up a treatment plan outlining how they intend to work with this particular client. Students will also type up a termination summary outlining how the course of treatment went with this particular client. Treatment plan and termination summary forms can be found under the student resource center in Angel. The case scenario for the Treatment Plan and Termination Summary can be found at the end of this syllabus.

Case Scenario for Treatment Plan and Termination Summary:
You have been assigned to work with James, a 44 year old African-American male. James has presented for help dealing with his addiction to alcohol, which he claims to have struggled with for 20 years. During your intake you learn that James is the youngest of five children, three brothers and one sister, and comes from a strong Baptist background. James reports that all of his siblings have struggled with substance abuse and addiction at some point in their lives. James states that his family has never been really close and that while growing up he often felt unwanted and rejected by his parents. James states that he once had a close relationship with the brother that is closest to him in age ? but their relationship became strained several years ago and now he feels rejected by this brother as well. James reports that he began drinking at age 14 ? when his closest brother gave him his first beer. James states that he would drink off and on through high school and would occasionally get drunk with some friends during his lunch breaks before going back to class. James remarks that he was a fairly popular kid in school, but that he often felt nervous being around large groups of people. James struggled during his first year of college because he was unsure of his intellectual abilities and he became ?caught up? in the partying life he encountered in college. James reports that he finally got his act together and ended up making good grades during the rest of his college years, graduating with a degree in business. James went on to get his MBA and then landed a ?dream job? in a fairly large and well established corporation. James remarks that he felt like a fraud after he landed this job and really began to question his competence and his ability to do well in the field of business. However, James excelled in his position and eventually met and married a woman who he says ?wanted him to be something he wasn?t.? They were married for 10 years, during which time he gradually began drinking more heavily. James states that he became really anxious and depressed and drinking was the only way he knew how to deal with his feelings. After many failed stints in rehab, and after losing two jobs, James and his wife divorced. James was homeless for about two years ? during which time he lived in a homeless shelter that was based on the concepts of the 12 steps, and provided him treatment for his alcohol addiction. After completing this program, James obtained a low level job with a hotel and eventually began working his way up to a management position. During this time he would relapse frequently, but never for long periods of time. Once he obtained a management position in the hotel he began dating a woman he had known years ago and they eventually married. However, after being married for a few months, James reported that he became comfortable with his new life and began to relapse for longer periods of time. James has currently been married for two years and has recently gone through alcohol detox after drinking heavily for the past seven month. James reports that his doctor told him he would die if he continued to drink. James also states that his wife has told him he needs to get and stay sober, or else their marriage is over. James states that he does not want to lose his wife and he wants to learn how to live a sober lifestyle once and for all.

Cite: Treatment plans

Essay Instructions: Read the following case studies: Determine a diagnosis for the child, write up what symptoms or characteristics they are displaying, which has lead you to believe they are suffering from that disorder. Also come up with a treatment/ intervention plan. Make sure to include all environments that the child is in and how they can all help in the treatment and how each of the environments will play a role, and provide adequate details in your treatment plans. That should be a large section of your paper.


Case Study:
Michael is a 7 year old boy, who was referred by the Pediatrician for an evaluation following his 2 year old exam. In the beginning of his development Mom stated that she has seen the same delays that the Dr. has and also has the same concerns. When called even if only a foot or less away Michael will not respond to his name. He does not even turn his head towards the voice. Michael is not able to follow simple one step directions like come here, sit down, or pick up. He does not really use words to request or say what he wants. Every once in a while, not consistently, he will repeat a word that is modeled. When playing around other children in the 2?s group mom has him in, he does not even notice the other children, he plays by himself, and does not really play, he will just hold 2 objects in his hand (usually the same 2) and when they are taken away he will fall the floor screaming and crying in a very intense tantrum. When he does play he tends to line items up in the same pattern or order, then he will move the line to another room or to another place. He does not seem to know how to play with toys and even if mom sits down to show him or to help him he does not make eye contact will not look at her or imitate what she is doing. He will not point to desired items, and if he wants something will just grab them, if not given what he wants immediately, he will tantrum. When greeted by someone he will not wave hi or bye and will not smile even when someone is smiling at him. Michael seems to be in his own world and does not want others to be in it with him. He tends to be more attached to certain items then he is to his parents or other familiar people. He will play with the same item over and over and repeat the same actions over and over until you break the cycle which can then lead to tantrums. Michael is now following one step directions and even 2 step directions, his tantrums have decreased but he is unable to attend a general education classroom. He gets lost and frustrated by the amount of work and also the amount of distracted by the other children. He is not as social as his parents would like but he has started to engage more with children in the classroom since he has been in Elementary school. Michael is a pleasure to have in class and is a great kid.

Essay Instructions: FOR THE HYPOTHETICAL CASE THAT YOU WILL FINE BELOW YOU NEED TO WRITE A 8 PAGE PAPER THAT THE QUESTIONAIRE BELOW THE CASE WOULD GUIDE YOU.
USE AS A TREATMENT PLAN CBT, PSYCHODYNAMICS, PERSON CENTER THERAPY AND MOTIVATIONAL INTERVIEW THECHNICS.
U CAN USE SOME RESOURCES TO BACK UP YOUR FORMULATION TO TREAT THE CASE.
TRY NOT TO BE TO SOPHISTICATED AS A LANGUAGE, BUT YET THIS IS A SCOLARLY PAPER SO TRY TO AVOID : I THINK, I GUESS, I LIKE LANGUAGES.


Hypothetical case:

Vera P is a 25 year old, never married, white female with the date of birth of Feb. 14, 1984 who currently resides Albuquerque, NM. Vera reported that over the last several months things have been "spiraling down." She explained that she approached her mother and told her about her struggles and they decided treatment would be a good idea.
Vera reported that her substances of choice are marijuana, cocaine, and Percocet. She began using marijuana around age 17 and progressed to regular use by 18. She has been using daily for the last six years. She reported that she spends about $700 per month on marijuana. Her last use was March 8, 2010. She began using cocaine around age 19 and it progressed to regular use around that time. She has been using daily since January 2010. She reported that she will snort about a gram throughout the day. Her last use was March 5, 2010. She began using Percocet this year. She reported that she has been using it daily with cocaine since January 2010. She generally takes between two and three, 30 mg. tabs. She did not report her last use of this substance. She began using Xanax and Ativan around age 25. She reported that she uses this sporadically. She will generally use .5 mg. per episode of use. Her last use was about one week ago.
Vera reported that she was admitted to inpatient treatment when she was 21. She stayed there for one month. She completed the program. Additionally, she went to an outpatient around age 17. She participated in this program daily for about two weeks.
Vera reported that she believes that she is addicted. She explained that she thinks about using drugs all of the time, craves them, and cannot stop even when she wants too. Vera reported that her use started because of her depression and anxiety but then symptoms would increase due to her use. She described withdrawal and thinking about her substance use all of the time as primary consequences. Additionally, she has experienced financial problems associated with her use.
Vera reported that she was raised by her biological parents until she was 10 years old when they divorced. She has always been much closer to her mother. Her mother remarried when she was 16. She liked her stepfather. In terms of her relationship with her father, she reported that it was not regular until December 2009. She explained that her father has more recently been very nice, calling her a lot, and trying to be a part of her life. She is not sure what changed. Vera reported she has a 17-year-old brother. She did not provide any great detail about the nature of this relationship.
Vera reported that she experienced some emotional abuse from her father growing up. She reported that her father has problems with alcohol. Vera reported that her father has never been diagnosed but she believes that he has a behavioral problem, primarily anger outbursts. Additionally, she reported that her maternal great grandmother and a maternal uncle had problems with depression.
Vera was living with her mother and stepfather prior to treatment. Vera self identifies as heterosexual. She has been dating her current boyfriend for about nine months. She explained that he smokes marijuana. She's had approximately 40 sexual partners and four were significant relationships. She reported that she generally does not practice safe sex and is interested in being tested while in treatment.

Vera reported that she is a high school graduate. She recently completed her Bachelor's Degree in psychology in January 2010. She said that she is currently unemployed.
Vera reported that she does not have any active legal problems. She explained that in 1994 she was charged with underage drinking but the charge was expunged after she completed community service.
Vera reported that she started in therapy around age 12. She has been working with the same psychiatrist for about four years. She explained that the psychiatrist does talk therapy, as well as medication management. When asked what they are working on, she said, "Nothing in particular." She likes working with her psychiatrist. She has been hospitalized on three separate occasions for intentional overdoses.
Vera reported that she has struggled with depression since age 12. She explained that most of the time she feels sad, unmotivated, loss of energy, loss of interest in activities she previously enjoyed, and sleeps too much. She described having problems with attention and concentration. She reported that she has problems feeling worthless and hopeless. She has felt little resolution to these symptoms. Vera reported that she is not currently suicidal. She explained that she has had thoughts of wanting to disappear in the past. She feels that things would have been easier if she did not exist. However, she has not had these thoughts within the last year.
Vera reported that she has really bad anxiety. She explained that it is present all of the time. She reported that her heart beats rapidly, she cries a lot, sleeps to avoid, and experiences muscle tension. She explained that anything and everything can produce these symptoms. However, there are shorter periods of time where she will feel and exacerbation of physiological symptoms.
Vera reported that she struggles with over shopping. She explained that shopping can be used as a release from any problems in her life. She generally shops daily. She experiences a lot of guilt around her shopping behavior.
Vera reported that about five years ago she was diagnosed with borderline personality disorder. She explained she has a chronic sense of emptiness, low self-esteem, and feels as though people are often talking about her or do not like her. She can be rather impulsive and engages in highly maladaptive means of coping, including substance use, self-injury, shopping, and sexual activity.



1. The purpose of this assignment is to help you clarify your views of counseling and psychotherapy.
2. Drawing upon the contents presented in course, write 10 page paper which:
a) Describe how you combine ideas and techniques from various theories covered in this course.:

COMBINE (INTEGRATE) CBT, MOTIVATIONAL INTERVIEW, SOME PSYCHODYNAMICS AND CLIENT CENTER THERAPY

b) Demonstrate how you would treat the client described “the hypothetical case” that you will use.

3. Your paper should address the fallowing issues:
a) What is your view of human nature?
b) What is your definition of counseling?
c) -How do u define your role as a counselor?
-What are the most important functions of a counselor or therapist?
d) What are your vies on therapeutic relationship between therapist and client?
e) How important is the relationship as a factor for change?
f) Which theory or theories come closest to your way of viewing counseling?
g) Which aspect(s) of those theories are most appealing to you or why?
h) In showing how you would apply this (these) theory (ies) to the hypothetical case, be sure to be specific in describing how you would influence your therapeutic decisions.
I) Describe some of the techniques that you would employ.

Essay Instructions: Case Studies - this at requires a discussion on the initial treatment the patient would receive in the hospital - as well as follow-up discharge planning and teaching?
In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

Description of your approach to care is offered in detail, while demonstrating evidence of deeper insight and/or reflection.
Recommendation of a treatment plan is offered in detail, while demonstrating evidence of insight and/or reflection.
Description of a method for providing both the patient and family with education is offered in detail, while demonstrating evidence of deeper insight and/or reflection.
A teaching plan is offered in detail, while demonstrating evidence of deeper insight and/or reflection.


? Use outside resources, and resources from the GCU library, as well as the text book is required
? Be sure to include a plan of care including nutrition for case study #1
? Provide a clear articulation of your treatment plan, this means you must meet this patient?s immediate physical needs, for case study number 2 and nursing approach to care for example: patient-focused, patient-centered, multidisciplinary, holistic, collaborative care
? BE SURE TO ADDRESS THE PATIENT?S IMMEDIATE EMERGENCY NEEDS IN CASE STUDY #2
? Treatment plan must include: scientific rationales for all interventions, medications, O2, monitoring,
? Provide appropriate patient teaching to both patient and family in terms they will understand
? Identify the method of teaching you will use after conducting a learning needs assessment and provide the rationale for using that teaching method
? Utilize resources that include peer reviewed journal articles from the GCU library, as well as your textbook and other reputable sources.
? Be sure you utilize APA formatting
? Be sure to have an introduction paragraph that discusses what you will be talking about in the paper and a conclusion statement that summarizes your entire paper
Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question
Considering Mr. P?s condition and circumstance, write an essay of 500-750 words that includes the following:
? Describe your approach to care.
? Recommend a treatment plan.
? Describe a method for providing both the patient and family with education and explain your rationale.
? Provide a teaching plan (avoid using terminology that the patient and family may not understand).