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28 Days
Overview
Gwen Cummings, from 28 Days, has been sent to your rehabilitation facility. Gwen uses
alcohol and Vicodin, a prescription analgesic. She wound up in your facility after she
and her boyfriend Jasper, already drun, arri!ed late to her sister"s wedding. Gwen
fell into the wedding cae at the reception, then stole a limousine and dro!e it into a
house. #n lieu of $ail, she has been sent to rehab for %& days.
Client name: Gwen Cummings
Psychiatric diagnosis: Substance dependence 'alcohol and Vicodin(
DSM-IV-TR criteria:
) maladapti!e pattern of substance use, leading to clinically significant impairment or
distress, as manifested by three or more of the following*
+. Tolerance 'either of the following(*
,eed for maredly increased amounts of the substance to achie!e intoxication
or desired effect
-aredly diminished effect with continued use of the same amount of the
substance
%. .ithdrawal 'either of the following(*
Characteristic withdrawal symptoms for the substance
Some of closely related substance is taen to relie!e or a!oid withdrawal
symptoms
/. Substance is often taen in larger amounts or o!er a longer period than was
intended
0. 1ersistent desire or unsuccessful efforts to cut down or control substance use
2. Great deal of time spent in acti!ities necessary to obtain the substance, use the
substance, or reco!er from its effects
3. #mportant social, occupational, or recreational acti!ities are gi!en up or reduced
because of substance use
4. Substance use is continued despite negati!e physical or psychological
consequences
Copyright %55&, 6ippincott .illiams 7 .ilins 28 Days 8 +
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9ate* March 1! "#1
:our name* $im%erly R& Regondola
,ame of the client you are assessing* Gwen Cummings
,ame of the mo!ie* 28 Days
.hat is the chief complaint; '#n the client"s own words, and report of others(
Response:
<There is something wring with my hands<
<# can=t sit still and be alone in a room. #cant breathe.<
>ased on the abo!e information and a close !iewing of the mo!ie, what questions would
you raise during history taing; .hat are some possible answers; :ou might base your
questions on the*
?istory of the client"s illness, problems encountered due to drining
@amily history of substance dependence
1sychosocial history
Response:
8.hat substance are you using;
8#s this prescribed by the doctor;
8?ow long are you been drining;
8?ow many standard drins do you ha!e on a typical day when you are drining;
8.hat do you feel after drining alcohol;
89o you always encounter problems when you are drun;
8#s there a member in your family who is alcoholic or substance user;
#n your opinion, is the diagnosis abo!e accurate;
Response:
:es
.hat 9S-8#V8TA criteria support 'or negate( this diagnosis;
Response:
8#mpulsiti!ity* act so energetic and wild and wasted
8.ithdrawal from the absence of alcohol* characteriBed by a number of
physiological symptoms 'tremor, anxiety, sweating, agitation and restlessness,
nausea(
8Cra!ing* an indi!idual"s compulsion to drin, triggered by any number of external
cues or <primed< by the first drin or two.
8 #mpaired control* an indi!idual=s lac of control o!er drining and difficulty
setting consumption limits.
Copyright %55&, 6ippincott .illiams 7 .ilins 28 Days 8 %
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.hat treatment plan would you outline;
Response:
8)d!ise her to continue consultation
81ro!ide health teaching such as about the substance abuse,how to control,the effect.
8gi!e time to listen the problem of the pt.
8teach some techniques to relax her self
.ith what expected outcomes;
Response:
81t. will stop alcohol intae
8pt. will reduce problematic drining
8to ease symptoms of withdrawal and cra!ing.
8pt will now how to relax her self.
Copyright %55&, 6ippincott .illiams 7 .ilins 28 Days 8 /