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Name of Group Member and Movie you watched 

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Name of Group Member and Movie you watched 

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Client Demographics like Age, Race, Gender, Sexual Orientation, Religion, etc...

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Client Demographics like Age, Race, Gender, Sexual Orientation, Religion, etc...

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Worth 2 pts

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Presenting Problem: What issues are the client currently presenting?

Precipitating Factors: What triggers or events lead up to the clients drug use?

Predisposing Factors: Family history of addiction? Genetics, socialization? Other factors that made them susceptible to substance use?

Protective Factors: What personal strengths or resources does this client have or use?

Perpetuating Factors: What is keeping the client in the current state of use/non-use/recovery?

Worth 10 pts

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Integrated Summary based on your “patient” using the ASAM criteria. Please speak to each specific ASAM Dimension when assessing their Level of Care. 

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Integrated Summary based on your “patient” using the ASAM criteria. Please speak to each specific ASAM Dimension when assessing their Level of Care. 

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Fill out ASAM form for this portion of the assignment

Worth 4 pts

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Place your patient in a “level of care” based on your assessment summary. You are to also discuss when (if at all) your patient went through the Stages of Change. 

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Place your patient in a “level of care” based on your assessment summary. You are to also discuss when (if at all) your patient went through the Stages of Change. 

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This will be at the bottom of your ASAM form
Worth 4 pts

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A Star is Born

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28 Days

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Client Demographics like Age, Race, Gender, Sexual Orientation, Religion, etc...

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Client Demographics like Age, Race, Gender, Sexual Orientation, Religion, etc...

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Jackson Maine
Age: Mid to late 30's
Race: White
Gender: Male
Sexual Orientation: Straight
Religion:  Not mentioned

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Gwen Cummings
Age: Early to mid 30s
Race: White
Gender: Female
Sexual Orientation: Straight
Religion: Not specified
Occupation: Newspaper Columnist
Martial Status: not married

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A Beautiful Boy

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Presenting Problem: Client suffers from alcohol dependence and Vicodin abuse. Client is also currently dealing with legal issues due to her being under the influence when stealing a car and driving it into a house.
Precipitating Factors: Client is in a relationship with a man that encourages and enables her use since he is also using himself. Client also has a strained relationship with her older sister and appears to be comparing herself to her since her older sister appears to be seemingly successful. Client's self-esteeme appears to be affected by her sister's success because she does not understand how they both suffered through the same trauma but yet her sister does not suffer from a substance use disorder. Client turns to substances when feeling bad about herself to numb the pain. Client's childhood memories are also triggers for her use since her mother portrayed drinking as the best way to have fun.
Predisposing Factors: Client's mother suffered from alcoholism and the client and her sister were exposed to it from a very young age. Client and her sister suffered from trauma due to her mother's use since they were repeatedly put in dangerous situations and were neglected due to her mother repeatedly being passed out from her excessive drinking.
Protective Factors: Client was able to find healthy coping mechanisms through her creativity by putting on a play and making a chain out of the gum rappers she had. Client is able to connect with people easily and was able to build good relationships early on with the people in the treatment facility. In spite of their relationship starting off a bit strained, the client's sister is  a good support system for her and her sobriety after they were able to mend their relationship.
Perpetuating Factors:
Use: Client is in a relationship with an enabling boyfriend. Client also has a strained relationship with her family and is constantly reliving traumatic memories from her childhood.
Non-use: Client was court mandated to attend treatment which prohibiting any type of use
Recovery: Client learned coping strategies while in treatment that she applies outside of the facility. Client learned to accept the things she cant change and to change those that she has control over. Client was also able to amend  her relationship with her sister so she now has another support system. Client was also able to find clarity and determined that her boyfriend was not good for her and she was able to trust in her decisions and actions.

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Presenting Problem: What issues are the client currently presenting?
Alcohol abuse [Drinking throughout the day and unable to quit using on his own] , Drug use [Prescription drugs], Depression, and Suicidal tendencies [One known previous attempt and one successful attempt at the end of the film]

Precipitating Factors: What triggers or events lead up to the clients drug use?
Suicidal Ideation as a teen. He tries to hang himself from a ceiling fan, the fan falls so he is unsuccessful.  Family history of substance abuse is highlighted through his father and his fathers alcoholism.  Spotlight lifestyle contributed because he was famous and easier access to drugs comes with that.   Mother died in childbirth.

Predisposing Factors: Family history of addiction? Genetics, socialization? Other factors that made them susceptible to substance use?
Father presented substance abuse issues. Mother's history is unknown. Being a celebrity also put a emphasis on use. He had the tinnitus [ringing of the ears/hearing loss]  so he was prescribed medication.

Protective Factors: What personal strengths or resources does this client have or use?
He had Ally his girlfriend who supported him through his recovery journey and encouraged him to quit multiple times. Bobby his half brother provided support early on in his addiction. He tried to keep his brother out of a lot of trouble and made sure he would get in bed safe.  A local family that took him in when he was found sleeping on their lawn. The father of the family encouraged him to get clean and focus on his relationship with Ally.  He has money which could help get him into better resources. He attended an inpatient rehab program and completed it. He was sent home.  His love for music could be seen as a personal strength as well.

Perpetuating Factors: What is keeping the client in the current state of use/non-use/recovery?
The life of fame puts a lot of stress on him and allows for easier access to substances.  Not working through his past trauma with his father's substance abuse and the hostile environment he grew up in is what keeps him in the state of use.

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Everything Must Go (2010)

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Nic Sheff
Age: 18-22; college aged
Race: Caucasian
Gender: Male
Sexual Orientation: Straight

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Six Balloons

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Presenting problem: unhealthy coping mechanisms/ inability to be present to reality/ running from shame/guilt, meth/heroin/pill/cannabis addiction. lying to loved ones.

Precipitating factors: parent's divorce/ dad's new family, parental pressure/ not wanting to disappoint them, seeing pills in cabinet at girlfriend family's dinner, running into friends he used to use with.

Predisposing factors: potential past drug abuse issues with dad; past alcoholism issues? smoked joint with dad

Protective factors: writing, ability to go to treatment, ability to go to college, intelligence, secure family attachment/ support network, safe home environment to be at , AA/ sponsorship , held job for 14 months.

Perpetuating Factors:
state of use: dad's slight enabling, running into use friends, running from feelings of shame/guilt/lack of self worth, lying to parents, stealing, getting defensive and angry when addiction is brought up
recovery: protective factors, making parents proud of him, being around family, keeping a job, ability to write, continuing education.

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Name: Nick Halsey
Age: Late 30s
Race: Caucasian
Gender: Male
Sexual Orientation: Straight
Religion: Unknown
Marital Status: Married but separated
Employment: Unemployed

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6 Balloons

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Patient was in recovery and had lapsed, due to his ongoing usage he lost his job. When he came home from loosing his job, he found his wife had kicked him out and all of his stuff was on the front lawn.
Presenting Problem: Patient has history of Alcohol Abuse and has recently lapsed

Precipitating Factors: Patient is a past addict. Patient took a business trip to Denver, where he got blackout drunk with a female colleague whom then filed a complaint against him leading to his firing and his wife kicking him out.

Predisposing Factors: Patient discloses family history of alcoholism. Specifically, patients father suffered with alcoholism. Patient disclosed family life as a child was difficult due to fathers ongoing usage. Patients wife was also in recovery for alcohol usage. Patient was vice president of a regional sales company and stated he has "easy access" to alcohol. Patient would continuously go to work drunk which resulted in him loosing his job. Patient had no preference in his style of drinking, patient disclosed he could drink socially or alone.

Protective Factors: When patient got kicked out of his house, his wife dumped all his stuff on the lawn. As a result, patient had to sell all of his belongings on the yard. In doing so, he not only used his skills as a sales person to sell his belongings but he taught the local neighborhood kid his skills as well.-Once everything was sold patient gave all the earnings to the child so he wouldn't go and purchase more alcohol with it.
Patient found old yearbook containing a letter from an old classmate and he reached out. At this point patient was going through withdrawal due to lack of funds to purchase more alcohol and the classmate provided patient with a valium. Classmate also provided support to patient but ultimately stated she would be no help due to her personal issues.
Patient finds his new neighbor who is pregnant, awaiting her husband and finds companionship in her.

Perpetuating Factors: Patient was in a pre-contemplative state for a long time and was in denial for a long time. Patient believed he would be just fine on his front lawn with all of his things and his wife would eventually want him back. Patient has a sponsor but his sponsor was also helping his wife and ended up having an intimate relationship with his wife. Therefore, patient no longer had a sponsor.
Towards the end, although patient did not have a plan set up for treatment, patient was in the contemplation stage of change. Patient was beginning to accept his wife not coming back, and accepting the fact he no longer had a job, and began to sell his things and move forward with his life.

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Seth
Age: Early 20's
Race: White
Gender: Male
Sexual orientation: Straight
Religion: not specified
Occupation: employed - placement unknown
Marital Status: single but has a 2 year old child

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Presenting Problem: Seth initially in the movie presents with minor heroin withdrawal symptom which progressively get worse as the movie goes on. Symptoms of his withdrawal include shivers, drowsiness, fatigue, abdominal pain, and diarrhea. Initially refusing treatment because he did not want his family to find out or lose his job by taking time off to be in the inpatient program.
Presenting Factors: Having money and withdrawal symptoms were all triggers for him. Family relationships and being a single father could also be triggers for him.
Predisposing Factors: Father possible alcohol abuse. Mother is possibly bipolar and hyperactivity disorder.
Protective Factors: Seth does have a family structure despite possible addictions and disorders. He has the love and support from his sister as well as a relationship with his 2 year old daughter who he seems to love. He does also have a stable living environment as well as a job.
Perpetuating Factors: Seth although he has been through detox, he has never completed a treatment program. Also, until the end of this movie, the behavior from his parents was disappointment and judgmental. His sister was destructively involved in his addiction and although she thought she was helping him, she was enabling his behavior. She would pay for his detox and drive him there repeatedly.

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Integrated Summary based on your “patient” using the ASAM criteria. Please speak to each specific ASAM Dimension when assessing their Level of Care. 

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Integrated Summary based on your “patient” using the ASAM criteria. Please speak to each specific ASAM Dimension when assessing their Level of Care. 

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We put Jackson in highest level which is a 3.5. He needs a lot of support and the ASAM revealed that. We think he is a very high-risk for every category.

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o   Seth Lives in Los Angeles, Ca.

o   30s, Caucasian male, father, heterosexual, no religious preference

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3.7, Seth needs Hospital assistance to detox before going to a treatment facility.

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Presenting Problem: What issues are the client currently presenting?

o   Severe Heroin withdrawal; shakes, sweating, altered mood and paranoid.

o   Anxiety

Unable to fulfill parenting roles

Precipitating Factors: What triggers or events lead up to the clients drug use?

o   He was without heroin when his sister picked him up. The reason that was apparent was because he was jittery. If Seth goes to long without heroin in his system, he can go into withdrawal. Going into withdrawal is a major trigger because it is very painful. Which makes him want to use again.

o   The anxiety from not having heroin when going to his sister’s party could be a possible trigger.

o   Being a parent and the responsibilities that come along with it could be a trigger for Seth.

Predisposing Factors: Family history of addiction? Genetics, socialization? Other factors that made them susceptible to substance use?

o   There was no evidence of family addiction in the movie.

o   One factor that led to Seth’s abuse could be his sister enabling him. He was able to manipulate her to take him to get some heroin instead of driving him to the second detox facility.

Protective Factors: What personal strengths or resources does this client have or use?

o   One personal strength noticed was his skill of manipulation.

o   He uses his sister as a resource. She drives him around to get a fix or to enroll him in detox.

o   He used his dad as a resource to get a job. Having a job can supply him with money for his addiction.

Perpetuating Factors: What is keeping the client in the current state of use/non-use/recovery?

o   His sister taking him to detox instead of him going by himself. This is apparent because at the end of the movie, she refused to take him. She stated that he needed to go himself.

o   His sister keeps giving him money.

o   Seth has no plan for going to detox on his own.

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Seth is in the contemplation stage because he recognizes his problem and the consequences that result, but has no commitment to action.

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Place your patient in a “level of care” based on your assessment summary. You are to also discuss when (if at all) your patient went through the Stages of Change. 

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Place your patient in a “level of care” based on your assessment summary. You are to also discuss when (if at all) your patient went through the Stages of Change. 

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We say that Jackson went through all stages except maintenance. He didn't get to this because you are suppose to hold a year of sobriety, but he ended up relapsing and then committing suicide.
Pre-Contemplation: He considered change but was unwilling. He continued his use.
Contemplation: He saw the possibility of change and started to explore his options.
Preparation/Determination: He decided he was going to go into rehab.
Action: He attended and completed rehab.

For Level of care we placed him in an intensive residential treatment program. He needs a lot of support and this placement will allow for that. After leaving residential he should step-down to a different level of care but not just return home like he did in the film.

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Level of Care: For the level of care we placed her in level 3 residential care. We chose this level of care because she demonstrated alcohol dependences and opioid abuse. She was also participating in risky situation and her legal issues showed she is a danger to herself and others.
Stages of Change: Client did go through the stages of change throughout the film. In the beginning she was in pre-contemplation until her first relapse. After her relapse she was in the stage of contemplation when she was facing jail time because of her relapse and she was reflecting her action of jumping out of a window. After that happened, she was in the contemplation stage when she started to participate in the program and she was connecting with the other people in the program. The client completed her treatment and left off the movie in the maintenance stage as evident by her breaking off with her boyfriend who was a bad influence for her.