Alcohol Dependence:

• Alice exhibits chronic alcohol use, which she uses to cope with stress, emotional pain, and the challenges of being a wife and mother.

• She consumes alcohol daily, often in secret, and the quantity increases over time.

Short-Term:

• Alice’s prognosis is guarded.

• She acknowledges her problem and enters rehabilitation.

• Early in recovery, she may face relapses, as her emotional volatility and reliance on alcohol are deeply ingrained.

Long-Term:

• Alice’s prognosis could be positive if she maintains her sobriety through continued participation in rehabilitation programs, family support, and therapy.

• Relationships may also improve if she remains sober and works on rebuilding trust.

Name: Alice Green

Age: Mid-30s (estimated)

Acquired Disability: None reported

Developmental Disability: None reported

Religion/Spirituality: Not mentioned in the film

Ethnicity: Caucasian

Sexual Orientation: Heterosexual

Socioeconomic Status: Middle-class, employed as a school counselor

Indigenous Heritage: None reported

National Origin: American

Gender: Female

Marital Status: Married to Michael Green

Children: Two daughters, Jessica (Michael’s stepdaughter) and Casey

Residence: Lives in a middle-class neighborhood in San Francisco, California

For Client:

1. Emotional Support: By engaging in group therapy or individual counseling, the client can receive emotional support, which helps them cope with the underlying stressors that contribute to drinking.

2. Accountability and Structure: Self-help groups and counseling provide clients with a structured environment and accountability, which is crucial for maintaining sobriety and preventing relapse.

3. Peer Connection: Participating in support groups like Alcoholics Anonymous (AA) helps clients connect with others who have similar experiences, reducing feelings of isolation.

4. Coping Strategies: Therapy and counseling helps clients learn healthier ways to manage stress, anger, and other emotional triggers that previously led to alcohol use.

For Providers:

1. Holistic Insight: Providers gain a more complete picture of client’s life, enabling them to offer more personalized and effective interventions.

2. Ongoing Monitoring: Regular therapy sessions or support group check-ins allow providers to monitor client’s progress and adjust treatment plans as necessary.

3. Interdisciplinary Support: Collaboration with other professionals (medical doctors for her physical health, addiction counselors for her recovery) creates a more comprehensive approach to her treatment.

For Client:

1. Fear of Stigma: Clients may fear being judged or labeled as an “alcoholic,” which could discourage her from attending support groups or being fully open in therapy.

2. Reluctance to Open Up: Clients may be resistant to discussing personal issues, especially if they feels shame or guilt about their drinking habits and its effects on family.

3. Emotional Discomfort: Facing the realities of the addiction can be emotionally painful, leading to potential avoidance of therapeutic interventions.

For Providers:

1. Resistance from the Client: Client’s reluctance to fully engage in treatment can make it difficult for providers to offer effective support, particularly if they are in denial of addiction.

2. Limited Information Sharing: If clients holds back important information (e.g.,emotional state or drinking habits), providers may not be able to tailor the most appropriate interventions.

3. Complex Family Dynamics: Providers must navigate the complex family dynamics between family members which could complicate treatment efforts.

AA can provide Alice with a non-judgmental, supportive environment where she can connect with others facing similar struggles.

Onset of Alcohol Use:

• Began drinking as a casual and social, but over time, it escalated into a way of coping with the pressures of her personal life and the demands of being a mother and a wife.

  *The film does not specify the exact time when her alcohol use became problematic, but it appears to have worsened in the years leading up to the events in the film.*

Prior Attempts to Quit:

• Before her self-admission to rehab, Alice may have attempted to reduce her drinking or stop entirely, but these attempts were either unsuccessful or short-lived, leading to her eventual breakdown.

Family History:

• Her father was an alcoholic, which suggests both a genetic predisposition to alcohol use disorder and potential exposure to maladaptive coping mechanisms in her upbringing.

• Alice’s marriage to Michael plays a significant role in her drinking.

• The frequent absence of her husband adds to her feelings of isolation and stress.

• Alice’s drinking affects her relationship with both her husband and her daughters.

Social History:

• Strained relationships due to alcohol, including detachment from friends and avoidance of social events. Issues in her marriage with her husband and children.

Legal History:

• No significant legal issues are mentioned in relation to her alcohol use or personal life.

Academic History:

• No specific academic background is discussed in the film.

Employment History:

• Alice is a school counselor, but her drinking negatively affects her ability to fulfill her professional responsibilities.

Military History:

• No military background is mentioned.

Health History:

• No specific medical conditions mentioned, but frequent heavy drinking leads to injuries and potential long-term health concerns from alcohol abuse (e.g., hangovers, physical deterioration).

Substance Use History:

• Alice has a long history of alcohol dependence, which started socially but escalated into daily heavy drinking. She acknowledges her problem after a significant incident involving her children and enters rehab.

Prior Counseling History:

• No prior psychiatric treatment is mentioned until her self-admission to rehabilitation for alcohol addiction.

• Emotional instability and mood swings are observed.

Cognitive Behavioral Therapy (CBT): Through CBT, Alice would learn to recognize the thought patterns and emotional triggers that lead her to drink. Therapy would help her develop healthier coping mechanisms for stress and negative emotions through cognitive restructuring.(Beck, 2011)

Family Therapy: Given the significant impact of Alice’s addiction on her family. It could help Alice and her husband, work through the codependent dynamics in their relationship and create a healthier environment for their daughters.

Motivational Interviewing : This intervention would help Alice explore her ambivalence about quitting drinking. By identifying her own reasons for change, Alice can become more intrinsically motivated to stay sober. (Miller & Rollnick, 2002)

Support Groups : Alice would benefit from attending regular AA meetings, where she can connect with others who are going through similar struggles and help her maintain accountability and prevent relapse.

Medical Detox and Rehabilitation: Initially, Alice would need medical supervision for detoxification, especially after years of heavy drinking. Long-term rehabilitation with both medical and psychological support would provide a structured environment for her recovery.

Mindfulness and Stress Management: Introducing mindfulness techniques and stress management strategies can help Alice handle the daily pressures of family life without turning to alcohol.

Encourage Emotional Honesty: Help clients address underlying emotional issues that drive their addiction rather than just treating the surface symptoms.

Support Family Involvement: Involve family members in the treatment process to address the systemic issues that may perpetuate the addiction.

Focus on Relapse Prevention: Develop a strong relapse prevention plan that includes triggers, warning signs, and coping strategies for managing stress and emotions.

Promote Healthy Coping Mechanisms: Teach clients alternative ways to deal with stress and emotional discomfort, such as mindfulness, exercise, and healthy communication.

“Alice’s struggle highlights the complex emotional underpinnings of addiction. It reminds me that treating the addiction itself is not enough—we must address the deeper emotional pain and psychological factors behind it.”

“Watching Alice’s family dynamics shows how addiction can ripple through a family system, making me reflect on the importance of involving the family in the recovery process to create lasting change.”

“Addiction is just a way of trying to get at something else. Something bigger. Call it transcendence if you want, but it’s like a rat in a maze. We all want the same thing. We all have this hole. The thing you want offers relief, but it’s a trap.”- Tess Callahan

“Recovery is something that you have to work on every single day and it’s something that doesn’t get a day off.”- Demi Lovato

Gender and Societal Expectations:

• Alice’s role as a wife and mother may be influenced by societal expectations about women managing both household responsibilities and personal well-being.

• There may be stigma associated with being a woman struggling with alcohol dependence, which could make her more reluctant to seek help or admit the severity of her issue.

Family Dynamics and Traditional Roles:

• The pressure Alice experiences in her marriage, where her husband plays a caretaker role while she feels guilt and shame, could reflect traditional gender dynamics.

Stigma Surrounding Addiction:

• Alice faces not only the personal battle of addiction but also the social stigma attached to alcoholism.

• This stigma may be exacerbated by her role as a mother, with societal judgments placing additional pressure on her to “get it together” for her children.

Access to Treatment:

• As a middle-class woman living in San Francisco, Alice may have access to treatment options that others in different socio-economic groups might not.

  (Lee, 2014)

Since Alice struggles with emotional regulation and denial, SMART Recovery’s focus on self-management and practical coping skills could be beneficial.

Alice would learn to identify and change the negative thought patterns and behaviors that fuel her drinking.

This group could offer Alice tools for handling stress and emotional triggers more effectively, which is key to her long-term sobriety.

WFS’s focus on empowerment and emotional healing may resonate with Alice, given the significant emotional turmoil she experiences related to her role as a mother and wife.

The group’s philosophy emphasizes rebuilding self-esteem, could help Alice regain confidence and learn to value her worth outside of her struggles with alcohol.

WFS also focuses on the emotional aspects of recovery, which can help Alice deal with the guilt and shame she feels about her addiction and its impact on her family.

(Reid, 2023)

Her husband and other family members could benefit from attending Al-Anon meetings.

These sessions could help family members understand how to support Alice without enabling her, while also addressing the codependent dynamics that have developed in their relationship.

By educating the family about addiction, Al-Anon could help create a healthier, more supportive environment for Alice’s recovery.

Primary Diagnosis:

Substance Abuse and Mental Health Services Administration (SAMHSA): A resource for professionals and individuals seeking help with addiction. https://www.samhsa.gov

The Recovery Book by Al J. Mooney: An essential guide for individuals and families on addiction recovery, relapse prevention, and living a life in recovery. https://www.amazon.com/Recovery-Book-Answers-Questions-Addiction/dp/1523508475

The Addiction Technology Transfer Center (ATTC) Network: Provides addiction counselors with access to training, webinars, and publications on current trends and best practices in addiction treatment. https://attcnetwork.org

American Society of Addiction Medicine (ASAM): Offers evidence-based guidelines for treatment, including the ASAM Criteria, which addiction counselors can use for patient assessment and treatment planning. https://www.asam.org

National Institute on Drug Abuse (NIDA): Offers research-based information on addiction, including clinical trials, treatment strategies, and educational materials to enhance counselor knowledge. https://www.drugabuse.gov