Interventions for Drug Addiction: Case Study

Interventions for Drug Addiction: Case Study 18893 Many attempts have been made to arrive at a universally acceptable definition of addiction and what causes addictive behaviour but the matter still remains unresolved. People often define addiction as drug abuse and misuse. To Krivak (1982,p.83), ‘Addiction will be defined as a behaviour pattern characterised by an ongoing and overwhelming preoccupation with the used of a drug and the securing of its supply.’ This definition could also say the addict is, ‘Someone who is involved with an activity to such an extent that it the major focus of his or her life’, (McAllister et all., 1991,p.5). For my assignment, I have chosen a client within the criminal justice system that has an addiction problem with drug misuse. He has been involved with the criminal justice system because of his offending behaviour relating to illegal drugs. I am basing my assignment on this client. I am going to discuss in my assignment, drug users and the criminal justice system, the psychology of addictive behaviour, Care planning and different options of planning and assessment, the initial referral and the in-depth assessment, methods of intervention and models of care and drug problems in prisons within the criminal justice system. Where there is an addiction to drugs, most drug users at some time or another come into contact with the criminal justice system. This is how my client got involved with the system. Some drug users spend periods of time in prison as a result of drug-related offending behaviour. There is an alternative to custody and these include fines, community service, probation and bail, which is subject to certain conditions such as participation in drug treatment programmes. My client is subject to certain conditions that he participates in a drug treatment programme. Criminal justice orders can be subject to conditions of residence for the offender. For drug service workers, close liaison with practitioners in the criminal justice field of work is normal practice. Joint care plans are carefully and sensitively devised to help both services work with the drug user in collaborative and constructive ways. Criminal justice practitioners are expected to work with offenders to achieve specific objectives and these are not always compatible with drug service objectives, for example, reducing drug-related offending behaviour rather than getting rid of it altogether (Robertson, 1998, p.389). My client has an addiction to drugs. The psychology of the addict involves behaviour that takes a repetitive form and is associated with increases of anxiety. Some behaviours that take a repetitive form are associated with increases or decreases in anxiety and these are considered compulsive behaviours. These types of behaviours can include drug addiction, gambling and exhibitionism. However there are important distinctions between these types of behaviour and action and true compulsive behaviour. Firstly addictive behaviours involve a pleasure-seeking component, which is not in compulsive behaviours. Secondly, the anxiety involved with the performance of criminal activity is appropriate in light of social sanctions. Obsessive-compulsive patients experience anxiety that is inappropriate to the situation (Oltman, 1995,p11). There are different options of planning and assessing with substance misuse offenders in the criminal justice system. For social workers, assessment is a key task and it will determine whether or not a care plan is needed for the offender of if a management service is needed. The NHS and Community Care Act (1990) provides guidance on procedures for assessment for people who are entitled to community care services. The assessment process includes, the initial referral, the initial assessment and the in-depth assessment. The assessment process should be needs led and not service-led. Community care services are greatly in demand and the screening process is used to determine who needs the treatment the most. Drug agencies undertaking assessment may receive referrals from the criminal justice system or other agencies. Basic referral forms are filled in with the details of the service user, such as factors and the reason for referral. My client has been referred from the criminal justice system to a drug agency for assessment. The initial interview with the service user will determine whether or not they need a more in-depth assessment or a formal care plan. Most local authorities have certain criteria and priority levels to which they can base their response on. The service user is told what is involved in the assessment, is told about confidentiality policies and whether or not there will be any participation of others. The service users are told what to do if they want to use complaint procedures or appeal if they are against any decisions made at or after the assessment. The initial assessment will determine the seriousness of the problem and the level of need required. My client has more complex needs with his addiction problems so he would require a more in-depth formal assessment so that a care plan can be made for him. This assessment will include personal details, family and relationships, social details, significant life events, social supports and networks, comprehensive history of addictions and associated problems. The assessment will also include, treatment history, risk behaviour, criminal history and current offending behaviour, financial status, physical health, mental health problems, past and present, self concepts, perceived needs and the level of motivation to address these needs, personal resources and abilities, resources and abilities of partners and carers, other agency assessments and specialist assessments and the conclusions and suggested interventions of the assessment. Robertson (1998,p.376) suggests that care planning should involved developing a package of care, which will meet the client’s needs. Care plans are systematic approaches and include all the care and treatment that will be provided and the desired outcome. Care plans are monitored measured and reviewed and will involve the client, service provider, an assessor and a care manager. The care plan will involve information gathered at the assessment in an easy to monitor format and will illustrate the behaviours that need to be addressed and it will have separate sections for identifying the needs of the problem. Partnerships between the criminal justice system and the treatment agencies direct substance-misusing offenders to the appropriate services. There are many initiatives aimed at encouraging substance misusers to take part in appropriate treatment that will help them. In the UK there are twelve step agencies that are also know as the ‘Minnesota method of treatment’. These agencies are funded through statutory sources. The aim of these agencies is to treat the dependence on drugs to help reduce drug misuse and to help the client give up drugs completely when they feel ready to do so. Three intermediate aims are to help resolve the underlying problems that contribute to drug misuse, to help the client gain more control and minimize harm also known as harm minimization (Keene, 1997,p.223). The Government produced a drug strategy in 1998 in the UK called, ‘Tackling drugs to build a better Britain.’ This was updated again in 2002. The strategy sets out the range of interventions and policies to help reduce harm caused by using illegal drugs by the year 2008. The drug intervention programme used to be known as the criminal justice interventions programme. The government aims to cut crime related to drug use. This strategy uses the criminal justice system to help direct offenders who used drugs out of crime and into treatment. There are different kinds of interventions used by drug service workers. Psychological interventions are very useful when it comes to help treat someone with a drug addiction. Professional psychotherapy is very effective and good quality drug counselling can also be very effective. Psychological interventions are, cognitive behaviour therapy, motivational interviewing, and the twelve-step treatment program that I discussed earlier and relapse prevention. Some people think that complementary and alternative therapies are useful, but there is not enough evidence in the population to back up this claim. The model of care, introduced by the National Treatment agency (NTA), is a framework that is used by Drug Services to ensure that the services provided are consistent and meet the needs of the service user. The framework is categorised by easy to understand tier levels and treatment levels. Tier one, includes primary care by health care professionals and general practitioners that provide medical services along with probation and housing services. Tier two (Open Access Services) offers a range of drop in street agencies that offer advice and support for stimulant users and substance misusers are able to drop in when there is a crisis. Tier three (Community prescribing services) is mostly geared towards opium user. Tier three, (Structured day programmes) are geared into providing education about drug misuse, and provide training for work skills and give advice about practical issues. Tier four, (Residential Care) has different systems in place for entry in different areas for entry in to residential care. The social services community care assessment team usually deal with the funding. Another option for the substance misuse offender is motivation to change. Motivational interviewing is based on using the motivational change model. The model consists of five stages with stage one being the pre-contemplation stage, stage two the contemplation stage, three the action stage, four the maintenance of change and five the relapse stage. Prochaska and DiClemente are two best-known authors on the importance of individual motivation in dependency treatment. The authors developed the motivational change module from their work with smokers. They use a Cognitive behavioural approach method and their interventions are concerned with cognitive and behavioural change (Prochaska and DiClemente, 1983,p.390). The control of drug misuse is a big problem in prisons. People are much more likely to use drugs in prison because of stress, anxiety and boredom. These levels are higher for substance misusers in prison so they would be more likely to take health risks. Drug treatment in prison could be approached the same way, as it is in the community with regimes to reduce drug related harm, rather than prevention. Because of the extent of my client’s addictive behaviour he has had a formal in-depth assessment done so that we can meet his needs. This has resulted in a care plan being made up for so that we can provide services for him and carefully monitor his progress. We have liased with other professional health services and we have had a full mental health assessment done for him. We have considered his past history of using drugs and the amount of offending he has done in the past and the length of time he has been involved in the criminal justice system. We have noticed that he has also had mental health problems in the past and that he suffers from depression. The client did not go into custody this time because of his substance offending behaviour instead he was given a probation order subject to certain conditions that he participate in a drug treatment service. We contacted drug service workers who were happy to help my client as long as he was willing to accept help. My client says that he does want to change his behaviour and put an end to his substance misuse. He has tried in the past to give up but this has always lead to a relapse. After careful consideration and after weighing up all the options of treatment for my client I decided that psychological intervention along with drug therapy was the best way forward to help reduce his drug dependency. I have decided that professional psychotherapy and relapse intervention would be the best option for him because other options have not helped him in the past. We are also going to offer him good quality counselling. My client has told me that spending time in custody has not done him any good. He told me that he gets very depressed when he is inside and this leads to more dependency on drugs. Our goal is to help him stay out of custody and reduce his dependency on drugs. We will continue to monitor, measure and review the clients care plan and see whether or not his dependency and addiction are getting bet ter. As substance service workers our goal is to meets the needs of the service user and in this instance it is to reduce substance addiction and the long term goal is to eradicate substance misuse altogether. In order to intervene effectively where there is addictive behaviour, social workers need to be able to assess and plan appropriate treatment. For my assignment I have chosen a client within the criminal justice system that has an addictive behaviour. He is a drug misuse offender and he has been involved with the criminal justice system for a few years now. I have discussed a bit about the psychology of addictive behaviour and how my client was referred to me through the criminal justice system. I have discussed the methods of assessment and the different options available. I have discussed the most suitable option for my client who I feel has deeper problems to address than some other substance misusers I have encountered. In this instance I felt that my client would benefit from a psychological form of intervention that would include psychotherapy. There are different types of psychotherapy; these are behaviour therapy that helps the client put an end to undesirable habits or certa in fears that they have. Cognitive therapy is a method that tries to show the client that certain thoughts that they are having are not good for them and that they are negative. The therapist will then try to get the client into thinking more positive thoughts in order that the persistence of negative thoughts will eventually fade away. Drug therapy is also called by the name of pharmacotherapy and it is a part of psychotherapy. The approach here with this method of intervention is to calm the person down using certain anti-anxiety drugs so that they permit the other therapies to have effect. The negative side is that sometimes these drugs encourage psychological dependence and the anxiety that was there before might return again. Some addictions such as obsessive – compulsive disorder have been successfully treated using certain antidepressant drugs. The types of interventions I have discussed do not always work for everyone. Social workers need to analyse the situation very carefully and sensitively when working with addictive behaviours. This is because it is a very sensitive area and if treatment goes wrong the client could go back to their old habits of substance misuse and become a part of the drug culture again. The aim is to reduce offending and minimise the number of substance misusers by putting carefully controlled care plans into place to address their needs. The intervention method that was used on my client was very successful and I am happy to say that my client has cured his addictive behaviour. It is important that assessments are done very carefully and to take into consideration all the important facts of the client. It is also important for social workers and other drug service workers to gain the trust of the client because without this there is less change of the client willing to accept treatment. References Barber, J. (2002) Social Work with addictions, 2nd ed. Basingstoke: Palgrave Macmillan. Keene, J. (1997) Drug Misuse; Prevention, Harm, minimisation and treatment. London: Chapman Hall. Krivanek, J. A. (1982) Drug Problems, People Problems: Causes, Treatment and Prevention, Sydney, Allen Unwin. McAllister, I., Moore, R. and Makkai, T. (1991) Drug users in Australian Society: Patterns, Attitudes and Policies, Melbourne, Longman Cheshire. Oltman, T. F. (1999) Case Studies in Abnormal psychology, New York: Chichester. John Wiley Sons. Prochaska, J. O. and Diclemente, C. C. (1983) Stages and Processes of self-change of smoking: Towards a more integrative model of change. Journal of consulting and Clinical Psychology. Robertson, R. (1998) Management of Drug users in the community, a practical handbook. Arnold publishers.

The Evil Character Medea in Euripides Medea Essay -- Euripides Medea

The Evil Character Medea in Euripides' Medea Euripides created a two-headed character in this classical tragedy. Medea begins her marriage as the ideal loving wife who sacrificed much for her husband's safety. At the peak of the reading, she becomes a murderous villain that demands respect and even some sympathy. By the end, the husband and wife are left devoid of love and purpose as the tragedy closes. In Medea, a woman betrays her homeland because of her love for a man. Jason is the husband that she ferociously loves and makes sacrifices for. They have two children together: Antigone and Ismeme. In Jason's quest for the golden fleece, Medea assists him in multiple ways. One of the things she does to help their cause is bring about the death of her own brother. Certainly this is a woman who would sacrifice anything for her husband. Weigel records the fierceness of Medea's passion in his critique: "As a woman of passion, Medea is wholly committed to Jason as the object of her emotional life, whether in love or hate. When she loved Jason she did not hesitate to kill her brothe... The Evil Character Medea in Euripides' Medea Essay -- Euripides Medea The Evil Character Medea in Euripides' Medea Euripides created a two-headed character in this classical tragedy. Medea begins her marriage as the ideal loving wife who sacrificed much for her husband's safety. At the peak of the reading, she becomes a murderous villain that demands respect and even some sympathy. By the end, the husband and wife are left devoid of love and purpose as the tragedy closes. In Medea, a woman betrays her homeland because of her love for a man. Jason is the husband that she ferociously loves and makes sacrifices for. They have two children together: Antigone and Ismeme. In Jason's quest for the golden fleece, Medea assists him in multiple ways. One of the things she does to help their cause is bring about the death of her own brother. Certainly this is a woman who would sacrifice anything for her husband. Weigel records the fierceness of Medea's passion in his critique: "As a woman of passion, Medea is wholly committed to Jason as the object of her emotional life, whether in love or hate. When she loved Jason she did not hesitate to kill her brothe...

From a close study of the opening of the novel Essay

â€Å"From a close study of the opening of the novel; and with reference to other stages throughout, discuss the relationship of George and Lennie, commenting on how it relates to the theme of loneliness† By Matthew Keane In the novel, the two main characters, George and Lennie, have a parent-child relationship, as George leads the way for Lennie; he also gives him advice and teaches him. Lennie follows all advice that George gives him. The idea of a teacher-student relationship is evident because George shows all signs of intelligence; he gives all the advice, and has all the ideas. Lennie on the other hand, is mentally challenged, and needs all the advice that George can give him. Lennie’s mental capability is reflected in his descriptive appearance, he is often compared to animals, his actions and reactions are childlike, and he also has a bad memory. However, Lennie’s bad memory can lead to friction, as George can lost his temper with him because he often has to remind Lennie several times before he can remember. Overall, they’re more like father and son than equal adults. From the first time they are introduced, we immediately get the impression of one being a follower and another being a leader, we can tell this by the line, â€Å"They had walked in single file down the path, and even in the open one stayed behind the other† The word â€Å"even† in this sentence signifies that no matter what, George will always lead Lennie, even though there was plenty of space for Lennie to walk next to him, he still stayed behind George. The reader is given an immediate insight to Lennie’s character when Steinbeck uses animal imagery; most of his actions are compared to animals, â€Å"Lennie dabbled his big paw† These animal comparisons tells the reader that Lennie shares the innocent qualities, as most of his actions are made on impulse, and he doesn’t think about what he’s doing. Lennie also has a childlike innocence, because he has the mind of a child and again doesn’t think about his actions. However, Lennie’s animal-like behaviour shows that he can have an unpredictable nature, as his acting on impulse can have unexpected results. The childlike qualities that Lennie displays can sometimes lead to friction between him and George. This happens when Lennie’s memory loss causes George to lost his temper frequently, â€Å"So you forgot that already did you? I gotta tell you again do I? Jesus Christ, you’re a crazy bastard† This happens frequently in the novel, this quote is taken just after the bus driver drops them off at the wrong place, George has a reason to chastise Lennie about his poor memory, these outbursts also show that he is in control of Lennie. Steinbeck reinforces the point about who is in control of the relationship by the description if when Lennie keeps a dead mouse in his pocket, and George forces Lennie to give him the mouse. â€Å"Lennie’s closed hand slowly obeyed. George took the mouse and threw it across the pool to the other side, amongst the brush† The tone used by George â€Å"Give it here!† clearly shows that he is in control. When Lennie retrieves the mouse from the bushes, George shows he is in control by snapping his fingers, and then Lennie immediately returns the mouse. There is another purpose in this episode, which is to show us Lennie’s irresistible urge to pet things; as later on in the novel it has an important role, as the urge lands him in trouble when he accidentally kills Curley’s wife by breaking her neck. So this part in the novel his significance to tell us about Lennie’s urge to pet soft things. The stroking of soft things symbolises that Lennie wants a soft and easy life, and doesn’t want the hard life that he has now. Lennie wishes for something soft that represents the desire for something finer, to be held onto in literal reality leads to tragic consequences of Curley’s wife’s death, made more poignant, almost dramatic irony takes place at the moment the news arrives that confirms that the ranch is there’s. Clearly without George around, Lennie has no control. This control that George has over Lennie also means that Lennie is totally dependant on George. As a result, George often seems angry or upset at Lennie. In the opening, George seems easily angered because of the bus driver, we can tell this by the tone that he speaks to Lennie in, â€Å"You’re a crazy bastard† This brings the negative side of the relationship to the surface, â€Å"If I was alone, I could live so easy† This proves that George can see Lennie as a hindrance to his life, that without Lennie, George wouldn’t have to always look after him. George also bring up the subject of what happened in Weed, just to make Lennie feel bad, â€Å"Jus wanted to feel that girls dress†¦well, how the hell did she know you just wanted to feel her dress?† Also he makes Lennie feel bad by saying that it’s Lennie’s fault that they both lose their jobs, â€Å"I got you! You can’t keep a job and you lose me ever’ job I get† This long passage acts as a warning to what happens later in the barn with Curley’s wife, we also learn of what happened in Weed, â€Å"How the hell did she know you jus’ wanted to feel her dress? She jerks back and you hold on like it was a mouse. She yells and we got to hide in an irrigation ditch all days with guys looking for us† This shows us Lennie’s urge to touch soft things, such as a dress, or Curley’s wife hair. The incident with Curley’s wife has an uncanny resemblance to what happened in Weed, as while stroking Curley’s wife’s hair, she gets scared and tries to scream, Lennie tries to stop her screaming and holds on to her, but he unfortunately breaks her neck. Although George is quick to anger, he doesn’t want to hurt Lennie, when George realises he has hurt Lennie’s feelings, he immediately feels bad, â€Å"His anger left him suddenly, He looked across the fire at Lennie’s anguished face, and then he looked ashamedly at the flames† The true nature of their relationship is revealed as father and son when George apologises to Lennie and then explains to him, â€Å"No look! I was jus’ foolin’, Lennie. Course I want you to stay with me. Trouble with mice is you always kill em† He then tries to reason, â€Å"First chance I get, I’ll give you a pup. Maybe you wouldn’t kill it. That’d be better than mice.† This passage ends with George re-counting they’re shared dream, â€Å"We’ll have a big vegetable patch and a rabbit hutch and chickens† This last phase of the opening chapter clearly shows how George also gets much from this relationship. The unreserved love that Lennie extends to George sets them both apart from the other drifters and farm hands who generally have nothing. â€Å"Guys like us, that work on ranches, are the loneliest guys in the world. They got no family. They don’t belong no place.† Even though, while angry, George tells Lennie that he could behave like the other men, â€Å"If I was alone I could live so easy†¦.when the end of the month came I could take my fifty bucks and go into town and get whatever I want† His true feelings are revealed later while George is telling slim why he and Lennie are so close, he tells Slim of how one time he abused Lennie’s trust, while swimming in the Sacramento river, he tells Lennie to dive in the water, even though he cannot swim. George then dives into the river to save Lennie, and since then George realises how much Lennie depends on George. This closeness is confirmed by George’s reaction when Curley’s wife’s body is found, â€Å"Maybe they’ll lock ‘im up an’ be nice to him† George also tries to defend Lennie as he knows that Lennie didn’t mean to kill Curley’s wife, â€Å"‘Lennie never done it in meanness’ he said ‘All the time he done bad things but he never done one of ’em mean'† The relationship established in the opening is then illustrated throughout the novel. The first time that George and Lennie meet Curley, George protects Lennie from Curley. â€Å"‘What the hell are you getting into it for?’ ‘We travel together’ ‘Oh so it’s that way?’ ‘Yeah it’s that way'† Also, when Curley’s wife first appears, George is again careful to make sure Lennie doesn’t make a mistake similar to the incident in Weed, â€Å"‘Listen to me you crazy bastard,’ he said firmly, ‘Don’t you even take a look at that bitch. I don’t care what she says or what she does'† The idea of a father-son relationship is continued during the passage where Curley is attacking Lennie, but Lennie will not fight back until George orders him to, â€Å"George†¦make um let me alone, George.† This shows us that Lennie waits for George to give him permission before he’ll do anything. When Candy finds Curley’s wife’s body, George makes it clear that he will not let anyone hurt Lennie â€Å"Maybe they’ll lock ‘im up an’ be nice to ‘im† This shows the strength of their relationship, as George knows that Lennie has done something bad, and should be punished, but he still doesn’t want anyone to harm him. Unfortunately, George was unable to save Lennie from himself, and so when Lennie accidentally kills Curley’s wife, George has no other option, but to shoot Lennie, he has to take this option because if Lennie was put into prison, he would be alone, with no-one to look after him properly, and condemned to a life if terror and madness. Curley, on the other hand, wants Lennie to die in pain and suffering. â€Å"Shoot for his guts. That’ll double ‘im over† Slim, being the voice of authority in the novel, gives the final confirmation on the killing of Lennie, â€Å"I guess we gotta get ‘im† In my opinion, the novel was very good, the shock ending was very surprising and unexpected, but a closer look throughout the novel foreshows us what happens, such signs as what happened in Weed, the mice that Lennie kills, the need to pet soft things, all of this gives the reader clues to what happens at the end. In my opinion, the relationship between George and Lennie is less than a relationship between two equal adults, and more like father-son, as one of the pair continually leads the other, while the other always follows

Developmental Aspects of Play - 1242 Words

Introduction to World Music Professor Glenn McMillan 1003 M Room gmac@mec.cuny.edu Office Hours Appointments Only 718 270 4929 Music 100 Please leave email Introduction to World Music Syllabus-Spring 2013 This course is an introduction to music and to the musical mechanics from a global perspective. There will be three aims: †¢ to increase the students understanding of music, including its elements, structures, and terminology through live performances, students and guest artists; †¢ to increase the students awareness, cultural connections to explore and their understanding of global relationships; how these cultures utilize musical elements,†¦show more content†¦No exceptions. †¢ Cell phones and pagers are a nuisance and do not contribute to the learning process. It is requested that you turn them off at the beginning of class. Once identified, should your use of cell phones and pagers continue to disrupt the lecture, your grade will be affected. Text Please note that the text book for this course is a collection of internet resources for students which are assigned through the weekly lectures and class discussions along with the required text World Music: Global Journey. Weekly Schedule Week One (January 27-31) Course Syllabi Review, Getting to Know You and Class Requirements-Jazz Video Presentation. Reading Assignment/Journal A-Literature of Jazz by Gary Carner Week Two (February 4-7) Jazz Video Presentation and General Overview and Review Review/Literature of Jazz (Course prep for summary and journal questions) Week Three (February 11-14) Please note that the Lincoln’s Holiday is Tuesday, February 12 so the Tuesday class will meet on Thursday, February 14. Lecture on the review of the Jazz journal, video and specific terminology terminology. Journal A/ Summary Review and Questions are Due this week for class. Grade 1 2 Reading Assignment/Journal B-The Double Meaning of the Spirituals Week Four (February 18-21) Please note that the President’s Holiday is Monday, February 18 so the Monday class will meet on Wednesday,Show MoreRelatedEssay on The Role of Methodology in Developmental Research1467 Words   |  6 PagesMethodology in Developmental Research Developmental psychology may be defined as a branch psychology devoted to understanding all changes that human beings, experience throughout the lifespan (Berk. E. L 2003). Developmental psychology focuses hugely on development in childhood, as major changes occur in childhood, it is the scientific study of ‘how we grow and develop’, (Davenport 1994). Developmental psychology aims to understand the important aspects of cognition,Read MorePlay Assessments And Developmental Skills710 Words   |  3 Pagesreviewed titled â€Å"Play Assessments and Developmental Skills in Young Children With Autism Spectrum Disorders† written by J. Pierucci, A. 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