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Book/movie review
22/08/2022
Question:
Case Study
Sarah, a 22 year old female, has come by the womens dropin centre where you work for information and advice. Sarah has been living with her partner, Nick, in and around Sydneys inner suburbs for the past five years. She and Nick have been using heroin for about as many years. When Sarah was 12 years old, her father, whom she says was a mean drunk, left suddenly and never came back. At 13 she started drinking and smoking cannabis. At 15 she dropped out of school and at 17 she moved in with Nick who introduced her to heroin. She says shes no longer in contact with her mother who cut her off a couple of years ago when she found out she was using. She says her mother was a smoker but never touched any drugs, not like my dad. Sarah says she has no other family.
On assessment, Sarah reports injecting around $300$400 of heroin each day which she says she needs just to function and not hang out. She says the amount varies depending on how good the junk is which she says has been pretty mixed lately. She says she injects around 23 times a day and last used yesterday when she finished work. Sarah says she started off smoking but changed to injecting not long after when she was about 19. Sarah says injecting gives her a better rush.
Recently, Sarah started sex working so she can pay for heroin. Sarah tells you that Nick is unemployed and that theyre at risk of eviction because they cant pay the rent. Sarah reports that she also smokes cigarettes and drinks alcohol daily. She adds that she has a joint now and then if theres one going. She says she probably drinks about a bottle of wine each night to get her through the night. She says if she cant score enough heroin, shell hunt around for some oxy or benzos to tie me over until I can get some H. She says Nick gave her some cocaine to try recently but she really didnt care for it that much. Sarah tells you that the alcohol and heroin help her to deal with how things are.
Sarah tells you her relationship with Nick has been up and down and that theyre not having sex that much. Sarah says that when they do have sex, Nick never wears a condom cause he says hes not one of my clients. Sarah says hes hit her before. She says she doesnt want to make him angry by asking him to wear one. Lately Sarah has been feeling dizzy and nauseous. She also hasnt had her period for about 67 weeks. She thinks she might be pregnant. She says she is not sure she can stop using heroin or work to have a baby although Ive always wanted kids. She says she is really confused about what she should do and wants advice so she can make a decision. Her friend who works with her at night told her not to stop using H if shes pregnant cause itd worse for the kid than to keep using. Her friend has been telling her Nick is bad for her and has offered her a place to stay. She says sometimes she thinks her friend is right and adds that shes been thinking about getting off the gear. Sarah is teary and says Im tired of it all. I just dont what should I do?
It is important to note that whilst there is no right or wrong answers the client presented has a number of issues that will need to be identified and addressed. In writing your report you will need to include evidence to support your treatment and intervention recommends.
Task
Whatdoes the literature say about the role of risk and protective factors in substance use? What risk and protective factors can you identify in this case study?
DescribeSarahssubstanceuseWhatsubstance(s)doesSarahseemtobemost dependenton?
Of the substances Sarah is using, which pose a greater risk of harm to withdraw from and why?
Whatother potential harms can you identify? What potential harms are there for Sarah? If Sarah is pregnant, what are the potential harms for the baby?
IsSarahsfriendcorrectinadvisinghernottostopusingheroinifsheispregnant?Why/why not?
AssessSarahsstageofchange
Whatcounselling approach would you apply to engage Sarah? Describe the approach, its evidence base and provide examples of the specific strategies and/or techniques you would use
Whattreatment options would you recommend to Sarah and why? Include a brief summary on the evidence base for the options recommended
Whatotherissuescanyouidentifyinthecasestudy?Whatreferralswouldyoumake?
Explainhow attitudes and stigma could impact Sarahs treatment and the handling of her Provide examples of how negative attitudes and stigma can be mitigated.
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The writer is very fast, professional and responded to the review request fast also. Thank you.
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