Diagnostic Information Most Critical to Collect

After studying Module 3: Lecture Materials & Resources, discuss the following:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar disorder both emerged in his late teens.  He says that he started to drink to “feel better” when his episodes of depression made it hard for him to interact with his peers.  He also states that alcohol and cocaine are a natural part of his manic episodes.  He also notes that coming off the cocaine and binge drinking contribute to low mood, but he has not responded well to referrals to AA and past inpatient stays have led to only temporary abstinence.  Yet, Richard is now trying to forge a closer relationship with his adult children, and he says he is especially motivated to get a better handle on both his bipolar disorder and his substance use.  He has been more compliant with his mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual diagnoses addressed with psychotherapy.

• What diagnostic information would be most critical to collect in the first visit?

• • OLDCARTS
  • Mood disorder Timeline
  • Psychiatry history
  • Motivation for change
  • Obtain psychosocial functioning, housing, employment, support systems

• Which diagnostic measures are recommended by the US clinical guidelines for the treatment of this patient’s family problem?

• • Consider:
  • Integrated Dual Diagnosis Treatment (IDDT): Treatment should address both bipolar disorder and substance use simultaneously in a coordinated and comprehensive manner.
  • Medication-Assisted Treatment (MAT): While not applicable for cocaine, MAT options (e.g., disulfiram, naltrexone) could be considered if alcohol is a primary concern.
  • Harm Reduction and Recovery-Oriented Systems of Care (ROSC): Focus on meeting the patient “where they are” rather than requiring abstinence to initiate care.

• Which evidence based harm reduction strategies would you recommend to treat this patient?

• • Psychoeducation with patient and whole family
  • Medication Adherence
  • Therapeutic Alliance
  • Family engagement/ therapy
    • Example model: Behavioral Couples Therapy for Substance Use Disorders can integrate whole family

• Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient.  (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?

• • Augustine Recovery
    • https://www.augustinerecovery.com/?utm_campaign=gmb
  • Dr. Paul’s by the Sea
    • https://drpaulbythesea.com/
  • Recovery Keys
    • https://www.recoverykeys.org/contact-recovery-keys-addiction-treatment-and-recovery-program/st-augustine-florida-location/

 

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style.
• Provide support for your work from at least 2 academic sources less than 5 years old.
• SOURCES MUST BE SCHOLARLY ARTICLES WITH DOI/ PUBLIC DOMAIN ACCESS
• Your initial post is worth 8 points.
• You must use an alternative treatment plan to the one provided in the textbook.