A client reports that he is feeling down and withdrawn lately. You notice that his movement and effect are slow and restricted. He is aware that he has become more isolated and doesn’t find much satisfaction in his work anymore. At one time he enjoyed his work and took pride in his skill as a cabinetmaker, but lately, he is having trouble completing the jobs he has and doesn’t have the energy to go after new jobs.
He tells you it is harder to get out of bed in the morning and he often doesn’t return calls from friends or customers. He says this has been going on for the last four months and he feels completely stuck.
He has become isolated from friends and ruminates over how he messed up past relationships. He says he drinks alcohol most nights – usually a few beers or wine with dinner. Occasionally, he has a few shots of brandy before going to bed. When you encourage him to be more specific about his alcohol intake, (e.g. how much wine and how many beers and when), he becomes irritated and dismisses your questions insisting that he doesn’t believe he has a problem with alcohol.
After reading the above Case Scenario, respond to the following:
What evidence indicates that the client has developed an alcohol use disorder?
Are there indications that the client is abusing any other drugs?
How could a medical condition, the abuse of alcohol and other drugs contribute to the emotional state and social isolation described by the client?
Prioritize the clinical interventions that are necessary to treat this subject.
