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Discussion Topic 1 of 2

Clayton is a year 36 year old multi-racial male who was referred to counseling for the first time by his mother. She has become more concerned of his drinking and angry outbursts. Clayton is a veteran and when he returned home 6 years ago his drinking and marijuana use significantly increased. He has never been in counseling and he is only trying to appease his mother by going. Clayton has had odd jobs over the past few years, but nothing stable. He has primarily lived with his mother, but also has stayed with a female friend from time to time. He is one of three siblings and is estranged from his father. He is closer with his older brother who was also in the military. Before the war, he attended church regularly with his mother, but stopped going when he came back. He has never felt like he fit in.

What underlying factors might be contributing to his substance use? What approach would you take to gather more information about his substance use and other issues, considering multicultural counseling competencies? What sociocultural information/factors are relevant and integrated to inform assessment, diagnosis and treatment? What counseling approach or theory might be the best fit for Clayton? Provide a rationale from your Readings or outside sources for your suggestions.

Read Chapter 14 in Frances, R.J., Miller, S.I., & Mack, A.H. (Eds). (2011). Clinical Textbook of Addictive Disorders (3rd ed.). New York: Guilford Press.

Cultural competency for addiction counselors is absolutely essential and in Chapter 14 we will look at the treatment of addictive disorders in minority populations.

Read Chapter 3 “Culturally Responsive Evaluation and Treatment Planning” in SAMSHA (2014). TIP 59 Improving Cultural Competence. Retrieved from

Discussion Topic 2 of 2

Imagine you are a psychology professional with a clinical practice focused on clients with a dual diagnosis. You have an appointment with Jack and before the appointment you review Jack’s history:

Jack has reported cocaine use over the past five years and has been diagnosed with Bipolar Disorder. He is currently using lithium as prescribed. Jack reports that when he uses cocaine (even before he was diagnosed with bipolar disorder) he experiences mood swings and if he stops using cocaine even for a few days, his moods swings stop. He denies any history of delusions or hallucinations.

Do you believe Jack is correctly diagnosed with bipolar disorder or is he misdiagnosed? If you believe he is misdiagnosed, what is his diagnosis? Support your position with references from the textbook, DSM-5, and/or other peer-reviewed journal articles.

How would you use Motivational Interviewing to change Jack’s addictive behaviors?

Next, select the client you developed in Unit 1, Jennifer in Unit 2 or Jack in Unit 4. Develop a treatment plan for your client using evidence-based effective psychological interventions for dual diagnosis clients. Remember to include client goals, objectives to reach those goals and time frames to reach those goals in your treatment plan.

Risk Assessment and Harm Reduction

Please read the following in your text about clinical risk assessment, risk management, and approaches to harm reduction.

Chapter 4: “Risk Assessment and Dual Diagnosis”

Chapter 5: “Reducing Drug-Related Harm Among Mentally Ill People ”