Directions: Select one of the individuals described in the case studies from Chapter 6 of your textbook: Ann (page 61), Daniel (page 65), Sam (page 67), or Dean (page 72). Based on the information provided in the textbook, complete the following form.
Client Name: Ann
Assessment Date: 06/07/2022
Substance Use History
Drug | First Use: Yes or No | Pattern of use over time? | Frequency of use in past month? | Date/amount of most recent use? |
---|---|---|---|---|
Alcohol | Yes | Occasional weekend evening drinking escalated to daily evening drinks, which transitioned to day drinking on the weekends. | Daily | Daily alcohol consumption |
Sociocultural Factors
Diagnostic Criteria Checklist
Criteria | Yes | No | Criteria | Yes | No |
---|---|---|---|---|---|
Was the substance taken in larger amounts or over a longer period of time than intended? | Yes | Were important social, occupational, or recreational activities given up or reduced because of substance use? | Yes | ||
Is there a persistent desire or unsuccessful efforts to cut down or control substance use? | No | Has the substance been used recurrently in physically hazardous situations? | No | ||
Was a great deal of time spent in activities necessary to obtain or use the substance, or recover from the substance? | Yes | Has use continued despite knowing of having a persistent or recurrent physical or psychological problem that is caused or exacerbated by substance use? | No | ||
Have they continued to use the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the substance use? | Yes | Has recurrent use of the substance resulted in a failure to fulfill major role obligations at work, school, or home? | Yes | ||
Is tolerance present? | Yes | Is withdrawal present? | No | ||
Is there a craving or strong desire or urge to use the substance? | No |