Problem
Case Study
Devin is a 21-year-old female who has come to the 8-week in-patient treatment centre where you work. Devin began using alcohol at age 9, marijuana at 11, and cocaine at 17. Devin uses marijuana and alcohol daily, and cocaine approximately once per week.
According to Devin she does not have a strong support system. Her parents divorced when she was 8 and at that time, she began living full-time with her mother. Her father visited sporadically and infrequently for two years until their contact ceased completely when Devin was 10. Devin's father was addicted to alcohol, and she drank for the first time when she found a bottle of liquor hidden in her father's closet. Devin was first introduced to marijuana at school and used regularly with her friends, often skipping class to do so. Devin always did well on the schoolwork she attended to, however, as time went on, she spent less and less time on schoolwork and more time using alcohol and marijuana with friends. Devin remembers always being able to drink more than her friends and that people were always impressed with how she could "hold her liquor".
Devin's mother worked two jobs to support Devin and her two younger siblings. As a result, Devin's mother hired a babysitter who would mostly ignore the children and often have her boyfriend over to "party". One night, Devin woke up to her babysitter's boyfriend sexually assaulting her. When Devin reported this to her mother, her mother said that they needed to be grateful for this babysitter's low fee and asked Devin not to "mess up" this arrangement. Devin's mother regularly reminded her that as the oldest child, she would need to start financially supporting the family as early as possible. When she completed grade 10, Devin's mother took her out of school and got her a job at a nearby convenience store. Devin was expected to give all her earnings to her mother.
When Devin turned 17, she decided to leave her mother's home and move in with her boyfriend of four months. He was five years her senior and shared an apartment with a friend. Both he and his friend regularly used cocaine and introduced Devin to it. Devin was often pressured into sexual acts with her boyfriend that she was not comfortable with, however, chose to stay because she had nowhere else to go, and her boyfriend said she would "never do better" than him. One day, Devin's paternal aunt reached out to her on Facebook. They had not spoken in years, but Devin fondly remembered the time they spent together during her childhood. Devin was offered a room at her aunt's home, and late one night when her boyfriend was asleep, she snuck out and fled to her aunt's. Without her boyfriend supplying cocaine, Devin began shoplifting from her workplace (Walmart) to finance her habit. Devin was caught shoplifting and was court-ordered to treatment when the connection between her substance use and shoplifting was discovered. Devin's aunt has expressed that she will only take Devin back into her home if she stops using substances entirely. Devin's aunt is paying for her treatment stay.
Your role with Devin will include her intake and needs-assessment, listening to her concerns and providing support, evoking motivation to change, problem-solving, information giving, referrals to service providers (internally and externally), and coordinating her care.
You are the first point of contact for Devin when she arrives at the treatment centre. In this capacity, you will conduct her intake and needs assessment.
What additional information would you want to know about Devin (and why) before presenting her case to the interprofessional care team? Use the following headings to organize your thoughts:
• Biological
• Psychological
• Social / Environmental.