Case Study: Work intensively with clients Essay Example

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Case Study: Work intensively with clients

Case Study: Work Intensively with Clients

Question one

The goals of intervention are integral component of Stella’s therapeutic program as they clarify expectations of the therapy and offer direction of her therapy. The main goals that needed to be achieved with Stella included making positive life changes, including finding suitable accommodation, long-term employment, and her children. However, the change in circumstances in the case significantly affects the initial goals. This is since they make it difficult to facilitate the effective application of the initial treatment approach or mutually agreed on plan for the direction of the treatment (Marsh et al., 2011).

The change in situation also hinders the support system from being conducive to abstinence. Further, it also triggers complex psychological issues that are likely to cause Stella to relapse unless the new psychological issues are addressed. More critically, the new situation is a critical risk factor for client relapse. This is since Stella initially experienced significant opiate addiction. After medication, her condition and life stabilised. However, Stella’s situation has changed following the return of her partner from a five-year term in prison. As a result, her physical, mental and emotional health has critically deteriorated.

The goals are therefore likely to change to begin focusing on relapse prevention strategies, to enable Stella to feel a sense of control over her decisions and actions and to accord her a sense of active participation in the change process. Therefore, the new goals would be to provide Stella with the variety of confidence and skills to deal with the relapse as well as reduce the fear of failure. Stella should also be helped to develop coping responses in order to get through the high-risk situations, caused by the return of her abusive partner. These could include skills she can use to cope with the stresses or anger in situations where her partner provokes her or causes extreme distress, such as relaxation training. This should be combined with helping the client to renew her commitment to the intervention. The relaxation strategies will also prevent Stella from having feelings of stress and anxiety that can become triggers for drug use. Stella should also be taken through cognitive structuring to remove the thoughts or beliefs that the presence of her partner automatically leads to stressful thoughts

Question two

Those to be involved determining appropriate action include Stella, her partner and the counsellor. In the spirit of motivational interviewing, the process will be collaborative, evocative, and autonomous (Kerrisk, 2010). This is since the overall aim would be to increase Stella’s intrinsic motivation to encourage change. Hence, Stella and her family, especially her partner, will be involved in the process. The counsellor will also be involved, even if he will not be an authority in determining what Stella should do or not do.

Question three

My first emotional response would be shock and panic. I would suppose that Stella’s partner intends to attack Stella, damage the office and inflict injuries on the staff and I. The situation may bring feelings of anger that is oriented towards Stella’s partner for his aggressiveness (Marsh et al., 2011). However, to deal with the situations, I would need to breathe deeply and stop panicking. I would also avoid confronting or arguing with him while allowing his need to talk. It would also be important to avoid taking his remarks, behaviours or comments personally. I would acknowledge that he is angry and show some empathy (SAMHSA, 1999).

Question four

As a duty of care, ensuring the safety of the counsellor, the client (Stella), the staff and Stella’s partner’s own safety would be paramount. Assessing his level of aggressiveness before allowing him to enter the room would also be essential. Ensuring safety exits once inside the room is also critical (Connolly & Roeg, 2004).

At the same time, identifying the substance that caused the aggression to anticipate his behaviour and to determine the level of risks would also help assess the risks in the situation. Monitoring his mental state is also essential, as it also helps anticipate his actions.

Question five

I would approach him slowly and calmly while at the same time exuding a sense of confidence. At this juncture, I would assure him and Stella that the situation is under control. I would reduce any likely environmental stimuli. To ensure this, I would move him to a quieter or calmer place. I would also let him to do the talking while avoiding any likely confrontation. At the same time, I would encourage Stella to remain confident and avoid any likely arguments (Connolly & Roeg, 2004).

I would speak gently and slowly while avoiding any sudden movements or behaving in a manner that may be interpreted as arrogant or threatening. I would also constantly reassure him that we would want to hear what he has to say, as well as listen to him attentively. While saying this, I will have to appear sincere and avoid any remarks that are likely to ridicule him (SAMHSA, 1998).

Question six

After this is all over, it would also be important to debrief other members of staff who might have been affected by the critical situation, so as to avoid excessive panic, anxiety of argumentative behaviour on the job. This would include assuring them that everything is under control. I would also find a rational response to their remarks, including reminding them that the client was merely experiencing the effects of anger and drugs and that they should not take his remarks personally (Marsh et al., 2011).

I would show I am available to the individuals who are affected by the critical incident. All workers should also be encouraged to show support for those affected. It would also be important to accept responses received from the individuals under stress, after the incidence. At this stage, I would have to show interest in the person affected rather than show interest in the situations. I would also be more supportive in more practical ways, such as providing a cup of coffee to the affected individuals. I will also listen to what they have to say, as well as share advice on what they should do and that has previously worked for me (Marsh et al., 2011).


Connolly, K. & Roeg, S. (2004). CHCAOD10A Work with clients who have Alcohol and Other Drug issues. Victoria: Education and Training Unit, Turning Point Alcohol & Drug Centre

Kerrisk, C. (2010). A Critical review of treatment approaches for alcohol and drug problems. Synthesis Therapy & Counselling Services. Retrieved: <>

Marsh, A. Dale, A. & Willis, L. (2011). A Counsellor’s Guide to Working with Alcohol and Drug Users. Drug and Alcohol Office

SAMHSA. (1998). Chapter 5 — Case Management for Clients With Special Needs. Rockville: Substance Abuse and Mental Health Services Administration (US)

SAMHSA (1999). Chapter 2—Brief Interventions in Substance Abuse Treatment. Rockville: Substance Abuse and Mental Health Services Administration (US)