Case : James
James is a 28-year-old Native American who has been referred to you for a mandated substance abuse assessment from the courts. He was arrested for the manufacturing and sale of methamphetamine, and is awaiting sentencing in the county jail. James works as a laborer at the Native American-owned casino, but lives off the reservation. He is very uncooperative and suspicious. James says he drinks, but does not use meth and reports he was “set up by some rednecks who hate Indians.” His court records indicate 2 arrests for drinking and driving and 3 investigations, but no convictions for domestic violence. James lives with a woman and her two young children. He also has three children of his own, ages 5, 8, and 10, from 2 women he rarely sees, although he says he does care about them.
- What would be your initial diagnostic impression of this case?
- What risk factors and behaviors are present in this case?
- What individual and family interventions might need to be considered?
- What type(s) of treatment settings and strategies may be needed?
- What cultural, ethnic, or special population factors may play a role in James’ treatment planning?
- Assuming James has a substance-use disorder, what specific challenges may need to be addressed to maintain his recovery to avoid relapse?
- What specific roles could or should healthcare providers, businesses, schools, and organizations play in James’ assessment, intervention, and treatment?
- What specific client advocacy, current public policy discussions, or ethical or legal issues may be related to this case study?
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