Psychology risk factors and behaviors

Case 1: Alan

Alan is a 25-year-old African American Army veteran who is introducing himself to you at the Veterans Hospital. He has been back home for 3 months after returning from his second 1-year tour of duty in Iraq, where he was in an infantry company in charge of maintaining security for local citizens. Alan was wounded in an explosion, and his lower right leg was amputated. He is awaiting final disability designation and benefits, and is getting increasingly frustrated. Alan is proud of his service, but finds it hard to show his feelings to others. He reports pain and PTSD symptoms, including nightmares, flashbacks, irritability, and anger. He is on prescription pain medication and antidepressants. Alan reports he is drinking more “as needed.” He is married and living with his wife of 3 years and their 2-year-old son. He reports his wife “doesn’t understand the pain I am in physically or psychologically.” Alan is not working and is worried about how he will provide for his family.

Questions

• 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 Alan’s treatment planning?

• Assuming Alan has a diagnosable substance-use disorder, what specific challenges may need to be addressed to maintain recovery and avoid relapse?

• What specific roles could or should healthcare providers, businesses, schools, and organizations play in Alan’s assessment, intervention, and treatment?

• What specific client advocacy, current public policy discussions, or ethical or legal issues may be related to this case study?

Solution: