John is a 28 white male who lost his driver’s license 6 months ago…

Question Answered step-by-step John is a 28 white male who lost his driver’s license 6 months ago… John is a 28 white male who lost his driver’s license 6 months ago after his third DUI offense.  He is required to finish a substance use treatment program in order to have the license reinstated.  He kept drinking on the first two occasions he was placed in the program and refused to attend the  required weekly AA meetings. This is the last opportunity the agency will give him to comply with  the program requirements before they close his case. Larry came to the interview at the treatment  facility well dressed and spoke articulately. He was somewhat fidgety, constantly wringing his hands and shifting in his seat. He also had some difficulty keeping his train of thought as he spoke about hisseat. He also had some difficulty keeping his train of thought as he spoke about his  situation, stating that he felt “distracted.”  Larry started using marijuana when he was 14 and drinking when he was 16. He was arrested  for several drug- and alcohol-related offenses in his youth and spent time in a juvenile justice facility  as a result. He was diagnosed with ADHD when he was in elementary school and struggled with all  academic subjects, especially math. He was on Ritalin for several years but is no longer taking it. He  dropped out of school during his senior year because he was making so much money dealing drugs  that he did not see the need to continue struggling in school. He later has his GED while serving a jail sentence for dealing.  Larry is now working as a realtor, but his business is suffering because he cannot drive. Although  he seems motivated to finish the program so that he can get his license back, he believes he has  learned to “control” his drinking and sees no problem with his regular marijuana use. When asked what he means by controlling his drinking, he said that the three DUIs got his attention and he does  not want to get into further legal trouble. He now drinks only “a couple of beers” on weekdays; on  weekends, he consumes a six-pack each night. He no longer drinks at bars because he cannot drive  and cannot afford to buy drinks. He says he is not seeing much of his friends lately because of his  transportation problems. Another reason he views his alcohol use as not being a problem is that his  friends tend to drink more than he does. In contrast, he sees himself as only a social drinker.  In sum, Larry does not think he should be in a substance use treatment program. He also thinks  he should be given credit for the few weeks he attended the program in the past, so that his current  requirements could be shortened. Larry is disgusted that he is required to attend AA, stating that he  is “not like those people” and asking, “How am I supposed to attend all these meetings and groups  if I can’t drive?”  Larry is the older of two boys. His parents divorced when he was 11, leaving his family to struggle  financially. He is close to his mother. Larry considers his mother his strongest support and often turns  to her for help. He says she is sympathetic to his driving prohibition, and she sometimes takes him  places he needs to go. She supports his need to seek treatment so that he can get his license back,  but according to Larry, “she doesn’t think I have a problem either.” Larry has not kept in touch with his  father, and his relationship with his brother is somewhat strained. Larry claims that his brother is the  source of much of his stress and that he has a lot of resentment toward him. It seems that Larry and  his brother started a business together that is not working out, and Larry feels his brother is to blame.  Members of Larry’s paternal family (an uncle and grandfather) have a history of alcohol use disorders.  Larry is currently living with his girlfriend of 18 months and their 3-month-old daughter in an  apartment. His relationship with his girlfriend has been a major source of stress for the last 6 months.  They were engaged to be married but have broken the engagement, because Larry wants to “move  on.” Though they still live together, they are not getting along, and Larry is having a hard time dealing  with the tension. He says they argue about his inadequate earnings, his drinking and marijuana use,  and his children from a previous marriage. Larry admits he gets so frustrated with the situation that  he has been violent with his girlfriend, usually when drinking. She has called the police, and Larry  has been arrested twice for family violence. When questioned about these episodes, Larry says, “I’ve  never hit her.” He does, however, admit to once pinning her against the wall and “getting in her face.”  He also shoved her out of the way when she blocked his way out of a room, which on at least one  occasion resulted in her being knocked to the floor.  Larry has three children from a previous marriage whom he cares for every other weekend. His  relationship with his ex-wife is acrimonious, according to his description. His oldest child, who is 6, was  diagnosed with leukemia 3 years ago. During that time, Larry was taking antidepressants to help him  deal with “that gut-wrenching situation.” The child’s cancer is now in remission, and Larry is no longer  taking the medication. When asked, he said that he did not notice if his distractibility and fidgeting  were any better on antidepressants as “I had other things on my mind.” He says that he does not feel  depressed currently but is “stressed out.”  Larry says he smokes marijuana to help him relax, and that it is the only thing that helps him in  this way. He has used it at least twice a week for several years in the evening. He finds using marijuana  preferable to being on medication. He does not report tolerance, saying that he has always smoked  one joint “to get high” and this amount has not changed in years.  Larry considers himself in excellent health and reports that “everything checked out fine” at a  physical examination about a year ago. He suffers from asthma, but keeps it under control by using  an inhaler before he exercises. He is not currently taking any other medications. He tries to work out  every day and notices that he is having an easier time working out since he quit smoking last month.  Larry states that he has problems sleeping. It is not hard for him to fall asleep, but he wakes  frequently and has trouble getting back to sleep. He feels that he does not get enough “deep sleep”  to feel refreshed in the morning. Larry also complains that he feels anxious all the time and cannot  remember when he has not felt that way. He worries about his children, his relationship with his  girlfriend, his job, and his need to be done with this program. He feels this anxiety in his stomach and Given his visible symptoms of distractibility and hyperactivity and the fact that Larry was diagnosed with ADHD as a child, the social work intern asked about other symptoms of inattention,  hyperactivity, and impulsivity. In regard to inattention, Larry admitted to avoiding tasks that take a lot  of mental energy and having difficulty keeping his attention on paperwork. He says that he would  probably make more money if he were better organized. He says that his girlfriend complains about  his forgetfulness and inattentiveness to her, even when she speaks to him directly. With regard to  hyperactivity, Larry fidgets, but he denies any of the other symptoms when asked about them. However, he admits to “feeling restless” if he does not drink or smoke marijuana in the evenings. What is the main diagnosis and is there a secondary one?   Treatment options too?    Psychology Social Science Social Psychology PSYCHOLOGY 24815 Share QuestionEmailCopy link Comments (0)