Addiction is a relatively common occurrence in many people’s lives. It manifests itself in multiple ways, which are often detrimental to a person’s wellbeing. Each case is usually unique with a specific root cause. The severity of addictive disorders increases with time thus early interventions are often advisable. This case study analyses Mr. Levy’s addiction by following both the client and the therapist on their sessions.
Episode 1
Mr. Levy hides his hangover behind sickness. Furthermore, he does not appear to perceive the negative effects of his overnight drinking. He is aware of the fact that things changed when he went to Iraq. However, he is reluctant to admit that he has a drinking problem. This makes him defensive and angry when the wife confronts him about the problem. Mr. Levy refuses to acknowledge that he is depressed. On the other hand, Mrs. Levy is very perceptive of the problem and its consequences for both his husband and the family. She is aware of the effects of her husband interacting with the children while he has a hangover and counsels that he try going back to bed. Moreover, she points out that he has a habit of drinking all night every day while watching only to complain in the morning of being sick. She also, tell him of his anger issues. Lastly, the wife is aware of the root cause of her husband’s drinking, depression. Her high level of perception of the problem makes her intervene because of the potential harm to the entire family. First, the problem is slowly breaking up the family. The continuous drinking and skipping work may eventually lead to financial problems within the family as well.
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Episode 2
I think the social worker’s ideas are well intended. Although she has not seen any research data to support the interventions, they are revolutionary practices that are being adopted in the field. Although her presentation of the ideas hints of misplaced priorities. When asked why she prefers the methods by her supervisor, she says that she has been dying to try one of them. Otherwise, I think they are progressive ideas that might be beneficial to her client. The social worker’s supervisor raised a number of very legitimate questions. They were rightly centered around the social worker’s rush to recommend a therapeutic approach even though she had not yet met the client to make a full analysis of the problem. I also think that the supervisor was justified in questioning the social worker’s priorities. Lastly, I think that he gave the social worker the right advice. It was flexible enough to allow her to choose whichever therapeutic method she deemed appropriate only after she had met the client.
Episode 3
I think Mr. Levy’s therapist responded very well to what he had to say. So much so that the client felt encouraged to make jokes during the session. She was attentive to the client and responded in a helpful and insightful manner. She also managed to make him open up about his traumas. I think that she showed a high level of professionalism and competency in handling Mr. Levy’s case. Therefore, I would argue that the session was a success since it remained objective and the therapist was making progress with her patient.
Voluntary deep breathing has the capacity to alter the underlying chemistry involved in respiration. First, deep breaths help reduce oxygen consumption in the body while decreasing the heart rate and blood pressure (Mackinnon, 2015). Deep breathing increase CO2 content in blood that may have been lost in hyperventilation. A normal CO2 concentration is necessary to maintain pH and the normal contraction of blood vessels to ensure optimum blood flow (Guyenet & Bayliss, 2015). Thus, altering breathing mechanics changes blood chemistry through regulation of the quantity of carbon dioxide and oxygen.
Mr. Levy’s therapist chose exposure therapy. The approach involves a combination of deep breathing exercises and a recount with the patient’s trauma (Hofmann, Mundy & Curtiss, 2015). As a therapist, I would also use exposure therapy in the said patient’s case. This is because the method will help Mr. Levy get over his anxiety through subjecting him to conditions that elicit the problem and showing him how to manage it (Hofmann, Mundy & Curtiss, 2015). Lastly, the therapist left a very good impression on me based on the way she handled Mr. Levy’s session. I think she is both professional and caring in her work. Above all, she appeared very diligent. The session as a whole was a success. Several studies have been conducted that prove the efficacy of exposure therapy in PTSD treatment. A good example is a 2018 study done by Foa et al.
Episode 4
My response to the client’s revelations would be as genuine and organic as possible. I would encourage him to open up more in order to face his traumatic experiences head-on, in line with the exposure approach. Based on his reaction, I would know whether to use Cognitive behaviour therapy, CBT, or a disorder independent approach (Norton, 2017).
Episode 5
Acting as the therapist supervisor, I would try to offer as much professional support as I can. In the particular situation where she is having difficulties with Mr. Levy’s story, I would ask her to recount for me the approach she used to inquire about the story in a stepwise manner. We would then go through the process to evaluate if there was a point where she missed something. If not I would recommend another approach, massed exposure therapy. This method has been proved to have better results in PTSD patients (Foa et al., 2018). A change in strategy should ensure a continuity in Mr. Levy’s narrative.
Conclusion
Indeed, the study analysing a war veteran struggling with anxiety shows the effectiveness of exposure therapy in treating addictive disorders. Despite the proven efficacy of this treatment method, therapists sometimes hit roadblocks just as in this case. The efficiency of exposure therapy is therefore dependent on its delivery as incompetence may lead to lack of progress with the patient.
- Foa, E., McLean, C., Zang, Y., et al., (2018). Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial. JAMA. 319(4). 354-364.
- Guyenet, P. G., & Bayliss, D. A. (2015). Neural control of breathing and CO2 homeostasis. HHS Public Access.
- Hofmann, S., Mundy, E., Curtiss, J. (2015). Neuroenhancement of Exposure Therapy in Anxiety Disorders. AIMS Neuroscince. 2(3). 123-138.
- Norton, P. (2017). Transdiagnostic approaches to the understanding and treatment of anxiety and related disorders, Journal of Anxiety Disorders. 46. 1-3
- Mackinnon, M. (2015). Take a Deep Breath: The Physiology of Slow Deep Breathing. Mindfulness, MD. Retrieved from https://www.mindfulnessmd.com/2015/06/27/neuroscience-of-mindfulness-take-a-deep-breath/
