Drug Addiction Case

Test report of DAST and HTP

Submitted by: Hajra Khan

Sap: 1536

Semester: 7th

Submitted to: Dr. Hina

Department: social sciences and humanity

Faculty: applied psychology

The client was a 19-year-old boy who was currently at phase of withdrawal. This

means he was in stable mental condition and was in recovering phase. The client was brought

to seek practitioner’s help after completion of his 2 nd year. After a thorough assessment of

client, it was inferred that the client still has somewhat linkage to signs and symptoms of drug

use and its effect thus cognitive behavioural therapy and dialectal behavioural therapy would

be utilised to recognize and change the maladaptive behaviour and to help client learn healthy

coping mechanisms which would help in preventing relapse.

Biodata

Name: M.S

Age: 19

Gender: male

Education: 12th grade

Number of siblings: 2

Birth order: 2nd

Marital status: Single

Informant: grandfather

Reason and source of referral

Client’s grandfather was the reason behind him seeking a practitioner’s help. The

purpose behind providing these services would be to assess and diagnose client’s problem.

Also, this report intends to fulfil the partial academic degree requirement.

Presenting complaints

M.S (currently in phase of withdrawal) had presented the following complaints by the

time he arrived to seek practitioner’s help:

“mujhy apny ghar walo grandfather ny khas tor par motivate kia to stop taking drugs”.
“I wanted to finish my involvement in drug addiction”.

“mairy doston ki waja sy main ny drugs lena shuro kia or ab mainy un ki company chor di or

mai chahta hu k normal life guzaru or drugs lena chor du”.

“drugs ki waja sy meri zindagi pr bura asar lagny laga tha jese parhai sy meri tawajjo hat gai

thi”.

Background history

Family history

The client was living among his family members including his grandfather, sister and

both parents who are very caring and loving. The client did not specify ages of his parents.

Sister of client who is older than him has a very friendly relationship with him. Grandfather

of client is also very caring and supportive and also encouraged him for his recovery and

normal life. Client reported that his grandfather was the reason behind his chances of such

speedy recovery and motivation to quit use of drugs. There has been no such reasonable

mental or physical illness among family members or in forerunners.

General home atmosphere

The client belonged to a middle-class family. The family faced no as such any

financial issues and were living peacefully. Each and everyone in the house had a friendly

and caring relationship with the client and others at home. The client always lived free life

without any restrictions from family except client’s father would sometimes outrage and

punish him if he had done anything wrong. Decision making and family dealings were

handled by client’s mom that client always respected and agreed upon.

Personal history

The client did not specify anything about his birth and related things but throughout

his childhood he remained a sober kid. He achieved all his developmental milestone at

adequate time and did not face any difficulty. Client was currently at the of age 19 and had
been abusing drugs since he was 12. Client had a normal childhood; he spent most of his

childhood in Gujranwala where he made a lot of good memories and had good friends. As

mentioned, client had good relations with family members, but his father would sometime

punish for doing anything bad that was not much intense and client was fine with that. The

client did not socialise much and would have a small friends’ circle by the time he went to

school or college. Client has left having friendships with past friends who would influence or

motivate him for abusing drugs. The client is financially stabled, has no concerns to worry

about and only focus on his complete recovery.

Educational history

The client has studied till 12th grade and currently on break from studying. He used to

be an average student and attained less score when started taking drugs. Client’s parents had

always been very motivating and supported him. They never discouraged him even though he

would score less later when under influence of drugs. Through his studying phase client

remained calm student and had positive relationships with friends and teachers till getting

involved with drugs

Sexual history

The client did not specify his sexual history.

Occupational history

The client has worked as a cashier at some restaurant when he was 17. He continued

till 3 months and then quit the job. client is satisfied by his job experience. Sometimes his

relationship with other co-workers would deteriorate due to his drug addiction. The client

also reported that he would spend most of his salary on buying drugs.

Premorbid personality

The client was a sober person before he started taking drugs and would have a

positive view on things. Client never had done anything or found himself as guilty of doing
anything that would disregard him. Client would go out and enjoy playing with friends such

as sport games. Also, friends circle was relatively small.

Medical history

The client did not have any medical history neither has there been any such

reasonable mental or physical illness among family members or in forerunners.

Drug history

The client first started with the use of tobacco at the age of 12and added on intake of

cannabis eventually. Client also had borderline personality disorder faced due to intense drug

abusing which would pay him unstable mental conditions and affected his relationship with

family members at home. The client never had any counselling session regarding any issue

before, neither been engaged any form of therapeutic treatment other than the current one.

After becoming under influence of drug addiction, client faced numerous problems such as

deteriorated relationship with family members and co-workers sometimes. As the client

became aware of his unhealthy behavior i.e. with the help of his grandfather efforts, he

immediately left his friends who had bad influence on him who made him start taking drugs.

Present illness history

Currently client was at phase of withdrawal. This means he was in stable mental

condition and was in recovering phase. The client did not have any other illness in past.

After involvement in drug abuse he developed Borderline Personality Disorder which cured

eventually as the treatment had started. No other medical or psychological illness was faced

by client before this.

Psychological Assessment

The assessment was carried out both formally and informally.

 Informal assessment

 Formal assessment
Informal Assessment

Informal assessment was carried out by using behavioural observation and mental

status examination.

Behavioural observation

Overall behavioural assessment of client indicated that he was recovering well. The

client was well dressed suitable according to weather conditions of the region, sat straight and

had potential to answer each question thoughtfully without hesitating. The client also

maintained eye contact, talked in a continuous rhythm and provided sensible answers that

were relevant to the questions asked.

Formal Assessment

In formal assessment following psychological tests were used:

 Drug Abuse Screening Test (DAST)

 House Tree Person (HTP) interpretation

1) Drug Abuse Screening Test (DAST)

Quantitative assessment: The client has answered YES to total eleven items while

NO to total 13 items. This means that the total score the client has obtained is 11 when being

assessed through DAST identifying that there is just a mere sensitivity to drug abuse and the

client do not have substance use problem.

Qualitative assessment: Client used to be somewhat social and welcoming person

but after coming under bad influence from friends he also began abusing drugs. Test findings

indicate that client does not have a definite problem with drug abuse but the problem of

abusing drug exists. Thus, there is a need to seek further help from an expert through proper

sessions in order to overcome and cope with the problem of abusing drugs.

2) House Tree Person (HTP) interpretation

be inferred that three of the figures do not have mutual coherences drawings are confined to

the left and upper portion side of the page which indicates withdrawal and fantasizing and

greater energy of the client. Out of the three drawings, tree was drawn first which symbolizes

the concerns of client with growth, development and issues of life and death. It took less time

to complete all three drawings indicating normal functioning of the client. Size of three

drawings is relatively small which demonstrate family life rejection. House id drawn very

simple and no attention is given to any of its part. Apart from that the client stated in verbal

words that the house is depicting his life that he spent in Gujranwala which was the happiest

time back then. The client stated nothing about the person drawn but head, hands and feet of

the person are separated from rest of its body, this distortion represents severe emotional

shock that the client may have experienced in past. There also is lack of detail provided such

as missing face features etc. which indicates withdrawal, low energy or boredom etc. of the

client. The tree drawn has bigger roots indicating insecurity feelings. Large trunk represents

more ego and cloud like crown of three represents fantasizing of the client.

Precipitating, maintaining factors for drug use

Another mental disorder i.e. borderline personality disorder occurred in comorbid

with drug addiction that aggravated drug addiction problem of client. There were no other

apparent reasons that could worsen client’s condition. The client also had no insight about his

unhealthy behavior in beginning which worsened the problem. Client was also influenced due

to external factors such as of social competence and peer pressure to maintain drug use.

Motivating factors to leave drugs

Provided motivation and encouragement; family supervision, strong client-parent

bond and above all grandfather of client made him aware of his poor health condition that

motivated him seek practitioner’s help and leave drug addiction.

If the client is frequently exposed to risks such as peers who take drugs, and losses

motivation and parental supervision etc. may have negative impact and increase chances of

relapse. All the motivating factors stated above are if lost act as risk factors for drug use

relapse.

Diagnosis

Through DAST Questionnaire it is demonstrated that the client has drug abuse

problem but it is not that intense. On the other hand, HTP provided results some of which

have mutual contradiction as seen above thus suggesting that results may not be reliable. But

overall or most of the descriptions signify the symptoms of drug addiction. Thus, it can be

inferred that the client may have drug abuse problem and continuation of therapeutical

treatment is needed to cope with the issue. Earlier the client was also diagnosed with

borderline personality disorder which was now cured.

Prognosis

The client has conceivable potential to withdraw drug abuse and begin normal

functioning. Although prognosis of client can be influenced by personal and environmental

factors but in this case, client showed greater motivation and encouragement for quitting

abusing drugs so the chances for relapse may be none or very little.

Case formulation

As a child, client had lovely time spent with family members and everything was

running smooth. Once at age of twelve, the client become friends with peers who were

abusing drugs and that badly influenced him. Afterwards, the client became under influence

of drug abuse and started taking tobacco and cannabis addictively. The client has cleared

detoxification phase of therapy and is now in withdrawal phase. Still the tests identify

toxicity of client and therapy continuation in needed to cope completely.

Planned initial sessions would be utilized and therapist and client will have

conversations on client’s problems and views. Basically, thoughts would be defined in these

sessions through collaborative way. The client himself would use statements to refer to his

own problem by answering probing questions. The therapist would work on identifying the

errors in thinking so that new automatic thought would be develop in place of it. In mid

sessions, different strategies would be applied to increase positive thoughts. Cognitive

Behavioural Therapy would be used so that client can recognize and change his maladaptive

behavior. It will also enable client to recognize the risky situations, learn coping skills and

preventing relapse. As the client also had Borderline Personality Disorder, so Dialectal

Behavioural Therapy shall also be utilized further to help client learn healthy coping

mechanisms and give up acts that reinforce substance use. Moreover, the final sessions would

focus on termination of the therapy and relapse prevention. The client would be asked to

practice what they learnt in sessions in their daily life and thus enhance self-management

skills.
Appendices