Purpose: A relapse prevention plan and safety plan are critical tools utilized when working with survivors. Since substance use and safety are intertwined it is important to assist the client in exploring both relapse prevention and steps to assure safety in one comprehensive plan. This assignment will challenge you to assess the client situation and design a template for a comprehensive document to address both needs.
Instructions: Develop a relapse prevention/safety plan model that incorporates characteristics that you believe would be important to assess and incorporate to assist clients in developing the relapse prevention and safety skills. A template is provided which you can use or develop your plan as long as it cover the primary areas to incorporate in the plan. You can change and edit if you would like or incorporate more.
Client: Jenny Duncan
Age: 25 Y/O
Referral Source: DCF
Info gather during assessment
Substances Used
Drug Marijuana Drug OxyContin Drug Dilaudid
1st use 10 y/o 1st use 23 y/o 1st use 25 y/o
Last use 2 weeks ago Last use 3 months ago Last use Yesterday
Route Smoking Route Oral/injection Route Injection
Duration Years Duration Years Duration Years
Frequency 2-3 times months Frequency Monthly Frequency Daily
Amount 2 joints Amount 60 mg Amount 80 mg
Drug Alcohol Drug Nicotine
1st use 9 y/o 1st use 18 y/o
Last use 3 wks ago Last use Today
Route Orally Route Smoke
Duration Years Duration Years
Frequency Monthly Frequency Daily
Amount A couple of beers Amount Pack/day
Social Support
Jenny states that she no longer has friends and that most of her co-workers have pulled away from her since she started seeing Andrew. She reports that he was the only person that she needed, but now she is starting to think differently. Jenny reports that she has some contact with her mother and notes that she feels if things were really bad and she wanted to leave that she could go there. She states that is really the only place that she knows of for support and she stayed there briefly after finding out she was pregnant.
Coping skills
When asked about things that have helped her not use in the past she reports thinking about her future. Jenny expresses a desire to not use at this time, because she knows that it could impact the baby. Jenny reports that meditation has helped in the past when she was dealing with a lot of stress and notes that she learned guided imagery when she was living at home with her father.
Triggers for Use
Jenny struggled to identify triggers to her use, but she notes that fear of what will happen if she does not use with Andrew has always pushed her towards using. Jenny also reports that recently she started using when he was not around just to deal with all of the stress that was going on. She notes that she worried all of the time about what Andrew will think and works so hard to make him happy. She reports that stress has been really getting her and that using lets her escape all of it.
Treatment Goals
Jenny expresses a desire to keep her unborn child safe and notes that she cannot use drugs and do that. She appears motivated to address the substance abuse issues, but display uncertainty regarding the status of her relationship with Andrew. When questioned she does admit that if necessary she would go to a domestic violence shelter because she wants to do whatever she can to keep her child safe. Jenny expresses witnessing DV between her parents as a child and does not want her child to have to go through that, however she believes that she should give Andrew a chance to change for their family.
Jenny is a 25 year old girl who has been having difficult time at home. It is noted her in history that her father, who raised her, had a short temper and got angry often and in Jenny’s words “…some times he would just flip. You’ll never know why” and “when he’s angry somebody is gonna get it….” Jenny doesn’t like this violence but she can’t remember a time during her childhood when her father was not like that.
2 years ago she met Andrew, a 27 year old athletic male, who works in the same office as she does. Andrew started off by being an ideal boyfriend. He was always in a good mood and pleased to see her at work. They spent as much time together as possible particularly on weekends and some evenings after work.
Andrew has a lot of male friends and “lots of girls fancy him” because “he is a good looking guy”.
After a couple of months into their relationship Andrew started telling Jenny off when she talked to other men at work even though the conversations were innocent. Jenny’s friends talked to her about this, but, Jenny was adamant that he loved her so much he didn’t like her talking to other guys and that this was sweet. Then Andrew became moody if Jenny wanted to see a female friend after work so she stopped meeting up with her friends and cut off contact with her family because they did not understand the relationship she has with him.
Andrew began texting her more than 20 times a day even though they were at the same work. During the evenings if they were not together he would text her every 10 to 15 minutes asking what she was doing and who she had been talking to and what they were saying. Jenny thought he must really love her to keep doing this.
About a year into their relationship Andrew and Jenny moved in together, which when she realized that he used cocaine and opiates. He told her that is was not a problem and asked her if she wanted to join in. Jenny was against substance use, especially since she saw how her father got after drinking. Andrew started yelling at her and telling her she was not any fund unless she chose to do drugs with him. He would hit her and yell if she refused what he was giving her stating that she was ungrateful and not the person he fell in love with. Eventually Jenny gave in and started using opiates. Before she knew it she need the drugs to function and reports that without them she get really sick. Andrew was the only that supplied drugs to her and often required her to have sex with him before she was allowed to get high.
One Saturday morning Jenny forgot her phone at home when going shopping. When she went home, she had more than 50 missed phone calls and infinite texts from Andrew. She immediately called him apologizing for having forgotten her phone but he was furious shouting. She told Andrew that she will make it up to him.
Andrew: “So you’ll make it up to me? Heh”
Jenny: “Yeah, I promise you. I’m really, really sorry.”
Andrew then slapped her and said “This is so you never fxxking forget again and isn’t anything like how much you hurt me.” He then grabbed her and they had sex. Afterwards all seemed to have calmed down. Jenny thought of how much her face hurt and how much Andrew should have felt hurt.
Ever since then Andrew has become increasingly demanding and finds any reason to punish Jenny hitting her, or embarrassing her in front of coworkers. Afterwards they always talk and Andrew tells her how much he loves her and how he wants her to himself and feels irritated when there are other people around her. Many times she thinks about how difficult Andrew can be but finds comfort in how much he loves her. She thinks “He loves me really so much, otherwise, with all the girls wanting him, why should he care?”
The intensity and frequency of Andrew’s anger has increased and so has the persistence and efforts of Jenny to appease him and to “make it up to him.” Until 3 weeks ago when she told Andrew that she is 2 months pregnant. Andrew starting shouting at her and asking whose baby that was, and used his belt to beat her up. She ran away from Andrew’s place and went back home. She had not told anyone at home about her violent relationship with Andrew and he presented as a good caring young adult. He convinced Jenny to return stating that he would be different and wanted to be a family, noting that a baby changes However, due to severity of her shouting 2 days ago, one of Andrew’s neighbors reported the couple to police for domestic violence. But, upon the arrival of the police both Andrew and Jenny denied any violence, and mentioned they just had a normal disagreement between couples.
The police could not take any further action but given that Jenny is pregnant they have referred the case to family and children services. The report from department of children and families notes that Jenny tested positive of opiates at the time of the investigation. As part of the current safety plan, Jenny was referred to you for a substance abuse assessment.
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