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Alcohol Dependency and Drinking Progression

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A new client describes a 20-year progression of drinking that has culminated in severe alcohol dependence. Your client drinks a case of beer each day and is experiencing withdrawal symptoms when not drinking. Your client has an extremely high tolerance for alcohol intake.

- Describe how you would use the Michigan Alcohol Screening test or the Substance Abuse Subtle Screening Inventory (SASSI-3) to determine if alcohol dependence is an appropriate diagnosis.
- Identify the clinical Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) symptoms of alcohol dependence that need to be present in order to place this diagnosis on Axis I.
- In looking at the other four axes used in DSM-IV-TR diagnoses, what other information would you need to gather from the client in order to formulate a comprehensive treatment plan?

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The solution describes how the Michigan Alcohol Screening test and/or the Substance Abuse Subtle Screening Inventory (SASSI-3) will be used to determine if alcohol dependence as an appropriate diagnosis for a specific client.

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- Describe how you would use the Michigan Alcohol Screening test or the Substance Abuse Subtle Screening Inventory (SASSI-3) to determine if alcohol dependence is an appropriate diagnosis.

Substance Abuse Dependence Disorder is described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR [APA], 2002) as, "A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems (p. 192). One instrument that can be used to assess substance abuse dependence for this client is The Substance Abuse Subtle Screening Inventory-3 (SASSI-3, Lazowski, Miller, Boye, & Miller, 1997). The SASSI-3 is designed to identify individuals who have a high probability of having a substance abuse dependence disorder (Clements, 2002). For instance, the SASSI-3 can appropriately be used to assess the client who does not admit to drinking. According to Lazowski et al., this is significant because clinicians do not have to rely solely on self-report to be truthful in reporting symptoms.

Based on DSM-IV-TR (2000) features describing substance abuse disorders, substance dependence ...

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