Blog

Vignette Exam Practice: Kevin, Question Four

Last question of the bunch: barriers to treatment.

In your first meeting with Kevin, 47, he tells you that he's been "feeling funny" lately, having trouble getting up in the morning, sleeping "too much." Kevin says he has "occasionally" used crack cocaine in the past, but says "I haven't hit the pipe in a week." Kevin has been homeless in the past. He currently lives in a sober living house downtown. Kevin tells you he sometimes thinks people are talking about him and laughing about him, "but it doesn't bother me much." Kevin says he has not worked since being laid off two years ago.

4. What are some of the potential barriers to treatment in this case?

1. Client refuses to take medication as prescribed
Client comes to session intoxicated
Client not motivated for treatment
Client does not trust doctors and refuses to get physical exam

2. Client refuses to take medication as prescribed
Your urge to "rescue" client
Client does not believe you can help him
Client hearing voices

3. Client refuses to take medication as prescribed
Client refuses to enter an abstinence contract with you
Client not motivated for treatment
Client comes to session intoxicated

4. Class differences between you and client
Client not motivated for treatment
Client refuses to take medications as prescribed
Client refuses to enter an abstinence contract with you
Categories :
comments powered by Disqus