Therapeutically Recovery Oriented Care Plan

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Subject Name : Medical Sciences

Video Script

Therapist: Hi Jesse, (smiles warmly and maintains eye contact)** thanks for coming in today. I want to acknowledge that I've received a handover and read through your notes. We're here to catch up and talk about some of the challenges you're facing right now and figure out a plan to address these issues. (nodding in empathy) Before we dive in, how have you been feeling lately?

Jesse: (leans back, sighs) Thanks for having me. It's been a bit of a rollercoaster, you know? Trying to stay on track, but it's not easy. But one day at a time, you know.

Therapist: (nods in understanding) Absolutely, one day at a time is a great approach. I'm here to support you through this journey. (gentle hand gestures) To start, can you tell me a bit about your experience in the army and what led to your decision to seek help for your anxiety and alcohol use?

Jesse: (with an uncomfortable clearing of throat) Well, the army was tough. I thought it would give me a purpose and direction, but it just felt like another trap. I started drinking to cope, and it got out of control. Now, I'm trying to stay sober and find a way forward.

Therapist: (leans forward with concern) It's commendable that you've been sober for 60 days. That's a significant achievement. (maintains a comforting tone) I'd like to understand more about your goals and aspirations. You mentioned wanting to become an ambulance paramedic. What draws you to that profession?

Jesse: (sits up, passionate) I've always wanted to help people, you know? Being there in emergencies, making a difference. But after the army, I'm not sure if I can make it happen.

Therapist: (nods and smiles) It's understandable to feel uncertain after what you've been through. (softly leans back) Let's explore that a bit more. What specifically makes you doubt your ability to pursue a career as an ambulance paramedic?

Jesse: (furrows brow, gestures with hands) I didn't finish school, and they said I lacked the right background and life experience. It feels like I messed up my chances.

Therapist: (maintains eye contact, nods reassuringly) It sounds like there's a sense of lost confidence. I want you to know that we can work together to explore ways to rebuild that confidence. (gentle pat on the back) Now, you mentioned living in a share house with people using alcohol and drugs. How has that been affecting your journey to stay sober?

Jesse: (crosses arms, shifts uncomfortably) It's tough. There's always temptation around. It's hard to stay focused when everyone else is partying.

Therapist: (tilts head in empathy) That sounds challenging. Creating a supportive environment is crucial. (clasps hands together) What kind of living situation would help you maintain your sobriety and work towards your goals?

Jesse: (uncrosses arms, leans forward) I need a place where people aren't using substances all the time. Somewhere I can focus on getting my life back on track.

Therapist: (smiles and nods) That's a clear goal we can work towards. Alongside this, I'd like to address the stress and anxiety you've been experiencing. You mentioned using diazepam. How do you feel about finding alternative ways to cope with stress that don't involve substances?

Jesse: (relaxes, nods) I'm willing to try. I just need something to help me get through the tough moments.

Therapist: (offers a supportive hand on Jesse's shoulder) Absolutely, we can explore coping strategies together. (maintains open body language) Now, you also mentioned feeling isolated and lacking a personal support network. Building a support network is crucial. Who, if anyone, do you feel comfortable reaching out to for support?

Jesse: (leans back, sighs) Honestly, I don't have anyone. My relationship with my parents is strained, and I can't connect with my army colleagues.

Therapist: (maintains eye contact, nods understandingly) Building a support network takes time, but it's an important aspect of recovery. (offers a reassuring smile) We can explore ways to connect with new people or rebuild relationships if you're open to that. How does that sound to you?

Jesse: (smiles faintly) Yeah, I'm willing to give it a shot.

Therapist: (smiles back) Great, Jesse. To wrap up, let's collaboratively develop a care plan that addresses your goals. We'll focus on rebuilding confidence, finding suitable accommodation, managing stress without substances, and building a support network. Does that align with what you're hoping to achieve?

Jesse: (nods appreciatively) Yeah, it sounds good. I appreciate your help.

Therapist: (offers a supportive pat on the back) It's my pleasure, Jesse. We'll take it step by step. I'm here to support you in this process.

** N.B- The words given in the bracket are actions and body language to portray nonverbal and paralinguistic communication skills. Those should not be read aloud.

Recovery- Care plan

Introduction

In Jesse's journey towards recovery, a comprehensive and collaborative care plan is designed to address key areas such as maintaining sobriety, navigating career indecision, finding suitable accommodation, managing stress, and building a personal support network.

Care plan

Person’s Need/Issue	Identified Goals	Interventions, actions & strategies to achieve goals	How will this issue be resolved?
1. Maintaining Sobriety	Develop coping strategies for cravings.	Incorporating Cognitive-Behavioral Therapy techniques to identify and reframe negative thought patterns related to cravings (Breuninger et al., 2020).	Demonstrated use of CBT strategies in daily life, effectively managing cravings.
	Establish a daily routine.	Integrate Behavioural Activation techniques into the daily schedule, focusing on reducing behaviours reinforcing substance use .(Maria José Santos et al., 2021)	Increased engagement in positive activities.
	Establish a daily routine.	. Implement contingency management, establishing a reward system for adhering to the daily routine and achieving specific goals (Proctor, 2022) .	Consistent adherence to the reward system, indicating the successful establishment of positive behavioural patterns.
2.Career Indecision	Regain confidence in pursuing the goal of becoming an ambulance paramedic.	- Collaboratively explore past achievements and strengths to boost confidence.	Demonstrated commitment to pursuing career aspirations.
		- Break down the goal into smaller, manageable steps for a sense of achievement.	Expression of increased self-assurance and optimism
		- Engage in career counselling or vocational training to gain necessary skills and knowledge for the desired profession (Savickas, 2019). ‌	Active engagement in pursuing educational or career options..
3.Unsuitable Accommodation	Find a living situation that supports sobriety and provides a focused environment.	- Collaboratively research and identify sober living arrangements or housing options that align with Jesse's goals and values .(DeGuzman et al., 2019)	Report of reduced exposure to substances and improved focus.
3.Unsuitable Accommodation		Develop a plan to communicate with current housemates about personal goals and boundaries related to substance use(Grisamore et al., 2022) .	Successful implementation of the communication plan leading to a more supportive living environment.
4.High Levels of Stress and Anxiety	Develop healthier coping strategies for stress that do not involve substances.	- Introduce and practise mindfulness techniques, deep breathing exercises, or meditation (Korecki et al., 2020).	Decreased reliance on substances and improved stress coping.
		- Explore and engage in activities that bring joy and relaxation, such as art or hobbies (Ertüzün & Yerli̇su lapa, 2020).	Increased use of alternative coping mechanisms.
		- Establish a routine to provide structure and reduce unstructured time for rumination.	Decreased use of diazepam and reported increased well-being.
5. Lack of Personal Support Network	Build a supportive network to provide emotional and practical assistance.	- Explore local community groups, clubs, or volunteering opportunities to meet new people (Pettersen et al., 2019).	Active participation and engagement in social activities.
		- Reconnect with colleagues, addressing and working through strained relationships.	Strengthened ties and improved communication.
		- Attend support groups or counselling sessions to build connections with peers in recovery (Pettersen et al., 2019).	Reported increase in feelings of connectedness and support.

Conclusion

As Jesse embarks on this recovery-oriented care plan, the integration of evidence-based interventions, including collaborative care, Cognitive-Behavioral therapy techniques and behavioural activation, and building a supportive network aims to empower Jesse towards sustained well-being and fulfilment.

References

Breuninger, M. M., Grosso, J. A., Hunter, W., & Dolan, S. L. (2020). Treatment of alcohol use disorder: Integration of Alcoholics Anonymous and cognitive behavioral therapy. Training and Education in Professional Psychology, 14(1), 19–26. https://doi.org/10.1037/tep0000265

DeGuzman, R., Korcha, R., & Polcin, D. (2019). “I have more support around me to be able to change”: a qualitative exploration of probationers’ and parolees’ experiences living in sober living houses. Therapeutic Communities: The International Journal of Therapeutic Communities, 40(1), 51–65. https://doi.org/10.1108/tc-04-2018-0008

Ertüzün, E., & Yerli̇su lapa, T. (2020). Relationship between adolescents’ leisure boredom and substance use in Turkey. Turkish Journal of Sport and Exercise, 22(3), 374-383. https://doi.org/10.15314/tsed.779348

Grisamore, S. P., Nguyen, R., Elzbieta Wiedbusch, Guerrero, M., Cope, C. E. A., Abo, M. G., & Jason, L. A. (2022). Journey to wellness: A socioecological analysis of veterans in recovery from substance use disorders. American Journal of Community Psychology, 70(3-4), 394–406. https://doi.org/10.1002/ajcp.12615

‌Korecki, J. R., Schwebel, F. J., Votaw, V. R., & Witkiewitz, K. (2020). Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Substance Abuse Treatment, Prevention, and Policy, 15(1). https://doi.org/10.1186/s13011-020-00293-3

‌Maria José Santos, Puspitasari, A. J., Nagy, G. A., & Kanter, J. W. (2021). Behavioral activation. 235–273. https://doi.org/10.1037/0000218-009

‌Proctor, S. L. (2022). Rewarding recovery: the time is now for contingency management for opioid use disorder. Annals of Medicine, 54(1), 1178–1187. https://doi.org/10.1080/07853890.2022.2068805

Pettersen, H., Landheim, A., Skeie, I., Biong, S., Brodahl, M., Oute, J., & Davidson, L. (2019). How social relationships influence substance use disorder recovery: A Collaborative narrative study. Substance Abuse: Research and Treatment, 13(1-8), 117822181983337. https://doi.org/10.1177/1178221819833379

‌Savickas, M. (2019). In Career counseling. Washington, DC: American Psychological Association.

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