(Anxiety, PTSD, Substance Use Disorder)

Angel Case Study

(Anxiety, PTSD, Substance Use Disorder)

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Case Study Details

Angel is a 44-year-old separated man who says that his substance dependence and his anxiety disorder both emerged in his early 20’s after joining the army.  He says that he started to drink to “feel better” at the NCO club on base when his episodes of anxiety made it hard for him to interact with his peers.  He states that his anxiety became extreme after his first deployment to Iraq. He worked as a military police officer and was often exposed to hostile fire as his group supported operations. He also states that alcohol and now cocaine were a part of his dishonorable discharge. 

His wife called police after an argument regarding his drinking. He shoved her and police arrested him and charged him with domestic violence (DV). He was required to attend DV classes as well as substance abuse treatment as part of the plea. He further has community service hours (48) and 2 years of probation.  You are conducting the intake assessment into your treatment agency.

Angel notes that coming off the cocaine and binge drinking contribute to low mood and increased anxiety, but he has not responded well to referrals to adjunct support services, and past inpatient stays have led to only temporary abstinence. He does not have VA connected benefits and his job as a cook offers no insurance coverage.  Yet, Angel is now trying to forge a closer relationship to his adult children, and he says he is especially motivated to get a better handle on both his PTSD and his substance use because he will be a grandfather in January. Angel states he and his wife are currently separated but talk on a daily basis. 


·         Alcohol Use 

·         Depression 

·         Anxiety 

·         PTSD 

·         Substance Abuse 

Diagnoses and Related Treatments  PTSD

The following treatments have empirical support for individuals with PTSD: 

·         Cognitive Processing Therapy (CPT)  

·         Trauma-focused Cognitive Behavioral Therapy (cf-CBT)  

·         Eye Movement Desensitization and Reprocessing (EMDR)

Mixed Substance Abuse/Dependence 

The following treatments have empirical support for individuals with Mixed Substance Abuse/Dependence: 

·         Motivational Interviewing plus CBT for Mixed Substance Abuse/Dependence 

·         Seeking Safety for Mixed Substance Abuse/Dependence 

·         Motivational Enhancement Therapy (MET) for Substance Abuse Treatment 

Generalized Anxiety Disorder 

The following treatments have empirical support for individuals with Mixed Substance Abuse/Dependence: 

·         CBT for Generalized Anxiety Disorder 

·         Psychoeducation 

·         Mindfulness  

Adjunct support services 

·         AA, NA or other 12-Step program  

·         SMART recovery  

·         Peer Recovery Coaching 

·         Mindfulness Recovery 

As referenced in the National Institute on Drug Abuse’s Principles of Effective Treatment, “Addiction is a complex but treatable disease that affects brain function and behavior. Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.”

Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment: A Research-Based Guide (3rd ed.). 2018. Principles of Effective Treatment https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

In diverse populations, with justice-involved individuals, these effects can prove challenging to address. It is important to examine the effects of substance abuse and addiction on these populations.

Read the Angel Case Study. 

Assume you are an intern for a local substance abuse facility. 

The treatment team at your substance abuse facility has requested your input for a report they will prepare for a regional organization. 

Based on the case study, write a 700- to 1,050-word summary report for the treatment team, in which you: 

1. Analyze the effects of Angel’s substance abuse and addiction on his life, including the impact on the following:

  • His marriage
  • His adult children
  • His health
  • His legal status

2. Explain how the adjunct substance abuse treatment support available in the correctional setting supports Angel. Include the following in your summary report: 

  • Identify one of the following programs: AA, NA, or another 12-Step program, SMART recovery, mindfulness recovery, or Peer recovery coaching.
  • Briefly describe the program you select for Angel (how long it is it, what the focus is, etc.).
  • Briefly describe how the principles of the program will assist Angel maintain sobriety.
  • Briefly describe the research that supports the effectiveness of the treatment program you would like Angel to attend.

3. Explain why Angel would benefit from group treatment strategies for substance abuse treatment while he is ordered to the correctional system. 

  • Briefly describe the benefits to Angel from this type of therapy.
  • Briefly describe how long Angel will be in this form of treatment.
  • Briefly describe any special considerations that should be taken into account for Angel’s offender status with substance abuse disorders.

4. Discuss why you believe Angel would benefit from individual therapy to address his PTSD and anxiety disorder. 

  • Briefly describe the benefits to Angel from this type of therapy.
  • Briefly describe how long Angel will be in this form of treatment.
  • Briefly describe any special considerations that should be taken into account for Angel’s offender status with substance abuse disorders.

Include a minimum of 3 references. 

Format your paper according to APA guidelines. 

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