Vignette #1: Alex
A 32 year-old, single Asian male, without children. He has lived alone since he was 25 years-old
and has school acquaintances, no identified friends. He is unemployed and he attends a
community college. For the past 7-years, Alex has experienced extremely high levels of anxiety,
but he cannot identify the source of the anxiety. When Alex is in social situations, he is often
terrified about being judged by others and fears that his anxiety will be seen by others. He
experiences shortness of breath, heart palpitations, chest pains, he feels wobbly, and has
difficulty concentrating. Alex has never received a formal diagnosis.
Alex has poor school attendance that he attributes to his symptoms. Alex stated that he ‘has to’
smoke marijuana (daily) to help ease his symptoms and that he cannot attend a class without
first smoking a ‘blunt.’ He stated that he is unable to maintain a job because he would be
absent on the days when he thought that employees would have to submit a urinalysis for a
drug toxicology screen. Alex stated that he feared that others could smell the marijuana on his
Although Alex has been in two accidents, that he attributes to “being high,” he continues to
smoke marijuana while driving and he drives while under the influence of marijuana. Alex has
smoked marijuana since he was 19 years-old and his use has increased over the past 3-years.
Alex relies on his parents to help him pay monthly rent and he often borrows money from his
parents to buy the marijuana. Alex admits that he needs help but said that he tried being
abstinent, but it didn’t help.
Development of appropriate evidence-based assessment strategies and treatment plan.
All sections completed and SMART goals used
Specific interventions and goals
Develop a treatment plan
Demonstrate critical thinking and analytical skills by identifying presenting symptoms of co-occurring disorders and developing an appropriate treatment plan related to a selected vignette.
Select one of the three Case Vignettes, pp. 4-5 and address each of the items noted in the outline to develop an appropriate case analysis and treatment plan.
Based on the presentation in the case study, what are the most immediate and critical assessment needs? Consider ASAM’s six-dimensional assessment criteria; Maslow’s Hierarchy of Needs; SHAG
Do the presenting symptoms seem to indicate a co-occurring disorder (COD)? Or, can the symptoms otherwise be accounted for? If yes, what are the disorders that may be indicated? Explain your answer.
Do the presenting symptoms seem to indicate a DSM 5 diagnosis (mental health or SUD)? Or, can the symptoms otherwise be accounted for? If so, which diagnosis may be indicated? Explain your answer.
Identify the strengths of the consumer.
Use the DSM 5 V/Z Codes, Other Conditions That May Be A Focus of Clinical Attention, to Identify additional considerations that may require attention, i.e. work, interpersonal relationships, school, recreation, legal and state the reason the identified domain(s) requires attention.
Formatting: APA formatting In-text citations and reference page
Cover page (Name, Course Number, Assignment Title)
Up to four pages maximum (Not including cover and reference pages)
Include numbered outline headings
Space at 1.5 lines