CNL610 Risk Assessment Scenario
Part 1: Risk Assessment Scenario
In counseling, clinicians conduct risk assessment to identify the risk factors potent of causing harm to the client(s). According to (Kourkoutas & Xavier, 2010), risk factors are linked with increased risk of harm for young people. In this case, Eliza D, the Caucasian female, is the client seeking therapy. As per the case study, Eliza can be diagnosed with Generalized Anxiety Disorder (GAD) since her Campus life has been characterized by “overwhelming stress.” As a result, Eliza has developed alcohol abuse behavior and become an alcoholic, which she cites as a coping mechanism that helps her relieve her stress. Thus, for purposes of risk assessment, Eliza’s “abuse of alcohol” is the scenario that requires a risk assessment.
Eliza’s alcohol abuse, which she cites as a mechanism to help relieve her coursework stress, is a critical risk assessment for the clinician. Despite alcohol use being prohibited on the Campus, Eliza has been found with alcohol more than once. According to the case, Eliza drinks alcohol to the extent of not waking up/ oversleeping. Also, upon the campus police search, Eliza is found with a half-empty bottle of beer, hid in the bathroom. Late in the night, like around 1 AM, Eliza is found drinking wine. This indicates that Eliza drinks wine to sleep and has sleeping difficulties (Peay et al., 2009). Sleeping late is the reason she oversleeps and misses morning classes. As per the case, Eliza abuses alcohol to have a sleep and cope with coursework stress.
I believe this increasing rate of alcohol abuse by Eliza requires risk assessment because it has already affected her sleeping patterns, ability to attend classes, connectedness with her parents, coursework grades, and social life (Peay et al., 2009). Also, alcohol abuse behavior is posing a higher risk for Eliza’s concentration on her coursework. Besides, due to Alcohol use, Eliza’s psychological functioning has been adversely affected to the extent of having suicidal ideation. Thus, these are possible signs of more severe risks if careful consideration, attention, care, and intervention is not taken to lower the risk’s intensity.
Part 2: Specific Behaviors
The risk assessment scenario in Eliza’s case is alcohol abuse/alcoholism behavior, which she is continually developing. Eliza’s specific behaviors that inform the creation of alcohol abuse risk assessment include sleeping problems (oversleeping and sleeping in late hours), hiding alcohol in the bathroom, using alcohol on the Campus where it is prohibited, missing morning classes while sleeping, suicidal ideation, ignoring her parent’s calls, and canceling counseling appointments with the counselor (Popoola & Oluwatosin, 2018). Also, despite therapy and alcohol classes, Eliza’s alcohol drinking behavior has escalated. In this case, Eliza’s unusual behavior at the school indicates that she is exposed to higher alcohol abuse risks if the issue is not adequately assessed and treated. All possible neglect signs are evident in Eliza’s case, low school attendance, high frequency of alcohol abuse, and other behaviors associated with excessive alcoholism. Since Eliza states she cannot take it anymore, it is the counselor’s mandate to undertake a risk assessment and develop a treatment plan that suits her case.
Part 3: Assessment (CACREP 2.F.7.c)
Popoola and Oluwatosin (2018) define assessment as the process that counselors use to collect client data needed to form a holistic view of the problems they present into counseling. Typically, clinicians assess client(s) throughout the therapeutic process, particularly in the initial stages. According to (Kourkoutas & Xavier, 2010) counselors can apply numerous approaches when assessing the client. In the case of Eliza, the counselor would need to apply the CAREP 2.F.7.c standards in the evaluation/assessment process ( CACREP , 2016).
First, the counselor would assess Eliza’s red flags/warning signs. These red flags would be categorized as verbal/physical, psychological, and emotional red flags (Peay et al., 2009). Verbal warning signs in Eliza’s case, such as admitting to attempting suicide due to the overwhelming coursework stress, whereby the client is honest about her suicidal thoughts, would inform the counselor the best approach for assessing Eliza. On the other hand, physical warning signs, including Eliza’s visible cuts in both wrists and alcohol abuse, would help inform the counselor over how to assess the client. The psychological red flags in Eliza’s case include the “overwhelming stress” due to the demanding coursework, which she states it’s difficult to withstand. Emotionally, Eliza’s red flags include her being visibly upset, and the fear of taking calls from her parents when she is drunk (Kourkoutas & Xavier, 2010). All these warning signs reveal Eliza’s presenting symptoms to the counselor and inform the client’s risk assessment process and treatment planning.
In Eliza’s case, certain factors could expand or lower the danger/risks for alcohol abuse. According to (Popoola & Oluwatosin, 2018), the counselor would have to identify what these components are, which would help him/her understand the degree, rate, or intensity of risk. Next, the counselor would have to address the risk level and select the client’s holistic treatment environment (Eliza). Last, the counselor would develop an appropriate action plan to use in Eliza’s treatment process.
To determine “Eliza’s rate of risk,” the counselor would require the client to respond to various questions: How frequently do you drink alcohol? – If Eliza provides an honest answer, this response will inform the counselor whether to encourage risk assessment or not; does either your father or mother drink alcohol? – This inquiry will inform the counselor whether Eliza’s family has a history of alcohol abuse; do you experience geographic or social isolation from your family, including lack of access to extended family? – This inquiry would inform the counselor whether Eliza gets any guidance from the immediate family/extended family or not concerning her stressors, and have you contemplated stopping the alcohol abuse behavior? – This inquiry will inform the counselor of Eliza’s willingness to avoid this self-destructive behavior (Popoola & Oluwatosin, 2018). Further inquiries would include “do you have an arrangement plan to help you mitigate or stop alcohol abuse?” this will provide the counselor sufficient and appropriate information on whether Eliza has a plan to get out of this alcohol abuse menace which is changing her normal life; “have you tried other types of drugs in the past?” this would caution the counselor over the urgency of contemplations, particularly if Eliza has attempted use of drugs or any other form of abuse to contemplate coursework stress, then it would be easier for her to attempt it again (Kourkoutas & Xavier, 2010).
Eliza’s responses to these questions, including documentation, would inform the counselor which protocol to follow during her assessment. First, the counselor would have to document all of Eliza’s answers to the asked questions. Every response by the client would be considered pivotal in informing the assessment process. Second, the counselor would disclose to Eliza all confidentiality limits and the responsibility as stipulated in the CACREP 2.F.7.c. ( CACREP , 2016). In case Eliza state indicates advanced risks for alcohol abuse, which would, in turn, raise her risks for suicidal ideation and actions, disconnection with parents, sleeping difficulties, and drop in grades, the counselor should assess this alcohol abuse behavior from top to its bottom. All the stressors, red flags, and warning signs would be easily discovered by analyzing the responses as documented. After that, the counselor would have to collaborate with Eliza and develop a suitable care plan ( CACREP , 2016). In this care plan, the counselor would need to ensure that people Eliza and the counselor can contact are incorporated.
References
CACREP. (2016). 2016 CACREP Standards. Boston: Author.
Kourkoutas, E. E., & Xavier, M. R. (2010). Counseling children at risk in a resilient contextual perspective: A paradigmatic shift of school psychologists’ role in inclusive education. Precedia Social and Behavioral Sciences, 1210-1219.
Peay, H., Hooker, G., Kassem, L., & Biesecker, B. (2009). Family risk and related education and counseling needs. American Journal of Medical Genetics, 149(3), 364-371.
Popoola, B. I., & Oluwatosin, S. A. (2018). Assessment and Testing in Counseling Practice. Advances in Social Sciences Research Journal, 5(3), 266-275.