Jeanette is a 22-year-old amphetamine addict who came to treatment at her doctor's recommendation. She had been obtaining amphetamines over the past five years by seeing different doctors for prescriptions ("doctor shopping") and by going to different pharmacies. One of the pharmacists notified one of her physicians of her amphetamine use, and she was confronted by that doctor about her addiction during her next visit. Her doctor also asked her at that time about the bruises on her body, and she admitted that her husband of two years beats her. She begged her doctor and her treatment counselor not to confront her husband, because she is afraid a confrontation of the issue will accelerate the violence. She has done well in inpatient treatment, has attended both AA and Women for Sobriety (WFS) self-help groups, has a sponsor/mentor in each of the self-help groups, and will be returning home in a couple of days. Although she is aware that she used drugs in part to cope with the violence (she used amphetamines to get more things done at home and at work so he would not be angry with her), she refuses to discuss the domestic violence in her home, and her husband refuses to attend family sessions at the treatment center.
As her aftercare counselor, answer the following six questions:
1. What would be a main concern to address with Jeanette immediately in her aftercare plans?
2. What high-risk situations might Jeanette face when she returns home?
3. What coping responses might she lack?
4. What evidence is there of decreased self-efficacy and positive outcome expectancies?
5. Do you see Jeanette as needing to make a lifestyle change in order to remain sober? If so, what changes do you see her needing to make, and how would you recommend that she make them?
6. Which counseling techniques (decision matrix, mapping, 10 common dangers, TIPS for coping) would you see as appropriate to use with her at this time?