Jeff is a 55-year-old man who admits to being addicted to alcohol and barbiturates. He also admits to being bulimic since his early 20s. He has never been married and has always lived with his mother. He describes his relationship with his mother as a love! hate one: His mother dominates him (which Jeff resents), but Jeff says he does not believe he could live without his mother. Jeff says his mother ignores every assertion or boundary he has made in the relationship. He believes his addiction and his eating disorder are fused: He drinks to avoid the shame of his eating disorder. Jeff has just entered the halfway house and is open to working on his issues. He says he does not see himself as being able to stay sober, because he knows he needs alcohol and barbiturates to be able to live with his mother. Due to financial constraints, Jeff will return to live with his mother when he leaves the halfway house in 6 weeks. As his primary halfway house counselor, answer the following seven questions:
1. What are high-risk situations for Jeff?
2. What coping responses might he lack in those high-risk situations?
3. How do you perceive his self-efficacy level in terms of his recovery, and how might that be a dangerous match with his positive outcome expectancies of the alcohol and drugs?
4. Based on his story, what are some possible abstinence violation effects Jeff may experience after using?
5. What positive addictions or substitutes might Jeff look at incorporating into his life?
6. What might be some early-warning signals for him in terms of a relapse?
7. Which of the counseling techniques (decision matrix, mapping, 10 common dangers, TIPS for coping) might you use with this client?