Ray is a 40-year-old male who has come to a local homeless shelter. He has a bulbous nose, tremulous hands, and appears quite disheveled. During the intake process, he rarely looks at the interviewer...

Ray is a 40-year-old male who has come to a local homeless shelter. He has a bulbous nose, tremulous hands, and appears quite disheveled. During the intake process, he rarely looks at the interviewer and instead focuses his eyes on the floor. His answers are short and lack detail. Ray says he cannot remember the last time that he had something to drink or how much he normally drinks. He seems suspicious and defensive about the questions about his drinking.

1. What would you focus on as a top priority with Ray?

2. How would you attempt to establish rapport with Ray?

3. What concerns might you have with the accuracy of Ray's substance use history and why?