Discussion 1: Substance Abuse and Comorbidity

Unfortunately, individuals living with a co-occurring mental disorder are more likely to abuse drugs or alcohol. One population that has struggled with substance abuse and comorbidity is veterans returning from the wars in Iraq and Afghanistan. Their returning to society after witnessing traumatic events and not always having the appropriate resources or treatment has contributed to substance abuse-related disorders. Understanding the prevalence of comorbidity of substance abuse and addiction with certain mental health diagnoses is important for clinical practice.

For this Discussion, review the Levy Family video. Then read the articles on your reading list for this week, including Jake’s case. Finally, identify the presenting problem for Jake Levy.

· Post a clinical diagnosis of Jake using the DSM-5 criteria, ICD-10-CM and the information presented in the Levy Family video and case. 

· Describe how you arrived at this diagnosis and what behaviors and/or symptoms met the criteria for this diagnosis. 

· Be sure to use the inputs from Other Conditions That May Be a Focus of Clinical Attention

· Analyze your diagnosis and the comorbidity of substance use and other disorders that exist in this case study. What would be your first area of focus in treating Jake?

References (use 3 or more)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

· “Substance-Related and Addictive Disorders” (pp. 481–590)

Muthén, B. (2006). Should substance use disorders be considered as categorical or dimensional? Addiction, 101, 6–16.

Nash, D., Wilkinson, J., Paradis, B., Kelley, S., Naseem, A., & Grant, K. (2011). Trauma and substance use disorders in rural and urban veterans. The Journal of Rural Health, 27(2), 151–158.

Nunes, E. V., & Rounsaville, B. J. (2006). Comorbidity of substance use with depression and other mental disorders: From Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to DSM-V. Addiction, 101, 86–96.

Plummer, S.-B., Makris, S., Brocksen S. (Eds.). (2014). Sessions: Case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

· “The Levy Family”

Room, R. (2006). Taking account of cultural and societal influences on substance use diagnoses and criteria. Addiction, 101, 31–39.

Sheidow, A. J., McCart, M., Zajac, K., & Davis, M. (2012). Prevalence and impact of substance use among emerging adults with serious mental health conditions. Psychiatric Rehabilitation Journal, 35(3), 235–243. doi:10.2975/35.3

Discussion 2:
Policy Implementation Challenges

When a policy is launched, its success is dependent on a variety of stakeholders. As the politics of decision makers, executives, staff, clients, and social workers begin to influence the implementation process, their beliefs—and subsequent actions—determine the fate of the policy.

Often a social worker must step out of the comfort of his or her social service world and may find himself or herself making difficult decisions about ethical issues and/or may find himself or herself involved in implementing policies that he or she feels is against his or her social work values. How does a social worker handle the intricacies and challenges of policy implementation on both a personal and professional level?

In this Discussion, you explore policy implementation and the challenges faced by social workers during policy implementation.

· Post your thoughts on whether social workers might try to undermine the implementation of specific policies. What ethical issues might they confront? Discuss how social workers can implement policies that they feel may be against their social work values. Discuss a specific policy’s impact that you would try to mitigate in the implementation phase. Provide an experience you have had with a policy you had difficulty implementing or a policy you are aware of that you would have serious qualms about implementing.

References (use 3 or more)

Jansson, B. S. (2018). Becoming an effective policy advocate: From policy practice to social justice (8th ed.). Pacific Grove, CA: Brooks/Cole Cengage Learning Series.

Chapter 13, “Troubleshooting the Implementation of Policies in Task 7” (pp. 460-487)

Lane, S. R., & Humphreys, N. A. (2011). Social workers in politics: A national survey of social work candidates and elected officials. Journal of Policy Practice, 10(3), 225–244. doi:10.1080/15588742.2011.582809.

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