What might a clinician want to know about Meredith’s alcohol use and why?
Meredith is a 24-year-old female who comes to the community counseling office where you work as a newly hired mental health counselor. On her intake form, which she filled out earlier while waiting for the appointment, she provides the following information, which is based on her answers to the questions on this form.
Home: Whiting, MA
Current job: Assistant to the activities director at a nursing home
Parents: Married, both living, Leek, MA
Father: Works full-time as a business manager
Mother: Works part-time as an office clerk
Parents’ histories: Father – heavy use of alcohol, two heart attacks; mother – use of prescription opiates for back pain.
Siblings: Meghan, 22, who is employed full-time in the publishing industry in New York City; Molly, 20, engaged to be married, still in college; Sarah, 18 (Meredith reported during her first session that this sister is “acting weird, washing her hair constantly, scared to go outside, almost seems afraid of everyone and thinks everyone is talking about her – she refuses to go to high school”), and Brian,12, who lives at home.
Medical history: Migraines? [she writes a question mark after migraines], menstrual problems [she writes in “serious cramps”]
Mental health history of patient: None
Substance use history of patient: First use of alcohol during first year of college; drinks during celebrations and weekend parties, uses alcohol to help with sleep. Medications: None, “but I think I need sleep medication” [client’s words]
Sexual History: [client left questions related to sexual activity blank]
Extended family information: Uncles on Father’s side are two “alcoholics?” [she writes the question mark after the term alcoholics]; father’s sister was hospitalized for a mental disorder for two years; “maternal grandmother – early death, question of alcohol use.
What prompted you to make this appointment? Meredith writes: “can’t sleep, eat, and my work is suffering because I can’t think…. I am stressed out…feeling out of control.”
1. Based on what the clinician has learned during the intake, what are some of the symptoms a clinician should look for, or ask about, when working with this client during the initial sessions? Explain each symptom.
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