Alcoholism Disorder

  • Support your approach with  evidence-based literature.

Note: please include a title page, introduction, summary/conclusion and references.

In a 3- to 4-page paper, address the following questions:

Episode 1

Program Transcript

[MUSIC PLAYING]

FEMALE SPEAKER: You‘re not dressed? You‘re going to be late for work.

MALE SPEAKER: I‘m not going to work. I‘m sick.

FEMALE SPEAKER: Of courseyou‘re sick. You‘re hungover. Idon’t want the

boys to see you like this. Go back to bed.

MALE SPEAKER: See me like what? I told you, I’m sick.

FEMALE SPEAKER: Well, what do you call it when someone is sick almost

every morning, because they drink every night while they sit in the dark watching

TV?

MALE SPEAKER: You calling me a drunk?

FEMALE SPEAKER: What do you call it?

MALE SPEAKER: I call it, leave me the hell alone.

FEMALE SPEAKER: Baby, you need to stop this. It’s tearing us up. The drinking,

the anger– you’re depressed.

MALE SPEAKER: You said, for better or worse.

FEMALE SPEAKER: My vows don’t cover this. You were never like this before.

You’ve changed. I want us back, the way we used to be.

MALE SPEAKER: That way is dead. It died when I went to Iraq

  • After watching Episode 1, describe:
    • What is Mr. Levy’s perception of the problem?
    • What is Mrs. Levy’s perception of the problem?
    • What can be some of the implications of the problem on the family as a whole?

Levy Family: Episode 2 Program Transcript

FEMALE SPEAKER (Mr. Levy’s social worker’s): I want to thank you for getting me this Levy case. I think it’s

so interesting. Just can’t wait to meet with the client.

MALE SPEAKER(Mr. Levy’s social worker’s supervisor): What do you find interesting about it?

FEMALE SPEAKER: Well, he’s just 31. Usually the vets I work with are older. If

they have PTSD, it’s from traumas a long time ago. But Jake, this is all pretty

new to him. He just left Iraq a year ago.

You know, I was thinking he would be perfect for one of those newer treatment

options, art therapy, meditation, yoga, something like that.

MALE SPEAKER: Why?

FEMALE SPEAKER: Well, I’ve been dying to try one of them. I’ve read a lot of

good things. Why? What are you thinking?

MALE SPEAKER: I’m thinkingyou should really think about it some more. Think

about your priorities. It’s a good idea to be open-minded about treatment options,

but the needs of the client have to come first, not just some treatment that you or

I might be interested in.

FEMALE SPEAKER: I mean, Iwasn’t saying it like that. I always think of my

clients first.

MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have

You seen any research or data that measures how effective they are in

treatment?

FEMALE SPEAKER: No.

MALE SPEAKER: Neither have I. There may be good research out there, and

maybe one or two of the treatments that you mentioned might be really good

ideas. I just want to point out that you should meet your client first, meet Jake

before you make any decisions about how to address his issues. Make sense?

FEMALE SPEAKER: Yeah.

  • After watching Episode 2, describe:
    • What did you think of Mr. Levy’s social worker’s ideas?
    • What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?

Levy Family: Episode 3 Program Transcript

JAKE LEVY: We’d be out on recon in our Humvees, and it would get so hot. We

used to put our water bottles in wet socks and hang them right outside the

window just so the water would cool off a bit, and maybe then you could drink

it.

Man, it was cramped in there. You’ll be drenched, nowhere to breathe. It’s like

riding around in an oven. And you’d have your helmet on you, 100 pounds of

gear and ammo. I swear, sometimes I feel like it’s still on me, like it’s all still

strapped on me.

FEMALE SPEAKER (Mr. Levy’s therapist): How many tours did you do in Iraq?

JAKE LEVY: Three. After that last recon, I just–—- There were 26 of us. Five

marines in the Humvee I was in. I remember I was wearing my night vision

goggles. We passed through a village and everything was green, like I was in a

dream or under water.

And then there was a flash, bright light just blinded me. There was this explosion.

I can’t– I can’t–

FEMALE SPEAKER: It’s OK, Jake. Take it easy. I understand this is difficult.

There’s something I;d like to try with you. It’s called exposure therapy, and it’s a

treatment that’s used a lot with war veterans, especially those struggling with

anxiety and PTSD.

JAKE LEVY: Exposure therapy?

FEMALE SPEAKER: Yes. It’s to help someone like yourself to confront your

feelings and anxieties about a traumatic situation that you’ve experienced. It’s a–

It’s meant to help you get more control of your thoughts, to make sense of what’s

happened, and to not be so afraid of your memories.

JAKE LEVY: Put that in a bottle and I’ll buy 10 cases of it.

FEMALE SPEAKER: Well, one part of it is learning to control your breathing. And

When you practice that, you can learn to manage your anxiety, to get more

control of it, not let it control you, to protect yourself. Do you want to try it?

JAKE LEVY: Right now?

FEMALE SPEAKER: Sure.

JAKE LEVY: Why not?

  1. Well, I know this sounds crazy, but a lot of people don’t

breathe properly. And it really comes from bad habits. When they inhale and

exhale, all the effort is here in their chest and shoulders. And the problem with

that is you get a really short, shallow breath. And that really increases the stress

and anxiety in your body.

Instead, a more natural breath should always involve your diaphragm, right here

in your abdomen. When you breath in, your belly should expand. And when you

breath out, your belly should fall. OK

JAKE LEVY: OK.

FEMALE SPEAKER: So, let’s practice. Close your eyes. Now, I want you put one

hand on your abdomen and the other across your chest. Good. Good. Now, I just

want you to take a few breaths, just like normal. What are you feeling?

JAKE LEVY: I feel my chest moving up and down. But my belly, nothing.

FEMALE SPEAKER: OK. So that’s what I was just talking about. That’s OK. Let’s

try this. I want you take a breath. And this time, I only want you to allow your

abdomen to expend when you breathe in and to fall when you breathe out.

OK, let’s try it. Breathe in. Breathe out. Breathe in. Breathe out.

You feeling better? More relaxed?

JAKE LEVY: Yes.

FEMALE SPEAKER: And the more you practice it the easier it will become. So

when you find that stress and anxiety coming on, just do your breathing. You can

keep yourself from getting swept by all those bad thoughts. OK?

JAKE LEVY: Yes. Thank you.

FEMALE SPEAKER: So, do you want to try to go back to what you were telling

me about before?

JAKE LEVY: I can try. It was night. We were out on recon. It was my third tour in

Iraq

  • After watching Episode 3, discuss the following:
    • What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
    • What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
    • Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
    • Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?

Levy Family:  Episode 4 Program Transcript

FEMALE SPEAKER: So do you want to try to go back to what you’re telling me before? 

LEVY: I can try. It was night. We were out on patrol. I remember it was so hot packed in our vehicle. Suddenly there was an explosion. We got tossed into a ditch. And somehow I made it out, and I could see it was the Humvee behind us. It’s whole front end was gone. It had hit a roadside bomb. Our vehicle had just driven past it, just mistriggering it. But not them. They didn’t make it. 

FEMALE SPEAKER: Remember how we practiced. Slow your breathing down. Inhale and exhale from your abdomen. 

LEVY: Thank you.                                                                                     

FEMALE SPEAKER: And just take your time. Whenever you are ready. 

LEVY: So the bomb went off. I managed to get out. I had my night vision goggles on. And I could see the Humvee, the one that got hit. It’s whole front end was gone. And there’s this crater in the road. And inside it I could see– I could see  Kurt’s– our platoon Sergeant, he was lying there everything below his waist was  gone, blown off. And he was screaming. Screaming like nothing you’d ever heard. 

And then he was looking at me. And he was screaming for me to kill him. To stop his suffering. He was yelling, please. Please. And someone tried putting tourniquets on him. But the ground just kept getting darker with his blood. And I was staring into his face. 

I had my rifle trained on him. I was going to do it. You know. He was begging me to. I could feel my finger on the trigger. And I kept looking into his face. And then I didn’t have to do nothing. Because the screaming had stopped. He’d bled out. Died right there. 

And all I could think was I’d let him down. His last request, and I couldn’t do it. I couldn’t put a bullet in him so he could die fast not slow. 

FEMALE SPEAKER: I can see and hear how painful it is for you to relive this story. Thank you for sharing it. Do you think this incident is behind some of the symptoms you’ve been telling me about? 

LEVY: When I go to sleep at night, I close my eyes, and I see Kurt’s there staring at me. So I don’t sleep too good. That’s why I started drinking. It’s the only way I can forget about that night. So I drink too much. At least that’s what my wife yells at me.  We’re not doing too well these days. I’m not exactly the life of the party. I left Iraq 10 months ago. But Iraq never left me. I’m afraid it’s never going to leave me alone. 

In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.

  • Discuss how you would have responded to this revelation.
  • Describe how this information would inform your therapeutic approach. What would you say/do next?

Levy Family: Episode 5

FEMALE SPEAKER: It was such an intense story. I just kept seeing things the

way he did, you know. The weird green of his night-vision goggles, his sergeant

screaming for Jake to kill him. I just keep seeing it all in my head.

[MUSIC PLAYING]

MALE SPEAKER: Why, do you think?

FEMALE SPEAKER: Why what?

MALE SPEAKER: Why do you think you keep thinking about this story, this

particular case?

FEMALE SPEAKER: I don’t know, maybe because it’s so vivid. You know, I went

home last night, turned on the TV to try to get my mind off it. And a commercial

for the Marines came on, and there was all over again– the explosion, the

screams, the man dying. Such a nightmare to live with, and he’s got a baby on

they way.

MALE SPEAKER: Could that be it, the baby?

FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other

vets I work with are older, and they have grown kids. But Jake is different.

I just keep picturing him with a newborn. And I guess it scares me. I wonder if

he’ll be able to deal with it.

Levy Family: Episode 5

Additional Content Attribution

MUSIC:

  • In Episode 5, Mr. Levy’s therapist is having issues with his story.
    • Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
  • Support your approach with evidence-based literature.

Note: please include a title page, introduction, summary/conclusion and references.

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