濫用藥物案例分析1
1.The Case of an Abandoned Orphan 案例:一個被遺棄的孤兒
Joe, a 28 years old man, came to you to seek counseling because of his recent divorce after 3 years of marriage. He felt depressed, anxious and dejected wondering he would ever achieve a satisfying long-term relationship. He had 2 other previous intimate relationships and none of them lasted for more than a year. He described a pattern of becoming intensely attached to women and then, quickly becoming insecure and jealous. As a result, he ended up being controlling and abusive to them. He felt guilty for his abusive behavior and understood his inappropriate behavior towards women came from his sense of inadequacy and unworthiness about himself.
Joe 是一位28歲的男子，最近他剛離婚結束了三年的婚姻生活，因此到來向你尋求協助。
他感到苦悶、徬徨和沮喪情緒低落，他懷疑自己不能與人發展合適的長久關係。
Joe之前曾發展二段親密關係，但都不能持續超過一年。
他形容自己很快就能投入一段新的戀情，但隨之而來只有嫉妒和不安的感覺。
結果，最終因為Joe對伴侣極度支配和虐待以致關係結
束。
對於這種對伴侣的虐待行為，Joe知道是不適當而且是亳無價值的，為此他亦非常內疚。
Joe had been consuming 7 to 9 drinks of alcoholic beverages per day for some years. He also used cocaine a few times every month. In addition, he took a large amount of pain-killers that had been prescribed to him by his doctor ever since his knee surgery a couple years ago.
Joe已經有多年習慣每日飲用7至9杯的酒類飲品，他每月吸食幾次可卡因。
此外，他因二年前進行膝蓋手術並經醫生處方止痛藥後，而大量用這些止痛藥。
Joe and his elder brother were placed in an orphanage after his parents died in a car accident when they were age 11 and 13 respectively where they were physically abused and emotionally neglected. His elder brother committed suicide 2 years later. He was adopted by a childless elderly couple a few months later. Although his adopted parents never showed much affection towards him, he recalled the feeling of warmth and intimacy he experienced with them when they
shared alcoholic drinks with him after dinners on a regular basis since his adoption.
Joe的父母在一場車禍中去世，當時他和長兄分別11歲和13歲，並被送到孤兒院，期間受到身體虐待和忽略。
二年後長兄自殺。
幾個月後Joe 被一對沒兒女的夫婦收養，雖然這對夫婦沒有對Joe表現太多情感，但Joe 仍常記起與他們一起享用餐後酒的溫暖和親密感覺。
Despite of such a difficult childhood, he managed to do well in school. At the time of his request for counseling, he had been working as a research assistant in a pharmacology laboratory. He reported being well-liked and was given lots of responsibility at work. He commented that no one at work knew that he was such a failure in his personal life and he hoped that they would never find out!
儘管有不快經歷的童年，但Joe在學業表現很好。
當Joe前來要求輔導時，他已經是在一間藥理學實驗室從事研究助理的工作。
Joe描述自己是一名盡責及受人們喜愛的員工。
沒有人知道他失敗的經歷，而且他亦永遠不會讓其他人知道！
1. What do you think where Joe stands in the continuum of drug use?
2. What stage of change is he at in regard to his drug use?
3. What do you think is the relationship between his relationship problems, his psychiatric symptoms and his drug use?
4. How does your assessment of his drug use situation help you to develop a treatment plan for him?
5. What are your strategies in work with Joe using the Harm Reduction Therapy?
1.你認為Joe處於那個用藥的STAGE？
2.他現在的濫藥行為是處於改變輪那個階段？
3.你認為Joe的人際關係問題，是與他的精神症狀相關還是與藥物濫用有關？
4.對於Joe的濫藥狀況評估，如何協助你去制定針對Joe的治療計劃？
5.你如何運用減害治療制定策略來幫助Joe?。