PSYC FPX 4300 Assessment 3 I’ve Got you Pegged Treatment Plan

Name

Capella University

PSYC FPX 4300 Introduction to Addiction Treatment

Prof. Name

Date

PSYC FPX 4300 Assessment 3: I’ve Got You Pegged Treatment Plan

Melissa’s case involves concerning daily Xanax (alprazolam) use that requires a comprehensive substance use and mental health assessment. Her reported use of four to five pills per day, daily consumption, increasing tolerance, secrecy, and access to Xanax through peers are important warning signs. Her parents’ divorce, perceived lack of parental attention, concerns about family acceptance, and other adolescent stressors may also be contributing to her substance use. Because Melissa is a minor, an effective treatment plan should address not only her benzodiazepine use but also her emotional health, family environment, peer relationships, developmental needs, and safety.

Substance Use History

Melissa’s primary substance of concern is Xanax, the brand name for alprazolam. Alprazolam is a benzodiazepine prescription medication that can cause sedation and physical dependence when used regularly. According to the case, Melissa takes approximately four to five pills each day and has used Xanax daily during the previous month.

The case does not indicate that Melissa previously used Xanax during an earlier period or that she regularly combines it with other substances. It also does not identify a specific physical complication caused by her current use. However, the absence of reported physical symptoms does not mean that her substance use is safe. Regular benzodiazepine use can lead to tolerance and physical dependence, and withdrawal can become medically significant.

Pattern and Frequency of Xanax Use

Melissa’s reported use of four to five Xanax pills every day is particularly concerning because she is an adolescent. Daily consumption suggests that Xanax has become a regular part of her routine rather than occasional medication use.

Another important concern is how Melissa obtains the medication. She reportedly deceives her physician to obtain Xanax. Seeking medication through deception can indicate problematic use and creates additional safety concerns because the prescribing clinician may not have accurate information about her actual medication consumption.

Her pattern of use should therefore be evaluated in terms of frequency, quantity, tolerance, access, cravings, loss of control, and the effects of use on her daily functioning.

Consequences of Xanax Use

Physical Consequences

The case does not describe a major physical complication directly caused by Melissa’s Xanax use. She reports experiencing positive feelings after taking the medication. Nevertheless, benzodiazepines can cause sedation, impaired coordination, slowed reactions, cognitive difficulties, and other adverse effects.

The risk becomes especially serious when benzodiazepines are combined with other central nervous system depressants, including alcohol or opioids. Because Melissa reports taking multiple pills each day, a healthcare professional should assess her for tolerance, physical dependence, adverse effects, and potential withdrawal risk.

Psychological and Emotional Consequences

Melissa’s Xanax use occurs in the context of several emotional stressors. She hides her substance use from her parents and school because she is afraid of getting into trouble. This secrecy may make it more difficult for adults to recognize the extent of her substance use or connect her with appropriate care.

Her parents’ divorce is another important factor. Melissa feels that her parents are paying less attention to her because they are focused on the divorce. She is also keeping her sexual orientation private because she is concerned about how her parents may respond in light of their religious beliefs.

These experiences may contribute to emotional distress, isolation, anxiety, or other mental health concerns. A comprehensive assessment should determine whether Melissa is using Xanax to manage difficult emotions, anxiety, family stress, peer pressure, or other problems.

Environmental and Social Factors

Melissa’s family and peer environments are important when evaluating the development and continuation of her substance use.

After her parents’ divorce, Melissa primarily lives with her mother and visits her father every other weekend. The circumstances surrounding the divorce appear to have reduced the emotional attention available to Melissa and her brother. This perceived lack of support may contribute to feelings of isolation or distress.

Her peer group presents another significant risk factor. Melissa’s friends also use Xanax and reportedly share or sell the medication among themselves. Easy access to a substance within a peer group can normalize its use and make it more difficult for an adolescent to stop.

Treatment should therefore consider not only Melissa’s individual behavior but also the social environments that may reinforce her substance use.

Family History

Melissa’s family history includes substance use and emotional difficulties. Her parents reportedly consume alcohol moderately, while her older brother uses marijuana and has experienced school consequences related to his marijuana use.

Melissa’s mother is also receiving therapy following the divorce. The case suggests possible anxiety or depression, although a specific diagnosis is not established.

These circumstances are relevant because family stress, communication difficulties, substance use within the household, and parental mental health concerns can affect adolescent substance use. Family assessment should help determine which factors may be increasing Melissa’s vulnerability and which family resources can support recovery.

Educational, Financial, and Legal Considerations

Melissa is in her final year of middle school and is preparing to enter high school. This transition can involve academic, social, and developmental changes that may increase stress.

The case does not identify employment or financial concerns, which is expected given Melissa’s age. No current legal problems are reported either. However, the absence of legal or financial consequences does not mean that her substance use is without significant risk.

Continued Xanax misuse could affect her school performance, relationships, physical safety, emotional development, and ability to successfully transition into high school.

Motivation for Treatment

Melissa does not appear to be actively seeking treatment for her Xanax use. Her limited motivation should not be interpreted as a reason to delay intervention.

A supportive and developmentally appropriate approach may be more effective than confrontation. Clinicians can help Melissa explore what she likes about Xanax, what problems it may be creating, and how her substance use relates to her current circumstances.

Motivational interviewing may be useful because it focuses on strengthening a person’s motivation to consider behavioral change rather than relying primarily on confrontation or judgment.

Recommended Substance Use Assessment

A comprehensive assessment should examine the reasons behind Melissa’s Xanax use as well as the effects of her substance use on her functioning.

Important areas of assessment include:

• The circumstances surrounding her first Xanax use and how her use progressed.

• The reasons she takes Xanax and the effects she expects from it.

• Tolerance and possible physical dependence.

• Withdrawal symptoms and previous attempts to reduce or stop use.

• How she obtains Xanax and whether she has access to other prescription medications.

• Alcohol, marijuana, opioids, or other substance use.

• Anxiety, depression, trauma, suicidal thoughts, or other mental health concerns.

• Family relationships and the effects of the parental divorce.

• Peer relationships and possible social pressure.

• Academic performance and school-related difficulties.

• Her willingness and readiness to participate in treatment.

• Immediate safety concerns and access to potentially dangerous substances.

Because Melissa is an adolescent, the assessment should also account for her developmental stage. Appropriate caregiver involvement should be considered while maintaining confidentiality according to applicable laws, ethical standards, and clinical policies.

Clinical Assessment and Diagnostic Considerations

Melissa demonstrates multiple indicators that warrant concern about problematic benzodiazepine use. These include daily Xanax consumption, reported tolerance, concealment of her substance use, obtaining the medication through deception, and exposure to peers who use and distribute Xanax.

However, these findings alone are not sufficient to establish a formal diagnosis. The DSM-5-TR uses the diagnostic term sedative, hypnotic, or anxiolytic use disorder rather than older terminology such as “Xanax abuse” (American Psychiatric Association, 2022).

A qualified clinician would need to determine whether Melissa meets the required diagnostic criteria and, if so, the appropriate severity level. Daily use and tolerance are important clinical findings, but tolerance by itself does not establish a substance use disorder.

The assessment should also examine symptoms such as unsuccessful attempts to reduce use, cravings, continued use despite negative consequences, hazardous use, impaired functioning, and other diagnostic criteria.

Factors Supporting Clinical Concern

Several factors increase the need for professional evaluation and intervention:

• Daily Xanax consumption.

• Reported use of four to five pills per day.

• Increasing tolerance.

• Concealment of substance use.

• Obtaining medication through deception.

• Peer access to and use of Xanax.

• Stress associated with her parents’ divorce.

• Feelings of reduced parental attention.

• Concerns about family acceptance of her sexual orientation.

• Limited motivation to seek substance use treatment.

Taken together, these factors indicate that Melissa needs a comprehensive assessment rather than simply being instructed to stop using Xanax.

Treatment Plan for Melissa

Melissa’s treatment plan should address both her substance use and the underlying emotional, family, social, and developmental factors associated with it.

Because regular benzodiazepine use can lead to physical dependence and potentially serious withdrawal, Melissa should not be advised to abruptly stop taking Xanax without medical guidance. A qualified healthcare professional should determine whether medical monitoring or a supervised medication-management approach is necessary.

The appropriate level of treatment should be based on a comprehensive assessment of her substance use, mental health, safety, withdrawal risk, family circumstances, and overall functioning.

Individual Therapy

Individual therapy can provide Melissa with a supportive setting where she can discuss her substance use, family circumstances, emotional concerns, peer relationships, and other issues affecting her well-being.

Cognitive behavioral approaches may help her identify unhelpful thought patterns and develop healthier ways of managing stress and difficult emotions. Motivational interviewing may also help her explore ambivalence about treatment and develop greater motivation to reduce harmful substance use.

Therapy should be age-appropriate and trauma-informed when indicated.

Family-Based Support

Family involvement may be particularly important because Melissa’s parents’ divorce and perceived lack of attention appear to be significant sources of stress.

Family-based treatment can help improve communication, establish healthy boundaries, increase emotional support, and address family conflict. Parents or caregivers can also learn how to recognize warning signs, support treatment participation, and create a safer environment.

Family involvement should be balanced with Melissa’s developmental need for privacy and the legal and ethical requirements governing adolescent confidentiality.

Substance Use Education

Melissa and her caregivers should receive clear, age-appropriate education about Xanax and benzodiazepine-related risks.

Education should address tolerance, physical dependence, impaired judgment, sedation, overdose risk, and withdrawal. It should also emphasize the dangers of combining benzodiazepines with alcohol, opioids, or other substances that can depress the central nervous system.

Understanding these risks may help Melissa make more informed decisions and recognize why professional support is necessary.

Rehabilitation and Relapse Prevention

Recovery planning should help Melissa develop alternatives to substance use. Treatment can focus on coping skills, stress management, emotional regulation, communication, decision-making, and strategies for responding to peer pressure.

A relapse-prevention plan should identify situations that increase her desire to use Xanax and establish safer responses to those situations. This may include reducing exposure to peers who provide or encourage drug use, developing supportive relationships, and identifying adults or professionals she can contact when she is struggling.

Mental Health and Emotional Support

Melissa’s emotional health should be evaluated alongside her substance use. Her parents’ divorce, concerns about family acceptance, possible anxiety or depression, and feelings of neglect may all influence her coping behaviors.

A mental health assessment should identify whether she has symptoms of anxiety, depression, trauma-related difficulties, suicidal ideation, or other concerns requiring intervention.

Treatment should avoid assuming that Xanax use is the only problem. Addressing the underlying emotional difficulties may be an important component of reducing her reliance on substances.

Ethical and Confidentiality Considerations

Because Melissa is a minor, confidentiality must be addressed carefully. At the beginning of treatment, healthcare professionals should explain what information can remain private and what circumstances may require disclosure.

Rules regarding adolescent consent, confidentiality, parental involvement, and substance use treatment vary by jurisdiction and clinical setting. Healthcare professionals should therefore follow applicable laws, professional standards, and organizational policies.

If Melissa presents an immediate risk of harming herself or someone else, or if another situation triggers a legal reporting obligation, confidentiality may have limits. Explaining these limits clearly can help establish trust while maintaining safety.

Expected Treatment Outcomes

The treatment plan should include realistic and measurable goals appropriate to Melissa’s developmental needs. Potential outcomes include improved understanding of benzodiazepine-related risks, increased willingness to participate in treatment, reduced reliance on substances, development of healthier coping strategies, improved communication with caregivers, and stronger support systems.

Treatment should also focus on improving school functioning, strengthening healthy peer relationships, addressing emotional distress, and reducing exposure to situations that increase the likelihood of continued substance use.

Overall Clinical Perspective

Melissa’s case illustrates how adolescent substance use can develop through an interaction of individual, family, peer, emotional, and developmental factors. Her daily Xanax use, reported tolerance, secrecy, access to the medication, and emotional stressors require professional attention.

The most appropriate approach is an adolescent-centered treatment plan that combines substance use assessment with mental health care, family support, education, coping-skills development, and relapse prevention. Melissa should receive professional medical guidance rather than being instructed to abruptly discontinue regular Xanax use.

Early intervention can reduce the potential for continued benzodiazepine misuse while helping Melissa develop healthier coping strategies and navigate the transition into high school.

Frequently Asked Questions

What is the main substance use concern in Melissa’s case?

The primary concern is Melissa’s daily use of Xanax (alprazolam), reportedly at a rate of four to five pills per day. Her reported tolerance, secrecy, deceptive acquisition of medication, and access to Xanax through peers further increase the need for professional assessment.

Does daily Xanax use mean that Melissa has a substance use disorder?

Not necessarily. Daily use is a significant warning sign, but frequency alone does not establish a DSM-5-TR diagnosis. A qualified clinician must evaluate the full diagnostic criteria, including impaired control, cravings, continued use despite problems, hazardous use, and effects on functioning.

Why is Xanax misuse concerning for an adolescent?

Adolescents are still undergoing important neurological, emotional, and social development. Misusing benzodiazepines can result in sedation, impaired judgment, dependence, and other health and safety risks. The risks can be greater when Xanax is combined with alcohol, opioids, or other sedating substances.

What factors may be contributing to Melissa’s Xanax use?

Potential contributing factors include her parents’ divorce, feelings of reduced parental attention, concerns about family acceptance, peer substance use, access to Xanax, and stress associated with adolescence and the transition to high school.

What treatment is recommended for Melissa?

Treatment should begin with a comprehensive clinical and substance use assessment. Depending on the findings, care may include individual therapy, family-based interventions, substance use education, mental health treatment, medically supervised management of benzodiazepine dependence when indicated, and relapse-prevention planning.

Should Melissa stop taking Xanax immediately?

No. Someone who has been using benzodiazepines regularly should not abruptly discontinue them without professional medical guidance. Withdrawal can be serious, so a qualified healthcare professional should determine the safest approach to reducing or discontinuing use.

How can Melissa’s family support her recovery?

Her family can provide consistent emotional support, improve communication, establish appropriate boundaries, participate in family-based treatment when appropriate, and help create a safer environment. Addressing stress associated with the divorce may also help reduce factors contributing to her substance use.

Why is motivational interviewing appropriate for Melissa?

Motivational interviewing can help Melissa explore her own reasons for using Xanax and consider the benefits and disadvantages of changing her behavior. This approach can be useful when an adolescent is uncertain or reluctant about treatment because it emphasizes collaboration rather than confrontation.

What role do Melissa’s peers play in her substance use?

Peers can significantly influence adolescent substance use, particularly when substances are easily available within the social group. Melissa’s friends reportedly use, share, and sell Xanax, which may normalize use and make it harder for her to stop. Treatment should therefore address peer pressure and help her develop healthier social supports.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals (2nd ed.). Guilford Press. https://www.guilford.com/books/Treating-Addiction/Miller-Forcehimes-Zweben/9781462533374

PSYC FPX 4300 Assessment 3 I’ve Got you Pegged Treatment Plan

National Institute on Drug Abuse. (2024). Benzodiazepines and other prescription medications. National Institutes of Health. https://nida.nih.gov/research-topics/prescription-drugs/benzodiazepines

Substance Abuse and Mental Health Services Administration. (2023). Treatment considerations for youth and young adults. U.S. Department of Health and Human Services. https://www.samhsa.gov/