Mrs. Cunningham has been addicted to heroin for at least 20 years. In developing an appropriate plan of treatment for Rosa Lee, the writer utilizes the integrated model of addiction and must consider several factors over the course of her lifespan (Jenkins, n. d.). According to Glenn, Johnson and Raine (2013), substance use is a complicated issue to disentangle. Research suggests that genetic and environmental factors contribute to the possibility of antisocial personality and substance use disorders (Glenn, Johnson & Raine, 2013). Hasin et al. (2011) assert that “cognitive and emotive deficiencies that underlie ASPD, such as poor self-control, ineffective behavioral regulation, and poor decision-making, may facilitate and …show more content…
Although Mrs. Cunningham is currently on outpatient methadone maintenance treatment, the writer proposes a modification of pharmacological treatments that involves compulsory isolation (residential treatment) because of Rosa Lee’s history of substance abuse and other complicating factors such as her repeated arrests, living/community environment, co-occurring ASPD, and medical condition (HIV). Mrs. Cunningham’s SUD is so intense and persistent that a program like the Drug Treatment Alternative to Prison (DTAP) is necessary to control or prevent severe physical and psychiatric consequences of withdrawal. Research shows that persons in the DTAP program had higher retention rates and less criminal recidivism than those of the other groups at both 6 and 12 month follow-ups (Daughters et al. (2008) cite Young, 2002; Young & Belenko, 2002). The writer also proposes pharmacotherapy for her HIV along with HIV/AIDS …show more content…
Cognitive behavioral therapy (CBT) would assist Rosa Lee in learning inhibitory control techniques by discovering maladaptive thoughts and issues that possibly led to her substance use (Doweiko, 2015). In addition, the writer proposes contingency management (CM) which is essentially a reward system for abstinence (Doweiko (2015) cites Winermann, 2013). According to Daughters et al. (2008), persons with ASPD that participated in both CBT and CM were more likely to abstain from substance use than those who participated in CBT only. Group therapy is also essential in Rosa Lee’s healing because—in theory—she will be able to recreate her family of origin within the group setting and the interactional process will help her resolve issues from her childhood (Doweiko, 2015). Brook (2008) states that the group setting can enable to Mrs. Cunningham to learn how to form healthy relationships while improving her self-esteem (as cited by Doweiko,