Client Map for Ray Charles Based on the Film Ray
In the movie Ray, Ray Charles is depicted as using multiple types of drugs, but only his use of heroin would meet the guidelines for a diagnosis under DSM-V. Furthermore, after recovers from his heroin addiction, the movie suggests that Ray became sober. In reality, Charles became a heavy drinker and used significant amounts of marijuana throughout his life. However, since that drug use is not portrayed in the film, those diagnoses are not included and will not be considered in this client map. Knowing that behavior would change the client map for him, but that knowledge and information comes from outside of the source material found in the movie.
Diagnosis
304.00, Substance Use Disorder, Heroin, Severe.
Under DSM-V, a scale of 1 to 11 symptoms is used to determine whether a substance use disorder is mild (2-3 symptoms); moderate (4-5 symptoms); or severe (6 or more symptoms). He took increasing amounts of the substance; he spent a great deal of time in drug-related activities; there was evidence of strong drug cravings; his drug use resulted in him failing to meet obligations at home; he continued to use heroin despite having legal problems; he used heroin despite it being physically hazardous (although this was not made explicit in the film, heroin use is inherently physically hazardous); he continued to use heroin despite it causing recurrent social and interpersonal problems; and he appeared to display tolerance.
Objectives
The short-term goal is to detox Charles from heroin. Of all substances, heroin is notorious for its physically hazardous withdrawal symptoms, which can mean that the detoxification process needs to be medically supervised. It can also mean that some addicts use opiate substitutes, such as methadone, to replace the heroin. For Ray, the goal would be total detoxification in a medically supervised facility. He would be expected to enter the facility immediately; he would not be expected to use within the facility; and detoxification would last approximately one week, though his initial treatment program would last longer than the physical detoxification. The mid-term goal would be for Ray to avoid scenarios that would tempt him to use heroin for six months after being released from the treatment facility. Because he is a musician and drugs are part of the music scene, it is unrealistic to expect him to avoid exposure to drug usage for an indefinite period of time, but avoiding triggering scenario initially may help him create new habits that reinforce sobriety. The long-term goal is for Ray not to use heroin for a one year period following his release from recovery.
Assessment
Ray's drug usage led to involvement with the criminal justice system, and this involvement would have played a role in his assessment, even if it was only through his arrest reports. Interviews with friends and family members could be conducted, but given Ray's celebrity status and the financial interdependency of many people in his life, it would be critical for an evaluator to consider whether those people could provide an objective assessment. Using the structure of the ASI would combine the benefits of a self-assessment with the structure of a more rigid tool.
Clinician
Ray's ideal clinician might not actually be a clinician at all. He began his drug usage intentionally because he believed it would promote creativity, so a clinician who was also an artist would be an ideal match. In fact, another artist who had successfully completed recovery and was continuing to thrive in an art community that had a drug-friendly environment could help Ray learn how to navigate sobriety. In this way, Ray's ideal clinician might actually be closer to a traditional sponsor in a 12-step program than to a clinician. However, given the difficulty in matching Ray's level of genius, an older, African-American woman with a holistic approach might be ideal for Ray's clinician because of his close relationship with his mother.
Location
Because his addiction is to heroin, which is notorious for creating very difficult withdrawal symptoms, his treatment should begin at an in-patient care facility. In-patient care should be continued not only until the threat of withdrawal symptoms has been removed, but long enough to give the patient sufficient time...
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