Dual Diagnosis Role Play

Dual-Diagnosis Role Play Script

BSHS 455 Week 3

Counselor: Hello, how are we doing today?

Spouse: I am doing well today.

Client: I have had better days. Today started out alright and then as it has gone on I am just in lots of pain now.

Spouse: It seems to me that every day is the same. I am not sure what to do because he says he is in pain but I don’t want to give him anything for the pain due to his addiction to narcotics.

Counselor: I understand what you saying, that it is difficult seeing him in pain but you don’t want to give him anything for it because he might get too addicted to the medication. Does it get worse out in the community?

Client: It does get worse especially at certain places of where I have been when I first started taking narcotics like when I went to the doctors and he prescribed me the narcotics for my pain originally now if I go by there it seems that my pain gets worse and everywhere else that I go the pain is not there, bearable and excruciating.

Spouse: I agree it is how it is; sometimes it is even around people he knows.

Counselor: Why do you think that is?

Spouse: I think it is because the people that he starts having these troubles around are people that he was around when he started getting these medications.

Client: It is just difficult to want to get out and be able to do things without having pain. I had surgery six months ago and I am still experiencing severe back and leg pain. My medication is not working, I need something stronger. Dr. is telling me that I have addiction problem. That’s not true; I am in a lot of pain.

Spouse: He is in a lot of pain. He needs help. All he does is sleep but still in pain.

Counselor: Narcotic pain medication used over a long period of time can cause a hyper sensitivity reaction that makes a person experience pain at heightened levels.

Client: (Annoyed) No one believes my pain is real.

Spouse: I know you are hurting dear but so many pills can harm you.

Client: I don’t care if they harm me. I can’t tolerate this pain.

Counselor: What medication are you taking for the pain?

Client: I am using OxyContin 60 mg. 3 times a day and Percocet 10mg. for break through pain every four hours.

Counselor: That is a lot of medication. You need to wean off of these medications.

Client: What about my pain? How I will survive?

Spouse: Yes. He needs help with pain.

Counselor: I understand. Just the absence of these medications will significantly decrease your pain. And the pain you are left with can be treated with alternative method.

Spouse: Like what?

Counselor: Including Cognitive therapy, Acupuncture and increased physical activity. All these methods are proven to be effective in decreasing pain.

Client: Ok. I’ll try anything if it works. How do we do this? Would I have to go cold turkey?

Counselor: That will cause withdrawal symptoms and it is not necessary to go through these unpleasant symptoms. Rapid Opiate Detoxification can be done with the help of anesthesia-assisted techniques or your doctor may suggest to gradually reducing medications. You need to discuss your options with your pain doctor and get the treatment.

Client: Ok. I’ll try this treatment.

Counselor: Yes. Discuss with your doctor about your pain and follow their advice.

Client: I definitely will.

Counselor: I want to see you again in 10 days, so please make an appointment to see your doctor between now and then so we can discuss the results and the information you found from the visit. I would like the records from your doctor sent to me please.

Spouse: I will make sure he makes that appointment sometime next week.

Client: Yes, I will make the appointment next week for sure.

Counselor: So in 2 weeks lets meet again, is Wednesday the 20th and 4:00 pm going to be okay for our next appointment.

Client: Yes, that will work for me.

Spouse: Will I have to come for this next session?

Counselor: No that won’t be necessary, he will be able to meet me by himself this time, since we will be discussing information from his visit with his doctor.

Spouse: Okay

Client: Thank you counselor, I will see you on the 20th at 4:00.

Counselor: Okay, see you then. Have a great weekend.

Client: Thank you and you do the same.

Reference

Spine-health. (2014). Retrieved from http://www.spine-health.com/treatment/pain-

medication/rapid-opiate-detoxification-treatment

University of Phoenix. (2014). Chemical Dependency. A Systems Approach, Fourth Edition.

Retrieved from University of Phoenix, BSHS-455 website.