Running head: FINAL SUBMISSION

Course Project Task VII Final Submission Gerry Hoffman Argosy University

FINAL SUBMISSION Name: Ms. G. Case Number: Case 1 Date of Birth: 07-01-1963 Test Date: 09-09-09 Interview Date: 09-10-09 Date of Report: 10-25-09 Introduction This assessment, to determine client's competency to refuse counsel, was determined by a competency to stand trial assessment at the request of the County Prosecutor's office. Reason for referral Ms. G., a forty-six year old Caucasian woman, was arrested when intoxicated and in possession of drugs, and charged with burglary of property belonging to her neighbor. Refusing a plea bargain and defense counsel, Ms. G. now faces a trial for the offense. Based on the arresting officer's report of

Time Spent: 180 minutes Time Spent : 90 minutes

combative, hostile, irritable, belligerent hyperactive, assaultive, irrational behavior at the time of arrest and officers at the county correction holding facility observing a high energy level and paranoid behavior while Ms. G. was in the holding cell, the prosecutor's office requested a determination of competency to stand trial. Behaviors at the time of arrest and while in the holding cell indicate client may have a mental or neurological disorder which would account for observed behaviors (DSM-IV TR). Presentation Ms. G. stated she has been using cocaine daily for the past six months. She appeared disheveled and malnourished. She blames her confusion and anger when arrested and in the holding cell on being under the influence of cocaine and subsequent coming down from the effects of the drug.

FINAL SUBMISSION

Testing Information : Minnesota Multiphasic Personality Inventory, second edition (MMPI-2) :The MMPI-2 is a selfadministered personality inventory designed to evaluate personality traits and symptoms of psychological illnesses and personal maladaptive adjustment(Megargee, 2009). Mental Status Examination consisting of a structured and an unstructured interview. Wechsler Adult Intelligence Scales, fourth edition (WAIS 4). The WAIS 4 is a full-scale intelligence test used to identify intellectual functioning and potential deficits in both verbal and non-verbal areas. Findings MMPI-2 scales: Hs,Hy,Pd,Mf,Pa,Pt ,Sc,Ma,and Si are within normal clinical scoring range. Scale Ddepression showed elevation. Her MAC-R (MacAndrew Alcoholism Scale-Revised) scores on the addiction proneness indicators are indicative of an addictive disorder (Butcher, n.d.). There is no indication that her elevated D scale score is associated with a suicide risk, as her means of coping with depression is to self- medicate to alleviate symptoms. Mental Status Examination structured examination revealed no major abnormalities, Ms. G. showed average insight and difficulty focusing with agitation. This was determined to be related to client's concern regarding current legal situation, as other testing showed normal results. Her structured mental status examination was normal. She was aware of time and place. Eye contact was appropriate. Speech was normal in clarity, rate, and volume. Thought content and processes were normal. Short, long and immediate memory and recall were normal. Client showed good comprehension and response to proverbs. Affect and mood were normal. Insight, reasoning and judgment were shown to be average. Reality testing was normal. Vocabulary and grammar indicate average intellectual functioning. Ms. G. was able to form good rapport and appeared eager to speak

FINAL SUBMISSION

and provide details regarding her arrest ; but, she has a distrust of authority which is a result of her boyfriend informing her she should not trust the police. WAIS 4 indicated client's general cognitive ability general verbal comprehension abilities and general perceptual reasoning abilities were in the average range. Ability to sustain attention, concentrate, and exert mental control is in the average range Clients ability in processing simple or routine visual material without making errors is in the average range. Diagnostic Impressions AXIS I: 292.11 Cocaine induced psychotic disorder with delusions with onset during intoxication 304.80 Poly substance dependence AXIS II: V71.09 AXIS III: None AXIS IV: problems related to unemployment, and social environment AXIS V: GAF: 50 serious impairment in social/occupational functioning Background Ms. G lost her parents at a young age and her foster family were very religious and strict when she was growing up. She stated she felt overwhelmed and oppressed and left home after an argument at age eighteen. She graduated high school but considers herself a below average student. She stated she had no employment skills when she left home and learned to do whatever was needed to survive financially. She considers herself street-wise and capable of making it on her own; although she is emotionally dependent on her boyfriend. Although she has been engaged in prostitution and substance use for twenty -five years, the client has only one previous legal incident, which was instigated by an individual other than the client as client and this person left a bar. She received a thirty day suspended sentence and completed a successful year of probation, securing factory employment through a

FINAL SUBMISSION temporary agency during this period. Psychological History Ms. G. denied a history of any treatment which her brother confirmed , to his knowledge, to be accurate. Her financial survival skills are well-honed. Her general coping skills are limited; however as revealed by a GAF score of 50. Her method of coping with financial frustration is to do whatever she feels is necessary to survive, although she denies engaging in robbery or theft or fraud. She states that prostitution and drug dealing are how she mainly survives, occasionally she will work temporary positions when something is available. Emotional frustrations are met with drug or alcohol usage. Her upbringing was restrictive and she rebelled against her foster parents values by moving away as a young adult. She grew up as an

only child and states she had periods of depression, as a result of being separated from her brother, which was the motivation for hiring a private investigator to locate him. Substance Use History Ms G. states she started using alcohol and marijuana at age fourteen , with initial use on week-ends. She states that by age eighteen, after she left her foster parent's home because of an argument, she started using alcohol and marijuana more frequently. Her drinking and marijuana use became several times a week. She states that she became a daily alcohol user at age thirty after a breakup with her boyfriend at the time. She attended Alcoholics Anonymous in her early thirties as she felt she wanted to start a family. She did not start a family and states that her boyfriend's use of alcohol and drugs made it difficult for her to remain sober and she returned to using after several years. She has used alcohol and marijuana regularly while with her present boyfriend for the past fifteen years. Six months ago she started using cocaine , when her boyfriend started selling the drug. She has no history of treatment for substance use. Her current use of cocaine has been daily for the past six months and was a factor in her behavior at the time of her arrest.

FINAL SUBMISSION Medical History

Ms. G. states she is in good health and takes no medications. Her older brother states that Ms. G's natural parents were alcoholic and that alcohol was a factor in the automobile crash in which they were both killed. Her brother is in good health with no substance problems. Conclusion Client was informed that information was being obtained in order to conduct evaluation for the prosecutors office. Limits of confidentiality were explained. The right to refuse to answer questions was explained and the consequences of refusing explained (Ford,2006). Client behavior was viewed in the context of American culture and her dependency on males was viewed in that cultural context. Individual identity and goals could be seen as unhealthy in the context of other cultures( Ford,2006). Client presents no psychological,neurological or intellectual obstacles to competency to stand trial and refuse counsel as shown through MMPI-2, WAIS-4 and mental status examinations. Client understands the legal process adequately responding to assessment questions regarding court procedures during the unstructured interview process. She is aware of the charges against her and the penalties. Failure to co-operate with police was based on her perception that no crime was committed as well as being under the influence of cocaine. DSM IV-TR diagnosis indicates her behavior was related to a cocaine induced psychotic disorder with delusions occurring during intoxication. Her MMPI-2 profile indicates elevations on substance abuse scales and her self reported daily use of cocaine for the past six months, along with her behavior at the time of arrest and while in the holding area , indicates she was in a state of cocaine intoxication when officers confronted her which accounts for her anger, hostility and belligerence. Client has elevated depression and addiction scales on MMPI-2 which are seen as a result of no family connection, and poor employment skills (Butcher,2003) which she believes requires her to engage in prostitution or drug dealing to make ends meet. Her depression may be related to her daily cocaine use as use of the drug depletes neurotransmitters

FINAL SUBMISSION indicated in depression (Earley,1991). Her social network is comprised of other drug users.

Communication with her brother is good, but seldom occurs due to her transient lifestyle. Client is of average to slightly above average intelligence with a high school education, but little formal employment skills .Client has slipped into a pattern of engaging in prostitution and drug dealing to support herself and has been using cocaine after her boyfriend began dealing the drug six months ago. Her general health is good but she is malnourished as a result of drug use. .Interview with her neighbor confirmed that she did have permission to remove property and they had a general understanding among their social group that one could borrow items and enter each others property when the residents were not home. Client needs to see other options for self sufficiency and gain in the understanding that; although, she has avoided legal difficulties as a result of her current lifestyle, she is engaging in behaviors that can cause her additional legal difficulties. Her DSM IV-TR diagnostic impressions lead to poly substance dependence and impairment in social and occupational functioning which is believed to be a consequence of long term drug use and a lack of employment skills training. Recommendation Client would benefit from inpatient substance abuse treatment and assessment for depression after sufficient time has elapsed to make determination as to whether elevated depression scale is result of drug usage or indicative of a condition needing additional treatment and medication. Milkman, Wanburg & Gagliardi (2008) cite a study by Covington (1998) who believes that treatment for substance abuse may enable women to recognize how criminal conduct that has created a sense of control has actually led to of a loss of control in life. Examination of unhealthy relationships and addictive processes can reveal how ability to make decisions based on good sense and self interest is being hindered. Respectfully submitted, Gerry Hoffman, B.S. / M.A. Community Counseling. Forensic psychology student Argosy University , October 25, 2009.

FINAL SUBMISSION References American Psychiatric Association(2000). Diagnostic and statistical manual of mental disorders.4th ed. Text revision. Washington, DC: American Psychiatric Association. Butcher,J.N.(n.d.) General corrections interpretive report: MMPI-2. The Minnesota Report:Reports for forensic settings. Retrieved from: http://www.pearsonassessments.com. Butcher,J.N.(2003). Pre-trial criminal interpretive report:MMPI-2 The Minnesota report:Reports for forensic settings. Retrieved from: http://www.pearsonassessments.com. Earley,P.H. (1991).The cocaine recovery book. Retrieved from: http://books.google.com Ford,G.G. (2006). Ethical reasoning for mental health professionals. Retrieved from: http://books.google.com. Frances, A. & Ross, R.(2001). DSM -IV-TR Case studies: A clinical guide to differential diagnosis. Retrieved from : http//books.google.com. Megargee, E.I.(2009). MMPI-2 :Criminal justice and correctional report. Retrieved from: http://psychcorp.pearsonassessments.com. Melton,G.B., Petrila,J., Poythress, N.G., & Slobogin,C. (2007). Psychological evaluations for the courts, 3rd Ed.: A handbook for mental health professionals and lawyers. Retrieved from: http://www.amazon.com. Milkman,H.B.,Wanburg, K.W., & Gagliardi,B.A.(2008).Criminal conduct and substance abuse treatment for women in correctional settings: female focused strategies for self-improvement and change. Pathways to responsible living. Retrieved from:http://books.google.com. Pearson Education Inc.(2009).WAISIV--Wechsler Adult Intelligence Scale4th Ed. Retrieved

from: http://psychcorp.pearsonassessments.com.

Forensic Assessment Template Gerry Hoffman Argosy University

Argosy University Forensic Psychology Individual Assessment Course FP6020 Name: Ms. G. Identification Number: Case 1 Date of Birth: 07-01-63 Time Spent: 180 minutes Time Spent: 90 minutes

Tests Date: 09-09-09 Interview Date: 09-10-09 Introduction

Name of Assessment : Competency to stand trial The purpose of this assessment is to determine client's competency to refuse defense counsel; which, is to be determined by a competency to stand trial assessment. The Courts determined in Godinez v. Moran (Melton, Petrila, Poythress, & Slobogin, 2007) that a person competent to stand trial is also competent to waive an attorney. The fact that a person may perform inadequately by doing so has no bearing. Additionally, it should be noted as per Moran that the Court determined the competency to waive counsel may not , in itself, make the waiver valid. A waiver must be voluntary and knowing. A voluntary waiver must be uncoerced and the defendant must know the dangers and disadvantages of self representation, thus knowing what he is doing. Although; not legally required, reasons for the defendant wanting to proceed pro se and a determination that the defendant has a clear understanding of the potential disadvantages will additionally be assessed. Reason for Referral Ms. G. is a 46 year old, Caucasian female charged with burglary. She was arrested for the offense after she was found by the police with her neighbors property. She was intoxicated and in possession of

drugs at the time of the arrest and showed surprise at being charged with a crime. Ms. G. faces a trial for her offense because she refused a plea bargain. She also refused defense counsel when it was offered. Client was referred by the county prosecutor's office for evaluation to determine competency to stand trial based on arresting officer's report of combative, hostile, irritable, belligerent hyperactive, assaultive, irrational behavior at time of arrest. Officers at the county correction holding facility observed a high energy level and paranoid behavior while client was in holding cell. Behaviors at the time of arrest and while in the holding cell indicate client may have a mental or neurological disorder which would account for observed behaviors based on arresting officer's report of combative, hostile, irritable, belligerent hyperactive, assaultive, irrational behavior at time of arrest. Officers at the county correction holding facility observed a high energy level and paranoid behavior while client was in holding cell. Behaviors at the time of arrest and while in the holding cell indicate client may have a mental or neurological disorder which would account for observed behaviors (DSM-IV TR) and may impact her informed decision to waive counsel ; alternatively, client behaviors may be related to her intoxicated state at the time of her arrest. The Minnesota Multiphasic Personality Inventory ( MMPI-2 ) can provide information regarding personality traits and symptoms of psychological illnesses and personal maladaptive adjustment .Criminal justice and correctional psychologists can use the information in the report to help: reliably classify inmates at initial intake or the reception phase of incarceration; to support important management, treatment, and programming decisions and better understand an inmate's background, attitudes, and abilities; to determine if they will benefit from treatment for substance abuse, mental health programming, and other services (Megargee, 2009). Wechsler Adult Intelligence scales fourth edition (WAIS-4) will be used to identify intellectual functioning and potential deficits in both verbal and non- verbal areas , a mental status examination consisting of structured questions and an unstructured interview will provide information regarding mental functions, neurological deficits, and thought processes of the client. Presentation

Ms. G. is a 46 year old Caucasian female who appears disheveled as a result of being held in jail and possibly her drug use. She appears thin and malnourished which is frequently observed in chronic drug users and she stated she has been using cocaine daily for the past six months. During the structured mental status examination the client had difficulty staying focused and appeared agitated stating it was a waste of time. During the unstructured interview she revealed her reason for believing the examination a waste of time is that she does not acknowledge any criminal behavior and believes her arrest to be a misunderstanding. She stated that she frequently enters her neighbor's home when the neighbor is absent and that the neighbor has no difficulty with these actions. She stated that the neighbor also enters her home. She claims the problem arose when a new neighbor in the building ,where she resides, saw her enter her neighbor's apartment and was unaware of the agreement she had with this individual. She blames her confusion and anger when arrested and in the holding cell on being under the influence of cocaine and subsequent coming down from the effects of the drug. Her neighbor will be contacted for confirmation on giving her permission to be in her apartment. Her structured mental status examination was normal. She was aware of time and place. Eye contact was appropriate. Speech was normal in clarity, rate, and volume. Thought content and processes were normal. Short, long and immediate memory and recall were normal. Client showed good comprehension and response to proverbs. Affect and mood were normal. Insight, reasoning and judgment were shown to be average. Reality testing was normal. Vocabulary and grammar indicate average intellectual functioning. Ms. G. was able to form good rapport and appeared eager to speak and provide details regarding her arrest ; but, she has a distrust of authority which is a result of her boyfriend informing her she should not trust the police. Current Life Situation Ms. G. is currently living with her boyfriend who sells and uses drugs. She has a long history of

sporadic employment and alcohol abuse and admits to selling drugs previously. Recently, in the past six months, she has started using cocaine. Ms. G. does not acknowledge the criminal nature of the current offense she is charged with and believes it to be a misunderstanding. She states her neighbor was willing to permit her to use the stereo she is accused of stealing. She has refused to reveal any personal history to officers because she feels wrongly accused and states she was angry and irrational due to being under the influence of cocaine. She has also refused defense counsel. Ms. G. has one prior arrest five years ago for disorderly conduct while intoxicated, for which she received a 30 days suspended sentence and a year of probation. She states that she was leaving a bar and a woman made a comment to her about her boyfriend and she became angry and a fight started. She has limited family contact and lives a transient lifestyle with her boyfriend of 15 years. Her social contacts are other drug users. She has been surviving by engaging in whatever behavior she deems is necessary since leaving her foster parents at age 18, mainly prostitution and drug dealing, and believes she is able to survive without assistance from others. As she does not see her arrest as justified, she believes it is not necessary to defend herself against a charge she feels is unwarranted. She does have an awareness of the penalties for her offense, but believes her neighbor will confirm that she had permission to enter her premises and ; therefore, committed no crime. Her boyfriend has encouraged her to refrain from revealing much of her history, as he feels it will be used against her. Background Information Ms. G. is the youngest of two children. Her brother reports Ms. G. lost her parents at an early age and was separated from him when they both went into foster care. Her brother reports minimal contact with her from age four years old until she was 18 and found him with the help of a private investigator. They maintained contact intermittently, as Ms. G. was transient, moving around the country on a regular basis. She held odd jobs, engaged in prostitution, sold drugs, and lived with boyfriends to survive. Her relationships have been formed with men she has met in bars and her current social circle is comprised of acquaintances of her boyfriend who all use drugs.

She entered Alcoholics Anonymous in her mid-thirties but stayed only several years. Her motivation was stated as being she felt she was getting older and wanted to start a family. She did not , and does not, have any children and states the pressure of living with her boyfriend and seeing him continue to use alcohol and drugs made it too difficult to remain sober.

Ms. G.'s foster family were very religious and strict when she was growing up and she states she felt overwhelmed and oppressed and left home after an argument at age eighteen. She graduated high school but considers herself a below average student. She stated she had no employment skills when she left home and learned to do whatever was needed to survive financially. She considers herself street-wise and capable of making it on her own; although she is emotionally dependent on her boyfriend.

Psychological History Ms. G. denied a history of any treatment which her brother confirmed , to his knowledge, to be accurate. Her financial survival skills are well-honed. Her general coping skills are limited; however as revealed by a GAF score of 50. She does not encounter frustrations turning to alcohol or drugs when a problem arises. Her method of coping with financial frustration is to do whatever she feels is necessary to survive, although she denies engaging in robbery or theft or fraud. She states that prostitution and drug dealing are how she mainly survives, occasionally she will work temporary positions when something is available. Emotional frustrations are met with drug or alcohol usage. Her upbringing was restrictive and she rebelled against her foster parents values by moving away as a young adult. She grew up as an only child and states she had periods of depression, as a result of being

separated from her brother, which was the motivation for hiring a private investigator to locate him.

Substance Use History Ms G. states she started using alcohol and marijuana at age fourteen. Her initial use was on weekends. She states that by age 18, after she left her foster parent's home because of an argument, she started using alcohol and marijuana more frequently. Her drinking and marijuana use became several times a week. She states that she became a daily alcohol user at age thirty after a breakup with her boyfriend at the time. She attended Alcoholics Anonymous in her early thirties as she felt she wanted to start a family. She did not start a family and states that her boyfriend's use of alcohol and drugs made it difficult for her to remain sober and she returned to using after several years. She has used alcohol and marijuana regularly while with her present boyfriend for the past 15 years. Six months ago she started using cocaine , when her boyfriend started selling the drug. She has no history of treatment for substance use. Her current use of cocaine has been daily for the past six months and was a factor in her behavior at the time of her arrest. Five years ago she was arrested for disorderly conduct after leaving a bar and getting into a disagreement with a woman which led to a physical altercation. The other woman was the aggressor and Ms. G. received 30 days suspended sentence and a year of probation, which went well. During this time she held factory positions with a temporary agency. Medical History Ms. G. states she is in good health and takes no medications. Her older brother states that Ms. G's natural parents were alcoholic and that alcohol was a factor in the automobile crash in which they were both killed. Her brother is in good health with no substance problems. Objective Testing

Minnesota Multiphasic Personality Inventory, second edition (MMPI-2) The MMPI-2 is a self-administered personality inventory designed to evaluate personality traits and symptoms of psychological illnesses and personal maladaptive adjustment. Mental Status Examination consisting of a structured and an unstructured interview. Wechsler Adult Intelligence Scales, fourth edition (WAIS 4). The WAIS 4 is a full-scale intelligence test used to identify intellectual functioning and potential deficits in both verbal and non-verbal areas. Findings MMPI-2 scales: Hs,Hy,Pd,Mf,Pa,Pt ,Sc,Ma,and Si are within normal clinical scoring range. Scale Ddepression showed elevation. Her MAC-R (MacAndrew Alcoholism Scale-Revised) scores on the addiction proneness indicators are indicative of an addictive disorder (Butcher, n.d.). This was confirmed during the mental status unstructured interview, as she did admit to long term substance usage. Individuals with this profile may include an expressed desire to change without actual full participation in psychological treatment ; and , failure to make long term changes which is consistent with her previous Alcoholics Anonymous experience. There is no indication that her elevated D scale score is associated with a suicide risk, as her means of coping with depression is to self- medicate to alleviate symptoms. Mental Status Examination structured examination revealed no major abnormalities, Ms. G. showed average insight and difficulty focusing with agitation. This was determined to be related to client's concern regarding current legal situation, as other testing showed normal results.

WAIS 4 indicated client's general cognitive ability is in the average range (FSIQ = 108).Clients general verbal comprehension abilities were in the average range (VCI = 105), and general perceptual reasoning abilities were in the average range (PRI = 104). Clients ability to sustain attention, concentrate, and exert mental control is in the average range (WMI = 105). Clients ability in processing simple or routine visual material without making errors is in the average range.

Diagnostic Impressions

AXIS I: 292.11 Cocaine induced psychotic disorder with delusions with onset during intoxication

304.80 Polysubstance dependence

AXIS II: V71.09

AXIS III: None

AXIS IV: problems related to unemployment, and social environment

AXIS V: GAF: 50 serious impairment in social/occupational functioning

Conclusion

Client was informed that information was being obtained in order to conduct evaluation for the prosecutors office. Limits of confidentiality y were explained. The right to refuse to answer questions was explained and the consequences of refusing explained (Ford,2006). Client behavior was viewed in

the context of American culture and her dependency on males was viewed in that cultural context. Individual identity and goals could be seen as unhealthy in the context of other cultures( Ford,2006). Client presents no psychological,neurological or intellectual obstacles to competency to stand trial and refuse counsel as shown through MMPI-2, WAIS-4 and mental status examinations. Client understands the legal process adequately responding to assessment questions regarding court procedures during the unstructured interview process. She is aware of the charges against her and the penalties. She believes the charges are unwarranted and that this will be substantiated by her neighbor. Failure to cooperate with police was based on her perception that no crime was committed as well as being under the influence of cocaine. DSM IV-TR diagnosis indicates her behavior was related to a cocaine induced psychotic disorder with delusions occuring during intoxication. Her MMPI-2 profile indicates elevations on substance abuse scales and her self reported daily use of cocaine for the past six months, along with her behavior at the time of arrest and while in the holding area , indicates she was in a state of cocaine intoxication when officers confronted her which accounts for her anger, hostility and belligerence. She and her neighbor appear to have an agreement regarding mutual use of personal property. This was confirmed by third party information supplied by her neighbor. Although she has been engaged in prostitution and substance use for 25 years, the client has only one previous legal incident, which was instigated by an individual other than the client as client and this person left a bar. She received a 30 day suspended sentence and completed a successful year of probation, securing factory employment through a temporary agency during this period. It is unknown if client engaged in drug dealing or prostitution during this time. Her probation was seen as successful as the county probation department reports no further arrests during this time period and compliance with employment and reporting requirements. Client previously attended Alcoholics Anonymous for two years during a period ten years ago. She has a long term relationship(15 years) with her boyfriend who is a drug dealer. Client has elevated depression and addiction scales on MMPI-2 which are seen as a result of no family connection, and poor employment skills (Butcher,2003) which she believes requires her to

engage in prostitution or drug dealing to make ends meet. Her depression may be related to her daily cocaine use as use of the drug depletes neurotransmitters indicated in depression (Earley,1991). Her social network is comprised of other drug users. Her activities center around drug use and drug dealing. Communication with her brother is good, but seldom occurs due to her transient lifestyle. Client is of average to slightly above average intelligence with a high school education, but little formal employment skills .Client has slipped into a pattern of engaging in prostitution and drug dealing to support herself and has been using cocaine after her boyfriend began dealing the drug six months ago. Her general health is good but she is malnourished as a result of drug use. Client is being told by her boyfriend that she should not cooperate with authorities as information will be used against her. Her boyfriend has had several arrests for drug dealing and has a distrust of police and the court system. Client faces the difficulty of entering substance abuse treatment when her lifestyle is centered around drug use and drug dealing and this has been her pattern for 25 years. She has also had a 15 year relationship with her boyfriend which, in the professional opinion of the assessor trained in substance abuse issues, would make her long term success at treatment difficult. Previous attendance at Alcoholics Anonymous may have provided insight, which client is currently failing to employ. Her current cocaine usage coincided with her boyfriends start of selling the drug. Interview with her neighbor confirmed that she did have permission to remove property and they had a general understanding among their social group that one could borrow items and enter each others property when the residents were not home. Client needs to see other options for self sufficiency and gain in the understanding that; although, she has avoided legal difficulties as a result of her current lifestyle, she is engaging in behaviors that can cause her additional legal difficulties. Her DSM IV-TR diagnostic impressions lead to polysubstance abuse and impairment in social and occupational functioning which is believed to be a consequence of long term drug use and a lack of employment skills training.

Recommendation Client would most benefit from inpatient substance abuse treatment and assessment for depression after sufficient time has elapsed to make determination as to whether elevated depression scale is result of drug usage or indicative of a condition needing additional treatment and medication. Client would have a difficult time succeeding with treatment if she was not removed from her present situation. Milkman, Wanburg & Gagliardi (2008) cite a study by Covington (1998) who believes that treatment for substance abuse may enable women to recognize how criminal conduct that has created a sense of control has actually led to of a loss of control in life. Examination of unhealthy relationships and addictive processes can reveal how ability to make decisions based on good sense and self interest is being hindered. Employment skills training to break the cycle of prostitution and drug addiction would provide client with an alternative means of self-support. Client has a minimal history of legal difficulties. The only other occurrence of legal difficulty was while client was intoxicated. Client does not present with a pattern of antisocial behavior. Her difficulties with the law have been minor and related to substance intoxication She met the requirements of her sentence with compliance. Her lifestyle likely arose out of a youthful need to survive financially and has become a patten, encouraged by her involvement with a boyfriend who also deals drugs. Inpatient addiction treatment and Alcoholics Anonymous and/or Narcotics Anonymous involvement is indicated. General therapeutic counseling is also indicated as client has a long history of using drugs and alcohol as a coping method and issues may present themselves once she gains sobriety and no longer uses substances for coping with frustrations. Perhaps, if client was required by law to not leave the city she would develop an improved relationship with her brother who is sober. Client cannot be prohibited from contact with her boyfriend , as he was not implicated in the arrest, but an expanded social network and increased contact with her brother would

improve her chances of remaining drug and alcohol free. Drug testing would give an indication as to success of treatment efforts. Gerry Hoffman, B.S. / M.A. Community Counseling. Forensic psychology student, Argosy University October 17, 2009

References

American Psychiatric Association(2000). Diagnostic and statistical manual of mental disorders.4th ed. Text revision. Washington, DC: American Psychiatric Association. Butcher,J.N.(n.d.) General corrections interpretive report: MMPI-2. The Minnesota Report:Reports for forensic settings. Retrieved from: http://www.pearsonassessments.com. Butcher,J.N.(2003). Pre-trial criminal interpretive report:MMPI-2 The Minnesota report:Reports for forensic settings. Retrieved from: http://www.pearsonassessments.com. Earley,P.H. (1991).The cocaine recovery book. Retrieved from: http://books.google.com Ford,G.G. (2006). Ethical reasoning for mental health professionals. Retrieved from: http://books.google.com. Frances, A. & Ross, R.(2001). DSM -IV-TR Case studies: A clinical guide to differential diagnosis. Retrieved from : http//books.google.com. Megargee, E.I.(2009). MMPI-2 :Criminal justice and correctional report. Retrieved from: http://psychcorp.pearsonassessments.com. Melton,G.B., Petrila,J., Poythress, N.G., & Slobogin,C. (2007). Psychological evaluations for the courts, 3rd Ed.: A handbook for mental health professionals and lawyers. Retrieved from: http://www.amazon.com. Milkman,H.B.,Wanburg, K.W., & Gagliardi,B.A.(2008).Criminal conduct and substance abuse treatment for women in correctional settings: female focused strategies for self-improvement

and change. Pathways to responsible living. Retrieved from:http://books.google.com. Pearson Education Inc.(2009).WAISIV--Wechsler Adult Intelligence Scale4th Ed. Retrieved from: http://psychcorp.pearsonassessments.com.