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TREATMENT PLAN
Diagnosis:
Axis I: 312.89 Conduct Disorder, Severe, Unspecified onset
Axis II: V71.01 Adult antisocial behavior
Axis III: Deferred to medical personnel
Axis IV: Difficult work conditions, discord with neighbors
Client-stated Desired Outcome
"It's a-me, Mario! Let's a go! Yah hoo! Ha ha ha! Okey dokey!"
Treatment Goal(s)
It was difficult to engage Mario in creating a treatment plan due to his persistent and inane chatter. It is unclear if he understood the purpose in meeting with a therapist.
For the sake of this treatment plan, his diagnosis implies he may benefit from:
(1) increased awareness of the effects of his behavior on others, and
(2) decreased interference from hallucinogen intoxication with regard to working in his trade.
Client Strengths in Meeting Goals
(1) Mario consistently appears upbeat and optimistic. Despite his behavior he has a good rapport with members of his community. He is willing to risk danger to himself in order to assist others.
(2) He maintains his identity as a plumber despite his lack of actual plumbing. He appears to be a quick learner.
Barriers to Meeting Goals
(1) Mario seems unaware of the constant violence he is inflicting upon others. His oblivious disregard for others can be very damaging to the community, such as pretending to be a medical professional.
(2) He has been basically unemployed as a plumber for an extended period of time and may no longer be proficient at his trade. He has limited awareness of the impact of hallucinogen dependence on his employment situation. He is likely in the Precontemplation stage of change. Additionally, Mario may face considerable temptation to relapse should he decide to quit using mushrooms because his community has frequent visual reminders of the substance.
Mario's communication style may make traditional therapy difficult.
Interventions
(1) Despite Mario's behavioral issues, he appears to genuinely care for others and desires to help them. He may simply lack an understanding of how his conduct impacts others around him, especially those not in his community. Processing these issues with him in therapy may be beneficial.
(2) Mario would perhaps benefit from processing his identity as a plumber despite rarely (if ever) engaging in this activity. It is possible that he struggles to find purpose or excitement in his profession and uses hallucinogens to cope. Mario also does not seem to particularly mind that he uses mushrooms and this may not be a significant problem for him.
Due to his many strengths and his communication style, it is anticipated that therapy would be brief, perhaps two to four sessions.
Termination
As always, termination will occur at the discretion of the client with input from the therapist. It is anticipated that termination will be considered when Mario's behavior is no longer problematic for himself or members of his community.