The Case Study of Marge: Session 1

© 2012-2023 Walden University, LLC

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The Case Study of Marge: Session 1
Program Transcript

INSTRUCTIONS:
Welcome to the first day of counseling for Marge, a patient struggling with alcoholism
who has just been admitted to the addictions facility. Please carefully read the
paperwork developed by a support staff member during Marge’s intake process earlier
today. Marge’s husband, Ken, was also briefly interviewed during this time.

After reviewing this information, click the “Next” button to begin Marge’s first counseling
session. Click the buttons “A” and “B” to review your question options. Use the “Select”
button for what you think is the best question to ask Marge out of the two options
offered.

If you ask an effective counseling question, you will receive more relevant information
from Marge. If you ask an ineffective question, you will receive an equally unhelpful
response. Choose wisely because the better you counsel Marge, the better her
treatment experience.

PAPERWORK:
Marge C.
41-year-old female
Married
Husband, Ken, works two jobs to make ends meet, so he is not home much. Husband
noted that he didn’t know what else to do about his wife’s drinking, and that he had
brought her to the facility out of desperation.
Patient has three children, ages 10, 12, and 16.
Patient was a teacher, but she lost job for alcohol-related reasons.
Patient had a one-car, alcohol-related accident 3 days earlier. She received minor
injuries and was issued a ticket for DUI. Husband, family members, and friends
determined that they needed to intervene to prevent Marge from harming herself and/or
others.
An intervention occurred earlier today, culminating in her being brought for treatment.
Patient will go through a week of detoxification during her first week in treatment to
address the physical withdrawal from alcohol.

Click the buttons “A” and “B” to review your question options. Use the “Select” button for
what you think is the best question to ask Marge out of the two options offered.

The Case Study of Marge: Session 1

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QUESTION #1:

Option A: Marge, I will be your counselor. I want you to know I’m glad you’re here. I
imagine this has been a hard day for you. Right now, I just want us to begin get to know
each other better. I also want to know more about your drinking so we can begin to plan
your treatment. It’s natural to be anxious and upset right now. You look like you feel like
that now. Are you?

CLICK HERE TO CHOOSE OPTION A FOR QUESTION #1.

Option B: Hello, Marge. I will be your counselor. I want you to know I’m glad you’re
here, and I want to help you in any way I can. I imagine this has been a hard day for
you, and I know that you and your husband have already answered many questions
during your admission process. Right now, I just want us to begin get to know each
other better. I also want to know more about your drinking so we can begin to plan your
treatment. It’s natural to be anxious and upset right now. Tell me your thoughts and
feelings right now.

CLICK HERE TO CHOOSE OPTION B FOR QUESTION #1.

The Case Study of Marge: Session 1

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QUESTION 1, OPTION A – FEEDBACK
Marge: Yes, of course I am! And furthermore, I don’t want to be here; I don’t need help.

Feedback: That wasn’t the best approach. Please select the alternate button.

CLICK HERE TO TRY QUESTION 1 AGAIN.

QUESTION 1, OPTION B – FEEDBACK
Marge: You’re right, I am anxious, and I’m more than that right now! I’m hurt, I’m scared,
and I’m furious at my husband Ken for dragging me to this place. I want you to know
right now I am not here on my own; I am here only because he and my so-called friends
threatened to have me committed involuntarily for “my own safety,” as they say, if I
didn’t agree to do it myself.

I know I drink too much, but I can handle it myself. I don’t need to be put in this rehab
and hid away from the rest of the world to do it. I’m not like the other people you have
here; they might need help, but I can do it on my own. I don’t need help.

Feedback: Well done. Click the “Next” button to continue.

CLICK HERE TO TRY QUESTION 2.

The Case Study of Marge: Session 1

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QUESTION #2:

Option A: You “don’t need help”?

CLICK HERE TO CHOOSE OPTION A FOR QUESTION #2.

Option B: I think you’re wrong; I think you do need help, and I want to help you see
that.

CLICK HERE TO CHOOSE OPTION B FOR QUESTION #2.

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QUESTION 2, OPTION A – FEEDBACK
Marge: No. I’m strong willed. I know I drink too much, but I have to because of all the
stress. Raising a family, and then when I was teaching it was double hard. I have
diabetes on top of it all, and I’m unemployed and this damn DUI hangs over my head.
Then, if that’s not enough, there’s Roger, my 12-year-old son. He’s always getting in
trouble at home and school. It’s never ending. I could go on and on.

Yeah, I admit. I drink too much, but I do it to deal with all my problems and my constant
depression. You would too if you were me. No one understands that. But I can go to AA
and back to that counselor at the community mental health clinic and stop without all
this ridiculous fuss of coming here. I’ve tried it before; I just didn’t give it all I had.

Feedback: Well done. Click the “Next” button to continue.

CLICK HERE TO TRY QUESTION 3.

QUESTION 2, OPTION B – FEEDBACK
Marge: No, I don’t; you’re just like them. No one wants to listen to me; they just jump to
their own conclusions about my life. I’ve tried to stop on my own before; I just didn’t give
it all I had. Now, I’ll tell you again for the umpteenth time, I DON’T NEED HELP!

Feedback: That wasn’t the best approach. Please select the alternate button.

CLICK HERE TO TRY QUESTION 2 AGAIN.

The Case Study of Marge: Session 1

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QUESTION #3:

Option A: You say you’ve tried to stop drinking before, Marge. Please tell me more
about that.

CLICK HERE TO CHOOSE OPTION A FOR QUESTION #3.

Option B: You said earlier that you’ve tried to stop drinking before but were not
successful. That tells me you need help. Don’t you agree?

CLICK HERE TO CHOOSE OPTION B FOR QUESTION #3.

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QUESTION 3, OPTION A – FEEDBACK
Marge: I could do it for a while. I went to AA and that counselor, like I said, and I went a
month or two once. But always things would start piling up, and I’d take a drink just in
the afternoon after 5 like I used to, and then before I knew it I’d be drinking all day
again.

I just didn’t try hard enough. I will now; I know I can do it. I feel guilty because I’ve been
too weak and just never tried hard enough. I know what alcoholism is, believe me, my
father was one, so was my uncle—they went to their graves drinking. I just need to get
strong and build up my willpower to make my mind up to stop. I need to stop being such
a weakling and an irresponsible mother and wife. It’s almost immoral the way I’ve been
doing, but I can do it now. I just need a change. I need to go home.

Feedback: Well done. Click the “Next” button to continue.

CLICK HERE TO TRY QUESTION 4.

QUESTION 3, OPTION B – FEEDBACK
Marge: No.

Feedback: That wasn’t the best approach. Please select the alternate button.

CLICK HERE TO TRY QUESTION 3 AGAIN.

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QUESTION #4:

Option A: Marge, let me share something with you that you may not know. We look at
alcoholism and other addictions as a disease. Some people have a genetic
predisposition for it. It’s not a moral issue, Marge, or a matter of lack of will power. That
puts a different light on your situation, doesn’t it, Marge?

CLICK HERE TO CHOOSE OPTION A FOR QUESTION #4.

Option B: Marge, I think I hear what you’re saying. You admit you drink too much, and
you seem to think you can stop on your own without coming here for 30 days. You think
you just haven’t tried hard enough, and you feel that you’re a weak and immoral person
for that.

Let me share something with you that you may not know. We look at alcoholism and
other addictions as a disease. Some people have a genetic predisposition for it. People
who are genetically predisposed to the disease when faced with the right combination of
conditions can’t handle alcohol. They may start just drinking socially in a controlled way
and then drink to deal with stress or other problems. Because of their genes, they need
more and more and eventually need to drink just to keep from going into withdrawal. It’s
not a moral issue, Marge, or a matter of lack of willpower. What are your thoughts about
what I just said?

CLICK HERE TO CHOOSE OPTION B FOR QUESTION #4.

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QUESTION 4, OPTION A – FEEDBACK
Marge: No.

Feedback: That wasn’t the best approach. Please select the alternate button.

CLICK HERE TO TRY QUESTION 4 AGAIN.

QUESTION 4, OPTION B – FEEDBACK
Marge: I never thought of it that way. Well, I guess I have, but I can see how that could
be. A disease maybe? It could explain why even though I don’t really want to be like this
I am and that I though I’ve really tried to stop I just haven’t known how.

When we first got married and began to have our children, I would have glass of wine
several times a week with dinner, or maybe even with Ken when we both got home after
a long day at work and the children had gone to bed. Then it was every day, then in the
morning, and then I was hiding my drinking habits and drinking just to feel normal.

I was teaching, and it got to where I would drink vodka before I went to school. I thought
no one would smell vodka, but it didn’t work. I was fired. My life has spiraled since then,
my children, my marriage, my health, everything. If I don’t drink now I get horribly ill; you
can’t imagine how ill. I start feeling things on my skin or seeing things; it’s bad. I get
crazy, just like my father and uncle used to get.

I know Ken has tried to protect me all these years. He means well. He would call the
school when I was too drunk to go and tell them I was sick. That’s what he’s always told
the children, “Your mother’s ill, she can’t help it.” Oh help me, please.

Feedback: Well done. Click the “Next” button to continue.

CLICK HERE TO TRY QUESTION 5.

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QUESTION #5:

Option A: Marge, you just turned the corner, and I’m proud of you. You’ve just made a
giant step today, and you’ve just started on your road to recovery. What are your
thoughts and feelings now as we conclude our first session?

CLICK HERE TO CHOOSE OPTION A FOR QUESTION #5.

Option B: Marge, I know this is hard, but until you admit you have a problem, your
drinking will only continue to get worse and cause you and your family more problems. I
want you to think about that before we meet again, OK?

CLICK HERE TO CHOOSE OPTION B FOR QUESTION #5.

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QUESTION 5, OPTION A – FEEDBACK
Marge: I guess I just feel grateful that someone is listening to me and understands.

I feel so embarrassed. My husband has put up with so much, and I know the kids have
needed me and I haven’t been around. I just wanted to take care of it by myself, do at
least one thing without having to rely on someone else for help, you know? I should at
least do that, since I’ve messed up so much already.

I don’t want to leave the kids alone for 30 days, but I guess I’ve left them alone anyway.
I’m scared, but I am willing to try. If you really think you can help me, I promise I’ll do my
best. I have to make it work for my kids and for Ken.

Feedback: Congratulations. You have now completed your counseling session with
Marge.

CLICK HERE TO START EXERCISE OVER.

QUESTION 5, OPTION B – FEEDBACK
Marge: Yes, I will. Listen, I know you mean well. But, I just don’t think you or anyone
else in my life hears me.

Feedback: That wasn’t the best approach. Please select the alternate button.

CLICK HERE TO TRY QUESTION 5 AGAIN.