Understanding and Treating James: A Comprehensive Approach

by | Oct 27, 2023 | Accounting

Please review the Case of James, and respond in a brief essay to the questions that follow:

James is a 24 year old white man who recently finished graduate school and began working as an account executive in a Fortune 500 company. As in intern with the company, he was very successful and quickly rose to the top of the ranks amongst his peers. He was hired on immediately after finishing his MBA because of his charismatic ability to charm new clients and earn their trust. James is very successful in his business, but his boss notices that he sometimes gets out of control with his substance use. For example, he tends to drink too much when he’s out entertaining clients. The firm recently lost a $5 million dollar account because, after drinking too much, James became belligerent with the client and said “we don’t need your business anyway—you need us more than we need you”. Also, James is a binge workaholic and is suspected to use cocaine to help him “burn the midnight oil”. He tends to have episodes of a few days where he seems to be unstoppable, but will quickly turn to weepy depression when triggered by something insignificant. His coworkers say that he bounces back and forth in his moods pretty quickly and unpredictably.

In his personal life, James is a serial monogamist, having one relationship after another. His relationships become intense quickly, and he believes that each partner that he meets is “the one for him”. However, the relationships tend to end as suddenly as they begin. His partners say that they can’t keep up with James’ need for constant attention, and he is way too clingy for the average partner. His most recent partner, who was also his coworker, left in the middle of the day while James was at work, leaving behind a note that said, “I can’t deal with your moodiness—I never know which James I’ll find when I come home. I hope you find someone who can keep up with you.”

In response to this, James went out from bar to bar hoping to run into his former partner and talk out their differences. Along the way, he drank heavily at each bar, until he finally ran into his ex. He begged for the relationship to continue, and the two ended up having sex that night. James also introduced his partner to cocaine for the first time that night. In the morning, James woke up, looked at his partner and said “I don’t need you nearly as much as you need me” and walked out the door. Immediately after leaving, he feel into a deep, dark depression. He went home and attempted to overdose on the benzodiazepines that he kept in his medicine cabinet for the times when he needed to come down from too much cocaine. After swallowing three of the pills, he called his partner and said “I need to end the pain you’ve caused me—I hope you’re able to find someone to make you happy”.

Luckily, the partner calls 911 and James is transported to the hospital. You talk with his ex-partner in the emergency room, and you gather that this is one of several suicide attempts that James has made in his adult life. Each time, he has survived and seems to bounce back quickly. This time, like others, his partner feels guilty and decides to give the relationship another try.

1. Describe the steps that you would use to assess James’ needs for treatment

2. Explain how you would engage James in treatment, and describe how you believe he will react to the notion of participating in treatment.

3. Illustrate how you will ensure that your assessment is culturally-appropriate for James (filling in any gaps of information that you might need to have a ‘cultural image’ of James).

4. Which, if any, co-occurring assessment and screening tools might you utilize as you begin to work with James? Provide a rationale for your choice.

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Answer

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Title: Understanding and Treating James: A Comprehensive Approach

Introduction
James, a 24-year-old highly successful account executive, is exhibiting concerning behaviors that indicate the need for treatment. His substance abuse issues, mood swings, and unstable relationships suggest the presence of a mental health disorder. This essay will outline the steps to assess James’ treatment needs, discuss strategies to engage him in treatment, emphasize the importance of cultural appropriateness, and suggest relevant co-occurring assessment and screening tools.

1. Steps to Assess James’ Treatment Needs
To comprehensively assess James’ treatment needs, the following steps should be undertaken:

Conduct a comprehensive clinical interview: Obtain detailed information about James’ substance use patterns, mental health symptoms, history of suicide attempts, relationship dynamics, and overall functioning.
Gather collateral information: Consult with James’ current and past partners, friends, and coworkers to gain additional insights into his behavior and symptoms.
Administer standardized assessment tools: Utilize validated tools such as the Addiction Severity Index (ASI), the Beck Depression Inventory (BDI), and the Mood Disorder Questionnaire (MDQ) to assess the severity of substance abuse, depressive symptoms, and potential bipolar disorder.
Assess for co-occurring disorders: Evaluate James for possible co-occurring mental health disorders such as bipolar disorder, borderline personality disorder, or substance-induced mood disorder.
Consider a physical examination: Rule out any underlying medical conditions or physical health issues that may be contributing to James’ symptoms.

2. Engaging James in Treatment
Engaging James in treatment requires a delicate approach due to his past suicide attempts and potential resistance. To foster his participation, the following strategies can be employed:

Establish rapport and trust: Build a therapeutic alliance by demonstrating empathy, active listening, and non-judgmental understanding.
Provide psychoeducation: Educate James about his symptoms, mental health disorders, the link between substance abuse and mental health, and the potential benefits of treatment.
Highlight personal strengths: Acknowledge James’ accomplishments and highlight that seeking help is a sign of strength rather than weakness.
Involve support systems: Engage James’ current partner or other supportive individuals in the treatment process to provide encouragement and enhance accountability.
Collaboratively set goals: Work with James to identify short-term and long-term goals that align with his values and aspirations.

James’ reaction to participating in treatment may vary. He might initially be resistant due to feelings of shame or denial. However, given his history of bouncing back quickly after previous suicide attempts, there is potential for him to recognize the need for help and embrace treatment as a means of improving his overall well-being.

3. Ensuring Cultural Appropriateness
To ensure cultural appropriateness in assessing James, it is crucial to gather additional information about his cultural background. This may include:

Understanding James’ cultural values and beliefs: Recognize how cultural factors influence his perception of mental health issues and help-seeking behaviors.
Exploring family dynamics: Assess the impact of family expectations and support systems on James’ behavior and coping mechanisms.
Recognizing cultural stigma: Be aware of potential stigma associated with mental health issues within James’ cultural context that may hinder his willingness to seek treatment.
Collaborating with cultural consultants: Engage cultural consultants or professionals from similar backgrounds to provide insights and guidance on culturally appropriate assessment and treatment strategies.

By considering James’ cultural background and incorporating culturally sensitive practices, therapists can create an environment that respects his beliefs, values, and unique experiences.

4. Co-Occurring Assessment and Screening Tools
Given James’ symptoms and behaviors, it is important to utilize appropriate assessment tools to screen for co-occurring disorders:

The Mood Disorder Questionnaire (MDQ): This tool can help assess whether James exhibits symptoms consistent with bipolar disorder.
The Structured Clinical Interview for DSM-5 (SCID): A comprehensive diagnostic tool used by mental health professionals to evaluate various psychiatric disorders.
The Substance Abuse Subtle Screening Inventory (SASSI): A brief questionnaire designed to identify individuals at risk for substance abuse disorders.

These tools will aid in diagnosing any co-occurring disorders that may be contributing to James’ substance abuse issues and mood fluctuations.

Conclusion
Assessing and treating individuals like James requires a comprehensive approach that considers their unique circumstances. By conducting a thorough assessment, employing effective engagement strategies, ensuring cultural appropriateness, and utilizing appropriate assessment tools, therapists can lay the foundation for effective treatment. With proper care and support, James can gain insight into his behaviors, develop healthy coping mechanisms, and work towards living a fulfilling life.

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