Sex, Sexuality, and Substance Abuse

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For this Assignment, select one of the substance use case studies (Case Study 3 or Case Study 4) located in this week’s resources. Consider a treatment plan, including a diagnosis, intervention, and prevention technique for the child or adolescent. Think about how you might include the parents/guardians in the treatment plan.

The Assignment (2–3 pages):

Select one substance use case study (Case Study 3 or Case Study 4). Identify a provisional diagnosis for the case you selected.
Using the Treatment Plan Guidelines template, create a treatment plan for the case study you selected.
Explain one treatment intervention you might use in the case you selected and justify the use of the intervention.
Explain one intervention you might use to prevent relapse and why it might be effective. Then, explain one intervention you might use to involve the parents/guardians in the treatment plan and why their involvement might be important.

Justify your treatment plan using evidence-based research.

More to Read:
Selecting a Case Study

Week 9: Case 4, Substance Use Lindsey is a 12-year-old white female referred to counseling for substance abuse problems. Lindsey lives in a foster home. She was removed from her mother and stepfather’s home at age 7, when the federal authorities conducted a raid and discovered a methamphetamine lab in the home. Lindsey and her foster mother report that Lindsey initially was given alcohol by her mother and stepfather at age 4. She began smoking cigarettes at age 7, just before the police raid. Lindsey was returned to her mother’s care at age 9. She began smoking pot shortly thereafter. At age 11, she tried methamphetamines and cocaine, had a bad experience, and ended up hospitalized and, once again, removed from her mother’s care. She is now in permanent foster care. The foster mother is very concerned about Lindsey’s well-being. Although there have not been any incidents of methamphetamine or cocaine use, Lindsey has been caught smoking cigarettes and pot on several occasions. Lindsey was also caught at school selling a small amount of pot and sent to the local juvenile drug court. The drug court referred her for counseling. When you meet with Lindsey alone, she insists that pot is not a problem. She refers to it as an “herb” and as “all natural.” She says she would never go down the road that he mother went down but that pot is different and it just keeps her mellow and out of trouble. She claims that pot is her medicine and that she needs it to function at home and at school.

© 2014 Laureate Education, Inc. Page 1 of 2

Sex, Sexuality, and Substance Abuse

In the DSM-IV, the chapter titled “Sexual and Gender Identity Disorders” included a
diagnosis of gender identity disorder. This diagnosis has been eliminated and
recategorized into its own diagnostic class. The new grouping—gender dysphoria—
reflects substantial changes in conceptualization.
Substance-related disorders have also been substantially changed in the DSM-5. The
most significant changes are related to diagnostic labels, criteria, and defining
terminology.
A brief summary of key changes in these two diagnostic classification groups are
provided below.
Gender Dysphoria
This new DSM-5 classification represents an evolution in the understanding of the
interrelationship between sex and gender. The diagnostic group is categorized by an
incongruence between assigned gender and the experience of gender. There are only
three diagnoses in this group: gender dysphoria, other specified gender dysphoria, and
unspecified gender dysphoria.
Both other specified gender dysphoria and unspecified gender dysphoria include
significant clinical distress or impairment in their diagnostic criteria but do not meet full
criteria for a specific diagnosis in this class. Clinicians should use other specified
gender dysphoria and add the specific reason for the more general diagnosis (e.g.,
insufficient duration to meet gender dysphoria diagnosis). The latter diagnosis—
unspecified gender dysphoria—is used when clinicians cannot (or choose not to)
identify reasons for the inability to make a more specific diagnosis, yet clearly observe
multiple criteria from the gender dysphoria criteria.
Gender Dysphoria
Distinct criteria sets for the presence of this disorder in children, adolescents, or adults
are outlined in the DSM-5. Language has been altered to include and clarify cultural
and environmental influences as well. The resulting gender dysphoria diagnosis is
more narrow and specific than the former gender identity disorder. In addition,
specifiers have changed dramatically. Those pertaining to sexual orientation previously
part of the gender identity disorder diagnosis have been removed, as it was
determined they were not relevant to the diagnosis of gender dysphoria. A
developmental specifier addressing the potential influence of a biological component
was added. In addition, a specifier reflecting the stage or status of transition was
added.

Substance-Related and Addictive

Disorders
There are significant differences in this classification, most prominently in the
© 2014 Laureate Education, Inc. Page 2 of 2
conceptualization and association of criteria. This category of disorders is marked by
activation of the brain reward system—an intensive experience that may interfere with
desire to partake in normal activities and/or make pro-social or healthy decisions. This
diagnostic classification is divided into substance-related disorders and non-substancerelated disorders. The former is further divided into substance use disorders and
substance-induced disorders. These categorizations aid in the clinician’s
conceptualization of the diagnosis itself as well as treatment planning options.
This chapter includes specific reference to 10 classes of drugs as well as a new
behaviorally based addition—gambling addiction. The DSM-5 also makes reference to
other addictive behaviors, though notes that at this time, insufficient research exists to
support a firm diagnosis of these.
As in the DSM-IV, the DSM-5 provides a descriptive table identifying associations
between specific substance use and other DSM-5 disorders, such as the potential
relationship between caffeine abuse and sleep disorders. Additional clarifying language
has been added to this table to aid in diagnosis, helping to clarify not only comorbid
diagnoses but also applicable specifiers for the substance use diagnosis
The most significant change to this diagnostic group has been the elimination of the
two-tiered abuse and dependence diagnoses. These have been merged into a single
use diagnosis, with severity and frequency specifiers. The criteria for recurring
substance-related legal problems has been deleted, and a criteria regarding presence
of craving or urge to use the substance has been added. Severity and frequency
specifiers include mild (2–3 symptoms present), moderate (4–5 symptoms present, and
severe (6 or more symptoms present). In addition, new specifiers have been added to
reflect remission status and circumstances, such as being in early remission and in a
controlled environment (limited access).
Lastly, polysubstance abuse—present in the DSM-IV—has been deleted. New diagnoses
include cannabis withdrawal, caffeine withdrawal, and tobacco use.
Reference:
• American Psychiatric Association (2013). Highlights of changes from DSM-IVTR to DSM-5. Retrieved from

Last Updated on January 30, 2025

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