The Value of Functional Analysis in Substance Abuse the Case of Paul Smith Essay

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Functional Analyses of Substance Behavior

The World Health Organization (2015) defines and describes substance abuse as the harmful use of psychoactive substances such as drugs and alcohol, in that they can develop dependence and a lack or loss of control. Dependence can be physiological, cognitive or behavioral to a point of neglecting more important responsibilities and relationships (WHO). In the United States, more than $700 billion a year has been incurred by substance abuse (NIH, 2015). These account for crime, health care and lost work productivity and hours (NIH).

Functional Assessment and Functional Analysis of Substance Abuse

Functional assessment consists of procedures, which aim at identifying the cause or causes of maladaptive or socially unacceptable behavior and control or reduce it (Carbone & Zecchin, 2015; Harley et al., 2003; CECP, 2001; EOHHS, 2015; Webster, 2015; Maclino, n.d; Opioidrisk, 2015). Assessment seeks out the causes in the person's immediate environment and his learning history. The finding of assessment is the basis of an analysis on how the person learned or developed the maladaptive behavior and how his current environment supports or maintains it. Unlike a medical diagnosis of disease, functional assessment does not classify the behavior according to symptoms but by its function. It then chooses the appropriate and precise treatment or intervention that will reduce the behavior (Carbone & Zecchin, CECP, EOHHS, Webster, Carbone & Zecchin, Opioid, Maclino).

Functional Analysis

This assessment processes identifies the controlling environmental functions of the person's behavior (Carbone & Zecchin, 2015). Hanley et al., 2003; EOHHS, 2015; Webster, 2015). These functions are then manipulated in order to change the maladaptive behavior. A functional analysis is capped by the least restrictive and most effective and promising interventions in reducing or increasing the maladaptive behavior. The five general steps used in functional analysis of behavior are a functional interview of knowledgeable or involved persons, a direct observation of the behavior, experimental and feasible manipulations, the summary, and the behavior lesson plan. Functional analyses of two behaviors are illustrated hereunder in the case of Paul Smith, a substance user, and his father John.

Paul's Assault on His Father

The functional assessment interviews were made with Paul's father, John himself and Mark Jones, who were the two involved persons in the incident. As the complainants, they alleged that Paul physically assaulted both of them. The assault on John resulted in chest bruises and left arm fracture. Mark Jones tried to intervene but Paul pushed him against the shop's front counter and used a broken bottle of alcohol to stop him from intervening. The CCTV footage substantiated their statement on the assaults.

Direct Observation

The Court Liaison Service observed and assessed his behavior in the watch house in addition to his history of consultations with mental health services. An authorized mental health service was also secured for another assessment of Paul's remand status.

Experimental Manipulations

Paul had to be arrested and restrained due to his aggressive and irrational behavior and then taken by force to the watch house by the authorities. In consideration of his mental state, he had to be subjected to an authorized mental health service and confined at the Goodwell Hospital for appropriate treatment.

Functional Analysis Summary

Paul behaved extremely aggressively in assaulting his father and Mark. He was under the influence of alcohol at the time with an alcohol level of 0.075. It was not known what led him to attack John and Mark at the latter's wine shop. The assaults bruised the chest of his father and broke his left wrist. Mark was not harmed. Paul was probably driven to assault his father for upbraiding his drinking. But there can be stronger underlying causes for the assault.

Behavioral Lesson Plan

The most immediate steps are to separate Paul from his father and for John to get treatment from his injuries. Treatment for Paul can consist of physical rehabilitation for substance abuse and psychotherapy where the deep causes of his alcoholism should be explored and confronted. His parents too should receive counseling as far as they are involved in the true and deep cause of Paul's heavy drinking and aggressive behavior and their serious consequences.

Functional Analysis of Paul's Substance or Alcohol Abuse

Functional Analysis Interviews

The two interviews are the most involved individuals in the substance addiction or dependence of Paul. John and Rita Smith gave different testimonies on the cause of Paul's strong dependence on alcohol and violent behavior. Paul is their only child and John himself was an alcoholic and a role model to Paul as that. This is his long-standing antecedent to his own misuse of alcohol or substance.

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Rita spoke openly about her husband's habitual domestic violence towards her and Paul from childhood to adolescence, basically because of the alcoholism of John. She recalled that Paul did not have any major developmental problems as a child. But, at 13, Paul had a violent encounter with John, which broke his ribs and arm. For his part, John described his relationship with his only son as "tumultuous" from the time Paul was 12. Rita concurred with this revelation and added that the violent relation became regular between John and Paul. The boy almost always suffered injuries as a result. From age 15, Paul's violent behavior took a turn and was projected to others but his focus was really his father.

Paul was a truant when in high school and was disinterested in school. He had no ambition to make good even at a vocational education so that he had to be on disability support because of his mental disorder. He also stole money from his mother but would afterwards promise to repay it. He also attempted to commit suiide by throwing himself before a moving train. He had no satisfying relationships and about the only moments of emotional stability did he show or express regret for being hard or violent towards others.

Direct Observation

One was his co-employee at the McDonald's who observed his erratic and unpredictable behavior at work. Others who observed his violent and overall disturbed behaviour were his teachers in high school, his fellow-employees in his unskilled employments and his peers in the community with whom he found extreme difficulty relating normally.

Experimental Manipulations

In an alone condition and Paul would not be subjected to stimulations, the torment of a cruel childhood and adulthood would still disturb him. In an attention condition when he does what he wants, he would probably seek out the activities, which would either allay the deep pains in his heart and mind or express the collected vengefulness and aggression within him on someone else or on objects. A demand situation, which should allow him to escape from the turbulent situation he regularly had with his father would not help very much. The deep wounds are in the inside, not in the outside or the outside world. Under a play condition manipulation wherein he would be allowed to engage in enriching activities un-connected with a turbulent relationship with his father and overall home environment, he may be distracted for a while but the tormenting agony of his life soon take over. His official psychiatric records show chronic schizophrenia.

Functional Analysis Summary

Paul was a very much abused child -- physically, emotionally and mentally. From his parents' interviews, it was learned that he had no balancing or compensating fulfilments to this horrible childhood and adolescent in school or in the community where his aggressive behaviour was common knowledge. His disability support, consultations with mental health services, the hospitals where he was treated for injuries and the police who arrested him for offenses were objective observers of his downhill life experience. Being left alone, or allowed to escape from the presence of his father or other authority figures or when he was given the attention he sought and should have been given him as a child would not help because the cause of his chronic hopelessness and destructiveness is inside him and which is difficult to access and reverse.

Behavioral Lesson Plan

Behavior reduction attempts can include procedures, which would assess the home environment, which is the primary cause of his overall aberrant and aggressive behaviour; manipulation of antecedents and the consequences; and replacement acceptable and satisfying equivalent behaviours taught directly to Paul in his specific situation of case.

If isolated from home and made to stay in the company of emotionally balanced individuals and support staff, Paul may be relieved but only momentarily. There is as yet no known cure for schizophrenia and his parents need as much psychotherapy as Paul does. Even if they realize their direct influence over the mental condition and life of Paul and submit to therapy themselves and improve, Paul may or may not respond positively or sufficiently to any therapy because of its chronic status. If and when a cure for schizophrenia is found, Paul may respond to it and be set free. But chronic alcoholism itself needs much support to overcome from those who overcame it, so there is hope.….....

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