DBT for Substance Abuse: Clinical Formulation

Laura-Petracek2

Private Practice

Key Points

  1. Michael’s problems could be traced back to childhood trauma from an abusive upbringing, which left him with emotional scars and increased his vulnerability to addiction.
  2. Environmental triggers, such as financial instability and inconsistent employment, contributed to Michael’s poor coping skills and escalated his substance use.
  3. A combination of underlying vulnerabilities and environmental factors highlights the importance of addressing both aspects in treatment to support the client’s recovery and well-being.
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Predisposition: Childhood Trauma and Emotional Scars

Michael’s struggles with addiction can be traced back to his childhood trauma. Both parents were emotionally and physically abusive toward him. He moved out of their house when he was 18. His father’s heavy drinking and his mother’s suspected alcohol and prescription drug abuse further contributed to his own vulnerability to addiction. This traumatic upbringing left Michael with deep emotional scars that persisted into adulthood.

He experienced a PTSD episode at 19, and was diagnosed with PTSD. He has also been diagnosed with major depressive disorder. All of these predisposing factors are likely to have made him more susceptible to substance abuse.

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