Introduction and Background
Tom Scott is a thirty-three year old man living in Fargo, North Dakota. His case is a point of interest because he is struggling with alcohol addiction and cigarette smoking, he used to take drugs, and has developed a negative attitude towards life and habits that places his wellbeing in jeopardy. Tom’s upbringing was unlike that of most children, particularly those that grew up in stable home environments. From Tom’s family history, it has been learned that he was brought up by a single mother, who was a drunkard and was often physically and emotionally abusive towards him. As a result of his turbulent relationship with his mother, Tom feels that the people in his life hate him. His mother’s treatment of him lowered his self-esteem, which made him believe that he is worthless. As a result, Tom isolates himself from his family and friends. Despite the struggles in his life, Tom was able to accomplish a degree. Nonetheless, Tom is unemployed at the moment due to his alcoholism. To turn his life around, Tom needs moral, emotional, as well as financial assistance that would help him recover and carry on with life normally. The succeeding assessment provides a clear and descriptive account of Tom’s situation including recommendations that would help him cope with his situation.
Presenting the Problem
Tom Scott went to a specialist in order to seek help and counseling. From the way he presented himself, the man lacks a sense of self-esteem and therefore, lacks confidence in himself. He also appears to have many frustrations in life. Due to the way that his mother brought him up, Tom has long believed that people hated him. Tom also feels that nobody loves him. Negative feelings about others and about himself led Tom to feel alienated and isolate himself from family, friends and the community. In fact, Tom spends most of his days locked in his room. Even at the age of thirty-three, Tom never experienced having close friends or girlfriends. As a result of this lack of a support system, Tom has indulged himself in the life of alcoholism with the hope that it will help him forget these problems in his life. To deal with his problem, Tom consulted with a counselor. Tom hopes that by opening up to somebody and sharing his problems, he will receive help that would enable him to live a fulfilling life. This attitude shows willingness on Tom’s part to change his life.
Mental Health and Substance Abuse History
Tom was confined to a rehabilitation center for substance abuse when he was in high school. During his early adolescent life, Tom began drinking, smoking cigarettes, and using drugs. While in the center, he had undergone sessions of guidance and counseling with a therapist. The major reason that contributed to Tom’s addiction to various substances was his mother’s upbringing. His mother was also alcoholic and was both physically and emotionally abusive when he was growing up. Based on the behavior of Tom’s mother, it is possible that the mother made him learn to find a way of escaping from the problems presented by life through alcoholism. Tom endured insults and hostile behavior from his mother throughout his childhood. Tom shared that his mother even locked him up in his room for two days. He had once been confined in his room for two days after receiving serious beatings from his drunken mother.
In terms of Tom’s mental health, he seems is paranoid and has a low sense of self-esteem as a result of the physical and emotional abuse that he experienced while growing up because of his abusive mother. His condition, which may be characterized as depression because of his suicidal thoughts, may be attributed to his upbringing and the effect of drugs and alcohol in his system. Judging by the way that he expressed himself and the way he looks, it is evident that he is suffering from stress and depression. Tom also feels alienated from other members of society, which causes anxiety in him. To make matters worse, Tom sometimes contemplates suicide especially when he is drunk. Tom’s state of mind indicates that his thoughts and behavior may cause self-harm, which increases the need for immediate attention to Tom’s case.
Medical History
Tom was confined in a rehabilitation center due to the impact of excessive alcohol and drug consumption. In terms of the physiological outcomes of his alcoholism, it shows in his appearance. Tom does not observe good personal hygiene due to his body odor, his unkempt hair, and long dirty nails. Tom’s body is also frail because he is not eating a balanced diet. Majority of his food consumption involves alcohol. Due to smoking and drug use, the color of Tom’s teeth changed from its natural color to yellow stained teeth.
Family and Personal History
Tom was brought up by a single mother. His parents divorced when he was only 2 years old. As a matter of fact, Tom does not know much about his father because the divorce took place when he was young. His mother is an alcoholic and does not demonstrate ideal traits of a role model for her child. At his tender age, his mother would confine Tom to his room and physically abuse him for days. Tom’s mother would also insult him to no end and make him feel bad about himself. It seems that Tom internalized his mother’s insults, which is why he has low self-esteem. His life in school was also tough because he had to cope with the challenges of attending school while his family struggles to pay for tuition. His emotional well-being during that time also indicates that he was not prepared to interact with his teachers and peers. While in school, he had to undergo sessions on guidance and counseling in high school to help him manage the demands of high school such as stress.
During his younger years, Tom’s uncle expressed concerned about him. His uncle has been his closest friend at this time because he frequently visits him and shows interest in getting to know more about him and progress in school. At the same time, Tom’s uncle also comforts him and offers him both emotional and financial support. As Tom grew older, his mother has gradually reduced her intake of alcohol due to her old age. Nonetheless, Tom’s mother still continued to physically and verbally abuse him.
Current Living Situation
Tom lives on aid as support from his uncle. He now lives in his own apartment but is unable to support his living costs. Majority of Tom’s spending is sponsored by his uncle. Tom also has some savings left from his last job from which he was terminated four months ago. There are times when Tom finds it difficult to keep things afloat especially when he runs out of funds. However, Tom does not prioritize his expenses because he mostly spends his money and his uncle’s money on alcohol and cigarettes. When he runs out of money, Tom sells some of his personal items so he can still purchase alcohol and cigarettes.
During most days, Tom is confined in his room. He avoids even his neighbors and makes sure that he would not meet other people so he would not need to communicate or interact with them. Tom’s withdrawn personal shows that it is important for him to seek help from a counselor so he may develop skills that would allow him to meet people and build meaningful and supportive relationships with them.
He is unemployed at present time and he spends most of his time drinking and sleeping in his room. He is resentful and he confines himself most of the time. He has worked and lost eight jobs. Sometimes, Tom harbors suicidal thoughts especially when under the influence of alcohol, which increases the urgency for Tom to have the support of his family to prevent self-harm on his part.
Mental Status Exam
Apart from occasions when Tom is drunk, he seems to be in a right state of mind. However, he does not like socializing and is always withdrawn. He shies away from people because he thinks that people dislike him. His negative perceptions about the way that other people see him makes him abhor the act of socializing with others. Scott always confines himself in his room and has no friends. He is resigned. Tom also appears to be in a depressed state of mind. His hair is unkempt and this shows that he neglects his personal hygiene and wellbeing. Although he has a sound mind, he presents himself like a person who is insane. He is under medication because of his continued use and abuse of alcohol and drugs. It is necessary for him to visit a psychiatrist regularly for treatment and therapy. Overall, Tom’s mental status indicate problems linked to paranoia, anxiety, and depression.
Academic/Educational History
Tom completed his high school and college degrees despite the difficulties he experienced when he was younger. During his primary school years, he went to school with bruises as a result of the beatings that he received from his mother. During counseling in school, they learned about how the mother treated her son while under the influence of alcohol. His life in school was terrible because he faced financial difficulties and lived with an abusive mother. He received education the hard way because of problems in the family. He used to attend sessions on guidance and counseling when he was in high school. Tom was also confined for two days in a health care center for misusing drugs. Tom earned a degree in electrical engineering.
Vocational History
Tom Scott secured a job immediately after graduating college. However, he was terminated from his first job later due to alcoholism. Tom was always drunk and he would often go to work drunk or with a hangover. He has worked in eight different places at different times where he has always been terminated due to the same reasons, which is alcoholism. Currently, Tom is not working. His current source of income is the savings that he had obtained from his last employment a few months before. He also depends on grants from his uncle. Nevertheless, when he gets completely broke and notices that there is no income that is impeding, he ends up selling some of his personal properties like the car.
Legal History
Tom was arrested several times for driving under the influence and for public disturbance when he gets into bar fights. In his drunken stupor, he becomes very abusive and disrupts the peace in bars. His state of alcoholism has caused him other kinds of trouble with other people. For instance, he often had cases to answer at his place of work because of absenteeism and attending work while drunk. The result of this is his subsequent termination from his jobs.
Primary Support System
As formerly noted, Tom depends on his uncle for financial grants. His other relatives also help him especially in paying for his counseling and rehabilitation. In his jobless state, Tom survives on his savings he had earned from his last employment four months ago. He has no friends to offer him help and even though has mother has changed slightly from her behavior, she remains very abusive to him. He, therefore, cannot count on her for either emotional support or financial support.
Leisure Activities/Hobbies and Interests
Tom does not engage in leisure activities nor show interest in different hobbies. He passes the time by playing computer games. He lives in a solitary state and his choice of entertainment – that is playing computer games – shows his disinterest in going out, socializing and meeting new people, or engaging in outdoor activities and hobbies such as sports. Tom isolates himself in that he only leaves his place often if he wants to drink at a bar or purchase drinks to take home. If not for these reasons, Tom would simply stay at home. Since Tom does not have any friends, he does not have anyone to spend time with or share experiences and activities with. No one, even from his family, visits him at his place. Tom’s uncle only visits him once in a while to ask how he is doing. Tom’s sedentary lifestyle is a cause of alarm because it might cause health problems for him. Without proper exercise and diet, Tom could develop diseases that result from inactivity and unhealthy food consumption.
Financial Status
Tom’s current situation shows that he has an unstable financial status. As formerly noted, Tom is currently unemployed. He tried to work in the past but his previous bosses would always terminate him because he goes to work drunk. Due to his drunken stupor, Tom does not perform well at work. Tom’s last employment was four months ago. At present time, Tom is currently living off the savings he obtained from his last employment. For an alcoholic and smoker who needs a source of income to satiate his addiction, Tom does not seem worried about his financial situation. He does not show any worry that his source of funds is slowly running dry. Even when he runs out of money, he still prioritizes his drinking and smoking. Tom sells some of his possessions just so he would earn money to buy alcohol and cigarettes.
The present condition of Tom is a result of his difficult childhood, his isolation from family, and lack of social support. Due to his mother’s constant insults and abuse, Tom grew up believing that he is worthless, that people hated him, and that nobody cares about him. With the absence of a support network, Tom sough to cope with his difficult situation and low self-esteem by resorting to drinking, drugs, and smoking. Tom chooses to drink alcohol to forget about his problems. Nonetheless, Tom shows much potential in improving his life because he is intelligent and discerning of the people and events that are happening around him. Through continued counselling, Tom may learn to quit his vices, pick up the broken pieces of his life, and make significant changes to improve his situation.
Recommendations/Action Plan
For Tom to recover completely, he needs to attend his counselling meetings regularly. Tom also needs to participate in support groups so that he can meet other people with the similar kind of situation and he could learn from them, particularly about ways to cope with their difficult situation. Tom should also engage in therapy wherein the counselor focuses on family therapy is one of the strategies to help Tom. Tom’s relationship with his family, particularly his mother, is one of the reasons why he became alcoholic and suicidal at times. For this reason, the counselor must focus on mending Tom’s relationship with is mother and establishing Tom’s other family as his primary support group.
Donors must also be engaged in helping Tom. Donors may help Tom by advising him about ways or strategies that he may adopt so he can cope with his situation, specifically by stopping his drinking and smoking habits, taking care of himself, and finding employment. Tom should also visit a rehabilitation center where he may receive training and counseling on how he would be able to change his life positively. After recovery, Tom should begin building relationships with other people so he can bolster his support system. Tom should work on gaining friends that are positive influences or maybe even dating women so he can marry and start a family of his own. Personal and intimate connections with other people may help him feel happy and content and he would be able to gain a source of love and emotional support.
