Tri-Fold Approach Case Study

The tri-fold treatment approach is a holistic method of utilizing the physical, emotional and spiritual factors in the treatment procedure. The philosophical underpinnings of this methodology is to ensure that the individual’s needs are addressed in each of the aforementioned levels. The probability of success in the recovery process will be strengthened when the physical, emotional and spiritual components are included in developing a treatment plan.

Anna

Anna is a seventeen year Latina female residing in the home with her parents and two siblings. Anna reports that her family is very religious and upholds the traditional beliefs of her culture. Anna indicates that her father is the head of the household and therefore makes all of the decisions

for the family. Anna states that she was sexually abused by her uncle from the ages of 6 to 9 and that her father blamed her for this occurring. Anna also stipulated that her parent’s relationship was very violate, and that her mother was physically and emotionally abused by her father. Anna indicated that by the age of 12, she began having sex with her 16-year-old boyfriend and drinking on weekends.
Anna was referred to our agency by her probation officer assigned to her from the juvenile court system. The purpose of this referral was to conduct a substance abuse evaluation and determine appropriate placement in a substance abuse program. Anna was evaluated and recommended for adolescent inpatient treatment at this time. The family system is resistant to residential placement because of their cultural and religious belief systems. However, the probation officer signed the necessary paperwork for placement and she has been placed in the Jackson Adolescent Inpatient Treatment Program.
The multiple team met prior to meeting with Anna to address areas of concern for her treatment program. Anna has experienced emotional trauma as a result of witnessing domestic violence and being sexually abused by her uncle. The team recommended at this time that a psychological evaluation be conducted to determine if a mental health diagnosis and medication intervention would be warranted. Anna’s history of drug usage began after the incident of sexual abuse and may have been utilized as both a coping skill as well as a mode of self-medication. The team also suggested that Anna receives trauma based therapy to address her family and sexual abuse issues.
Anna met with her addiction therapist to assist with developing a treatment plan centering around her physical, emotional and spiritual needs. Because of her history of sexual abuse Anna is experiencing both emotional and spiritual issues. Anna is experiencing conflict with her spiritual and emotional beliefs as she is both angry at “God” for allowing her to experience this abuse and suffering low self-esteem because of her assumption that she is unworthy of receiving help from her spiritual being.
The physical component of addiction was also addressed due to the impact that addiction has on the body. An educational program was included in the treatment program regarding the effects of drugs and alcohol on the body. Another area that was included in the educational component was on how substances impact the brain and brain development in adolescents.
In order for Anna’s treatment program to be successful the holistic approach need to be accessed. The substance abuse disorder is just one of the aspects that is focused on in the recovery process. The trauma she experienced as a child impacting her spiritual and emotional parts must also be included in the treatment plan. The physical component via educational programs will provide knowledge regarding the impact of her addiction on her physical well-being including changes in her brain. The individualized treatment plan was developed by both Anna and her therapist.
Joe
Joe is a 62-year-old homosexual that was referred to the agency following his detox from the hospital setting. Joe had a secret partner since the age of 25 to 45. His partner had died from AIDS in the mid-80’s and had to grieve in silence due to his fear of sharing his sexual preference to his family and friends. Joe reported that his drinking has gotten worse with the death of his partner.
Joe met with the addition therapist to set-up an individualized treatment plan.

The approach that was utilized was the tri-fold approach. Joe grew-up in a religious family system, whereas homosexuality was viewed as a sin. Joe experienced shame and guilt related to his sexual orientation and his religious beliefs. Even though he shared his sexual preference in his 50” s, Joe did not do so until after the death of his partner and parents. Joe has encountered the physical effects that drinking has had on his body. Joe experienced extreme withdrawals, blackouts, and also been diagnosed with heart disease and pancreatitis.

The tri-fold approach applied within the treatment plan will include elements of spirituality, emotional and physical components. The spiritual aspect focus will include making peace with his sexual orientation and his religious up bringing. Because of his biological background, with encouragement, Joe will be able to connect the biological nature of his sexual orientation in coming to terms with his spiritual beliefs.

In regards to his emotional balance, Joe will enhance this through individual therapy sessions and cognitive restructuring whereas he will be able to replace the negative beliefs regarding his sexual orientation to embrace his homosexual

identity.
The physical component is essential in order for Joe to be successful in his recovery process. The medical doctor on staff will evaluate his conditions and make recommendations related to his health and health style changes that are needed.
Anna and Joe experienced substance abuse disorders. However, if the treatment plan is to be successful, the therapist must tailor this to their needs in terms of the tri-fold approach. Even though both have substance abuse issues, each have different issues that must be addressed in the spiritual, emotional and physical parts of their person.