Transcript -

Manuel Sanchez Client Background

Manuel Sanchez is a 50-year-old Hispanic man who has been married to his wife, Isabella, for 27 years. Manuel and Isabella live in Columbia, South Carolina, and have two children. The oldest is Peter, who is 26 and lives in Washington, D.C., with his wife and 2-year-old daughter. Peter works in a mid-level management position at a bank, and his wife stays home with their child. Manuel and Isabella also have a daughter, Elliana (Elli), who is 23 and single. She has been a student for several years and is working on a bachelor's degree in social work. Elli lives with Manuel and his wife and they fully support her educationboth financially and in every other waybut this has begun to bother Manuel more and more. He does not see the value in higher education and does not see any end to Elli's academic pursuits.

Manuel moved with his parents and two older brothers from Jurez, Mexico, to El Paso, Texas, when he was 6 years old. The entire family found it difficult to adjust to the American lifestyle and traditions; at home, they continued to speak Spanish and follow Mexican customs. Manuel's oldest brother joined the military and was killed in action when Manuel was 13. In the aftermath of this loss, his other brother began selling drugs and was eventually arrested and incarcerated.

Manuel graduated high school and started working in construction when he was 18 years old. He enjoyed the work and the comradery with his coworkers, many of whom shared his immigrant background. However, one day at work there was an accident with heavy machinery that killed Manuel's best friend and left Manuel with several injuries. Manuel recovered but lives with chronic pain and painful memories of witnessing his friend's death.

Several years later, Manuel met and fell in love with Isabella, who was visiting relatives in El Paso at the time. He followed her to South Carolina, leaving his father and mother behind. Manuel was hired by a large shipping company as a delivery driver and has remained in the position for the past 25 years. He has always enjoyed the work because his daily schedule is predictable. He can "do his thing" without having to talk to and engage with others or listen to supervisors boss him around all day. Although he considers himself an outgoing person, Manuel has experienced numerous racial and ethnic insults from customers, supervisors, and neighbors and has become wary of others. As a driver, Manuel knows exactly what to expect: He has his route, he can listen to music as he drives, and he does not have to worry about anybody else.

Present Functioning

Ever since their son Peter married 3 years ago, the relationship between Manuel and Isabella has changed. Isabella says that she wants more out of life, that she is too young to "just be sitting at home" and that she wants to "better herself." Manuel has felt surprised by these comments, as he feels like things are fine the way they are and doesn't wish for anything to change. When Manuel tries to talk to Isabella, Elli begins to back her mother up, which Manuel finds frustrating. Manuel feels unsettled about the possibility of losing the life he has built with Isabella and finds himself up many nights unable to sleep as his mind races between fears about the future and painful flashbacks from the past.

A big issue between Manuel and Isabella is what Isabella calls Manuel's "drinking problem." She says Manuel drinks way too much. Manuel admits to drinking two to three cans of beer with dinner every night, and then maybe one or two more as he watches TV before bed. Manuel has consumed beer throughout his adult life, just like his father did. If he is honest, Manuel agrees that he has been drinking more lately, but that's because things are so stressful at home. He has even begun to have a couple beers at work during his lunch break. Manuel believes his alcohol consumption is not a problem and that he could easily stop whenever he wants to. However, the other day, Manuel got in trouble because a customer called the office to complain that "the delivery driver smelled of alcohol when he came to the door."

Manuel was able to smooth things over with his boss, but his boss told him that he must make an appointment with the Employee Assistance Program (EAP). Manuel did so, and the counselor asked all sorts of questions Manuel found very intrusive about his childhood, his father's disciplining practices, his relationship with Isabella, and his drinking habits. The EAP counselor's report indicated that Manuel may have a substance use disorder and recommended that he seek further assessment and counseling. Manuel's boss stated that these recommendations are mandatory if he wishes to maintain his employment.

Manuel believes that his private life should be off limits to people at work and that the few drinks during lunch should not be such a big deal. Manuel feels he has been an exemplary employee for decades: he never calls out sick, he has never been late, he goes above and beyond to ensure timely delivery of his packages, and he has never received a ticket. To make matters worse, Isabella has begun talking about divorce. Manuel feels betrayed and frustrated. He does not understand why everybody is against him. But to save his job, he is willing to seek counseling.

To prepare:

Access theCase Scenariosand revisit your chosen case from Week 3.

Review the Dahlgren-Whitehead Model and pay close attention to the three innermost layers of the model: Age, Sex and Constitutional Factors, Individual Lifestyle Factors, and Social and Community Networks.

Consider how factors such as race and ethnicity, age, sex, nutrition, sleep habits, and social relationships can contribute to the development of a substance use disorder.

Question

My chosen case is Manuel Sanchez (The UPS driver)

Briefly introduce the individual featured in your chosen case.

Analyze the individual and interpersonal factors that may have contributed to the development of a substance use disorder for the individual featured in your case.

Be sure to address factors associated with each of the three inner layers in the Dahlgren-Whitehead Model: Age, Sex, and Constitutional Factors, Individual Lifestyle Factors, and Social and Community Networks.