Introduction
The significance of Charlie, who is a young Hispanic male with ADHD and a complicated substance abuse case, to the social work field is high due to the intersectionality aspect with mental health, addiction and cultural diversity. Charlie’s problems with hyperactivity affected sleep patterns and dependence on medication to highlight the interconnection between neurodevelopmental disorders and substance abuse, signifying a major challenge in social work practice. Ensuring Charlie’s needs are met necessitates a comprehensive approach that includes culturally congruent interventions, effective therapeutic modalities, and support for his circumstances. In this paper, Charlie’s story reflects the main function of social workers related to giving access to complete services, fostering equal treatment and enabling clients to get positive life changes.
Client Demographics
Charlie, a pseudonym for a Hispanic male in his late twenties, is the primary focus of the social work system, grappling with a range of interconnected issues. He was raised in a particular culture, so his perception of himself as a single Hispanic man might affect his behaviours, perceptions, and help-seeking skills. Constructively, he belongs to the age group of people who often seek to go through transitional periods, such as independence, education or work, and different types of relationships. Certainly, his situation is aggravated. Among Charlie’s major presenting symptoms are physical, cognitive and behavioural manifestations. ADHD is his disorder underlying insomnia, which is hyperactive and attention-deficient by its nature. ADHD is a neurodevelopmental disorder with the symptomatic profile of impulsivity, inattentiveness, and hyperactivity because of the combined type of ADHD he is diagnosed with. This diagnosis not only exposes the underlying neurobiological factors that mask Charlie’s challenges but also suggests that we need to look at social work through a prism of mental health multidimensionality.
Moreover, when Charlie, in his attempt to cover up the symptoms, uses cocaine and marijuana, he utilizes a defence mechanism that is characteristic of many ADHD patients. The comorbidity of ADHD and substance use disorders typically exacerbates preexisting challenges, resulting in a downward spiral path without functionality and, thus, more complications (Young et al., 2023). When handling the situation of Charlie, the social worker ought to obtain a multidimensional standpoint in relating to his origin, his development, and the relationship between his ADHD diagnosis and substance use. In terms of treatment options, culturally sensitive interventions that resonate with the Hispanic culture of Charlie, together with evidence-based therapies targeting ADHD symptoms and substance abuse, must be employed. Also, multidisciplinary team collaboration between psychiatrists, therapists, and community resources is required to support Charlie’s overall needs.
Services Received
Being a volunteer at Your New Beginning, a centre focused on substance use issues and treatment, He will learn and know how to take part in order to achieve the purpose of handling his struggle. The IOP and SOP programs of the agency are structured interventions and therapeutic support specially designed for Charlie. It is a structured way of treatment that usually includes group therapy sessions and individual counselling; the patients also receive support through educational workshops. This program provides Charlie with six weeks of treatment, which is extensive in the field of substance control, as well as the origin of this condition, like impulsivity and hyperactivity, associated with ADHD diagnosis. Moreover, IOP is marked by group dynamics where the participants form a community and cohesion, making peer support and learning from each other possible.
This intervention occurs after the IOP’s completion when Charlie moves to the Supportive Outpatient Program. This aspect has been in progress for 12 weeks after he was released from the residential program. In contrast to IOP, which is characterized by the high concentration of the therapy, SOP is a partial hospitalization program that takes a flexible and less structured approach and allows Charlie to apply what has been learned during the initial stage of treatment to real life (Himelhoch et al., 2021). The objective of this stage is relapse prevention and coping skills, as well as continued support that would help to facilitate Charlie’s recovery and reintegration into normal living. In his journey to recovery and growth, Charlie is provided with an important facilitator through these programs embodied by a social worker. Through enlightening the participant’s experience of the adverse effects of alcohol and drugs, facilitating group discussions, and giving personal support, the social worker provides Charlie with the opportunity to make informed decisions, establish some coping skills, and pursue personal goals. Moreover, the social worker is a source of support, recognition, and consultancy, building a therapeutic rapport characterized by trust and partnership. Therefore, due to the coordinated actions of the agency, the social worker, and other professionals, Charlie benefits from providing the whole raft of services meant to address his complex needs and contribute to his overall welfare.
Review of Literature
Ginapp et al. (2023) focused on the consequences of interpersonal relationships and the bank user of ADHD and online communities. By addressing the subtleties of the societal implications of ADHD, this qualitative study presents an in-depth discussion of how ADHD affects social interaction and community functioning. Through a unique situation in which the research explores offline and online environments, the work contributes to a holistic view of the social struggles of individuals affected by ADHD. The qualitative method of this study enriches the literature where qualitative stories prevail and can improve social work practice to help Charlie improve his social behaviour.
Leffa et al. (2022) offer an extensive review of ADHD in childhood and adulthood, emphasizing the role of proper diagnosis and prognosis. The literature review provided here serves as the basis for understanding the course of the developmental trajectory and long-term consequences of ADHD. This review informs the social worker about the implications in the future, the perspective on each adult as an adult, and the ADHD challenges that remain intact throughout their life to support the formulation of interventions suited for Charlie.
Robinson et al. (2022) add to the literature by exploring ADHD symptoms and diagnosis in adults who were born preterm. We see the attention that the study devotes to the role of developmental factors in the comprehension of ADHD, which is especially pertinent to populations with differently shaped early life experiences. This study is particularly relevant to social workers who work with individuals like Charlie, who may have additional complications due to preterm birth and, thus, call for idiosyncratic consequences resulting from diagnosis, interpretation, and intervention.
Literature review on diversity, the issues
Diversity issues literature related to the case of Charlie points to racial and ethnic differences in diagnosing and treating ADHD. Such disparities play a vital role in establishing health injustice when it comes to access to medical services; this is very worrying as it is daunting even for people like Charlie, who are struggling with many barriers.
Shi et al. (2021) analyze racial differences in the diagnosis of ADHD within the nationally representative US birth cohort. Their results show significant differences in ADHD epidemiology between racial groups, and some of the minority groups have lower rates of diagnoses compared to their White peers. This gap indicates possible diagnostic biases and the importance of culturally competent evaluations and interventions as a way to deal with ADHD in various population segments.
Winders Davis et al. (2021) also examine racial/ethnic differences in the diagnosis and treatment of ADHD in Medicaid-enrolled youth in Kentucky. The variety of assessment methods reveals substantial differences in ADHD diagnosis and treatment. It indicates that minority youth are less likely to be provided with timely and gentle therapy compared to White youth. Since vulnerability and social determinants of health cannot be disentangled from one another, much can be inferred from these findings about the intersecting patterns involved in race/ethnicity and social status as major determinants in healthcare access and utilization among vulnerable populations.
Second, Yang et al.(2022) add to the research by evaluating racial and ethnic disparities in ADHD treatment access and usage nationwide. The study they report on shows persistently differential access to services for treatment of ADHD, where minority children have worse barriers to obtaining and benefiting from appropriate care than White children. These findings imply that healthcare disparities are systemic and that inequalities in healthcare should be addressed at the structural level.
Conclusion
The case of Charlie, a Hispanic male in his late 20s with ADHD combined type, reflects a complex situation that must be addressed with attention to his diverse needs and in the larger framework of health inequality. The nature of Charlie’s problems with hyperactivity, substance use, and social impairments points to the intricate correlation between neurodevelopmental disorders, identity, and socio-economic aspects. The literature review highlights the racial and ethnic differences in the diagnosis and management of ADHD, outlining the need for culturally competent and equitable practices in healthcare. Through the incorporation of the insights gained from doing research in the case analysis, we intermediate the overall social work(s) functions so that individuals like Charlie would be supported in a holistic style, hence being addressed personally and more advocated for systemic changes to promote health equity and improve health outcomes for the vulnerable communities.
References
Ginapp, C. M., Greenberg, N. R., MacDonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2023). The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study. SSM – Qualitative Research in Health, 3, 100223. https://doi.org/10.1016/j.ssmqr.2023.100223
Himelhoch, S., Currens, M., Benford, J., & Weintraub, E. (2021, September 8). Somewhere to Go: Implementing Medication-Based Treatment for Opioid Use Disorders in Rural Maryland and beyond. Www.intechopen.com; IntechOpen. https://www.intechopen.com/chapters/77322
Leffa, D. T., Caye, A., & Rohde, L. A. (2022). ADHD in Children and Adults: Diagnosis and Prognosis. New Discoveries in the Behavioral Neuroscience of Attention-Deficit Hyperactivity Disorder, 57, 1–18. https://doi.org/10.1007/7854_2022_329
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Shi, Y., Hunter Guevara, L. R., Dykhoff, H. J., Sangaralingham, L. R., Phelan, S., Zaccariello, M. J., & Warner, D. O. (2021). Racial Disparities in Diagnosis of Attention-Deficit/Hyperactivity Disorder in a US National Birth Cohort. JAMA Network Open, 4(3), e210321. https://doi.org/10.1001/jamanetworkopen.2021.0321
Winders Davis, D., Jawad, K., Feygin, Y., Creel, L., Kong, M., Sun, J., Lohr, W. D., Williams, P. G., Le, J., Jones, V. F., Trace, M., & Pasquenza, N. (2021). Disparities in ADHD Diagnosis and Treatment by Race/Ethnicity in Youth Receiving Kentucky Medicaid in 2017. Ethnicity & Disease, 31(1), 67–76. https://doi.org/10.18865/ed.31.1.67
Yang, K. G., Flores, M. W., Carson, N. J., & Cook, B. L. (2022). Racial and Ethnic Disparities in Childhood ADHD Treatment Access and Utilization: Results From a National Study. Psychiatric Services, 73(12). https://doi.org/10.1176/appi.ps.202100578
Young, S., Abbasian, C., Al-Attar, Z., Branney, P., Colley, B., Cortese, S., Cubbin, S., Deeley, Q., Gudjonsson, G. H., Hill, P., Hollingdale, J., Jenden, S., Johnson, J., Judge, D., Lewis, A., Mason, P., Mukherjee, R., Nutt, D., Roberts, J., & Robinson, F. (2023). Identification and treatment of individuals with attention-deficit/hyperactivity disorder and substance use disorder: An expert consensus statement. World Journal of Psychiatry, 13(3), 84–112. https://doi.org/10.5498/wjp.v13.i3.84
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