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Substance Abuse and Pregnancy

Scenario for Maria:

You are a psychologist working in a women’s unit for a
substance abuse agency as a member of the treatment team. Your specific job is
to conduct individual sessions with clients who have problems that are
un-treatable in group therapy. Typically, you provide mental health services
for clients who do not have another psychologist and your clients are very
needy. In fact, virtually all of your clients are unemployed and are quite
poor.

During Maria’s appointment, you learn that she has just
discovered that she is six weeks pregnant, and despite her continued drinking
and use of cigarettes, she thinks that her baby will be healthy. The agency
nurse asked you to talk to her about how her behaviors are likely endangering
the baby. She has explained the physical problems, but Maria responds better to
you. Maria does not understand how her tobacco and alcohol use, lack of sleep,
poor nutrition, unprotected sex, and other risky behaviors might be dangerous
to the embryo. Maria dropped out of high school as a sophomore and has a sixth
grade reading level.

What specific information is most important to introduce to
Maria to help convince her to make some changes? 

Remember that you do not want
to overwhelm her with complicated information and explanations. How would you
approach Maria to help to educate her about pregnancy risks? 

What specific
behavior changes does Maria have to make to help her baby to be healthy? 

What
interventions would you suggest to Maria and the rest of the treatment team
that will help to support the changes that she needs to make?

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