28 Days: Name: Date: February 8, 2022 Block: DDD

Name: Date: February 8, 2022
Block: DDD
28 Days
Overview
Gwen Cummings, from 28 Days, has been sent to your rehabilitation facility.
Gwen uses alcohol and Vicodin, a prescription analgesic. She wound up in
your facility after she and her boyfriend Jasper, already drunk, arrived late to
her sister’s wedding. Gwen fell into the wedding cake at the reception, then
stole a limousine and drove it into a house. In lieu of jail, she has been sent
to rehab for 28 days.
Client name: Gwen Cummings

Psychiatric diagnosis: Alcohol Use Disorder; In a controlled environment;
Severe
*For the criteria supporting this diagnosis, please refer to the Diagnostic and
Statistical Manual of Mental Disorders, 5th edition, by the American
Psychiatric Association, and/or your Wolters Kluwer mental-health nursing
textbook.
Date: February 8, 2022
Your name:
Name of the client you are assessing: Gwen Cummings

Name of the movie: 28 Days
Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 1

What is the chief complaint? (In the client’s own words, and report of others)
Response:
Gwen was in denial of her condition when she defended herself that she can
act normal and when she said that being an alcoholic is normal for people
like her because she was a writer. Gwen initially refused to accept, but later
admitted that her alcoholism was a serious issue. Gwen first claims that she
doesn't have a problem and that she doesn't belong in treatment with "all
these other people," claiming that she has the ability to leave at any time but
doesn't want to. In fact, she appears to crack jokes whenever important or
difficult subjects are discussed. Gwen's sister thinks she's conceited and
alcoholic. She is very outspoken about the client's drinking problem. She
believes it is a waste of time to attempt to love Gwen because it is too tough.
Her sister put it this way: "You make it difficult to love you." Gwen's
boyfriend, Kasper, doesn't think there's anything wrong with her. He, too,
downplays it.
In the conversation she had with Cornell Shaw after her fall incident, Gwen
tells him that she does not want to go to jail because she believes they would
be unable to assist her and that she would eventually die if she did. She
argues that she just wants to breathe and beg for a second chance to give
her just 28 days to finish the treatment. That night before, she was terrified
and noticed how her hands were trembling out of control and admitted that
she needed help. She was in need of guidance.
Based on the above information and a close viewing of the movie, what
questions would you raise during history taking? What are some possible
answers? You might base your questions on the:
 History of the client’s illness, problems encountered due to
drinking.
 Family history of substance dependence.
 Psychosocial history.
Response:
1. When did you begin to drink or use drugs?

Gwen: I was a teenager then when I started to expose myself
with these substances. These helped in taking away some pain I
have felt after dealing with my mother’s death and having spent
my whole life dealing with her alcoholism.
2. What is the reason for your use of alcohol and drugs?

Gwen: To take my mind of from the misery of my childhood, and
just to basically get away from reality.

3. Was there a particular event in your life that you feel contributed to
your habits now?
Gwen: It has to be my mother’s death.
4. Have you ever attempted in quitting drinking or taking drugs on your

own before?
Gwen: I never felt like there’s something wrong nor that I have a
problem so I have never attempted to quit drinking and using by
myself.
5. Have you ever felt guilt whenever you drink alcohol or use drugs?
Gwen: Actually, no. I feel like drinking or using comforts me to
the point that when I’m down I would seek for it and just drink
more.
6. Do you believe that drinking and taking drugs have negative

consequences?
Gwen: I understand why people are upset. I understand where
are they coming from but I’m not entirely convinced that it brings
a huge problem. Maybe they’re all just exaggerating.

In your opinion, is the diagnosis above accurate?
Response:
YES. I believe that this is the right diagnosis for Gwen.
What requirements does the client meet that support this diagnosis, based
on DSM-5 criteria?
Response:
Axis 1-Primary Psychiatric Diagnosis I.E. Alcohol Dependence

-when Gwen is having delusions, hallucinations, and avolition
Gwen would need to satisfy six criteria to be diagnosed with severe alcohol
use disorder.
1) A strong desire to consume alcohol – Even after already consuming a

great amount of alcohol the night before, the morning in the first minutes of
the movie, Gwen yet again indulged herself in drinking a bottle of alcohol on
the way to her sister’s wedding.
2) Abuse of alcohol on a regular basis, resulting in an inability to

meet significant role responsibilities.
3) Drinking despite having continuous or recurring social or interpersonal
issues caused or aggravated by alcohol's effects.
4) Repeated alcohol consumption in physically risky conditions.
5) Alcohol usage causes important social, occupational, or leisure activities to
be abandoned or curtailed.
6) A requirement for a significantly reduced effect when the same amount of
alcohol is consumed.
What treatment plan would you outline?
Response:
 Detoxification, followed by a mix of supportive counseling, self-help
group participation which would help her express herself to release
anxiety and problems in her life that prompt her to become a
substance and alcohol addict, and continued coping mechanism
improvement in the Rehabilitation center.
 Provide patient and family education about Gwen’s illness.
 Counseling and medicines are used in rehabilitation to teach the
recovering alcoholic the skills he or she will need to stay sober.
 An alcoholic must be self-driven to maintain sober.
 Inpatient treatment, attending AA meetings after discharge, finding an
AA sponsor, following up with a counselor or group as she tries to
make new or sober friends and rebuild her life.

With what expected outcomes?
Response:
1)Ensure the client's safety and security.

2) Ensure that fluid and electrolyte balance is maintained.
3) Encourage a good night's sleep.
4) The client will recognize that alcohol is a problem and will accept
responsibility for it.
5) Recognizes the necessity for lifestyle modifications.

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Name: Date: February 8, 2022

Client name: Gwen Cummings

Date: February 8, 2022

Name of the client you are assessing: Gwen Cummings

Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 1

1. When did you begin to drink or use drugs?

2. What is the reason for your use of alcohol and drugs?

Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 2

4. Have you ever attempted in quitting drinking or taking drugs on your

6. Do you believe that drinking and taking drugs have negative

Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 3

YES. I believe that this is the right diagnosis for Gwen.

Axis 1-Primary Psychiatric Diagnosis I.E. Alcohol Dependence

1) A strong desire to consume alcohol – Even after already consuming a

2) Abuse of alcohol on a regular basis, resulting in an inability to

What treatment plan would you outline?

Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 4

1)Ensure the client's safety and security.

Copyright © 2015 Wolters Kluwer • All Rights Reserved 28 Days - 5

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