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Meet Mark
Mark’s drug use began in his adolescence. According to Mark, he did not have a strong family
support system. His father left him and his mother, when he was about 3 years old, and he had no
contact with his father since then. His mother, Barb, became the only breadwinner and had a very
difficult time trying to keep a roof over their head. However, Mark was well liked in school and was
an average student.
Mark’s mother met Danny when Mark was 8 years old. Danny became his stepdad soon after they
met. Couple of months after Danny moved in with them, Mark’s behaviour changed at school and he
was emotional, distracted, easily frustrated.
Mark attempted suicide at the age of 9, and following his suicide attempts he was hospitalized for
two months in a psychiatric unit. At that time Mark alienated from her mother and close friends, and
gravitated more to substance using peers. He was especially hurt by his mother’s reaction to his
suicide attempts, which he felt conveyed frustration and anger, rather than compassion.
Danny had a somewhat distanced relationship with Mark. Danny believed that Barb kept
information from him because she thought he might lose his temper with Mark. Danny never lost his
temper with Mark, but he got easily frustrated and verbally and physically aggressive with Barb.
After Mark’s suicide attempt, Danny asked for help to stop his abusive behaviour. By that time, Barb
and Danny struggled individually and as a parenting team to deal with Mark’s drug use and other
problems. When they became upset with him and/or tried to set limits, he threatened to run away,
and they backed down. Barb had generally not wanted to bring Danny into her problems with Mark,
and Danny also admitted that he was okay to stay on the sidelines.
At the age of 10 Mark smoked cigarettes and drank beer with his peers behind his school. Mark
almost always drank until he was obviously drunk. He also experimented with many other drugs,
including marijuana, cocaine, heroine, speed and downers. He expressed no motivation to stop
using, and had no desire to be in treatment. Procuring drugs, using drugs, and describing the
experience became the focus of his life. Failing school was no surprise. His moods were highly
variable, and he was often unpleasant. Mark’s mother and stepdad knew he “occasionally” drunk
too much, but they did not know (or did not want to know) about his drug use. His dismal
performance seemed to be related to his missing most classes. He had for long months forbidden
anyone from going into his room, after his mother found little packets of white powder (probably
cocaine) in his sock drawer. He said he was keeping it for a friend and that he would return them
immediately. Money was sometimes missing from the house, and once some computer equipment
disappeared. Mark never admitted that he had anything to do with those situations. Mark was
smoking tobacco and marijuana daily, drinking beer and getting drunk several times a week, and was
using cocaine and other available drugs weekly.
Mark’s relationship with his mother was tense. Barb felt like a failure as a mother and doubted
herself so much that she could not make any parenting decisions. Barb had a history with addiction,
and during those difficult times she returned to use alcohol to manage her anxiety and used it as a
sleeping aid, too. Her use of alcohol also prevented her from properly supervising Mark.
One day CAS was called by Mark’s teacher, and they started to assess his situation and that is how
he was referred to your care. Mark was 12 years old at that time. Your learned from the referral that
Danny, the stepdad, was working mostly away from the family (4 weeks away, 1 week he was at
home) and his involvement in family life was sporadic. Mark was angry for having been forced by the
school and CAS to undergo the assessment. Mark considered himself an adult, and he was angry and
resentful. He resented his mother the most. He described his mother as a drunk, who say things and
make promises, but she does not follow through.
From Mark’s teacher, you learned that Mark was the oldest student in the class and that bothered
him. He was embarrassed and angry about being in class with younger teens.
Instructions for your assignment
You are asked to engage and assess Mark and his situation. In order to do so, you are asked to
understand his substance use problem in his unique, individual context. (Please, consider using
information of chapters #1, #16 and #22, however other chapters from the textbook might be also
useful, and the relevant presentation slides from week #1 to #9)
You are asked to integrate the BPS+ model and life span/developmental perspective (e.g.,
responsibilities that can be expected) when analyzing the complex situation, you read about. Use
screening and
