Jerrel's Story
Jerrel's story is a case study that illustrates how a clinician with knowledge and experience in CRT and counter-storytelling intervenes to assist an African American male successfully complete substance abuse treatment.
Jerrel
Jerrel was a 37 year old African American male with low self-esteem. He had history of major depressive disorder and opioid dependence. Jerrel had difficulty completing many substance abuse treatment programs due to continued relapse. He faced many systemic barriers such as unemployment and lack of stable housing. Jerrel also experienced racialized trauma and felt that many of his substance abuse counselors could not understand his lived experiences.
*Pseudonym name used for confidentiality purposes.*
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Jerrel
This is my Story
"I'm a failure, that's what they see me as..."
Counter-storytelling through
Building Rapport
Upon entering treatment, Jerrel was guarded, encountered negative treatment experiences, and viewed himself as a failure. Therefore, it was important to begin building rapport during the first session by validating his feelings, showing empathy, and challenging his negative thoughts through cognitive restructuring. To reframe Jerrel's negative thoughts, I encouraged him to identify two things that he accomplished in his life. Challenging his belief that he was a failure provided him with insight into his accomplishments and was the beginning phase of improving how he viewed himself.
Counter-storytelling through Jerrel's Words
I developed a weekly individual session schedule for Jerrel, which provided him with a sense of security and belongingness. Jerrel was given a homework assignment that allowed him to identify goals that he wanted to achieve during his time in treatment. This assignment allowed Jerrel to be part of the treatment planning process, provided him with assurance that he was in control of his own treatment, and that his goals were important. Involving Jerrel in the treatment planning process strengthened the therapeutic alliance and made him feel heard.
"I can't keep holding all this pain in."
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"I feel like I matter, like my story matters."
Counter-storytelling
through Song
Trust was established after a few months of meeting with Jerrel. His mental health was stabilized and he maintained sobriety. In session, Jerrel played a song that depicted his life story. The purpose of this counter-storytelling activity was to continue gaining awareness and understanding of how his childhood experiences influenced his decision making in adulthood. This exercise empowered Jerrel to share his story and gave him control of his narrative. After sharing about his lived experiences, I thanked him for his strength and courage. By continuing to validate and encourage Jerrel, he felt motivated to continue working toward his goals, supported, and empowered.
Counter-storytelling through
a Letter of Forgiveness
Because of Jerrel's history of invalidation, racialized trauma, and discrimination, he struggled with low self-esteem and hadn't fully forgiven himself for the choices he made in life. Therefore, Jerrel's assignment consisted of writing a letter of forgiveness to himself, as well as identify his strengths. The purpose of the assignment was to promote healing. Additionally, this assignment was effective in shifting his internal belief that he was a failure.
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After several months of treatment and effective case management to address systemic barriers he faced, Jerrel successfully completed the program. Using the framework of CRT and counter-storytelling was an effective approach to understand, address, and prevent Jerrel's return to drug use and stabilize his mental health. Giving him weekly homework assignments, allowing him to express himself and change the narrative through creative activities, and treatment planning collaboration were techniques that produced positive outcomes. Creating a safe place for Jerrel was pivotal in the healing process and provided a corrective treatment experience.
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"I'm not a failure and I will be successful."