The clinical counseling involves Whip Whitaker, the main character of the movie Flight, directed by Robert Zemeckis in 2012. The movie depicts the story of a pilot, Whip Whitaker, who could land a crashing airplane with no casualties and hence, saved hundreds of lives. Undoubtedly, for his near impossible landing, he was glorified by the government and the public. However, after some investigation, law regulators found that he flew the plane under the influence of alcohol and cocaine. The movie also details Whitaker’s deeper problems related to his systemic alcoholism, family difficulties, and personal mental struggles. Eventually, Whip Whitaker confesses to his substance use before the flight and is imprisoned for manslaughter.
The name of the client, fictional character, is Whip Whitaker. Demographic details include around 40 years old African-American male, divorced with one son, and employed as an airplane pilot. The client lives alone in Atlanta, Georgia, with few friends. He also previously worked as a navy pilot. The client suffers from chronic alcoholism and subsequent depressive, anxiety disorders. As a result of alcohol dependence, he is estranged from his teenage son and wife.
Screenings, Assessment, and Diagnosis
Alcohol Use Disorder
Assessment of symptoms reveals that the client can be diagnosed with Alcohol Use Disorder (AUD) as a primary diagnosis and PTSD, and Differential Depression as co-occurring diagnoses. DSM-5 states that individuals suffering from severe substance use disorders feel “intense drug craving when exposed to the drug-related stimuli” (DSM-5, 2013, p. 483). Whip could not resist the stimuli of drinking alcohol after seeing a refrigerator full of alcohol even though he was aware that day after that he was going to the testimony to prove his innocence.
Another description of the disorder according to DSM-5 is the social impairment whereby individuals often fail to comply with their social, work, or family obligations as a result of their substance use dependence (DSM-5, 2013). Similarly, Whip fails in his responsibility both as a father and as a husband. Criteria 8-9 state that individuals suffering from this diagnosis continue to intake substances even in “physically hazardous situations” (DSM-5, 2013, p. 483). The client fits into this criterion because he also failed to abstain from alcohol and cocaine despite knowing that it might risk not only his life but also those of hundreds of passengers. Hence, the patient fits eight of the 11 symptoms outlined in the Alcohol Use Disorder (AUD) in DSM-5 (2013, p. 491). Moreover, the client suffers a severe type of AUD, that is, DSM-5 303.90 since he demonstrated the presence of six or more symptoms (DSM-5, 2013).
According to the risk assessment method based on IS PATH WARM, the client demonstrates a heightened risk of suicide. Whip does not show Ideation, that is, threatening to kill or hurt himself or deliberately seeking methods of dying. However, he fits other warning signs of suicide, including increased substance use, having no sense of purpose in life, feeling trapped, and experiencing uncontrolled anger. Moreover, the movie shows that he was unable to sleep before the flight, indicating that he is suffering from anxiety and agitation. His withdrawal from family also correlates with the signs of suicide. Lastly, Whip recklessly acts since he risks flying the plane despite his alcohol and drug consumption. Thus, Whip Whitaker shows an acute risk of suicidal behavior.
Beck Depression Inventory
According to Beck Depression Inventory (BDI), a tool to measure a patient’s depression symptoms, Whip Whitaker suffers from a severe form of depression. Namely, Whip seems to suffer from several symptoms of severe depression (on a scale of 29-63 in BDI-II). These symptoms include but are not limited to changes in sleep pattern, loss of concentration, changes in appetite, loss of interest, worthlessness, agitation, and loss of energy (Wang & Gorenstein, 2021). Although supplementary screening tools are needed, based on BDI, the counselor can conclude that Whip suffers from a major depressive disorder.
Model of Addiction Etiology
The client demonstrates a brain disease model of addiction (BDMA) since his addiction approximates the chronic brain disease. According to DSM-5 (2013), individuals suffering from substance use are often driven by “specific reward structures” in the brain (p. 483). Hence, alcohol addiction, from which Whip Whitaker suffers, is a brain disease, which is induced through changes in neurological mechanisms (Matošić et al., 2016). Nevertheless, healthcare professionals should also explore genetic explanations since they frequently appear as determinants of alcohol dependence. Thus, such etiology implies that the client has minimal control over his alcohol addiction.
Theory and Interventions
Cognitive-behavioral therapy (CBT) can be one of the effective methods of intervention since CBT is often applied to the treatment of PTSD patients. This type of intervention has one of the highest empirical support for the treatment of alcohol use disorder (Carroll & Kiluk, 2017). Other researchers have found the effectiveness of combining CBT and motivational interviewing with pharmacological therapy in addressing cannabis use disorder (Trigo et al., 2018). Hence, similar intervention can be applied to the treatment of alcohol use disorder since it is often “associated with the similar problems to those associated with other substances, including cannabis” (DSM-5, 2013, p. 492). Thus, along with pharmacological treatment, CBT and motivational interviewing can be effective interventions to treat the client.
To conclude, the counseling with the patient, Whip Whitaker, reveals that he can be diagnosed with Alcohol Use Disorder and comorbid major depressive disorder. Analysis based on the risk assessment, IS PATH WARM, indicates the client’s high suicidal tendency. Additional screening and evaluation are needed to reveal a more detailed diagnosis. Cognitive-behavioral therapy and motivational interviewing can be two major interventions that can alleviate the patient’s condition.
American Psychiatric Publishing. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5®).
Carroll, K. M., & Kiluk, B. D. (2017). Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again. Psychology of Addictive Behaviors, 31(8), 847–861.
Matošić, A., Marušić, S., Vidrih, B., Kovak-Mufić, A., & Čičin-Šain, L. (2016). Neurobiological bases of alcohol addiction. Acta Clinica Croatica, 55(1), 134–150.
Trigo, J. M., Soliman, A., Quilty, L. C., Fischer, B., Rehm, J., Selby, P., Barnes, A. J., Huestis, M. A., George, T. P., Streiner, D. L., Staios, G., & Le Foll, B. (2018). Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial. PLOS ONE, 13(1), 1–21.
Wang, Y.-P., & Gorenstein, C. (2021). The Beck Depression Inventory: Uses and applications. The Neuroscience of Depression, 165–174.