Introduction
This paper will provide a comprehensive assessment and treatment plan for a client suffering from a major depressive disorder. The first part of the paper will focus on the diagnosis of the client’s health problem and the social factors that have shaped it. The second part will focus on the treatment plan that will be used to address the client’s problems.
Assessment
DSM-5 Diagnosis
The client is suffering from a major depressive disorder with mixed features. She experienced persistent depressed mood that lasted nearly the whole day. The client also complained of insomnia and fatigue. Other relevant medical diagnoses included recurrent episodes of severe headaches, as well as, joint and abdominal pains. Attention deficit/ hyperactivity disorder is another medical condition that should be a focus of clinical attention. This perspective is supported by the fact that symptoms of a major depressive disorder such as distractibility and low frustration tolerance can also be presented by patients suffering from attention-deficit/ hyperactivity disorder (“Depressive disorders”, 2014). Generally, the client’s condition was severe because of the worsening of her health condition.
Rationale for Diagnosis
The main advantage of using the DSM-5 is that it provides improved guidelines for diagnosing the client’s condition. For instance, it helps to distinguish between personality disorders and mental disorders during the diagnosis process. The main disadvantage of the DSM-5 model is that it lacks a laboratory test to diagnose a major depressive disorder (“Depressive disorders”, 2014). Thus, the diagnosis is mainly based on observed symptoms, which might not fully reveal the client’s problem.
The main symptoms that a therapist is likely to observe in a client with a major depressive disorder include depressed mood or loss of interest in most activities for at least two weeks. In addition, the client must experience a change in appetite, weight, sleep, and psychomotor activity; fatigue or loss of energy; feelings of guilt and hopelessness; poor thinking and concentration; and suicidal ideation (Kearney & Trull, 2011). The client was diagnosed with a major depressive disorder because she had exhibited these symptoms for over two consecutive weeks.
Theoretical Model of Psychopathology
According to the biological model of psychopathology, depression has a genetic link (Durand & Barlow, 2012). Thus, individuals whose parents suffered from a major depressive disorder are likely to be diagnosed with the condition. In this context, the client is likely to have acquired the disorder through genetic transfer if one or both of her parents had experienced the disorder.
In psychological models, a major depressive disorder can be explained by behavioral theories. The client’s condition can be attributed to her inability to share her problems with others to find solutions. The resulting increase in stress is likely to have led to the emergence of symptoms such as restlessness and fatigue (Michele & Neale, 2011). According to the social model, family relationships can cause depression. Abusive family relationships often worsen depression and vice versa. Although the client’s family was supportive, her condition did not improve.
The psychopathology of depressed individuals has a negative impact on family functioning. Specifically, depressed individuals have little or no interest in interacting with their family members. Thus, the behaviors of a depressed person can cause members of his family to develop stress.
Impact of Social Contexts
Improved awareness about the importance of being accommodative, understanding, and supportive to depressed individuals has reduced the stigma associated with a major depressive disorder. This has enhanced the diagnosis of the disorder since more people are willing to share their experiences with counselors. Improved economic growth coupled with the political will of the government has promoted the adoption of policies and technologies that facilitate diagnosis and treatment of depression.
Treatment Plan
During the assessment and diagnosis process, I will gather information concerning the client’s symptoms. Information about the client’s medical history will also be gathered to determine if the disorder can be explained by a particular medical condition. Moreover, I will collect information about the client’s social environment to determine if her condition can be attributed to socio-cultural factors. I will also use the latest research findings as a guide to diagnose the client’s condition and to recommend evidence-based treatment methods.
Focus Therapy
The key issues and concerns that will be addressed include the client’s self-esteem and depressed mood. In addition, medical conditions such as loss of appetite, headache, and joint pains will be addressed to improve the client’s health.
Long-Term Goals
The first goal will be to help the client to improve her depressed mood in the long-term. The second goal will be to improve the client’s interpersonal skills so that she can share her problems with others to reduce stress and depression. The last long-term goal will be to help the client to improve her self-esteem.
Short-Term Goals
The first short-term goal will be to treat the client’s medical conditions. This will involve recommending treatment for headache and loss of appetite. The second goal will be to address the social factors that are likely to contribute to the client’s problems.
Theory to Guide Treatment
The treatment plan will be guided by the cognitive behavioral theory of depression. The theory posits that depression is caused by maladaptive, faulty, and irrational cognitions that are often presented in terms of distorted judgments and thoughts (Kuyken, Dalgleish, & Holden, 2007). Depressive cognitions often develop when an individual lacks the skills that are necessary for adapting to challenges. A person is likely to be depressed if he/ she believes that the future is bleak, his/ her experiences will lead to failure, and his/ her capabilities are inadequate. Thus, the treatment plan will focus on helping the client to change these beliefs.
Interventions
The cognitive behavioral therapy (CBT) will be used to address the client’s problems. In this respect, the client will have to undergo a cognitive restructuring process (Chen, Jordan, & Thompson, 2006). This will involve helping her to identify unhealthy thinking patterns and to alter them in a structured manner. Moreover, the client will be taught about relaxation techniques, methods of increasing her participation in the things she like, and interpersonal skills such as effective communication to enable her to cope with negative feelings. The improvement of the client’s activity level, thoughts, mood, and interpersonal skills will be monitored through regular homework assignments.
Larger Environments and Social Systems Impacting Diagnosis and Treatment Plan
Managed care companies have focused on reducing the cost of quality healthcare in the country. Consequently, the client will be able to get treatment at an affordable cost. Moreover, the client has a supportive family that is likely to encourage her to cooperate during the diagnosis process so that she can get the best treatment. The policy that guides treatment in my agency is that clients must be given the best counseling services irrespective of their social, economic, and cultural backgrounds. Moreover, counselors must use evidence-based diagnostic and treatment methods. This will help in recommending the right treatment plan for the client.
References
Chen, Y., Jordan, C., & Thompson, S. (2006). The effect of cognitive behavioral therapy. Research on Social Work Practice, 16(5), 500-510.
Depressive disorders. (2014). Lifelong Learning in Psychiatry, 1(1), 1-33.
Durand, V., & Barlow, D. (2012). Essentials of abnormal psychology. Belmont, CA: Wadsworth.
Kearney, C., & Trull, T. (2011). Abnormal psychology and life: A dimensional approach. Belmont, CA: Cengage Learning.
Kuyken, W., Dalgleish, T., & Holden, E. (2007). Advances in cognitive-behavioural therapy for unipolar depression. Canadian Journal of Psychiatry, 52(1) , 5-12.
Michele, M., & Neale, J. (2011). Case Studies in abnormal psychology. New York, NY: John Wiley and Sons.