Diagnostic criteria for depression in John
John is likely to be diagnosed with depression. He has started to sleep poorly and is suffering from a low mood. John has lost interest in pleasurable activities like meeting with friends or going out and has started feeling empty and guilty. He is always at a loss of energy when doing any work. According to the case study, it can be stated that he spends most of the time watching television and seems to be hopeless about his future as he stated that his future seems to be bleak to him. John is also detected with a feeling of hopelessness about the utility of his life. All these symptoms are attributed to the fact that he might be suffering from depression. His symptoms match with the DSM V and ICD 10 diagnostic criteria.
According to DSM V, the diagnostic criteria for depression that matches with John includes:
- John is facing insomnia nearly every day. He is sleeping poorly and waking up at 4 am nearly every morning.
- John shows feelings of lack of self-worth, and a loss of energy is also evident in John.
- John has shown a marked loss of interest in pleasure activities, (psychiatry.org, 2022).
According to ICD-10, John has been facing
- John is showing a marked loss of interest in activities that he used to like, like going out with friends.
- ICD stated that suffering from depression can cause loss of appetite in clients and following that, it can be stated that John might be suffering from depression as he falls under this category of suffering from poor appetite, and no manic phase has been detected in him.
- He might be suffering from a loss of confidence as for him; life has lost its meaning, (who.int, 2022).
Presenting problem of John beyond diagnosis:
- John is suffering from disturbed sleep. He complained that he was sleeping poorly. He wakes up early every morning. He sleeps during the day as he gets tired of waking up so early.
- He has lost interest in doing any work in general. Works that were of pleasure for him once are not so interesting for him at present. He has lost interest in all pleasure-seeking tasks.
- Life has lost its meaning for him. He thinks he has failed in his life and thus suffers from grief. He thinks that his life is bleak and has lost its meaning and that he suffers from acute hopelessness.
- He feels empty inside and sad. He spends time watching television as he has lost hope that he might get a job if he tries again for it. Though he sees job advertisements, he lacks the energy to apply for them.
- According to the case study, he suffers overwhelmingly sad and finds his future bleak. He possesses negative thoughts in the background of their thought process.
- He suffers from a lack of appetite and interest in every job he might have liked once. He thinks of himself as a big failure.
- He feels demoralised, and as a result, he does not feel the urge to apply for a new job anymore for about eight months.
- His family has complained that he is suffering from a social withdrawal tendency and low mood due to losing his job. The family also complained that he is gradually losing interest in life. Thus, his family suggested he needs to seek professional mental health support.
- He was reported to experience a happy childhood, (case study).
Perpetuating factor:
John had being the elder brother to the younger siblings, he felt it was his responsibility to support his struggling mother, who was having a hard time supporting the family. Thus, it might be said that he had faced struggle from a young age which might act as a perpetuating factor to his depression as he grew older as faced a similar struggle at this age, (Treasure et al., 2020).
Precipitating factors that lead to depression include independent adverse life events. For John, the event was being laid off from his successful professional life. He was hopeful that he would get a job, but over the last eight months, there was a change in his mental health. He gradually felt hopeless, (Dudley & Kuyken, 2014).
The situation which prompted the mental health challenge in John is the loss of his job. It can be stated, at present, he is having negative and depressive thoughts. He is also suffering from hopelessness and a feeling of emptiness and sadness. The physiological factors that he is suffering from include sleeplessness. He is suffering from a lack of sleep and feeling sleepy during the day. The other physiological factors that are affecting him include loss of appetite. An affective component includes him feeling turned all-time, and behaviour includes avoiding his friends, (Greenberger and Padesky, 1995).
Coping strategies and problem-solving skills will be provided to John as a protective factor through the therapeutic techniques. He is gradually withdrawing from social and family connections. The therapy will help them with more energy (Padesky, 2020).
- After the targets are identified and recognised, if they can be treated, the treatment procedures can be identified. As for John, his automated negative thought patterns need to be changed. The identification of negative automatic thoughts and schemas can be identified and tried to be modified using thought diaries and restructuring the core beliefs, (Howell, 2018). After identifying John’s negative thoughts by following a thought diary, for example, when he feels himself complete failure and that he has lost the meaning of life, the identified negative thought patterns automatically occur in John when he fails in getting a job, and such core beliefs can be modified using the thought challenge worksheets. Such worksheets effectively improve extremely challenging and unhelpful negative thoughts of John, (Westbrook, Kennerley& Kirk, 2010).
- The other treatment intervention provided to John motivates him to meet his behavioural deficits. This can be done by behavioural activation and motivating him to take part in different pleasant activities by scheduling activities that are found pleasant, (Vujanovic et al., 2017). This process will help in scheduling positive events and boosting the mood of John. This is effective for John as it will help him to avoid isolating himself and engage himself in those activities that would encourage happiness and pleasurable for him. He will get gradually motivated to again involve himself in activities he liked earlier, for example meeting his friends or going out jogging. Withdrawing himself from activities that he once used to like, in a way, increases depression in him. His symptoms might increase over time, and thus, he might over time gradually show heightened withdrawal tendencies. Thus, to break this cycle, it is important to use this technique to elevate his mood, (Wright, Williams & Garland, 2002).
Precipitating factors: Loss of job and its impact on mental health
CBT is considered to be providing cognitive behavioural therapies. The different levels of cognition according to Beck, are Negative automatic thoughts (NAT), Assumptions and core beliefs, (Beck, 2020). According to NAT, it explains the distressing experiences of consciousness. For example, when John has experienced job loss in the past, most likely, he might think that he will fail to get a job in the future as well. This conscious thought might make him feel that he is a failure. He checks for new job prospects but does not apply for them as he assumes that he will not get one. The assumption is conditional and thus can be understood from the actions. This aspect of the behaviour can be identified from the self-question that the client often asks himself. John has been detected to be at this stage as he was seen complaining that if he does not get a job, he will prove himself to be a failure. Core beliefs can be explained as the stage at the deepest level of cognition. The core beliefs provide the ground for assumptions. The core beliefs that John might have about himself includes his faulty self-perception. He assumes he is a failure as he has lost one job. This core negative faulty self-concept which makes him feel that his future is bleak leads to the assumption that he will always fail in the future, and thus, he might not be eager to take chances to apply for fresh jobs, although he at times searches for new ones, (Currid, Nik?evi? & Spada, 2011).
The assumption stage can be identified at the assessment stage. The therapist will try to identify the problem areas. At the behavioural stage, John’s core beliefs will be tried to be analysed, and at the behaviour stage, NAT will be analysed. The recognition of the stages will be done by observation and dual effort from the therapist and John, (Currid, Nik?evi? & Spada, 2011).
Behavioural experiments in CBT are effective as a part of CBT. The rationale to use the therapy technique is that it includes exercises that are involved in information collection. The technique analysis the accuracy of the belief that holds, (Kube et al., 2017). For example, using the technique, it can be analysed how accurate their beliefs of John. Using this technique, he might be encouraged to apply for jobs again and analyse he is not failure. The rationale for using the exposure and response prevention technique is the development of coping strategies for stressful and phobic situations. The techniques encourage the clients to be exposed to phobic stimuli by allowing the obsessive thoughts to occur but not neutralising them, (Division of Clinical Psychology, 2011).
Perpetuating factors: Negative and depressive thoughts, sleep loss, and loss of appetite
ERP and CBT are not similar to each other. Based on the client’s needs, the therapeutic techniques used like ERP are more effective while treating clients with Obsessive-Compulsive Disorder (OCD) and Behavioral experiments can be used to treat a wide range of disorders like depression. Thus, they are different on certain grounds while also similar to each other based on other grounds, (McKay, Abramowitz & Storch, 2021).
For example, Behavioral experiments are effective while analysing the accuracy of the core beliefs that are often held by clients like. For example, they are not perfect and thus, others do not like them. While ERP is more effective in treating clients with OCD, (Sunde et al., 2019).
References
psychiatry.org. (2022). Get Help With Depression. Psychiatry.org. Retrieved 25 March 2022, from https://www.psychiatry.org/patients-families/depression.
Padesky, C.A. (2020). Collaborative Case Conceptualization: Client Knows Best. Cognitive and Behavioral Practice.
Wright, B., Williams, C., & Garland, A. (2002). Using the Five Areas cognitive–behavioural therapy model with psychiatric patients. Advances in Psychiatric Treatment, 8(4), 307-315. doi:10.1192/apt.8.4.307
Currid, T. J., Nik?evi?, A. V., & Spada, M. M. (2011). Cognitive behavioural therapy and its relevance to nursing. British Journal of Nursing, 20(22), 1443-1447.
Beiling, P.J. & Kuyken, W. (2003). Is cognitive case formulation science or fiction?
Clinical Psychology: Science and Practice, 10, 52-69.
Division of Clinical Psychology (2011). Good Practice Guidelines for the use of Psychological Formulation. Leicester, UK: The British Psychological Society.
Dudley, R., & Kuyken, W. (2014). Case formulation in cognitive behavioural
therapy: A principle-driven approach. In L. Johnstone & R, Dallos (Eds), Formulation in psychology and psychotherapy: Making sense of people’s problems (2nd edn.) (pp.18-44). London: Routledge.
Westbrook, D., Kennerley, H. & Kirk, J. (2010). An Introduction to Cognitive Behaviour Therapy: Skills and Applications. London, UK: Sage Publications. Chapter 8
Sunde, T., Hummelen, B., Himle, J. A., Walseth, L. T., Vogel, P. A., Launes, G., … & Haaland, Å. T. (2019). Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC psychiatry, 19(1), 1-13.
McKay, D., Abramowitz, J. S., & Storch, E. A. (2021). Mechanisms of harmful treatments for obsessive–compulsive disorder. Clinical Psychology: Science and Practice, 28(1), 52.
Beck, J. S. (2020). Cognitive behavior therapy: Basics and beyond. Guilford Publications.
Treasure, J., Willmott, D., Ambwani, S., Cardi, V., Clark Bryan, D., Rowlands, K., & Schmidt, U. (2020). Cognitive interpersonal model for anorexia nervosa revisited: The perpetuating factors that contribute to the development of the severe and enduring illness. Journal of Clinical Medicine, 9(3), 630.
Kube, T., D’Astolfo, L., Glombiewski, J. A., Doering, B. K., & Rief, W. (2017). Focusing on situation?specific expectations in major depression as basis for behavioural experiments–Development of the Depressive Expectations Scale. Psychology and Psychotherapy: Theory, Research and Practice, 90(3), 336-352.
Howell, C. (2018). Keeping the Blues Away: The ten-step guide to reducing the relapse of depression. CRC Press.
Vujanovic, A. A., Meyer, T. D., Heads, A. M., Stotts, A. L., Villarreal, Y. R., & Schmitz, J. M. (2017). Cognitive-behavioral therapies for depression and substance use disorders: An overview of traditional, third-wave, and transdiagnostic approaches. The American journal of drug and alcohol abuse, 43(4), 402-415.
who.int. (2022). Who.int. Retrieved 25 March 2022, from https://www.who.int/classifications/icd/en/GRNBOOK.pdf.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
