Case of a Client with Major Clinical Depression

The plan of intervention selected for Mrs. Lopez is to use individualized and group cognitive behavioral therapy (CBT) to address her presenting problems and to focus on the diagnoses of major depressive disorder and posttraumatic stress syndrome along with opioid dependence. It should be noted that integral to the treatment plan is the use of medical management. Specifically, Mrs. Lopez will be treated with risperdal and fluoxetine HCL (prozac). This pharmacotherapy is seen by many as necessary to facilitate a reduction in depressive symptomology and the corresponding anxiety formation that is often observed among patients with major clinical depression (MacGillivray, Arroll, Hatcher, Ogston, Reid, Sullivan, Williams, & Crombie, 2003).

However, it should be noted that there is limited evidence of the relative efficacy of these pharmaceutical treatments via antidepressant therapy. MacGillivray, et al (2003) reported that patients receiving a tricyclic antidepressant often tend to withdraw from treatment prematurely and to ultimately go off a medication regimen because of side effects. Thus, while Mrs. Lopez will be given pharmacotherapy as part of her treatment regimen, it is essential to offer targeted CBT in order to ameliorate many of the inadequate cognitive schema that continue to distort her perceptions and lead to risk-taking behaviors.

The plan of intervention therefore focuses on a course of CBT

. . .
oral therapy consists of the Beck Depression inventory (BDI). In assessing the validity of the BDI, the readily apparent face validity of the BDI must be addressed. The BDI looks as though it is assessing depression. While this may be quite advantageous, it may make it easy for a subject to distort the results of the test. Content validity would seem to be quite high since the BDI appears to evaluate well a wide variety of symptoms and attitudes associated with depression. One study addressing concurrent validity demonstrated a correlation of .77 between the inventory and psychiatric rating using university students as subjects (Beck Depression Inventory, 2002). Beck (1967) reports similar studies in which coefficients of .65 and .67 were obtained in comparing results of the BDI with psychiatric ratings of patients. The normative sample included 226 psychiatric in- and out-patients. Thus, the BDI is an attitudinal inventory scale which is useful in measuring both the presence of the level (and, by implication, source) of depression. Other Attribution-Style Questionnaires are also employed in this process (Davison & Neale, 1990). Differentiating between anxiety and depression is seen by Tollef
. . .

Some common words found in the essay are:
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Approximate Word count = 4186
Approximate Pages = 17 (250 words per page)

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