Essay Example on Depression: Overcoming with MI/CBT Strategies - A Medical Perspective

Introduction

Depression has become a major social problem affecting numerous persons in different parts of the world. Without proper medical intervention, depression can have adverse side effects on an individual, which might be inclusive but not limited to madness and suicide. Today, motivational interviewing (MI) and Cognitive Behavioral Therapy (CBT) can be utilized as effective clinical methodologies of addressing depression among patients in a medical environment. MI/CBT strategies like the Mood disorder Questionnaire (MDQ), Bipolar Spectrum Diagnostic Scale (BSDS), and Generalized Anxiety Disorder (GAD) can be employed as effective methodologies for addressing Karen Bonner's depression and subsequently promoting her overall mental health.

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Assessment Section

Biospychosocial Information and Pertinent History

Karen is a young woman aged 28 and she has been married for more than six years. Currently, Karen is a young mother of two boys who are aged 4 and 6. The measure of socioeconomic status (SES) of Karen asserts that she is from a low income social demographic grouping. Additionally, she is a Native American and she has no major underlying healthcare issues that have been diagnosed in her past medical history. Nevertheless, from recent self-evaluation, it is evident that Karen feels that she is depressed and she would wish to have a clinical intervention administered on her to mediate her depressed condition.

Assessment of Key Issues

Strengths of the client: the evaluation of Karen's case revealed that she has two primary strengths. First, Karen has a high level of self-awareness, which is evident because she knows that she depressed and in need of medical intervention. In this case, self-awareness is considered to be the first step in seeking a recovery process. Additionally, the second strength that Karen has is readiness for change. In this case, mental health issues are optimally medicated if a patient has the willingness to change positively and transform into a better person by seeking viable solutions for the underlying mental health issues.

Issues or concerns: there are two issues that can also be manifested in Karen's case, which might compromise her recovery process. The first issue is Janet's secrecy attribute. In this case, it is evident that Janet is unwilling to inform her husband about her mental health problems. In this case, failure to be transparent with her husband about her medical condition could in overall compromise her overall wellbeing. Additionally, Janet's use of drugs as a strategy to address her mental health problems is also a second challenge. In this case, Janet might become addicted to the drugs and consequently, compromise her overall recovery process.

Nature of the referral for treatment or care: to mediate Janet's case, she should be advised to seek the professional medical help of a psychiatrist since they are healthcare professionals with proficient skills to medicate emotional, behavioral, or mental health issues. Furthermore, Janet should also be advised to visit a medical professional who is proficient with addiction medicine in the event she has already become addicted to the addictive substances that she is consuming. In this case, it would be ideal for Janet to be enrolled in a drug rehabilitation center, where she can attain professional medical help to address her addiction problem.

Assessment Measures

The MDQ was the first assessment tool that was employed to assess Janet's mental health status. Additionally, the MDQ is measured to be the most effective tool for diagnosing bipolar disorder condition in patients. Also, the MDQ is a very short self-report instrument that takes approximately five minutes to be completed. In the MDQ assessment, Janet scored six, positive and moderate ratings in questions 1, 2, and 3 respectively. Also, the psychiatric patient sample evaluation of the MDQ revealed that Janet has a sensitivity score of 70% and a specificity rating of 90%. Also, the community sample evaluation of Janet's MDQ revealed that she had a sensitivity score of 23% and a specificity rating of 90%. The test revealed that Janet is not suffering from bipolar disorder but mild depression.

Janet also executed a BSDS assessment in the psychiatric intervention sessions. Additionally, the BSDS is also a tool that can be employed to determine whether a patient is suffering from bipolar disorder or not. Janet's evaluation of the BSDS revealed that recorded that she had a 45% rating in sensitivity bipolar I, 36% rating in sensitivity bipolar II/NOS, a specificity of 44%, and a cumulative score of 49% for bipolar types NOS, I as well as II. In respect to these assessments, it is evident that Janet does not have bipolar disorder but instead, she could be suffering from mild depression.

The GAD-7 assessment tool was employed as the last measure of evaluating Janet's mental health condition. Generalized anxiety disorder (GAD) is a mental health condition characterized by constant as well as chronic worrying, tension, and nervousness (Ansara & Schulte). The GAD-7 tool contains 7 structured questions administered in the form of a questionnaire to determine whether a patient has GAD. In Janet's case, the evaluation revealed that she had a score of 10 out of possible 21 in the GAD-7 tool. Additionally, the presented evaluation ratings revealed that Janet is not suffering from GAD but instead, mild depression.

Case Conceptualization

Origin of the target problem: The review of Karen's medical case reveals that the root of her problem could have originated from her childhood experiences when she was still living with her parents. Additionally, that is because Karen grew up in a domestically violent homestead, whereby her father was abusive to Karen's mother. As a result, Karen's mother who was a housewife became depressed and resulted in using drugs to cope up with domestic violence. Eventually, Karen's mother became addicted to drugs and neglected her duties towards Karen and her two siblings. As such, it is plausible that the tough upbringing of Karen in her childhood could be the primary contributing factor to her current mental health issues.

Pertinent history and precipitating factors concerning the presenting problems: Janet's current situation has primarily been contributed by her husband's change in character in recent years. In this case, Janet's husband, who is a surgeon, started keeping late hours at the workplace, on the basis that he was working. However, Janet believes that his husband has been having an affair and as such, she started cheating on him to get back at him for his infidelity. Also, Janet's mental health issue or depression has been worsened by the reason that Janet's husband started using harsh words on her, which subsequently affected her emotional wellbeing.

Measurable goals: There are three measurable goals that will be employed to assess Janet's mental health performance after she has started her medical intervention process. In the first goal, Janet will fully recover from her depression within six months of psychiatric treatment measured using the MDQ, BSDS, and GAD. In the second goal, Janet will be successful in eradicating her addiction within the first four months after enrolling in a drug addiction rehabilitation center. In the third goal, Janet will be in a position to be transparent with her husband regarding her addiction and infidelity behaviors within 15 days after enrolling in a psychiatric treatment center.

Application Section

Description of the MI/CBT Methods Used in the Case and Explanation of Why the Methods Were Used

The MDQ, BSDS, and GAD were utilized as the appropriate tools for determining the underlying mental health condition that was facing Janet. Additionally, the stated methods were used in Janet's health assessment because they have been certified by past research as effective in identifying aspects of bipolar disorder and generalized anxiety among patients. As such, the assessment tools can be utilized as effective evidence-based applications for determining the two identified mental health issues among patients.

Evidence Base Supporting the Efficacy and Effectiveness of the Intervention Method

There are a number of researches that have certified the effectiveness of MDQ, BSDS, and GAD in identifying Janet's mental health condition. Among such research include research articles authored by Yang et al. (2014) ascertained that MDQ can be utilized to evaluate the mental health status of depressive patients with mood disorders. Different research that was executed by Nagata et al. (2013) certified that BSDS can also be employed to assess mood disorder conditions among patients with unipolar depression in a healthcare setting. In this case, the two research publications certified that MDQ and BSDS are effective tools for ascertaining different forms of depression that could be impacting patients.

Other scientific studies such as those of authored by Kroenke et al. (2013) also certified the effectiveness of using the GAD-7 tool in differentiating whether a patient is suffering from generalized anxiety mental health disorder or depression. Kroenke et al. (2013) is a clinically-controlled trial that sought to determine the effectiveness of patients' health anxiety questionnaire and depression scales like GAD-7 in diagnosing the mental health of a patient. The effectiveness of using the GAD-7 scale in evaluating mood disorder conditions has also been verified by Johnson, Ulvenes, Oktedalen, and Hoffatt (2019) research. In this research, it was evidenced that GAD-7 is excellent for its internal consistency in gathering data on patient diagnosis, particularly in determining whether a patient has GAD or other depressive conditions. As such, it is plausible to be conclusive in stating that the MDQ, BSDS, and GAD are effective EBPs that can be utilized in performing diagnosis for Janet's mental health condition.

Conclusion

In conclusion, MI/CBT strategies like the Mood disorder Questionnaire (MDQ), Bipolar Spectrum Diagnostic Scale (BSDS), and Generalized Anxiety Disorder (GAD) can be employed as effective methodologies for addressing Karen Bonner's depression. Additionally, the effective implementation of the stated intervention strategies can promote the overall mental health of patients in the healthcare setting. In this case, MDQ and BSDS can be utilized as effective health assessment intervention tools for diagnosing the prevalence of bipolar disorder condition in a patient. Contrary, the GAD-7 assessment can be employed in determining whether a patient is suffering from generalized anxiety mental health disorder. Collectively, the stated tools can also be utilized to indicate the symptoms of mild depression in a person.

References

Ansara, E., & Schulte, S. (2017). Anxiety disorders: Generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD). Pharmacotherapy First: A Multimedia Learning Resource. https://doi.org/10.21019/pharmacotherapyfirst.anxiety_overview

Johnson, S. U., Ulvenes, P. G., Oktedalen, T., & Hoffart, A. (2019). Psychometric Properties of the General Anxiety Disorder 7-Item (GAD-7) Scale in a Heterogeneous Psychiatric Sample. Frontiers in psychology, 10, 1713. https://doi.org/10.3389/fpsyg.2019.01713

Kroenke, K., Wu, J., Yu, Z., Bair, M. J., Kean, J., Stump, T., & Monahan, P. O. (2016). Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials. Psychosomatic medicine, 78(6), 716-727. https://doi.org/10.1097/PSY.0000000000000322

Nagata, T., Yamada, H., Teo, A. R., Yoshimura, C., Kodama, Y., & Van Vliet, I. (2013). Using the mood disorder questionnaire and bipolar spectrum diagnostic scale to detect bipolar disorder and borderline...