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Discussion Question:
Your answer/MAP to each discussion question must illustrate depth and breadth of the subject matter. Do not provide a terse response. The answer
to the question is worth a total of 10 points. Each initial response must be at least 250 words and no more than 500 words. Your response must clearly
answer the question(s) and provide justification, examples and explanation to support your answer. Make sure to complete the weekly
reading/viewing BEFORE answering the discussion question. Please review the grading rubric for specific guidelines on how you will be graded.
Discussion Question Responses:
You are required to respond to two classmates’ discussion question answers each week. Each response must be at least 150 words and no more than 250
words. If you do not stay within the limit guidelines, points will be deducted. Your response to your classmate is a substitute for the in classroom
discussions; therefore, your answer should be engaging and provide clear support for your perspective. Responses are worth 5 points each for a total of
10 points. Please review the appropriate grading rubric for specific guidelines on how you will be graded. You must submit your answer to the initial
discussion question by Midnight on Tuesday and your response(s) to two classmates before midnight on Thursday.
Discussion Question Rubric
Page 2 of2
Discussion replies:
Discussion 1:
Diagnosis:
“Luci presents with symptoms and behaviors that are consistent with a DSM-5 diagnosis
of Persistent Depressive Disorder, Severe; Early Onset, with persistent Major
Depressive Episode, with Melancholic features (F34.1)
Criterion met:
·
Sleeping too much- Luci states that she is always tired
·
Psychomotor retardation-Luci demonstrates minimal eye contact, stares blankly,
answers are slow-no emotion
·
Loss of energy-Luci self-reported lacking energy
·
Reduced self-esteem-Feelings of guilt/worthlessness-Luci self-reports feeling
hopeless, having bad thoughts about herself, feeling left out, unable to have fun, wishes
she were dead, self identifies as “ugly, stupid and retarded.”
·
Reduced ability to concentrate and make decisions-Luci states that she is unable
to think straight
·
Recurrent thoughts of death and suicide-Luci states that she is actively thinking
about killing herself by jumping out a window. Has previously tried to kill herself by
putting a knife to her stomach about a month prior.
Luci reports that these feelings have been ongoing since she was 14 (early onset),
following she and her family immigrating to the United States from Central America,
indicating a huge social and cultural loss. These feelings have been persistent for at
least the last 2 years and have progressed to the current persistent Major Depressive
Episode resulting in a suicide attempt. There is no indication of mania or hypomania
history and Luci presents as despondent, experiencing psychomotor retardation, and
loss of interest or pleasure in activities.
Objectives of Treatment:
·
Alleviate Depression
·
improve coping skills
·
Improve family support, other relationships
·
Improve social/occupational functioning
·
Reduce cognitive distortion
·
Increase self-esteem, activity levels
·
Reduce suicidal ideations
Assessment Tools:
·
DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
·
Beck Depression Inventory
·
Cultural formation Interview
·
SAD PERSONS Scale
Clinician Characteristics:
·
Culturally competent
·
Develop rapid strong therapeutic alliance
·
Supportive and patient but structured
·
Able to model and teach effective interpersonal functioning
·
Able to instill hope
Location of Treatment:
·
Inpatient setting initially, due to high risk of suicide-Luci does have a plan and the
means
·
Outpatient once stabilized
Interventions to be used: Combination Psychotherapy and medication therapy
·
Motivational Interview
·
Supportive and Interpersonal therapy
·
Mindfulness Based Cognitive Therapy
·
Family Focused Therapy
·
Medication Therapy-Selective Serotonin Reuptake Inhibitors (SSRI’s)
Emphasis of Treatment:
·
A combination of cognitive, behavioral, and emotional emphasis
·
Initially directive and supportive
·
Later on, more evocative approach
Numbers:
·
Individual therapy
·
Adjunct family therapy if possible
Timing:
·
Two sessions per week initially (reduction of suicidal ideations, and depression,
improve functioning)
·
One session per week once stabilized and shown improvement
(cognition/behavior)
·
Anticipated duration of 3-9 months; possible extension if necessary
Medications Needed:
·
Referral to a psychiatrist
·
Medication therapy with SSRI’s
Adjunct Services:
·
Mindfulness based meditation
·
Development of coping skills
·
Homogenous support group
·
Family focused therapy
·
Career counseling
Prognosis:
Poorer prognosis due to the early onset; however, with use of mindfulness based
cognitive therapies, the situation could be improved
5 Questions I’d like to ask from the Cultural Formation Interview Questionnaire
1. Sometimes people have different ways of describing their problem to their family,
friends, or others in their community. How would you describe your problem to them?
2. Are there any kinds of support that make your [PROBLEM] better, such as support
from family, friends, or others?
3. Sometimes people have various ways of dealing with problems like [PROBLEM].
What have you done on your own to cope with your [PROBLEM]?
4. Has anything prevented you from getting the help you need?
5. What kinds of help do you think would be most useful to you at this time for your
[PROBLEM]?
Discussion 2:
-Clinical Diagnostic:
The patient has a chronic depressive disorder.
-Focus and objectives:
Eliminate suicide
Do self-care
Learn and improve positive behaviors for an overall wellbeing.
-Client Assessment:
See the scale of client depression
Assess suicidal thoughts
Intake of physical exam
Assess need of drugs abuse of other medications
-Doctors or clinicians Studies
Analyzing and clarifying the client behavior and state of mind.
Help client focus and maintain therapy session.
Give resources and interventions to support client initiatives to make a change.
-Treatment setting
The patient appears to be inside a hospital environment because of negative thoughts and high
risk of suicide. Patient needs care, treatment, and follow-up.
-Implementation
Proper medication regimens could be beneficial to the client with therapy sessions to alleviate
suicidal thoughts. Patient needs to socialize in order to share other people testimony and
experience. Patient also needs to be involved in social activities, participate in workshop, and
extend his social network.
-Care and numbers of sessions
The patient treatment will be focusing on therapy sessions and medications to reduce depression.
The patient can be seen if depression is on high level once a week. Family is a great support
system as well that can be incorporated in client treatment if needed. Client can benefit from
social group intervention with meeting to discuss life experiences.
-Outcomes
Client Luci is dealing with a persistent depressive disorder called Dysthymia. In my
understanding as a social worker, she could have treatment and have a better life with a
supportive clinical group on her side. Luci had experienced some depressive mood, she was very
tired, and her self-esteem was very low. The depressive disorder was a good fit in Luci diagnosis
because she was sad and not happy. She had suicidal thought and quit her job. She might be
dealing with a mental illness and her quality of life was affected considerably.
Luci was unconfutable during therapy session. Open-ended question during session could have
help her open up more to conversation.
Questions like:
-What scare you the most in your present situation?
-Does
family support could make you feel
better.?
How could other organizations help you in your current situation?
Luci could think about her problem deeply by responding to those questions. Decent supportive
group and resources could help her be back on track and live a positive life.
References:
Your Mental Mess
By DR. Caroline Leaf
American Psychiatric Association {2013}. Diagnostic and statistical manual of mental disorder.

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