The most effective therapeutic approach for Maggie’sdepression is cognitive therapy or cognitive behavioral therapy (CBT) becausestudies have shown it to be as effective as antidepressents in treatingdepression.
Studies have also shown it to be effective at reducing relapses inpatients after therapy. Cognitive behavioraltherapy is different from other therapies because it is short, taking only fiveto ten months for most mental problems and often requiring only 10 to 20sessions. The focus and method of CBT is alsodifferent. CBT is a more short-term approach than psychodynamic(psychoanalysis) therapies.
Other types of therapies may require several yearsfor discovery and treatment. CBT involves changing thinking patterns and focuseson what and how a person thinks more than why a person thinks that way.Sessions provide patients an opportunity to identify current life situationsthat may be causing or contributing to their depression. This is different frompsychoanalysis.
That type of therapy involves looking to the past to discoverunconscious sources of the problems that the patient is facing. CBT is also goal-orientedand educational. Therapists use structured learning experiences that teachpatients to monitor and write down their negative thoughts and behaviorpatterns. The goal is to see how these negative thoughts affect their mood,behavior, and psychical condition. CBT therapists also teach important copingmechanisms, such as learning to control andmodify distorted thoughts and reactions.The main issue we need to consider when determining whichtype of therapeutic approach to use for Maggie’s depression is the underlyingfactors that are causing her depression. Psychodynamic therapy is based on thebelief that a person is depressed because of unresolved, unconscious conflictsthat occur during childhood. Humanistic therapy helps individuals understandtheir feelings, gain a sense of meaning in life, and reach self-actualization.
Behavioral therapy is based on the idea that maladaptive behavior is learned,and thus adaptive behavior can also be learned. The goal is to teach newbehaviors to minimize or eliminate problems, rather than focusing on theunconscious mind. Cognitive therapy or CBT seeks to modify negative thoughtpatterns in order to change moods and behaviors. It’s based on the belief thatnegative moods and behaviors are the result of current dysfunctional thoughtsor beliefs. According to this case study, Maggie has very high standards forherself and is very self-critical. She also struggles with significant feelingsof worthlessness and shame due to herinability to perform as well as she always has in the past. It seems thatMaggie is suffering from dysfunctional thinking which is also affecting hermood and behavior towards her coworkers and husband. So it appears that CBT isthe best approach to her depression.
Maggie needs help identifying and changingher dysfunctional thinking which will change her mood and behavior. CBT would viewMaggie’s depression as a direct result of her negative dysfunctional thinking.Maggie’s inaccurate perceptions about herself and her abilities are causing herto have feelings of worthlessness and shame. This is causing her to havedepressive symptoms such as mood and behavior changes, dissatisfaction withlife, disrupted sleep, herlack of interest in sexual activity, loss of concentration, fatigue ortiredness during the day, and suicidal thoughts. At the core of CBT is the ideathat a person’s mood is directly related to his or her patterns of thought.Negative, dysfunctional thinking can affect a person’s mood, sense of self, behavior,or physical condition. Some examples of dysfunctional thinkinginclude overgeneralization: drawing general conclusions from a single usuallynegative event, such as thinking that one bad grade makes you a failure, andmaximization/minimization: maximizing your problems or blowing the effects ofthem out of proportion to the situation or minimizing the value of yourpositive qualities. Thesenegative thought patterns can take the form automatic thoughts.
The goal of CBT is to help a personlearn to recognize negative thought patterns, evaluate their accuracy, and replacethem with more healthy ways of thinking. Therapists also help patients changepatterns of behavior that come from dysfunctional thinking. Negative thoughtsand behavior can make a person more susceptible to depression and makeit nearly impossible to break free from its downward spiral. According tocognitive behavioral practitioners and researchers, when negative patterns ofthought and behavior are changed, so is mood. In this case if Maggie’s negativethought patterns are changed so will her mood and behavior.Eachtherapy session would involve analyzing Maggie’s negative thoughts, feelings,and behaviors to work out if they’re unrealistic, inaccurate, or harmful anddetermine the effects that they have on each other and on Maggie.
To help withthis Maggie should keep a diary or write down her negative thoughts andbehavior patterns. I would then help Maggie to work out how to change her unhelpfulthoughts and behaviors. After working out what Maggie can change, I would askher to practice these changes in her daily life. This would involve questioningnegative thoughts and replacing them with more accurate and healthy ones, orengaging in pleasurable activities that make her happy.
Maggie would also betaught coping methods, such as learning to control and modify her negativethoughts and reactions, practicing self-talk that is accurate and balanced, andusing self-evaluation to reflect and respond appropriately. Doing some homeworkbetween sessions is also vital to helping her with this process. At eachsession Maggie should discuss with me how she’s been doing with putting thechanges into practice and how it makes her feel. During sessions, I would checkto see that Maggie is comfortable with the progress that she is making. One ofthe great benefits of CBT is that after the therapy is over, Maggie cancontinue to apply the principles and coping methods learned to her daily life.This should make it less likely that her symptoms will return. My therapeuticgoals would be to terminate therapy as soon as I see and confirm with Maggiethat her depressive symptoms are gone and that she is competent at the skillsand principles that she was taught in the sessions. Studies have shown that anyone suffering from depression can likely benefit from CBT,even without taking psychiatric medications.
Although many people respond wellto cognitive behavioral therapy, experts point out that the type of personlikely to get the most benefit from it is someone who is motivated, sees themselvesas able to control events that happen around them, and has the capacity for introspection.Cognitive behavioraltherapy introduces patients to a set of skills and principles that they canapply whenever they need to, and that’ll last them for the rest of their lives.CBT can significantly reduce thesymptoms of many mental disorders and clinical trials have shown this. Whenpatients are followed up two years after therapy has ended, many studies haveshown a marked advantage for CBT.
For example, just twelve sessions of CBT canbe as helpful in treating depression as taking medication throughout the twoyears after therapy. This research suggests that CBT helps bring about a realchange that goes beyond just feeling better while in therapy. Maggie can getthe most benefit from CBT if she remains motivated throughout treatment.
Thesupport of Maggie’s husband and close friends can also assist with her treatmentby helping to remind and encourage Maggie to complete all essential parts ofher treatment such as attending every therapy session, taking psychiatricmedications if she is prescribed, and completing homework assignments. Maggie’shusband can also attend a few sessions to learn about what’s causing herdepression and CBT and learn specific ways in which he can support or assistMaggie throughout her treatment.