The most effective therapeutic approach for Maggie’s
depression is cognitive therapy or cognitive behavioral therapy (CBT) because
studies have shown it to be as effective as antidepressents in treating
depression. Studies have also shown it to be effective at reducing relapses in
patients after therapy. Cognitive behavioral
therapy is different from other therapies because it is short, taking only five
to ten months for most mental problems and often requiring only 10 to 20
sessions. The focus and method of CBT is also
different. CBT is a more short-term approach than psychodynamic
(psychoanalysis) therapies. Other types of therapies may require several years
for discovery and treatment. CBT involves changing thinking patterns and focuses
on what and how a person thinks more than why a person thinks that way.
Sessions provide patients an opportunity to identify current life situations
that may be causing or contributing to their depression. This is different from
psychoanalysis. That type of therapy involves looking to the past to discover
unconscious sources of the problems that the patient is facing. CBT is also goal-oriented
and educational. Therapists use structured learning experiences that teach
patients to monitor and write down their negative thoughts and behavior
patterns. The goal is to see how these negative thoughts affect their mood,
behavior, and psychical condition. CBT therapists also teach important coping
mechanisms, such as learning to control and
modify distorted thoughts and reactions.

The main issue we need to consider when determining which
type of therapeutic approach to use for Maggie’s depression is the underlying
factors that are causing her depression. Psychodynamic therapy is based on the
belief that a person is depressed because of unresolved, unconscious conflicts
that occur during childhood. Humanistic therapy helps individuals understand
their 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 new
behaviors to minimize or eliminate problems, rather than focusing on the
unconscious mind. Cognitive therapy or CBT seeks to modify negative thought
patterns in order to change moods and behaviors. It’s based on the belief that
negative moods and behaviors are the result of current dysfunctional thoughts
or beliefs. According to this case study, Maggie has very high standards for
herself and is very self-critical. She also struggles with significant feelings
of worthlessness and shame due to her
inability to perform as well as she always has in the past. It seems that
Maggie is suffering from dysfunctional thinking which is also affecting her
mood and behavior towards her coworkers and husband. So it appears that CBT is
the best approach to her depression. Maggie needs help identifying and changing
her dysfunctional thinking which will change her mood and behavior.

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CBT would view
Maggie’s depression as a direct result of her negative dysfunctional thinking.
Maggie’s inaccurate perceptions about herself and her abilities are causing her
to have feelings of worthlessness and shame. This is causing her to have
depressive symptoms such as mood and behavior changes, dissatisfaction with
life, disrupted sleep, her
lack of interest in sexual activity, loss of concentration, fatigue or
tiredness during the day, and suicidal thoughts. At the core of CBT is the idea
that 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 thinking
include overgeneralization: drawing general conclusions from a single usually
negative event, such as thinking that one bad grade makes you a failure, and
maximization/minimization: maximizing your problems or blowing the effects of
them out of proportion to the situation or minimizing the value of your
positive qualities. These
negative thought patterns can take the form automatic thoughts. The goal of CBT is to help a person
learn to recognize negative thought patterns, evaluate their accuracy, and replace
them with more healthy ways of thinking. Therapists also help patients change
patterns of behavior that come from dysfunctional thinking. Negative thoughts
and behavior can make a person more susceptible to depression and make
it nearly impossible to break free from its downward spiral. According to
cognitive behavioral practitioners and researchers, when negative patterns of
thought and behavior are changed, so is mood. In this case if Maggie’s negative
thought patterns are changed so will her mood and behavior.

Each
therapy session would involve analyzing Maggie’s negative thoughts, feelings,
and behaviors to work out if they’re unrealistic, inaccurate, or harmful and
determine the effects that they have on each other and on Maggie. To help with
this Maggie should keep a diary or write down her negative thoughts and
behavior patterns. I would then help Maggie to work out how to change her unhelpful
thoughts and behaviors. After working out what Maggie can change, I would ask
her to practice these changes in her daily life. This would involve questioning
negative thoughts and replacing them with more accurate and healthy ones, or
engaging in pleasurable activities that make her happy. Maggie would also be
taught coping methods, such as learning to control and modify her negative
thoughts and reactions, practicing self-talk that is accurate and balanced, and
using self-evaluation to reflect and respond appropriately. Doing some homework
between sessions is also vital to helping her with this process. At each
session Maggie should discuss with me how she’s been doing with putting the
changes into practice and how it makes her feel. During sessions, I would check
to see that Maggie is comfortable with the progress that she is making. One of
the great benefits of CBT is that after the therapy is over, Maggie can
continue to apply the principles and coping methods learned to her daily life.
This should make it less likely that her symptoms will return. My therapeutic
goals would be to terminate therapy as soon as I see and confirm with Maggie
that her depressive symptoms are gone and that she is competent at the skills
and 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 well
to cognitive behavioral therapy, experts point out that the type of person
likely to get the most benefit from it is someone who is motivated, sees themselves
as able to control events that happen around them, and has the capacity for introspection.
Cognitive behavioral
therapy introduces patients to a set of skills and principles that they can
apply whenever they need to, and that’ll last them for the rest of their lives.
CBT can significantly reduce the
symptoms of many mental disorders and clinical trials have shown this. When
patients are followed up two years after therapy has ended, many studies have
shown a marked advantage for CBT. For example, just twelve sessions of CBT can
be as helpful in treating depression as taking medication throughout the two
years after therapy. This research suggests that CBT helps bring about a real
change that goes beyond just feeling better while in therapy. Maggie can get
the most benefit from CBT if she remains motivated throughout treatment. The
support of Maggie’s husband and close friends can also assist with her treatment
by helping to remind and encourage Maggie to complete all essential parts of
her treatment such as attending every therapy session, taking psychiatric
medications if she is prescribed, and completing homework assignments. Maggie’s
husband can also attend a few sessions to learn about what’s causing her
depression and CBT and learn specific ways in which he can support or assist
Maggie throughout her treatment.