For this post, use the case of Nellie Bowman or Mary Melody to develop an intervention plan that is based on a chosen theory. Our text and research demonstrate multiple methods and concepts concerning theory. Choose one of the methods or concepts within the text to support your application of theory to Nellie or Mary.
Start by reviewing the cases:
The Case of Mary Melody
Mary Melody is a 46-year-old married woman with two children, ages 23 and 25. “I’ve been sad for most of my life. I’ve just felt down for as long as I can remember. I’ve been thinking of suicide on and off since I was 16 years old,” she said. Mary goes on to say that she hates everything about herself: how she looks, how she talks, and how she acts around other people. She feels most comfortable in her room curled up in bed with the shades drawn and the lights out. “My kids are grown and they really don’t need me. You might say my work in that department is done. They turned out okay but I just feel really hopeless. Now that the birds have left the nest, I don’t have much of a purpose,” she adds.
The Case of Nellie Bowman
Nellie Bowman is a 25-year-old graduate student. She starts her conversation with you by stating, “You know, I’ve lived a pretty normal life. Of course I’ve had the usual ups and downs. Then it happened. One night after a party, I came back to my apartment and I guess I forgot to lock the door. Some guy must have followed me. I woke up and he had a knife at my throat. My life flashed before my eyes. I don’t really remember what happened next, but I remember jumping on the bed and screaming and he ran from the room. I called my roommate and she came right back to the apartment. I called my parents and the police. Filed the report, they didn’t find the guy, but we changed all the locks and I thought I’d put it behind me. Then six months later, I woke up in the middle of the night and had this vague feeling of apprehension. All of a sudden my heart started pounding. Like I was having a heart attack. I started sweating and my chest hurt something awful. Right these and then I thought I was dying. It was really weird. I ran to my roommate’s room, but it felt like I was moving in slow motion. It was like I was detached from the whole thing. Right away she called the ambulance. When they checked me out at the hospital the docs said I was just fine. Now I’m a little scared to be by myself for too long. Good thing I have my roommate. I’m afraid it might happen again.”
For your discussion post:
- Identify the case you have chosen to review and the diagnosis you would provide to either Nellie or Mary.
- Provide your rationale for the diagnosis.
- Discuss an intervention plan using the generalist intervention model that addresses the micro, mezzo, and macro systems. What kind of therapy would you provide this client, what kind of intervention would you provide for the family, and the community?
Theory Application
The case under analysis is Mary Melody. The diagnosis in the case study is suicide ideation due to depression that has persisted most of the client’s life.
Rationale
The rationale for the diagnosis is the presenting symptoms that meet the DSM-5 criteria for a depression diagnosis. According to the DSM-5, the criteria for making a depression diagnosis is five or more symptoms (Tolentino & Schmidt, 2018). From the case study, Mary meets the following conditions for a positive diagnosis: she has a depressed mood most of the time; she has diminished pleasure in daily activities, especially with her children all grown; she feels down all the time; she feels worthless; and has recurrent thoughts of death, which have been present since she was young. The suicidal thoughts have increased recently since she feels that her children do not need her anymore and lacks a purpose to live. The symptoms are causing the client clinically significant distress.
Intervention
Psychotherapy is the therapeutic theory that will inform treatment for Mary. The therapist will use narrative or talk therapy to help the client open up about her underlying problem and possible childhood events leading to the depression. The therapist will work with the client to establish the possible causes of the negative and depressive thoughts and replace them with positive and enabling thoughts and attitudes (Wampold, 2019). Apart from working with the client, the therapy will also include family therapy and education to help her husband and children to support her recovery. The process involves loved ones in treatment to help the client understand what she is going through (Olfson et al., 2016). Success in the therapy will have a community impact since it will address the cost of depression and suicide.
References
Olfson, M., Blanco, C., & Marcus, S. C. (2016). Treatment of adult depression in the United States. JAMA internal medicine, 176(10), 1482-1491.
Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: implications for clinical practice. Frontiers in psychiatry, 9, 450.
Wampold, B. E. (2019). The basics of psychotherapy: An introduction to theory and practice. American Psychological Association.
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