Treatment of Women Diagnosed With Dysthymia Term Paper

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Treatment of Women Diagnosed With Dysthymia

This proposal for a clinical case study of the treatment of a woman diagnosed with dysthymia employs a cognitive behavioral approach to identifying effective treatment modalities for patients with depressive disorders. In cognitive behavioral sessions, psychotherapists seek to help a patient identify his or her harmful thinking patterns in order to develop better coping strategies and social skills. The focus of the research in this study is on how people in general think, behave, and communicate in the present rather than on their early childhood experiences.

Proposal for a Clinical Case Study Dissertation - Doctor of Psychology in Clinical Psychology

Chapter One. Introduction

Statement of the Problem



Chapter Two: Review of the Relevant Literature

Background and Overview

Etiology of Dysthymia

Symptoms of Dysthymia

Theoretical Bases for Clinical Treatment

Chapter Three: Methodology

Client Information

A. Presenting problem

B. Client's current symptoms

C. Therapist's observations of client's symptoms

D. Family history

E. Medical history

F. Psychotherapeutic history

G. Substance use/abuse

H. Initial diagnosis

I. Impressions of client

Beck: Cognitive Behavioral Therapy

Storm Clouds - Beginning Phase

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Sessions 1-4

Unbearable Pain - Middle Phase

Looking for Relief in All the Wrong Places

Sessions 5-15

Making Peace - Final Phase

Sessions 16-24

Future Treatment Considerations

Chapter Four: Concluding Thoughts


Case Study Proposal: Identifying Efficacious Treatment Modalities for Chronically Depressed Dysthymic Patients

Chapter One: Introduction

TOPIC: Term Paper on Treatment of Women Diagnosed With Dysthymia This Assignment

This study is comprised of four chapters; this chapter provides an introduction and overview of the research, a statement of the problem to be considered, the purpose of the study and the rationale in support of the client selected. Chapter Two presents a critical review of the peer-reviewed and scholarly literature, and Chapter Three describes the methodology employed. The final chapter summarizes the findings of the research and provides a discussion of concluding thoughts that resulted from the research and the treatment sessions that formed the basis of the project.

Overview of the Study

This is a proposal for a clinical case study on the treatment of a woman diagnosed with dysthymia. Dysthymia, or minor depression, is characterized by the presence of a depressed mood for the majority of the day for a minimum 2-year period with no more than 2 months' of respite from the symptoms during this period. Further, at least two of the following symptoms must occur concurrently with the depression: disruption in eating habits -- poor appetite or overeating; disturbed sleeping pattern -- insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; and a feeling of hopelessness (Rakel, 2004). This case study will employ the relational model, cognitive behavioral therapy (CBT). This technique is a relatively short-term, focused psychotherapeutic approach that can be used for a wide range of psychological problems including depression, anxiety, and personality problems. The cognitive behavioral approach has provided an effective framework in which to better understand individuals and their unique problems and circumstances, and, further, it provides an effective approach to use developing individual therapy modalities (Fine & Schwebel, 1994). The focus of this research project will be on how the client thinks, behaves, and communicates currently rather than on early childhood experiences.

Statement of the Problem

Depression is the most prevalent mental disorder in the United States today, and all signs indicate that the condition is on the rise (Helm, Boward, McBridge et al., 2002). The costs associated with this range of depressive disorders are enormous. In fact, it has been estimated that depression results in more than 200 million lost workdays and costs the U.S. economy $43.7 billion annually; further, much of those costs are hidden, including $23.8 billion lost to U.S. businesses in absenteeism and lost productivity (Myslinksi, 2004). Claims for short-term disability for those with depression are comparable to other chronic medical conditions, including diabetes, heart disease and lower back pain. People who experience unrecognized depression are also greater users of healthcare resources for their physical ailments (Myslinksi, 2004). On a final note, it should be pointed out that there are currently no data supporting qualitative differences in symptomatology between major depression and dysthymia (Klein, 1991).

Purpose of Study

The purpose of this investigation is to highlight those aspects of Cognitive Behavioral Therapy that have been shown to be effective in treating depressive disorders in general and those that affect the patient in this study in particular. It is the intent of this dissertation to demonstrate how an application of the basic tenets and theoretical principles of cognitive behavioral theory may be applied and utilized in the treatment of the client, Mary.

It is relevant to note that these theoretical constructs bridge into clinical practice and are not only theoretically central but also help the therapist to think about the nature of the therapeutic relationship, the analysis of which is at the heart of cognitive behavioral practice. Cognitive Behavioral Therapy has always grown from a fertile interaction between theory and clinical practice. Clinical experience comes to challenge the contemporary theoretical understanding and demands a development of that theoretical understanding so as to accommodate the emerging clinical experiences.

All the chapters in this volume address the Mary's struggle to come to know and tolerate some of the indisputable facts of life, including dependency and the inevitability of loss.

This dissertation is concerned with the conceptual foundations of cognitive behavioral theory. I undertake an integration of the theory and technique of cognitive behavioral theory in this dissertation. It is designed to introduce essential theoretical tenets of cognitive behavioral theory, especially as they apply to the client, and to illustrate how this theoretical model lends itself to the clinical situation. It is important to remember that cognitive behavioral theory is a clinical science. The test of the goodness of its theory is that it generates actions leading to change in a direction taken to be desirable by the client.

This is not a dissertation about looking into the past and finding fault so that all of our present-day problems can be explained away. Too often these days, it appears that people are looking to place responsibility for their problems everywhere except in their own lives and in their own choices. This is not to say that early events in our lives don't influence our current functioning -- they do. It is to say, however, that events in the past cannot be changed. Instead, what we do with those events, how we think about those events, and how we use those events to make us stronger in our present day lives is what is important.

There are times when it is good to pause for a moment and ask ourselves: Whence have we come? Where do we stand now? Where are we going? This dissertation attempts to answer these questions for the field of cognitive behavioral therapy. As I resisted the idea of a dissertation consciously, I was already at work writing it on a preconscious level. When I found myself one afternoon running through points of interpretation 'in my head,' I realized that the question had been decided for me. A fresh rethinking created opportunities to return to the received canon, to rescrutinize cognitive behavioral theorists and themes and, additionally, to treat at length thinkers I incorporated selectively or inadequately earlier: I had in mind Beck and.... And so the die was cast.

In this dissertation I attempt to do two things. First, I try to trace the history of cognitive behavioral theory. Second, I try to incorporate the theory with clinical practice. My major aim in writing this dissertation has been to develop an integrated position with respect to knowledge about cognitive behavioral theory.

Psychologists neither live nor work in a vacuum. Each day, students of psychology learn concepts and techniques that will affect their interactions with other people, whether as clients, co-workers, or as companions, for the rest of their lives. Each day, instructors face the responsibility of teaching those students. Each day, researchers gather data and draw conclusions upon which both the knowledge of psychology and its application are based. And, each day, clinical practitioners must apply the concepts and techniques they were taught in graduate school, as well as newly developed theories and applications that they later learn, in order to assist to the greatest extent possible the individuals and families that they serve.

Regardless of the environment in which psychologists work, whether they are involved in basic research or education or applied psychology or clinical practice, they are seeking out real world issues and functional methods for understanding the impact of those issues on individuals.

There is still much to be learned. Some processes and methods of coping that may be "healthy" at one moment in an individual's life may, 6 months, a year, or 5 years later, be less effective as a coping strategy. Psychologists -- who are as intensely concerned with generating new knowledge about human reaction and interaction as they are with helping others -- have a vital, day-to-day role to play in identifying, assessing, and treating… [END OF PREVIEW] . . . READ MORE

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