Comprehensive Case Study

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Social Work for Mental Health

Adjustment disorder with depressed mood is also referred to as situational depression and can only be diagnosed if the recurring depressive symptoms are resulting from onset of stressors. Some of the symptoms include aggressive behavior, agitation or irritable mood and feelings of hopelessness (Jones, 2021). The theories used to aid the client in the recovery process are cognitive behavior theory and attachment theory. The intervention method selected is cognitive behavior therapy (CBT). Clients with depression respond positively to CBT treatment (Williams, 2019). Cognitive behavioral therapy aids patients in understanding their thought processes leading to the behaviors exhibited, making them realize they have control over the outcomes.

Differential Diagnosis

The primary diagnosis for the patient is Adjustment disorder with depressed mood. The patient’s symptoms are consistent with Criteria A which requires presence of emotional or behavioral symptoms in response to an identifiable stressor occurring within three months on onset. The patient appears agitated and nervous during the interview and she began drinking when her mother left them at 14, when she got her first child at 22, when she got her second child, and when her husband was fired and demanded that she quit school for him to look for a new job. The symptoms are also consistent with Criteria B2 because they affect her social and occupational functioning areas. The patient is unable to perform well in school and her peers do not want to work with her.

The second most probable diagnosis for the patient is major depressive disorder. The diagnosis for the condition requires that the individual have one of the two symptoms to meet Criteria A of the DSM-5; depressed mood, or loss of interest or pleasure. The client should feel hopeless or empty most of the day nearly every day based on requirements for Criteria A1. The patient claims during the interview that she feels worthless and overwhelmed because everyone needs something. The patient also has no pleasure in her activities which is consistent with Criteria A2 as she states that most of the days she does not want to get out of bed. The symptoms have been occurring for the past six months meeting the two-week duration stated under Criteria A. The symptoms also cause impairment in her social and occupational areas of functioning consistent with Criteria B. She does not want to go home after school and goes to the bar instead. The client’s peers do not want to work with her because she wants to meet in the local bar. However, the disorder is ruled out because the symptoms are only recurrent during the onset of psychosocial stressors in the patient’s life consistent with Criteria A of the adjustment disorders.

Another probable diagnosis for the patient is alcohol-induced depressive disorder. Criteria A requires that the persistent mood disturbance is marked by diminished pleasure in almost all activities. The client’s peers claim that she is never engaged in learning and is more worried about what to drink next. The patient claims that only when drinking does it get her through the day indicating the disorder with onset during withdrawal. The patient’s impairment in social and occupational functioning areas is also consistent with Criteria E. Her peers do not want to work with her. The diagnosis is ruled out because the symptoms preceded the onset of the substance use, persisting a month after cessation based on requirements of Criteria C of substance-induced depressive disorder.

Social Work Theories

The therapeutic intervention that should be used is cognitive behavioral therapy (CBT) (Cissé, 2022). The theory of cognitive behavior is used by social workers to aid the client to reframe their negative or limiting behaviors (Morrise, 2020). The patient will be guided stepwise to understand her behavior and the thought processes leading up to it. The attachment theory will also be used to understand the behavior of the patient’s six-year old daughter. The theory claims that development of healthy attachments gives a child confidence to meet the world and when broken the child develops maladaptive behaviors (Joseph-Micliz, 2020). The patient’s six-year old had no interest in making friends or doing well in class. She is also very quiet and keeps to herself. The child should also be treated with CBT before development of the mild depression to severe.

Conclusion

CBT helps individuals to alter their negative thinking and adopt positive ones by reflecting on their cognitive processes, to change their behaviors. The patient is diagnosed with adjustment disorder with depressive mood because her depressive episodes occur on the onset of psychosocial stressors. Other possible diagnoses that were ruled out are major depressive disorder and substance-induced depressive disorder. Attachment and cognitive behavior theories are used to develop the intervention plan. The intervention recommended to the patient and her family is CBT.

References