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Psychology has a major role in science and the different branches of psychology offer specialties that drive new theories and techniques. Clinical psychologists work with a variety of patients who face diagnosis’s such as that of Jose, who faces anxiety, depression, inability to eat or sleep, irritability, and impaired emotional and social functioning. This paper will explain the case of Jose, a seventeen-year-old Hispanic high school junior who identifies as homosexual. It will also cover interventions to assist Jose that demonstrate real world application of clinical psychology.

Case overview

Jose lives at home with his parents and three siblings. His parents have noticed that his usual cheerful and energetic disposition has changed drastically. In fact, he now displays behavior that is explained as tearful, lethargic, irritable, and anxious. He is also experiencing difficulty sleeping and eating. There is a family history of depression and anxiety. The tests that were administered were an interview along with BDI, CBCL, and SCL-90-R. Jose’s test result scores placed him in the severely depressed range, there also was an elevation in anxiety and paranoia. The interview offered some insight into the cause of his symptoms. A former boyfriend has tested positive for HIV and he is in fear of taking a test to find out is he has contracted it. He is also in fear of telling his parents of the former boyfriend’s HIV status. A clinical psychologist made recommendations that Jose could benefit from ongoing treatment that will be sensitive to his ethic background and sexual orientation. There are different factors to be considered in handling Jose’s case.

Biological, psychological, and social factors

Three categories of factors interact with each other in Jose’s case to cause or perpetuate his anxiety, sensitivity, vulnerability to depression, and impaired emotional and social functioning. These categories are biological, psychological, and social factors. The biological factors include genetics and neurotransmitter activity. According to Smoller & Block (2009), genes are strong indicators of risk factor for anxiety disorders. Similarly, genes can also influence the degree of vulnerability to depression. In Jose’s case, the familial history is marked by significant incidences of depression and anxiety disorders. As such, genes are a vital factor to consider in his case. Neurotransmitter activity denotes the decreased activity of particular neurotransmitters in the CNS that lead to development of depression symptoms such as reduced appetite, sleeplessness, and mood strains (Brigitta, 2002).

The psychological factors involved in Jose’s case include stress and life events. Smoller and Block (2009) state that stress and undesirable life events tend to predispose an individual to anxiety and depression disorders. Notably, Jose experienced an undesirable life event, which is the recognition of the HIV status of his boyfriend and the sudden realization that he may too test HIV positive. This event then triggers stress largely due to the uncertainty of the future of his health and a lack of knowledge on how to handle the situation.

The social factor is stigmatization due to both his possible HIV positive status and sexual orientation. People living with HIV are usually discriminated by the society leading to development of stress, social seclusion, and impaired social relationships. Similarly, gays are discriminated by a significant portion of the society, which predisposes them to depression, anxiety, and depression disorders (Hatzenbuehler, McLaughlin, & Keyes, 2010).

Intervention 1

Interpersonal therapy (IPT) is an appropriate intervention in the field of clinical psychology for treating individuals with depression, anxiety, conflict, and emotions. Interpersonal therapy concentrations on relationships and social roles. The person receiving the treatment usually works with a therapist to assess specific issues in the individual’s life that is causing them discomfort, such as conflicts with family, friends, coworkers or significant life changes. Also the therapists look at past experiences that will assist treating the patient and focusing on improving relationships in the present. This treatment usually takes place inside a therapist’s office, a mental health clinic, or a college counseling center. The patients may attend the treatment individually or in a group. Research has documented that receiving ITP is effective because it highlights the ways in which the individual present social context and relationships cause symptoms rather than exploring the deep-rooted sources of the symptoms. IPT goals are swift and the symptoms decrease and enhanced social modification. According to Mufson, Weissman, Moreau, & Garfinkel (1999), “Patients who received IPT-A reported a notably greater decrease in depressive symptoms and greater improvement in overall social functioning, functioning with friends, and specific problem-solving skills. These preliminary findings support the feasibility, acceptability, and efficacy of 12 weeks of IPT-A” (p. 572). Therefore, this peer-review suggests effective IPT treatment is effective in improving interpersonal problem-solving skills and social functions.

Intervention 2

Another terrific intervention for José and his severe depression would be biological intervention, as his symptoms have interfered with his personal relationships and has begun to really worry his family. It would be beneficial for José to meet with a clinician along with his family to speak about his feelings, troubleshoot his worries associated to his relationship with his partner, and to assist in assisting him as he works towards his goal of ultimate wellbeing.

Through biological intervention, José and his family would have the opportunity to meet with a clinician in a comfortable setting, for example, the family living room area. This would assist José in his comfort level while working through such serious issues. Research proves that the use of cognitive-behavioral therapy (CBT) and medication can greatly improve the symptoms of depression amongst those demonstrating such severe symptoms (Beauchaine, Neuhaus, Brenner & Gatzke-Kopp, 2008). During the biological intervention, the clinician will work towards both biological and psychological factors. Biological factors are incredibly important in rectifying the situation, as José comes from a family which battles with depression. Additionally, the psychological factor of the intervention would allow José to reflect on the areas of his life which he has placed on hold due to the fear and regret he is feeling from finding out his partner has tested HIV positive.

Intervention 3

Jose is experiencing severe depression based on a variety of issues. Facing the challenges of declaring his homosexuality, the discovery that he possibly has been infected with HIV and a family history of depression and anxiety requires a treatment plan that would include mindfulness cognitive behavior.

Utilizing mindfulness is a technique that bring ones’ thoughts into the present. During mindfulness training, Jose can reach that phenomena that can change perceptions, cognition’s, sensations and emotions in a nonjudgmental environment. Mindfulness-based interventions have been empirically supported and treatment proven clinical significance. Unlike other empirically supported treatments, mindfulness cognitive training was not developed to treat any specific disorder however, it has been shown to provide significant stress release (Baer, 2003).

Jose would be encouraged to seek the assistance of a clinician experienced in the methods of mindfulness training. The training can be conducted through a series of classes over a period of eight to ten weeks and practiced every day. This would equip Jose with the tools to work through much of the stress he is experiencing. The practice of meditation can provide him with the ability to self-regulate his depressive state.

Conclusion

References

Baer, R., (2003, Summer). Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology Science and Practice, 10(2), 125-143. doi:10.1093/clipsy/bpg015

Beauchaine, T. P., Neuhaus, E., Brenner, S. L., & Gatzke-Kopp, L. (2008). Ten good reasons to consider biological processes in prevention and intervention research. Development and Psychopathology, 20(3), 745-74. doi:http://dx.doi.org/10.1017/S0954579408000369

Brigitta, B. (2002). Pathophysiology of depression and mechanisms of treatment. Dialogues in

Clinical Neuroscience, 4(1), 7-20.

Hatzenbuehler, M. L., McLaughlin, K. A., & Keyes, K. M. (2010). The Impact of Institutional Discrimination on Psychiatric Disorders in Lesbian, Gay, and Bisexual Populations: A Prospective Study. American Journal of Public Health, 100(3), 452-459.

Mufson L, Weissman MM, Moreau D, Garfinkel R. Efficacy of Interpersonal Psychotherapy for

Depressed Adolescents. Arch Gen Psychiatry. 1999; 56(6):573-579. 

Smoller, J. W., & Block, S. R. (2009). Genetics of anxiety disorders: the complex road from DSM to DNA. Anxiety Disorders Association of America, 26(11), 965-975.