major depressive disorder

Respond by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.

NOTE: (positive Comment)

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The most likely diagnosis of the patient is major depressive disorder and it is considered as a serious mood disorder. According to the DSM-5 criteria for the diagnosis of depression, there is markedly diminished interest or pleasure in all or almost activities most of the day; weight reduction due to the loss of appetite; the reduction in the thoughts and physical activities; feeling of worthlessness; reduced ability to concentrate; and the recurrent thoughts of deaths of suicidal. Based on the case study, it is evident that the patient has stopped attending rehearsals for the bands two months ago since she is no longer interested; low self-esteem; low energy; and two previous suicidal attempts. Therefore, the patients use self-injury as a way of coping with his depression, a means of relief, to regulate his feelings, self-punishment, and to seek attention (McGillivray & Evert, 2014). The patient is a 15-year-old who reports a self-harming behavior. The patient also feels that the family is not supportive making develop suicidal thoughts. The patient has attempted committing suicide severally, most recently two months ago. The patient is adequately progressing since he does not show any agitation of motor health. The patient is also alert of the surrounding and promptly identifies the root of the problem. The concentration and attention of the patient are also alert (American Psychiatric Association, 2013). Besides, the patient shows no history of drug abuse of psychiatric medication.

The most important group therapy that can help the patient is Cognitive-Behavioral Therapy. This therapy is important in ensuring that unhealthy, adverse beliefs, and behaviors are replaced with healthy and adaptive ones. This therapy helps in improving the individual thought of the patient so that the negative and the inaccurate thoughts are reshaped appropriately.The therapeutic approach that I will use in the case is cognitive behavior therapy (CBT). The approach primarily focuses on altering the behavior of the patient by avoiding destructive behaviors and self-injury. The model is implemented through regular meetings with the patient (American Psychiatric Association, 2013) (Restek-Petrović et al., 2014). We will agree with the patients on the most appropriate time for the meetings. The model helps the patient to identify any destructive behaviors and negative influences of the behavior.CBT will be effective since it focuses on the negative thoughts, challenges them, and replace them with positive opinions. The underlying principle of CBT is that thoughts play a vital role in the behaviors of the patient; hence manipulation of the thoughts plays a vital role in the changing behavior of the patient. The approach will help the patient realize his self-worth and the impact of emotional stress on the patient (McGillivray & Evert, 2014). CBT will enable the patient to focus on a positive activity for his to avoid destructive behavior and self-injury. The activities include engaging in another game or another healthy activity.

The patient’s parents got divorced five years ago and he lives with the mother. The patient has minimal contact with the father. The information could impact the therapy since the patient could be dealing with identity issues (McGillivray & Evert, 2014). The patientl is 15 years that lies in Erikson’s stage of psychological development that lies between 5 and 18 years. During the stage, people must form good social and family relations with themselves (Wheeler, 2014). If people have poor relations in their environment, they exhibit confusion and emotional stress. The patient in the case could be having emotional stress that could alter the results of the therapy. The patient to develop healthy problem-solving skills that are important in the identification and management of the triggers of the suicidal attempts and self-injury. The patient is expected to improve emotionally and to manage the distress. His performance in school is expected to improve and have a good relationship with his family. He is also expected to report a reduction in the suicidal thoughts (McGillivray & Evert, 2014). There are legal and ethical issues that are faced by the licensed counselor and they must be put into considerations. The process of breaching confidentiality is against the ethical and legal expectations and this ruins the trust between the patient and the counselor. Psychiatrists have a responsibility of protecting the information of the patients and his family. The breaching of confidentiality leads to legal consequences because of malpractice. Another ethical and legal concern is related to autonomy whereby the patient, in this case, has the right to be informed about the type of medication and treatment being provided to them. However, there are situations where these might not understand the treatment approaches and medication or diagnosis.


McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44(8), 2041-2051.

Restek-Petrovic, B., Bogovic, A., Mihanovic, M., Grah, M., Mayer, N., & Ivezic, E. (2914). Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: A preliminary study. Nordic Journal of Psychiatry, 68(5), 333-340.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.