Behavior Plan Case Study: Behavior Modification- Depression Disorder

I. Case History/Background Information

NoMad is a 22-year-old Salvadoran male from Santa Ana, California. NoMad enjoys sporting events and attempts to stay busy by assisting them when he has time. Currently, NoMad is single and has no children. He grew up in a Christian household but he stated he isn’t religious as a Christian should be. NoMad has lived in his townhome since the age of  2 years old. He currently only lives with his parents. NoMad has lived under the influences of drug and alcohol. NoMad reported that no one in his family has a drug history.

works full-time, he works as a Supervisor at a sports shops in the mall. He has held the same position for 6 months. He is currently enrolled as a full-time student and is part of the football team at his community college. Although NoMad holds a modest job, he still lives at the home where his parents help support his basic needs. Also, his parents will continue to provide a shelter while he aspires to reach his goals and dreams.

Currently, NoMad is living his life with one difficulty, he has not been able to sustain a relationship with the opposite sex. NoMad was diagnosed with generalized depression disorder in his second year of middle school back in 2007, he noted that he had minor symptoms during his first year of middle school. NoMad shared he had no energy and had difficulty finding the strength of getting himself dressed for school. Unfortunately, his emotions affected his academic performance and his parents became concerned about his poor behavior and judgment. NoMad was diagnosed with a depression disorder in 2010. NoMad depression disorder continues to impact his daily functions. He would unexpectedly experience a variety of moods.

Currently was has been effective for NoMad and has shifted his behaviors by investing his time in his social media blog. His blog is where he shares highlights of his favorites team and destresses.

II. Description of the Presenting Problem

Before being diagnosed with depression, NoMad lost relationships that he had, not only with his significant others, but with family members too. Those who surrounded him didn’t understand what was happening, and before NoMad received a correct diagnosis for depression, he couldn’t explain his behavior to anyone as he couldn’t account for what was happening.

NoMad faced discomfort and isolation.

NoMad was diagnosed with generalized depression disorder at the age of 11 years old. Although Nomad has be prescribed medication to control his depression  NoMad doesn’t want to depend on his medication. Nomad wants to build his communication skills to help him build a support group for himself. NoMad has recently lost interest for his family and friends once again. He became suicidal and had feelings of being a burden to everyone who cared for him. NoMad is 22 years old and continues to face many challenges with his disorder. NoMad has been feeling hopelessness and helpless. NoMad wants to improve his social skills and challenge his depression without medication. He has shared he wants to find his inner self and control losing more relationships.

NoMad isolating himself also prompts negative behaviors from other adults at is work who believe NoMad simply doesn’t like them. NoMad behavior is most prominents during slow days at work when his staff members approach him to have a conversation while no one is in the store.

Data Collection

One of the first steps in the course of the therapy is the establishment of the contact with patients, finding out their current knowledge of the problem of depression and their understanding of the problem of depression. At this stage, the visualization of the therapy is very important because the use of visual signs will help patients to get insight into what depression is and starting from that backbone they can start sharing their problems and experience of having depression or similar conditions. In addition, the use of quiz will help patients to word in the concept of depression succinctly so that they will be able to understand what depression really is. The maintenance of the dialogue between the presenting team and patients is very important because this is one of the main goals of the therapy – to make patients start talking, sharing their experience and views on depression and their problems that will help to pave the way to the solution of the problem and helping patients to recover.

The next step in the development of the therapy of the patient was the identification of causes of depression. Another important stage in the therapy is the identification of possible causes and risk factors that trigger depression. At this point, the focus on the personal experience and views of patients is pivotal. Each patient provides the individual response concerning his/her experience and view on causes of depression. In such a way, the standpoint of each patient becomes clear, while other patients may get some new perspectives on the problem of depression and its possible causes. The imperative element of this stage is the revelation of possible causes by patients rather by the presenter.  Such approach to the revelation of causes of the problem is more effective because patients get to the understanding of causes of depression by making their own efforts and sharing their actual experience.

As causes of the depression are identified, the therapy moves on to the next step, which is the elaboration of coping strategies that may help patients to deal with depression in their life. The therapy aims at the revelation of several key coping strategies, which can help patients to deal with depression, including the following:

  • Simplify your life
  • Write in a journal
  • Read reputable self-help books and websites.
  • Locate helpful groups.
  • Don’t become isolated.
  • Learn ways to relax and manage your stress.
  • Structure your time.
  • Don’t make important decisions when you’re down.

In fact, these strategies turned out to be helpful but it is important that client of the therapy have taken the active part in the discussion of possible strategies to cope with depression. In this regard, the therapy involved practical recommendations to the client as well as vivid and friendly discussion of the key points of every strategy that helped the client to understand better how to use those strategies in his life.

At this point, the psychological aid provided for the client focuses on the discovery of the client’s problem by the client and the rise of the necessity to change his lifestyle. To urge the client to change his lifestyle the client was engaged in practicing sports, swimming. The client was offered two months intensive training course during which he could focus on the training process. The observation of the client during the training and after the training revealed positive changes in his behavior. He felt being more balanced after the training and he felt being more stable in his behavior. He manifested fewer complaints after training. Moreover, he reported positive changes in his physical condition. For example, after two weeks of the intensive training, he reported the improvement of his sleep, while after three weeks he reported the consistent improvement of his sleep. The client also reported the change of the mood and emergence of the positive mood, especially after training. He recognized that training helps him to forget about his troubles and focus on different goals. He also became better organized because training urged him to learn how to manage his time and plan his diet to reach possibly better outcomes in the training process. Finally, the client developed new social ties which he found helpful for the development of his wellbeing and elimination of his depression. The client admitted that new social ties distracted him from negative thoughts and made his life more meaningful and colorful.

Conclusion

Thus, NoMan was the patient that suffered from the depression and needed the professional aid to cope with his problem. In response to his condition, the therapy based on counseling services and physical activities use was introduced and implemented successfully. The counseling therapy led the client to the recognition of the problem and rise of the awareness of the importance of its elimination. To facilitate the coping with depression, the client was recommended to practice sports, swimming, which has brought positive outcomes. The positive change of the physical condition of the client stimulated the improvement of his psychological condition. Also the client developed new social ties that made his life more meaningful. Hence, the proposed therapy has brought positive effects and helped the client to cope with his depression, but the further, long-term counseling and rehabilitation is needed.

References:

Imel ZE, Malterer MB, McKay KM, Wampold BE (October 2008). “A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia”. J Affect Disord. 110(3): 197–206

Lyoo I. K.; Yoon S.; Kim T. S.; Hwang J.; Kim J. E.; Won W.; Renshaw P. F. (2012). “A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder”. American Journal of Psychiatry. 169 (9): 937–945

Smail, D. J. (2005). Power Interest and Psychology. Ross-on-Wye, UK: PCCS Books.

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