Cognitive-behavioral therapy

Cognitive-behavioral therapy

Cognitive-behavioral therapy

Week 8 Journal Entry The first client is a 25-year-old female who presented to the facility one year after the death of the mother. She reported having feelings of sadness and hopelessness which have affected her social interactions. At the time she presented, she reported difficulty in sleeping, and recurrent thoughts of suicide. The patient had also lost interest in activities which she previously found to be interesting. The patient was diagnosed with major depressive disorder. The diagnosis is supported by the DSM-5 criteria which state that for this diagnosis a patient should present with five or more symptoms of depression in the same two-week period (American Psychiatric Association, 2015). 2 Of the presenting symptoms, one of them should either be a loss of interest or a depressed mood. The patient is under citalopram for the management of symptoms.

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The second client is a 28-year old male who presented to the facility and was diagnosed with a generalized anxiety disorder. The patient started developing excessive worry that he would fail in his Post-graduate examinations. The worry has lasted for seven months, and it has affected his ability to read and understand school content. The patient found it difficult to control the symptoms. He also explained that he was easily fatigued, was highly irritable and was facing sleep disturbances. 3 The symptoms are in line with the DSM-5 diagnostic criteria for generalized anxiety disorder. For a positive diagnosis, the patient must present with excessive worry or anxiety for a period exceeding six months and also three of the six cardinal symptoms of anxiety (Er, 2015). The symptoms include irritability, sleep disturbances, easy fatiguability, concentration difficulties, restlessness, and muscle tension (Er, 2015). Furthermore, the disturbances should cause clinical distress and should not be attributable to the psychological effects of a substance. The patient is administered with alprazolam.

Cognitive-behavioral therapy would be effective for the group of patients. 4 It has been shown to be effective in the management of both generalized depressive disorder and generalized anxiety disorder (Powers, de Kleine & Smits, 2017). The expected outcomes would be an improvement of the symptoms of the patients and improved ability of the patients to engage in social interactions. There are several ethical considerations related to the counseling of each of the patients. It is important to protect the patient information which may have severe consequences on their social and personal lives if it is made public. It is also necessary to promote the confidentiality of the patient concerning the information they share. Finally, any health care provider is obligated to provide treatment with a favorable risk to benefit ratio.


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