Tratamiento para la depresion

Section I

TREATMENT PLANNING

DEPRESSION MASTER BEHAVIORAL DEFINITION LIST

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

Loss of appetite. Depressed affect. Diminished interest in or enjoyment of activities. Psychomotor agitation or retardation. Sleeplessness or hypersomnia. Lack of energy. Poor concentration and indecisiveness. Social withdrawal. Suicidal thoughts and/or gestures.Feelings of hopelessness, worthlessness, or inappropriate guilt. Low self-esteem. Unresolved grief issues. Mood-related hallucinations or delusions. History of chronic or recurrent depression for which the client has taken antidepressant medication, been hospitalized, had outpatient treatment, or had a course of electroconvulsive therapy.

11

CHILD*

BEHAVIORAL DEFINITIONS
A. See MasterList. B. Unique Definitions 1. 2. 3. 4. 5. 6. 7. . . . Preoccupation with the subject of death. Moody irritability. Isolation from family and/or peers. Deterioration in academic performance. Refusal to communicate openly. Use of street drugs to elevate mood. Little or no eye contact.

LONG-TERM GOALS
1. Elevate the mood and show evidence of the usual energy, activities, and socialization level.2. Show a renewed typical interest in academic achievement, social involvement, and eating patterns, as well as occasional expressions of joy and zest for life. 3. Reduce irritability and increase normal social interaction with family and friends. 4. Acknowledge the depression verbally and resolve its causes, leading to normalization of the emotional state.

*

Most of the content of thischapter (with minor revisions) originates from A. E. Jongsma, Jr., L. M. Peterson, and W. P. McInnis, The Child Psychotherapy Treatment Planner (New York: John Wiley & Sons, 2002). Copyright  2002 by A. E. Jongsma, Jr., L. M. Peterson, and W. P. McInnis. Reprinted with permission.

13

14

THE COMPLETE DEPRESSION TREATMENT AND HOMEWORK PLANNER

. . .

SHORT-TERM OBJECTIVES
1. Completepsychological testing to evaluate the depth of the depression. (1, 2)

THERAPEUTIC INTERVENTIONS
1. Arrange for the administration of psychological testing to facilitate a more complete assessment of the depth of the client’s depression. 2. Give feedback to the client and his/her family regarding psychological testing results. 3. Assess the client’s level of selfunderstanding about self-defeatingbehaviors linked to the depression. 4. Interpret the client’s acting-out behaviors as a reflection of the depression. 5. Confront the client’s acting-out behaviors as avoidance of the real conflict involving his/her unmet emotional needs. 6. Teach the client the connection between angry, irritable behaviors and feelings of hurt and sadness (or assign the exercise “Surface Behavior/Inner Feelings”in the Brief Child Therapy Homework Planner by Jongsma, Peterson, and McInnis). 7. Reinforce the client’s open expression of underlying feelings of anger, hurt, and disappointment. 8. Explore the client’s fears regarding abandonment or the loss of love from others. 9. Ask the client to discuss what is missing from his/her life that contributes to the unhappiness. 10. Probe aspects of the client’scurrent life that contribute to the sadness.

2. State the connection between rebellion, self-destruction, or withdrawal and the underlying depression. (3, 4, 5, 6)

3. Specify what is missing from life to cause the unhappiness. (7, 8, 9)

4. Specify what in the past or present life contributes to sadness. (10, 11)

CHILD

15

5. Express emotional needs to significant others. (12,13, 14)

6. Express feelings of sadness, hurt, and anger in a play-therapy setting. (15, 16)

7. Identify and replace negative self-talk that precipitates feelings of hopelessness, helplessness, and depression. (17, 18)

8. Stop the verbalized interest in the subject of death. (18, 19)

9. Terminate suicidal behaviors and/or verbalizations of the desire to die. (20, 21) 10. Initiate and...