Clinical Depression Case Study

• You are approached by a potential client suffering from clinical depression. He has been treated on and off by doctors for over 20 years, has a lifestyle of moving around and engaging in hedonistic activity. He is not currently registered with a doctor. He wants to use CBT to control his depression alongside smoking cannabis. How would you respond to this case?
1. Only accept him with signed GP consent and liason with the GP in relation to treatment
2. Goals – medication compliance and reduction in Cannabis use
3. Journaling
4. Note cannabis is illegal so it is your duty to report criminal activity therefore you do not want a self-help sheet in his file stating he is a regular cannabis user. Also think about your own ethics, certainly my
He does not want to carry on seeing his psychiatrist, who he hates, and he is refusing his medication. How would you respond to this case?
1. Encourage him to go to his GP, offer to write a letter for him, ask to have his psychiatrist changed and advise of his non-adherence to medication
2. Do not take him on without the full multi-disciplinary package of support in place
• You are approached by a 35 year-old woman who is suffering from Dysphoric Disorder (PDD). She is professional, well-presented and knowledgeable. She is with a number of support groups and seems to know a lot about her condition generally. She has moved to your area and is not yet registered with a doctor, since she prefers herbalism and homeopathy. She is requesting CBT support for managing her condition. How would you respond to this case?
1. She needs to register with her GP and give him details of current self-medication, then she can come back if the GP feels you could
Obtain GP consent
2. This happens regularly enough where CMHT have to adhere to an allocated budget and also use this to manage their waiting lists but I would confirm it just in case. I would contact them with his permission to see what has been done/ worked/ didn’t work as you have an ethical duty not to charge him for something he doesn’t need
3. Coaching style approach with mindfulness will follow counseling and addressing “old” issues
4. You are looking for him to set lifestyle goals, address unaddressed issues from his past and allow him to move on in taking some control of the negative effects of the condition
5. You will need to be assured of continuing medication adherence

• You are approached by a 55 year-old male with a diagnosis of Borderline Personality Disorder. He is in the care of a GP and has had his maximum mandatory CMHT support. He is asking for assistance in managing his condition and controlling his self-medication with alcohol and caffeine. He is afraid to discuss this self-medication with his GP. How would you respond to this case?
1. Obtain GP