Summary: <p>Treatment Planning for Depression<br> Dr. Dawn-Elise Snipes<br> Executive Director: AllCEUs.com<br> Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review and Happiness Isn’t Brain Surgery</p> <p>Objectives<br> ~ Identify instruments to guide treatment planning<br> ~ Identify the causes of depression<br> ~ Identify behavioral interventions<br> ~ Identify cognitive interventions<br> ~ Identify Emotional Interventions<br> Effects of Depression on Treatment<br> ~ The client with depressive symptoms may have difficulty in any or all of the following areas:<br> ~ Ability to follow instructions and keep appointments.<br> ~ Energy to participate in or maintain interest in program activities.<br> ~ Motivation for change.<br> ~ Ability to make appropriate decisions about treatment needs and goals.<br> ~ Belief that he or she can be helped.<br> ~ Responsiveness to reinforcements.<br> ~ Ability to handle feelings.<br> ~ Ability to handle relations with other clients.<br> ~ Ability to attend to (and not disrupt) group activities.<br> ~ Ability to avoid relapse after treatment is completed.</p> <p>Placement Instruments<br> ~ ASAM<br> ~ Acute crisis and dangerousness<br> ~ Biomedical conditions and complications<br> ~ Emotional, behavioral or cognitive issues (See assessment instruments, next slide)<br> ~ Readiness for change for EACH issue/objective<br> ~ Improve mood<br> ~ Address sleep hygiene<br> ~ Improve nutrition<br> ~ Cut out caffeine<br> ~ Increase exercise<br> ~ Relapse or continued problem potential<br> ~ Recovery environment<br> Screening Instruments: Emotional<br> ~ DSM V PROMIS<br> ~ Severity Measure for Depression, Adult(Patient Health Questionnaire [PHQ-9])<br> ~ Zung Self-Rating Depression Scale<br> ~ Center for Epidemiologic Studies Depression Scale (CES-D), NIMH<br> ~ Severity of Posttraumatic Stress Symptoms, Adult (National Stressful Events Survey PTSD Short Scale [NSESS])<br> ~ Severity Measure for Generalized Anxiety Disorder, Adult</p> <p>Screening Instruments: Cognitive<br> ~ Attributional Style<br> ~ Hardiness and Perceived Stress Scales<br> ~ Stress Awareness/Hardiness<br> Causes of Depression<br> ~ Biochemical imbalance<br> ~ Norepinepherine (focus, motivation)<br> ~ Serotonin (contentment, relaxation, pain, sleep, hunger, heart rate)<br> ~ Dopamine (motivation/pleasure, memory, focus, pain)<br> Causes of Depression<br> ~ What is causing the biochemical imbalance<br> ~ Physical<br> ~ Lack of quality sleep<br> ~ Exhaustion/burnout<br> ~ Poor nutrition<br> ~ Chronic pain<br> ~ Diabetes<br> ~ Thyroid and sex hormone imbalances<br> ~ Vitamin D deficiency<br> ~ Hypocortisolism/Adrenal Fatigue<br> ~ Anemia<br> ~ Side effects of medications<br> ~ Other illnesses such as MS, lupus, fibromyalgia, chronic fatigue, lyme disease, stroke…<br> Interventions Physical<br> ~ Changing Behaviors<br> ~ Identify a behavior that can be addressed:<br> ~ Keep it simple and achievable.<br> ~ Break big problems down into smaller, achievable components.<br> ~ Identify the goal (outcome) the client would like to achieve:<br> ~ Make the goal measurable so the client can know when he or she has achieved it.<br> ~ Explore ways the client has achieved similar goals in the past.<br> ~ Identify barriers (internal and environmental) to success and identify what parts the client can control.<br> ~ Identify how those barriers can be overcome in specific behavioral terms. Make addressing the barrier something to do, rather than something not to do.<br> ~ Identify supports and specific steps needed to achieve success<br> ~ Elicit a commitment and take action to achieve the goal</p> <p>Interventions: Physical<br> ~ Get a physical to rule out hormone imbalances, physical issues causing lack of energy, fatigue, difficulty concentrating, sadness, irritability<br> ~ Address nutrition to provide </p>
