Psychodynamic Case Study Maggie's Depression

The most effective therapeutic approach for Maggie’s depression is cognitive therapy or cognitive behavioral therapy (CBT) because studies have shown it to be as effective as antidepressents in treating depression. Studies have also shown it to be effective at reducing relapses in patients after therapy. Cognitive behavioral therapy is different from other therapies because it is short, taking only five to ten months for most mental problems and often requiring only 10 to 20 sessions. The focus and method of CBT is also different. CBT is a more short-term approach than psychodynamic (psychoanalysis) therapies. Other types of therapies may require several years for discovery and treatment. CBT involves changing thinking patterns and focuses

on what and how a person thinks more than why a person thinks that way. Sessions provide patients an opportunity to identify current life situations that may be causing or contributing to their depression. This is different from psychoanalysis. That type of therapy involves looking to the past to discover unconscious sources of the problems that the patient is facing. CBT is also goal-oriented and educational. Therapists use structured learning experiences that teach patients to monitor and write down their negative thoughts and behavior patterns. The goal is to see how these negative thoughts affect their mood, behavior, and psychical condition. CBT therapists also teach important coping mechanisms, such as learning to control and modify distorted thoughts and reactions.
The main issue we need to consider when determining which type of therapeutic approach to use for Maggie’s depression is the underlying factors that are causing her depression.

Psychodynamic therapy is based on the belief that a person is depressed because of unresolved, unconscious conflicts that occur during childhood. Humanistic therapy helps individuals understand their feelings, gain a sense of meaning in life, and reach self-actualization. Behavioral therapy is based on the idea that maladaptive behavior is learned, and thus adaptive behavior can also be learned. The goal is to teach new behaviors to minimize or eliminate problems, rather than focusing on the unconscious mind. Cognitive therapy or CBT seeks to modify negative thought patterns in order to change moods and behaviors. It’s based on the belief that negative moods and behaviors are the result of current dysfunctional thoughts or beliefs. According to this case study, Maggie has very high standards for herself and is very self-critical. She also struggles with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past. It seems that Maggie is suffering from dysfunctional thinking which is also affecting her mood and behavior towards her coworkers and husband. So it appears that CBT is the best approach to her depression. Maggie needs help identifying and changing her dysfunctional thinking which will change her mood and

behavior.
CBT would view Maggie’s depression as a direct result of her negative dysfunctional thinking. Maggie’s inaccurate perceptions about herself and her abilities are causing her to have feelings of worthlessness and shame. This is causing her to have depressive symptoms such as mood and behavior changes, dissatisfaction with life, disrupted sleep, her lack of interest in sexual activity, loss of concentration, fatigue or tiredness during the day, and suicidal thoughts. At the core of CBT is the idea that a person's mood is directly related to his or her patterns of thought. Negative, dysfunctional thinking can affect a person's mood, sense of self, behavior, or physical condition. Some examples of dysfunctional thinking include overgeneralization: drawing general conclusions from a single usually negative event, such as thinking that one bad grade makes you a failure, and maximization/minimization: maximizing your problems or blowing the effects of them out of proportion to the situation or minimizing the value of your positive qualities. These negative thought patterns can take the form automatic thoughts. The goal of CBT is to help a person learn to recognize negative thought patterns, evaluate their accuracy, and replace them with more healthy ways of thinking. Therapists also help patients change patterns of behavior that come from dysfunctional thinking. Negative thoughts and behavior can make a person more susceptible to depression and make it nearly impossible to break free from its downward spiral. According to cognitive behavioral practitioners and researchers, when negative patterns of thought and behavior are changed, so is mood. In this case if Maggie’s negative thought patterns are changed so will her mood and behavior.
Each therapy session would involve analyzing Maggie’s negative thoughts, feelings, and behaviors to work out if they’re inaccurate or harmful and determine the effects that they have on each other and on Maggie. To help with this Maggie should keep a diary or write down her negative thoughts and behavior patterns. I would then help Maggie to work out how to change her unhelpful thoughts and behaviors. After working out what Maggie can change, I would ask her to practice these changes in her daily life. This would involve questioning negative thoughts and replacing them with more accurate and healthy ones, or engaging in pleasurable activities that make her happy. Maggie would also be taught coping methods, such as learning to control and modify her negative thoughts and reactions, practicing self-talk that is accurate and balanced, and using self-evaluation to reflect and respond appropriately. Doing some homework between sessions is also vital to helping her with this process. At each session Maggie should discuss with me how she’s been doing with putting the changes into practice and how it makes her feel. During sessions, I would check to see that Maggie is comfortable with the progress that she is making. One of the great benefits of CBT is that after the therapy is over, Maggie can continue to apply the principles and coping methods learned to her daily life. This should make it less likely that her symptoms will return. My therapeutic goals would be to terminate therapy as soon as I see and confirm with Maggie that her depressive symptoms are gone and that she is competent at the skills and principles that she was taught in the sessions.
Studies have shown that anyone suffering from depression can likely benefit from CBT, even without taking psychiatric medications.

Although many people respond well to cognitive behavioral therapy, experts point out that the type of person likely to get the most benefit from it is someone who is motivated, sees themselves as able to control events that happen around them, and has the capacity for introspection. Cognitive behavioral therapy introduces patients to a set of skills and principles that they can apply whenever they need to, and that’ll last them for the rest of their lives. CBT can significantly reduce the symptoms of many mental disorders and clinical trials have shown this. When patients are followed up two years after therapy has ended, many studies have shown a marked advantage for CBT. For example, just twelve sessions of CBT can be as helpful in treating depression as taking medication throughout the two years after therapy. This research suggests that CBT helps bring about a real change that goes beyond just feeling better while in therapy. Maggie can get the most benefit from CBT if she remains motivated throughout treatment. The support of Maggie’s husband and close friends can also assist with her treatment by helping to remind and encourage Maggie to complete all essential parts of her treatment such as attending every therapy session, taking psychiatric medications if she is prescribed, and completing homework assignments. Maggie’s husband can also

attend a few sessions to learn about what’s causing her depression and CBT and learn specific ways in which he can support or assist Maggie through her treatment.