Assignment: Treating Miranda’s depression.

Assignment: Treating Miranda’s depression.

Respond by Day 5 to at least two colleagues with two or three strategies your colleague might apply in treating Miranda’s depression.

Colleague 1: Tiffany

I would use The Hamilton Depression Rating Scale on Miranda also known as the HAM-D. The HAM-D is designed to rate the severity of depression in patients. Although it contains 21 areas you have to  calculate the patient’s score on the first 17 answers. The client filling out the HAM-D would circle the answer that best describes how they feel.

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I would ask Miranda to complete this scale after we talked a few minutes. I would ask her to be honest with her answers so I would know how to address her issues better. I would also remind her of the confidentiality between client and social worker. I would remind her everything she tells me or circles on the scale would be confidential, unless she told me she had a plan to hurt herself or someone else. I think the target population would be young adults to middle age adults using this scale. There is a geriatric scale and a children’s scale that would be a better fit for that population. I would ask Miranda how often or how long does she sleep. I would ask Miranda what time of day does she eat a lot, what are her hobbies, does she enjoy doing the thing that use to make her happy.

A red flag would be staying in the bed too much, calling in to work a lot, eating heavy at night, not keeping herself or her home clean. Giving away personal items that use to mean a lot to her.

I would use the Columbia Suicide Severity Rating Scale also know as C-SSRS on Miranda if some of the red flags come up in our assessment.

References

Hawkins, R. L., & Kim, E. J. (2012). The socio-economic empowerment assessment: Addressing poverty and economic distress in clients. Clinical Social Work Journal, 40(2), 194–202.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

http://www.assessmentpsychology.com/HAM-D.pdf

Colleague 2: Dawn

The DSM-IV assessment is my scale of choice. It includes descriptions and criteria for diagnosing disorders and key clinical features. It also includes background information, such as research findings, age, culture, or gender trends and each disorders risk course, complications, predisposing factors and family patterns. DSM-IV requires clinicians to evaluate a client’s condition on five separates axes, or branches of information; including, when making a diagnosis (Comer, 2011).

DSM-IV is useful for diagnosing such disorders as mood, anxiety, somatoform, and personality to name a few. Miranda was ultimately diagnosed with panic disorder and major depressive disorder; however, the range of Miranda’s symptoms and circumstances made it difficult to narrow down one assessment tool. The DSM-IV offers a multi-axis approach that allows the social worker to focus on PIE. It also includes cultural formations and Culture Bound Syndromes (Holosko, Dulmus, & Sowers, 2012) which may be used when taking Miranda’s Scottish heritage into account. Other questions to ask Miranda to help with her diagnosis may be about her past or present medications and culture specific questions such as the mindset toward therapy.

Suicide may be a difficult subject, but it is one that cannot be avoided especially when treating with clients with a mental disorder or who suffer from the effects of trauma. In completing a comprehensive assessment in which the client speaks of feelings of hopelessness, the social worker should not avoid introducing the discussion of suicide, because it is a misconception that talking about suicide will give a client the idea (Holosko, et.al., 2012).

Most people who have suicidal thoughts will not complete suicide, however, it is a major risk factor (Holosko, et. al. 2012). Miranda said she was not having suicidal/homicidal ideation but verbalized feelings of wanting to be dead, which, again, is a risk factor (Plummer, Makris, & Brocksen, 2014). The severity of Miranda’s risk level may be measured using the Scale for Suicidal Ideation (SSI). The SSI was designed to quantify the intensity of current conscious suicidal intent by scaling various dimensions of self-destructive thoughts or wishes (Ghasemi, Shaghaghi, & Allahverdipour, 2015). The scale should be used in conjunction with other assessment measures and can be updated during further assessment to check for changes in risk levels.