Psychoeducational Cognitive Behavioral Group Therapy for Divorced Women Experiencing Anxiety and Depression
August 20, 2012
Axis I300.02 Generalized Anxiety Disorder
296.23 Major Depressive Disorder, Single Episode, Severe without Psychotic Features Axis IIV71.09 No diagnosis
Axis IVProblems with primary support group, problems related to the social environment, occupational problems, problems related to interaction with the legal system Axis VGAF 50 (current); GAF 91 (highest past year)
Patient is experiencing depressed mood for most of the day and has feelings of excessive guilt and worry. Patient is unable to sleep and has been unable to concentrate. Patient is easily fatigued, irritable, and has been unable to control her excessive worrying for over six months.
Will need to identify and alter the dysfunctional thought patterns, attitudes and beliefs, which may trigger and perpetuate the patient’s anxiety and depression.
The patient presents increasingly depressed mood with excessive worrying and anxiety. Since her divorce, she has an intense fear of social situations and believes that her life is “over” that her mood is “pretty down most of the time.”
Education and Employment History:
Patient indicated that she reached milestones at the appropriate time during her childhood development. She maintained A’s and B’s in school. Patient currently works as a teacher at a high school.
Medical and Psychiatric History:
Patient reported no previous medical or psychiatric problems.
Substance Abuse History:
Patient reported no history of drugs.
Patient was divorced within the last year.
Patient indicates that she has never had difficulty maintaining friendships and was “quite popular” in high school. Patient exhibits poor coping skills and has low self esteem since her divorce.
Patient was dressed in clean clothing and her hair and make-up were neatly done. Her mood throughout the interview was level. Her emotional reactions were appropriate. Patient had no trouble recalling her history. She had no problems with orientation to person, place, time and situation.
1. Complete structured interview, such as Beck Depression Inventory (BDI) 2. Cognitive Restructuring through Cognitive Behavioral Therapy, individual counseling, twice weekly for 60-90 minute sessions, for approximately 4-6 months and group counseling, one weekly for 60-90 minute sessions, for approximately 8 weeks to increase self awareness, improve self esteem and self control, and instill positive, healthy coping skills in place of the negative coping skill of restricting food 3. Patient education to help patient identify and change their irrational thoughts and to make real changes through specific behavioral interventions
1. Regular sleep
2. Recognize triggers that cause irrational beliefs
3. Introduce exercise
4. Stabilize mood with medication or increasing personal activities, such as getting a manicure or a massage Beginning Stage Interventions:
1. Establish collaborative relationship with the client 2. Introduce thought journal to keep record of irrational thoughts 3. Introduce thought cards
Progressive Stage Interventions:
1. Maintain the collaborative relationship with the client 2. Introduce relaxation exercises
3. Education regarding healthy coping skills
1. Maintain rational thoughts
2. Maintain exercising at least 3-4 times per week
3. Prevent relapse
Psychoeducation Cognitive Behavioral Group Therapy for
Divorced Women Experiencing Anxiety...