DEPRESSION

BEHAVIORAL DEFINITIONS
. Demonstrates sad or flat affect.
. Reports a preoccupation with the subject of death.
. Reports suicidal thoughts and/or actions.
. Exhibits moody irritability.
. Isolates self from family and/or peers.
. Deterioration in academic performance.
. Lacks interest in previously enjoyed activities.
. Refuses to communicate openly.
. Demonstrates low energy.
. Makes little or no eye contact.
. Frequently expresses statements reflecting low self-esteem.
. Exhibits a reduced appetite.
. Demonstrates an increased need for sleep.
. Exhibits poor concentration and indecision.
. Expresses feelings of hopelessness, worthlessness, or inappropriate guilt.
. Reports unresolved feelings of grief.
. Uses street drugs to elevate mood.

LONG-TERM GOALS
. Elevate mood and show evidence of usual energy, activities, and socialization
level.
. Renew typical interest in academic achievement, social involvement, and eating
patterns as well as occasional expressions of joy and zest for life.

. Reduce irritability and increase normal social interaction with family and friends.
. Develop healthy cognitive patterns and beliefs about self and the world that lead
to alleviation and help prevent the relapse of depression symptoms.
. Develop healthy interpersonal relationships that lead to alleviation and help
prevent the relapse of depression symptoms.
. Appropriately grieve the loss in order to normalize mood and to return to previous
adaptive level of functioning.

SHORT-TERM OBJECTIVES

.
Describe current and past experiences with depression complete with its
impact on function and attempts to resolve it.

Verbally identify, if possible, the source of depressed mood.

.
Complete psychological testing to assess the depth of depression, the need
for antidepressant medication, and suicide prevention measures.

.
Provide behavioral, emotional, and attitudinal information toward an
assessment of specifiers relevant to a DSM diagnosis, the efficacy of treatment,
and the nature of the therapy relationship. , , , ,

Verbalize any history of suicide attempts and any current suicidal urges.

Comply with recommendations for reducing urges to harm self.

.
Take prescribed psychotropic medications responsibly at times ordered by
physician. ,

Participate in cognitive behavioral therapy for depression. ,

.
Parents and child learn about depression, factors that influence its
development and continuance, and methods for overcoming and preventing its
relapse.

.
Identify and replace depressive thinking that leads to depressive feelings and
actions. , , ,

.
Learn and implement calming skills to reduce overall tension and moments of
increased anxiety, tension, or arousal. ,

.
Learn and implement personal skills for managing stress, solving daily
problems, and resolving conflicts effectively.

Learn new ways to overcome depression through activity.

.
Learn and implement social skills to reduce anxiety and build confidence in
social interactions.

Initiate and respond actively to social communication with family and peers. ,

.
Discuss current personal and/or interpersonal conflicts/problems with
therapist. ,

Verbalize any unresolved grief issues that may be contributing to depression.

Implement a routine of physical exercise.

Learn and implement relapse prevention skills.

.
State the connection between rebellion, self-destruction, or withdrawal and
the underlying depression. , ,

Specify what is missing from life to cause the unhappiness. ,

Specify what in the past or present life contributes to sadness. ,

Express negative feelings through artistic modalities. ,

.
Participate in family therapy to improve relationships and support among
members.

Improve academic performance as evidenced by better grades and positive

teacher reports.

Adjust sleep hours to those typical of the developmental stage.

Eat nutritional meals regularly without strong urging from others.

Express feelings of sadness, hurt, and anger in play therapy sessions. ,

.
Verbalize the changes that would result in a reduction of sadness and an
increase in hope and meaningfulness in life.

DIAGNOSTIC SUGGESTIONS

Using DSM-/ICD--CM/ICD--CM:
ICD--CM ICD--CM DSM- Disorder, Condition, or Problem
.
F.
Adjustment Disorder, With Depressed Mood
.xx F.xx Bipolar I Disorder
.
F.
Bipolar II Disorder
.
F.
Persistent Depressive Disorder
.xx F.x Major Depressive Disorder, Single Episode

.xx
V.

F.x
Z.

Major Depressive Disorder, Recurrent Episode

Uncomplicated Bereavement

Notas sobre: Arthur E. Jongsma, Jr. The Child Psychotherapy Treatment Planner.
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