Dawn's presenting problems, such as a sleep-related disorder and anxiety symptoms, it is possible that she may be diagnosed with a mild depression, or to use the DSM-V code, F32.0 Major depressive disorder, single episode, mild. Measured on the Ham-D scale of depression, Dawn's score will likely fall between 9-12 (Weissman, Markovitz & Klerman, 2007). However, monitoring Dawn over time will be necessary to see if the depression is recurrent.It is unclear when her "feeling stressed" about her grades began, exactly, or when her sleep patterns started to be disrupted. Therefore, if a DSM-V diagnosis is necessary, the F32.0 diagnosis is the most sensible for now. As Hayes, Pistorello & Levin (2012) also point out, the DSM diagnoses are limited in applicability and accuracy. They have "failed to give rise to functional diagnostic entities, which is a major goal of syndromal diagnosis," (p. 976). The process of diagnosis also occurs in the absence of theory. Theories like Acceptance and Commitment Therapy (ACT) offer "a unified model of behavior change applicable to human beings in general, not just those fitting certain diagnostic criteria," (Hayes, Pistorello & Levin, 2012, p. 978). ACT also avoids overreliance on diagnoses (Hayes & Lillis, 2012; Twohig, M.P., 2012).
In Dawn's case, Interpersonal Therapy (IPT) might be indicated due to the proven efficaciousness of the modality: deMello, Mari, Bacaltchuk & Neugebauer (2005) performed a meta-analysis and found...
75). IPT also offers a "time limited" method of helping Dawn, who may benefit from a targeted and brief approach. deMello, et al. (2005) also found that IPT proved more efficacious when treating depression versus cognitive behavioral therapies. Because IPT has proven results with depression specifically, it is recommended to proceed with Dawn's treatment using IPT.
Dawn's treatment plan within an IPT framework will begin with a brief explanation of the treatment and theory. The therapist can explain what depression is and why it is believed Dawn exhibits symptoms. Dawn's use of alcohol to fall asleep should not be viewed as a sign of substance abuse at this time; she only "discovered" her appreciation of alcohol's ability to relax her recently. The therapist's goal is to prevent Dawn's use of alcohol from becoming habituated, to impede the goals of therapy, or to lead to her reaching for other sleep aids that may contain opioids. All this should be told to Dawn immediately, and her responses solicited. Medication is contraindicated, not only because of the deMello, et al. (2005) study showing that IPT is more efficacious than medication, and does not lead to improved results when used concurrently with medication.
Reviewing Dawn's "interpersonal inventory," as…
