Strengths Based Approach for Depression

Life-Stage Considerations: Strengths-Based Approach
Introduction
A strengths-based approach to treatment resonates greatly with resiliency models involving patients and their families, as well as family-focused care grounded in mutually helpful practitioner-patient family therapeutic relationships. In this sort of care setting, patients and their family members actively engage in identifying concerns or issues, making decisions, and formulating steps for patient health restoration and promotion (Swartz, 2017, p. 1). In particular, Ballantyne and Gan (2016, p. 233) delineate a solutions-oriented or strengths-grounded intervention approach for families of teens suffering from severe brain damage. According to the authors, every household possesses the strength, capability, and resources for recovering from adversity. Additionally, they explain that unlike the conventional clinical model, strengths-based therapy revolves around strengths as opposed to deficiencies, promotes teamwork as against hierarchy, makes use of resources as against expert opinion, emphasizes skills and solutions as opposed to what must be resolved, and concentrates on what works as against what doesn't.
The relationship between strengths-focused care and resilience theory within the context of nursing literature has been expounded upon further by Gottlieb (2014, p. 26), whose work describes a comprehensive strengths-based nursing care approach. In simple terms, strengths-based nursing care offers an alternate model to the initial deficiencies- based one whilst collaborating with patients. It concentrates on a broad understanding of deficiencies. Nursing personnel who apply this model attempt at identifying patients and their family members' skills, capabilities, and competences. Through identification and mobilization of patient/family resources, capabilities, and fortes, nursing staff are able to further guide and promote recovery of patients in collaboration with patients and their family members, whilst simultaneously supporting resiliency. Hence, the healthcare system responds better to individual patient families' distinctive needs, empowering them to deal with their own healthcare needs.
Health Promotion
The process of health promotion entails enabling individuals to better control and improve their personal health. It is an all-encompassing political and social process that espouses actions aiming to strengthen individual capabilities and skills as well as actions targeted at effecting changes in social, economic, and environmental conditions, for lessening their influence on individual and community health. Lastly, health promotion enables individuals to improve control over health determinants, thus improving their health. Involvement proves crucial to sustaining health promotion activities (World Health Organization, 1998, p. 11).
This paper adopts a strengths-based approach as well as the health promotion concept based on a case study scenario analysis.
Discussion
This case study revolves around, Susanna, an unmarried mom of three children, who is raising them by herself while her significant other, Aaron, the father of her children, serves a prison sentence for drug use charges. One of her children, Fiona, has been brought to the emergency room for treating a foot burn that occurred a few days ago. Susanna fears the wound is now infected. The ER staff member treating Fiona's wound notes a dirty dressing that isn't well- adhered to her skin. Further, Susanna has come with both her other children as well, who are without shoes. She admits to struggling with finances and doesn't know what to do and how to handle things without Aaron. She struggles with simple grocery and rent costs and is wondering how to work things out the next month. Her relationship with Aaron's mother is strained. Further, a delayed period causes her to believe she may be expecting once again. All the above information garnered for her suggests she is psychologically exhausted, vulnerable, and utterly anxious. She cannot adequately care for her children in such a frame of mind. She may be prone to depression, and one depression theory, namely, the Hopelessness Theory of Depression, may be related to this case. According to this theory, the interaction of negative cognition with negative occurrences in life gives rise to a feeling of hopelessness which, successively, is theorized to suffice, in itself, to cause depression. This theory, to the extent that a cognitive diathesis is a trait-like, stable construct, explains initial depression onset as well as its recurrence/ relapse (Liu, Kleiman, Nestor & Cheek, 2015, p. 349).
In addition, the theory of hopelessness puts forward the idea of the presence of a discrete cognitively mediated depression subtype, namely, hopelessness depression; here, hopelessness particularly results in this subtype. The conditions for a hopelessness depression diagnosis are no less than a fortnight of experiencing hopelessness along with a minimum of 5 out of the 11 symptoms listed as follows: unhappiness, tiredness, slow voluntary reaction initiation, suicidal conduct or thoughts, disturbed sleep with initial sleeplessness, self- blame, difficulty concentrating, anxiousness, psychomotor retardation, dependency, and low self- esteem. Nevertheless, hopelessness depression overlaps with other kinds of depression to a certain degree; for instance, it is believed to encompass cases of acute depression, endogenous depression, and dysthymia (Liu et al., 2015, p. 349). Susanna presents the above symptoms. For instance, she is tired, utterly despondent, upset, holds herself guilty for things going wrong in her life, and suffers from low self- esteem. Moreover, she cannot perform routine tasks linked to taking care of herself and her three children.
When an individual starts facing difficult times or a difficult stage of life, he/she will naturally shift his/her focus to the problems plaguing him/her, investing efforts into resolving those issues. Just as a mechanic first determines the cause underlying a damaged motor and attempts to fix that damaged element, individuals tend to first attempt at determining the source of their symptoms (for instance, anxiety), followed by attempting to come up with strategies for diminishing their frequency and intensity (for instance, breathing methods, logical analysis, cognitive approaches, and so forth). Though the strategy may prove useful, it may also end up causing one to solely concentrate on the issues one encounters, whilst failing to look at one's other aspects, namely, one's fortes. In certain situations, this may result in decreased self-confidence, and might even aggravate symptoms. A growing pool of evidence exists in support of the notion that concentrating and improving on one's internal strengths may prove to be just as effective as, or probably even more effective as compared to, concentrating only on one's symptoms (Ditton, 2015).
The single most salient factor in the strengths-based approach is the client's responsibility to effect change. Further, the client must identify his/ her fortes. In Susanna's case, resilience is her strong point. She was sufficiently resilient to keep away from drugs for her kids and bring her life on track. She stayed away from them, knowing it would have consequences, in the long run, both for herself and her entire family. Additionally, her strength is manifested in how she is raising her children all by herself while their father serves a prison sentence. But she is psychologically crumbling and struggling to cope with things now. She can better control her life and issues if she realizes the strengths she possesses and how she should apply them. Lastly, she needs to be responsible for her own wellbeing and health.
Depression-related risk factors with regard to Susanna are stress, substance abuse, and sadness. Stressful occurrences in life that overwhelm individuals and their coping skills may lead to depression. According to experts, high cortisol hormone levels, secreted when a person is stressed out, can impact neurotransmitter serotonin levels, resulting in depression. Susanna grieves over her partner, Aaron, languishing in jail. Owing to his conviction, he has also been deprived of his apprenticeship, meaning he won't have a job after getting back from prison. Susanna currently survives on Centrelink payments made once in two weeks, though some of her money is currently being withheld as debt repayment since was paid extra earlier, having failed to have declared her de- facto relationship. While her grief symptoms will probably diminish with time, an aggravation of symptoms might end in depression. Finally, she did take drugs previously. All of the abovementioned risk factors make Susanna vulnerable to depression.
The strengths-based approach encompasses the following strategies: All individuals possess some or other strengths that they can apply for improving their quality of life. Additionally, the patient's motivation to lead a better life arises out of focus on his/ her strengths. Lastly, all environments comprise of resources that aid individuals in cultivating or honing their respective strengths. In the case of Susanna, the strengths noted were robustness of nature and resilience. She must, however, realize these strengths within herself and apply them to make her life better. The strengths-based therapeutic approach indicates patient communities and families might form part of their resources for developing their strengths. Psychological health practices can team up with institutions in the local community for the purpose of identifying and coming up with informal support systems for patients, or for providing them with facilities for organizing activities or meetings. Psychological health practices may develop a more formal structure calling for patient engagement as well as familial and community input. Those suffering from mental health issues may facilitate their own recovery by means of meaningful activities. Meetings, social interventions for patients, their families, and providers, and informative/ educational sessions may be made a part of this formalized structure (Xie, 2013).
Susanna will be aided with strengths-based therapeutic activities through forging a meaningful, help- based relationship, characterized by cooperation, teamwork, and mutuality. She will direct this helping effort, with providers functioning in the capacity of caring consultants. Further, providers will help her inculcate more faith in herself to control her life and situations. Her desired goals in life will be determined and steps adopted for fulfilling them. Informal conversations with clients are recommended as a means of discerning their strengths. For clients who struggle with identifying their own strengths, providers must interact with them, posing general questions pertaining to their leisure activities or hobbies, or their previous means of coping with an acute disease phase. Moreover, patients may be requested to mull over their workplace, academic, or personal achievements. Using the strengths identified, providers can collaborate with patients in identifying strengths that they may apply in order to cope with their current problems. Subsequently, they can formulate a plan for the utilization of these strengths, establishing plan targets, and arriving at details in consultation with the patient.
Conclusion
To sum up, this paper describes how a strengths-based therapeutic approach can be utilized in promoting health and wellbeing in the case of Susanna. The mental health practice has mostly been influenced by a clinical model in which emphasis is given to the resolution of issues and controlling mental illness symptoms. This approach concentrates on clients' positive aspects. Identifying and taking advantage of their strengths can lead them through a successful recovery. Nurses, by adopting a patient-focused care approach, are ideally-positioned to promote this approach. The forging of a partnership between providers, community agents, and patients, besides the implementation of specific practices and policies, can help minimize or entirely overcome the challenges potentially linked to the strengths-based therapeutic approach (Xie, 2013).
References
Ditton, L. (2015). Depression Treatment: Strengths-based Approaches. Available at http://www.esteempsychology.com.au
Gan, C., & Ballantyne, M. (2016). Brain injury family intervention for adolescents: A solution-focused approach. NeuroRehabilitation, 38(3), 231-241.
Gottlieb, L. (2014). Strengths-based nursing: A holistic approach to care, grounded in eight core values. American Journal of Nursing, 114(8), 24-32.
Liu, R. T., Kleiman, E., Nestor, B., Cheek, S. (2015). The Hopelessness Theory of Depression: A Quarter Century in Review. Clin Psychol, 22(4), 345-365. DOI:10.1111/cpsp.12125.
Swartz, M. K. (2017). A Strength-Based Approach to Care. J Pediatr Health Care, 31, 1-1. Available at https://www.jpedhc.org/article/S0891-5245(16)30281-4/pdf
World Health Organization. (1998). Health Promotion Glossary. World Health Organization. Available at https://www.who.int/healthpromotion/about/HPR Glossary 1998.pdf?ua=1
Xie, H. (2013). Strengths-Based Approach for Mental Health Recovery. Iran J Psychiatry Behav Sci, 7(2), 5-10. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939995/