IPT and ACT Treatment Plan for Mild Depression Case Study
This paper presents a clinical treatment plan for a client referred to as Dawn, a graduate student experiencing anxiety, sleep disruption, and stress linked to parental academic pressure. Using DSM-5 criteria, the paper proposes a diagnosis of mild major depressive disorder (F32.0) and recommends Interpersonal Therapy (IPT) as the primary modality, supported by research demonstrating IPT's efficacy over both medication and cognitive behavioral approaches. The paper outlines a structured IPT framework including an interpersonal inventory, psychoeducation about depression, symptom monitoring, and targeted communication strategies. Acceptance and Commitment Therapy (ACT) is discussed as a potential complementary approach. The treatment goals center on empowering Dawn to manage parental pressure, reduce alcohol reliance as a sleep aid, and reconnect with intrinsic academic motivation.
- Diagnosis and Assessment: DSM-5 diagnosis and Ham-D scoring for Dawn
- Rationale for Interpersonal Therapy: Research evidence supporting IPT over alternatives
- Initiating the IPT Treatment Plan: Psychoeducation, inventory, and early therapy steps
- Treatment Goals and Specific Interventions: Coping goals, parental dialogue, and alcohol use
- Prognosis and Long-Term Outcomes: Expected recovery and communication skill development
- References: APA-formatted citations for all sources used
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What makes this paper effective
- The paper grounds clinical recommendations in peer-reviewed evidence, citing a meta-analysis by deMello et al. (2005) to justify the preference for IPT over medication and CBT.
- It applies theoretical frameworks (IPT and ACT) directly to the client's presenting problems, moving seamlessly from diagnosis to rationale to structured intervention steps.
- The paper acknowledges the limitations of DSM-5 diagnoses and integrates a transdiagnostic perspective through its discussion of ACT, showing critical awareness of diagnostic tools.
Key academic technique demonstrated
The paper demonstrates evidence-based clinical reasoning: the student does not simply select a therapy modality but justifies it using a hierarchy of evidence, beginning with a meta-analysis and supplementing with theoretical literature. This shows how academic sources can be used to build a persuasive and clinically defensible argument rather than merely to cite authority.
Structure breakdown
The paper opens with diagnosis and assessment, including a Ham-D score estimate and DSM-5 code. It then builds the case for IPT using published research. The middle sections detail the treatment plan step by step — beginning with psychoeducation, proceeding through the interpersonal inventory, and culminating in specific intervention goals. The paper closes with a forward-looking prognosis emphasizing autonomy and coping skill development. References follow APA format throughout.
Diagnosis and Assessment
Given Dawn's presenting problems — including a sleep-related disorder and anxiety symptoms — it is possible that she may be diagnosed with mild depression, or, to use the DSM-5 code, F32.0: Major Depressive Disorder, Single Episode, Mild. Measured on the Hamilton Depression Rating Scale (Ham-D), Dawn's score would likely fall between 9 and 12 (Weissman, Markowitz & Klerman, 2007). However, monitoring Dawn over time will be necessary to determine whether the depression is recurrent.
It is unclear precisely when her feeling stressed about her grades began, or when her sleep patterns first became disrupted. Therefore, if a DSM-5 diagnosis is necessary, the F32.0 diagnosis is the most appropriate for now. As Hayes, Pistorello, and Levin (2012) point out, 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.
Rationale for Interpersonal Therapy
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, 2012).
In Dawn's case, Interpersonal Therapy (IPT) is indicated due to the proven efficacy of the modality. deMello, Mari, Bacaltchuk, and Neugebauer (2005) performed a meta-analysis and found that IPT produces results comparable to medical interventions for depression, and that outcomes "did not increase when combined with medication" (deMello et al., 2005, p. 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 in treating depression than cognitive behavioral therapies. Because IPT has demonstrated results specifically with depression, it is recommended to proceed with Dawn's treatment using IPT.
Initiating the IPT Treatment Plan
Dawn's treatment plan within an IPT framework will begin with a brief explanation of the treatment and its theoretical basis. The therapist can explain what depression is and why Dawn is believed to exhibit its symptoms. Dawn's use of alcohol to fall asleep should not be viewed as a sign of substance abuse at this time; she only recently "discovered" alcohol's ability to help her relax. The therapist's goal is to prevent Dawn's use of alcohol from becoming habituated, from impeding the goals of therapy, or from leading her to reach for other sleep aids that may contain opioids. All of this should be communicated to Dawn immediately, and her responses actively solicited. Medication is contraindicated — not only because the deMello et al. (2005) study shows that IPT is more efficacious than medication, but also because combining the two does not lead to improved outcomes.
Reviewing Dawn's "interpersonal inventory," as suggested by Weissman, Markowitz, and Klerman (2007), would be the next step in treatment. IPT is designed to help the client contextualize her problems within an interpersonal framework — in Dawn's case, her relationship with her parents. Helping Dawn draw a direct connection between her anxiety, sleeplessness, and parental relationship will allow the IPT process to begin in earnest. Dawn may also be given a symptom checklist to help the therapist better target interventions and make more accurate diagnoses over time. The therapist can help Dawn see that these are "symptoms and not personal flaws" (Weissman, Markowitz & Klerman, 2007, p. 13). The checklist also enables the therapist to educate Dawn about the nature of depression, helping her understand why she feels as she does and how interpersonal therapy can help. At this stage, the therapist might also recommend concurrent modalities such as ACT, which Dawn may appreciate if she has prior experience with mindfulness techniques or wishes to incorporate mindfulness as part of her ongoing strategy.
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