Population and Problem Selected
The selected population is adolescents. It can be argued that adolescents are individuals between the ages of 10 and 19 years. At the beginning of this age bracket, many individuals start to acknowledge their unique features. This is further enhanced by physical growth as the human body changes from that of a child to that of an adult. Critically, all these changes affect the mental health of adolescents. Although the issue of mental health has not been given much attention, especially for adolescents, there is a need for the same due to the concern of identity. It should be noted that people start to develop their identity at this crucial stage. The assignment will look into one of the numerous mental issues that affect adolescents based on this. Critically, the issue of depression is pronounced in the age bracket due to confusion brought on by the changes happening and also peer pressure.
Review of Articles
A review of articles that have been used in the project reveals two main things. The first is that there have been numerous attempts to treat adolescent depression. This has led to a large database of information on the topic. The information is easily accessible via both digital and physical libraries. This is important to note due to the fact that the influx of information can cause confusion as numerous studies have different conclusions on the best treatments for adolescent depression. To ensure that the articles read were at par with the requirements of the course, only peer-reviewed journals were used. This ensures that the information is not only of quality but also that it can be replicated elsewhere. Further, all articles that were used were not older than 5 years. This is to ensure that the information gathered and cited in the assignment is recent.
Secondly, the review revealed that there are two main ways of dealing with adolescent depression. These two interventions are interpersonal psychotherapy and cognitive-behavioral therapy. They will be discussed further in the essay. A key lesson learned when undertaking the assignment and selecting the right articles to cite is that there is a critical need for more studies on the topic. Indeed, although there is numerous information online about the topic, there are few recent studies that have been published in peer-reviewed journals.
There are numerous programs and interventions that have been used as a treatment for adolescent depression. However, for the purpose of this assignment, two evidence-based interventions will be highlighted. The first is interpersonal psychotherapy (IPT), which is defined as a time-limited and highly focused treatment option for mood disorders (Mychailyszyn & Elson, 2018). As the name suggests, the approach focuses on improving the interpersonal relationships of the affected individual. This would, in turn, lead to a better quality of life for the affected. This reduces distress and makes the depression more manageable for both the affected and his or her psychiatrist (Holosko, Dulmus & Sowers, 2013). It is important to note that addressing interpersonal deficits help the patient become more comfortable with his or her surroundings. Often, this also leads to a better understanding of self, which resolves the identity crisis that is the foundation of the depression.
The second evidence-based intervention that has been used for the target population is cognitive-behavioral therapy (CBT). Just like interpersonal psychotherapy, this therapy has been used to resolve psychological issues. Pu et al. (2017) note that the approach has been successfully used to treat anxiety, depression, severe mental illness, and eating disorders. According to Rasing et al. (2017), the approach has been successful due to the fact that it encourages the patient to change his or her thinking patterns. The affected adolescent is able to also appreciate the differences between people and the larger environment. This will, in turn, help the individual not only address but also understand the difficulties he or she is going through. According to Krebs et al. (2017), it is this understanding that ensures the patient resolves the mental concerns he or she has at the time.
Client values and clinical expertise are important when making a decision on which intervention to use. An appreciation of both allows the affected adolescent and their health provider to strike a perfect balance in regards to the treatment option of the patient. Further, a proper consideration of both allows the patient to be involved in the whole treatment process, ensuring that they understand the different treatment options and go ahead and pick the right one for their situation.
The selected intervention is cognitive-behavioral therapy. One of the reasons why this intervention is ideal is the fact that it has been used more broadly to treat depression compared to interpersonal psychotherapy. Further, the approach is based on three principles that are critical when dealing with the mentioned mental issue. The first principle revolves around how one thinks (Blake et al., 2017). It is arguable that thinking patterns subject the patient to either a positive or negative outlook on life. When an adolescent has unhelpful and unhealthy thinking patterns, whether it is about issues of self or others, then they become more depressed. Resolving this would help restore positive and hopeful thinking patterns.
Secondly, the approach also targets unhealthy behaviors that might increase feelings of depression in adolescents. Rasing et al. (2017) explain that apart from negative thoughts, there are several behaviors that might sink the patient into further depression. It is critical for adolescents to identify these behaviors and understand how they contribute to their feelings of depression. The third principle of the approach is learning, where the affected are encouraged to learn better ways of coping with their feelings (Rasing et al., 2017). The wholesome experience that cognitive-behavioral therapy offers makes it easier for adolescents to adopt.
Application of Specific Skills and Techniques of the Chosen Interventions
One way of applying the specific skills and techniques of the chosen intervention is through proper collaboration with the patient. Due to the fact that the affected is still young and decision-making might be difficult, it is critical that proper support is accorded throughout the treatment process. This can be done by encouraging the affected to note down their fears and other concerns on a piece of paper. Crowe and McKay (2017) note that any treatment used in resolving mental health issues should be involved full participation from the patient. This is especially critical due to the fact that adolescents are trying to create their identity, and this can only be done from an individual point of view.
Secondly, the application of the approach can be done through role-playing. Rasing et al. (2017) define role-play as the use of different scenarios and characters to discuss and bring out issues that might happen in those different scenarios. The use of role-playing is effective in depression treatment as it allows the patient to safely discuss their feelings, fears, and also solutions to their concerns without feeling too pressurized to act in a certain way.
Third, the skills can be applied through the use of yoga and other meditation approaches. It is important for the patient to be able to calm their bodies and their minds. This will result in a more guided thought process that further enhances healthy behavior. Keeping one’s mind calm can be achieved by doing things that the patient enjoys. For example, some might react better to music, while others might prefer running to clear their mind and get clarity.
Measuring the Outcome
Measuring the outcome of the selected intervention is key in both providing the right treatment for the patient and also furthering the study on the impact of the approach in adolescent depression management. It is important to have baseline data that will enable proper interpretation of the measuring outcomes. One way to measure is through evaluating and monitoring the adolescent’s symptoms. It is important to also assess the progress of the patient by evaluating the milestones achieved. This can be easily and effectively done by setting realistic and smart goals at the beginning of the sessions and identifying milestones as treatment continues. Crowe and McKay (2017) note that the measuring process should not only focus on what has been achieved but also on where more work is needed. Importantly, target behaviors have to be used as milestones as well. This will ensure that the adolescent understands what they are working to achieve.
One cultural consideration that has to be taken into account is the issue of consent. Many communities believe that adolescents cannot be treated without either written consent from the parents or guardians or the latter being physically present during the sessions. Sussman and DeJong, (2018) note that this creates an ethical issue as the target audience is also scared of being open about their issues in the presence of family. It is important to consider the legal requirements for treating adolescents. Each state might have different legislation on the same. However, as best practice, it is essential to have written consent from the parents or guardians but to hold separate individual sessions with the patient. There is also a need to have family sessions as, at times, the family set-up either encourages progress or otherwise.
A second consideration is traditional values and norms that are upheld by the family of the affected individual. It is important to note that although the approach can be used on any patient, it has to be customized to fit the values and norms of each individual. These norms are often tied to traditional family values. It is important to note that it is not the job of the psychiatrist to change the values and norms that the individual holds, especially if they have no impact on the mental wellbeing of the person. However, in the event that these cultural norms are negatively affecting the individual and further contributing to their depression, then strategies have to be adopted to help reduce the anxiety brought on by the traditional values.
Application of the Code of Ethics
The code of ethics applies in numerous ways when working with adolescents who are suffering from depression. The first principle that applies is the development perspective. Sussman and DeJong, (2018) explain that this principle ensures that the cognitive, social, emotional, and psychological development of the patient is considered throughout the treatment process. Secondly, the principle of nonmaleficence applies as it encourages avoiding any action that will be detrimental to the adolescent (Sussman & DeJong, 2018). Debatably, the code of ethics fully protects the interests of the adolescent. It is, however important to also note that it also protects the psychiatrist. For example, the principle of assent and consent protects both the psychiatrist and the patient. This is due to the fact that the latter do not have the full capacity to make decisions about themselves and have to be guided by parents or guardians.
Application of Trauma-Informed Lens
A trauma-informed lens is critical when working with adolescents. This is due to the fact that there are numerous types of traumas that might affect individuals at this age. Sensitivity is critical in ensuring progress. One way a trauma-informed lens can be applied is through appreciation of the trauma that the patient might have experienced. It is critical that the psychiatrist does not generalize the experience but appreciate the unique nature of each individual. Further, it is important that the lens is considered due to the traumatic experience that occurs due to change. One of the hurdles that have to be crossed will involve the issue of change (from negative to positive behavior). The psychiatrist has to be sensitive in order to make the process that much easier.
Blake, J. M. et al. (2017). A cognitive-behavioral and mindfulness-based group sleep intervention improve behavior problems in at-risk adolescents by improving perceived sleep quality. Behaviour Research and Therapy, 99, 147-156. Web.
Crowe, K., & McKay, D. (2017). Efficacy of cognitive-behavioral therapy for childhood anxiety and depression. Journal of Anxiety Disorders, 49, 76-87. Web.
Holosko, J. M., Dulmus, N. C., & Sowers, M. K. (2013). Social work practice with individuals and families: Evidence-informed assessments and interventions. New York, NY: Wiley.
Krebs, G., et al. (2017). Long-term outcomes of cognitive-behavioral therapy for adolescent body dysmorphic disorder. Behavior Therapy, 48(4), 462-473. Web.
Mychailyszyn, M. P., & Elson, D. M. (2018). Working through the blues: A meta-analysis on Interpersonal Psychotherapy for depressed adolescents (IPT-A). Children and Youth Services Review, 87(1), 123-129. Web.
Pu, J., et al. (2017). Efficacy and acceptability of interpersonal psychotherapy for depression in adolescents: A meta-analysis of randomized controlled trials. Psychiatry Research, 253(1), 226-232. Web.
Rasing S. et al., (2017). Depression and anxiety prevention based on cognitive behavioral therapy for at-risk adolescents: A meta-analytic review. Frontline Psychology, 8, 1066. Web.
Sussman, N., & DeJong, M. S. (2018). Ethical considerations for mental health clinicians working with adolescents in the digital age. Current Psychiatry Reports, 20(113), 1-8. Web.