Case Study: Major Depressive Disorder and Social Anxiety Disorder
The issue being discussed is Laura’s mental health struggles, specifically her recurrent major depressive disorder and social anxiety disorder (social phobia). Her experience includes various depressive symptoms like feeling sad or losing interest, along with insomnia that leads to fatigue during daytime hours. Alongside concentration problems and being too critical about herself, she has also been facing other issues, for instance, facing fear when put into a situation where one needs to be socially active or having trouble communicating or asserting oneself. Maintaining relationships has been hard for her. She feels distressed and culpable because of her mother’s care, as well as not being able to have kids as a result of menopause (McBride & Atkinson, 2009).
Intervention of choice
My intervention of choice is solution-focused Therapy (SFT). SFT is a goal-oriented, present-focused, and brief psychotherapy model that focuses on solutions rather than problems. The premise is that solutions exist in the current time frame regardless of prior events. What matters most are recent and future events, and the past events are of little significance (Hammonds et al., 2019). The objective is to assist clients in distinguishing and developing solutions for their present issues. In this model, a therapist will aim to recognize the client’s unique set of skills, which are then utilized as a part of the solution-building process. The therapist aids the client in developing the vital abilities needed to establish and sustain a more positive outlook (Corcoran, 2021). The key focal point is on the present and future, and the therapist and client work collaboratively to develop an action plan to aid the client in attaining their objectives.
Solution-focused Therapy is a relatively new approach to counseling and psychotherapy, first created in the late 1970s by Steve de Shazer and Insoo Kim Berg. The creators were both trained in the traditional psychoanalytic approach to Therapy and sought to find a way to help their clients more effectively. Their intention was to design a therapy model that put more emphasis on being active and setting goals rather than looking back at the past or trying to uncover why someone is experiencing emotional pain (Zinnia Health, 2023). De Shazer and Berg based their model on the idea that people are resourceful and can solve their problems. They recommended that it was not essential to focus on the individual’s distress cause, and rather, the focal point should be on seeking solutions to the issue; therefore, while serving as an assistant, the therapist could help the patient recognize their resources and using them to achieve their goals.
De Shazer and Berg also argued that clients should be viewed as active participants in their Therapy rather than passive treatment recipients, which meant that the therapist should take a collaborative approach to Therapy, engaging the client in dialogue and allowing them to take ownership of their recovery (Zinnia Health, 2023). This approach was in contrast to conventional psychoanalytic approaches, which perceived the therapist as the power figure and the client as a passive guidance recipient of the therapist. De Shazer and Berg also argued that the goal of Therapy should be to achieve a preferred future rather than simply resolving the problem at hand, implying that the focus should be on assisting the client in developing a vision for their future and then taking action to attain it. This contrasts with more conventional approaches, which center around resolving the problem without future consideration.
De Shazer and Berg’s approach was revolutionary at the time and has since become one of the most popular psychotherapy approaches. The treatment of different psychological issues, for instance, depression, addiction, trauma, and relationship issues, has effectively utilized it. Aiding clients in reaching personal objectives and inducing favorable adjustments in their lives is another application of it (Zinnia Health, 2023). De Shazer and Berg’s approach’s success is because of its focus on solutions instead of the cause of the issue, its collaborative nature, and its spotlight on creating a preferred future. Countless individuals have found solutions to their problems and taken control of their lives through this approach.
Features of the intervention model
The SFT model is based on the humanistic psychology theory, which views individuals as having intrinsic worth and capable of making decisions for themselves. The model emphasizes that individuals are the primary agents of change and that they can create their solutions (Grant & Gerrard, 2020). Additionally, it rests on the assumption that individuals are able to develop new capabilities and modify their actions. By utilizing the SFT model, individuals can identify their goals and learn how to use resources effectively to create a positive impact. The therapist aids clients in recognizing and amplifying their strengths along with developing fresh abilities, which allows them to attain the results they want.
The SFT model views humans as having the ability to make a significant change in their lives and to take action to accomplish their goals. Additionally, it views humans as having the capacity to recognize and use their strengths to accomplish their goals and to make positive adjustments (Grant & Gerrard, 2020). The SFT model also emphasizes the significance of developing a “solution-focused” mindset, which incorporates learning to perceive and utilize resources, adjusting existing abilities and behaviors, and creating plans of action to attain goals. The therapist assists the client in identifying and building upon their existing abilities and resources and establishing a change plan.
The SFT model views problems as developing when a person feels stuck in a certain situation or circumstance and is unable to move forward, which can occur when an individual feels overpowered by an issue or circumstance and cannot find a solution. Besides, the SFT model views problems as resulting from a lack of resources or skills and an inability to recognize and use existing resources or skills to move forward and is designed to assist clients in identifying and use their strengths and existing resources to move forward in a positive direction. Collaboratively, the therapist works with the client to recognize and build upon their strengths, foster new abilities, and create a change plan. The SFT model also stresses the significance of creating a “solution-focused” mindset and taking action to accomplish the desired results (Gupta & Fakhr, 2022).
I would apply solution-focused Therapy to the case by helping Laura to identify and focus on her desired outcomes. I would begin by asking her to describe her ideal life and then work cooperatively to recognize the steps she can take to move toward her objectives. I would also help Laura look at her current situation in a more positive light and identify any current strengths or successes that she can draw on to make progress. By doing this, we can build on her existing resources and strengthen the hope she has in achieving her goals. Furthermore, I would work with Laura to distinguish her qualities and the significance of her life, which can be a strong source of inspiration and can assist her with finding purpose in her life. Besides, I would urge Laura to take action consistent with her values and objectives, assisting her with making small improvements in her day-to-day existence that will ultimately prompt the desired result.
Model’s helpful aspects
I believe that SFT is a valuable approach to psychotherapy and can be beneficial in many cases. This collaborative approach prioritizes enabling the client to recognize and leverage their own resources toward positive change. Moreover, it is a present-oriented strategy that focuses on finding remedies for present problems rather than dwelling on the past. In addition, SFT is a goal-oriented approach that supports clients in creating a vision for their future and then working towards accomplishing it. Nevertheless, there are some restrictions to SFT that should be thought of. SFT does not address the underlying causes of the issue but rather centers around finding solutions in the present time and place (Jerome et al., 2023). It also relies on the client’s motivation and commitment to making positive changes, which can be difficult to maintain. Also, it may not be compelling for more complex mental problems, for instance, trauma.
Generally, I believe that SFT is a significant approach to psychotherapy and can be valuable in many cases. I would use the theory in practice, as it is a collaborative approach emphasizing the client’s ability to create change. Besides, it is a present-focused approach that does not dwell on the past and is goal-oriented, assisting the client to create a vision for their future. However, some restrictions to SFT should be considered, for instance, the lack of research on its effectiveness in managing specific types of psychological issues.
Corcoran, J. (2021). Theoretical Perspectives for Direct Social Work Practice.
Grant, A. M., & Gerrard, B. (2020). Comparing problem-focused, solution-focused, and combined problem-focused/solution-focused coaching approach: Solution-focused coaching questions mitigate the negative impact of dysfunctional attitudes. Coaching: An International Journal of Theory, Research, and Practice, 13(1), 61-77.
Gupta, H., & Fakhr, R. (2022). Solution-focused brief Therapy and depression. depression, 6(S2), 8892-8902.
Hammonds, D. S., Jordan, N. A., & Block, J. L. (2019). Clinical mediation: Advocating for a new role. Journal of Counselor Preparation and Supervision, 12(2), 7.
Jerome, L., McNamee, P., Abdel-Halim, N., Elliot, K., & Woods, J. (2023). Solution-focused approaches in adult mental health research: A conceptual literature review and narrative synthesis. Frontiers in Psychiatry, 14, 477.
McBride, C. and Atkinson, L. (2009). Attachment theory and cognitive-behavioral Therapy. In J.H. Obegi & E. Berant (Eds.), Attachment theory and research in clinical work with adults (pp. 434-458). New York: Guilford.
Zinnia Health. (2023, February 3). What is solution-focused brief Therapy?