Case Study: Analyzing Allison's Mental Health and Treatment

This assignment presents a case study analysis of a 38-year-old woman named Allison, focusing on her mental health condition of depression. The student applies the clinical reasoning cycle to assess Allison's situation, considering her stressors (divorce, financial instability, weight gain) and protective factors (family, friends, and her boyfriend). The analysis involves collecting cues and information through a bio-psycho-social approach, including a mental status examination (MSE). The student then processes this information, identifying symptoms aligned with DSM-5 criteria for major depressive disorder. Problem areas such as financial instability, relationship issues, and poor self-coping are highlighted. Goals are established to improve Allison's self-management abilities, financial stability, and relationships. Interventions like cognitive behavioral therapy, interpersonal therapy, and antidepressant medication are suggested. The student recommends follow-up sessions and the use of depression assessment tools to evaluate progress. The reflection emphasizes the value of the MSE and the clinical reasoning cycle in providing comprehensive patient care.

Running head: CASE STUDY OF ALLISON
CASE STUDY OF ALLISON
Name of the student:
Name of the university:
Author note:

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CASE STUDY OF ALLISON
Introduction:
This assignment would mainly present a reflection based on the case study analysis of a
30 year old lady called Allison. In this assignment, clinical reasoning cycle would be applied to
analyze the healthcare conditions and needs of the patient and accordingly interventions would
be provided to help her get over the symptoms of mental health disorder of depression.
Considering the situation:
Allison is a 38 year old woman who the mother of two children with one is being 9 and
the other being 11. She had been divorced about four years ago and works in a local supermarket
to meet the ends. She had been suffering due to a number of life stressors like reduction in the
wages after the supermarket was taken over by a new employer. She is also feeling low because
of her weight gain issues. She is failing is coping with present situations and cannot even manage
to have quality time with the children although she feels that the children should be cared for in a
better way which she is failing. However, certain protective factors had been noted from the
video analysis is that she is supported by her family members, friends, sister and to some extent
by Dave who is her boyfriend.
Collecting cues and information:
The healthcare professional attending a patient should be undertaking bio-psycho-social
approach for analyzing her healthcare needs and accordingly should try to develop an in-depth
idea about the social, biological and psychological factors contributing to the present mental
health condition of the patient (Whooley, 2016)). The professional should focus more on
developing knowledge about the etiology of the mental health condition of the client so that they
can plan the interventions for the patient after identifying the healthcare priorities that need to be

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attend to. In order to do so, the healthcare professional in this step can undertake the mental
status examination called MSE so as to develop an understanding about the present mental health
condition of the patient and also the different causes that are affecting the mental stability and
emotions of the patient and also get an idea about her coping abilities in the situations (Otte et
al., 2016). I viewed the video in details and realized the efficiency with which the professional
had undertaken the assessment procedures and derived great deal of information from the client
that helped her to reach a conclusion (Ratanasiripong et al., 2015). MSE indeed helped the
person in collecting a large amount if information about the present state of mind of Allison and
helped the professional in developing a preliminary idea about the disorder that she is suffering
from. She was clean in her appearance with properly combed air and clean clothing. She was
completely without makeup and nothing much unusual was observed from her appearance
analysis. She was stuttering in her speech and was found to be quite slow with minimum amount
of pauses. Her volume was low and her tone seemed teary with a monotone of sadness and grief.
Even her behaviors when studied properly showed that she was not having any eye contact with
the professional but showed good manners, was cooperative with her. She did not show any
restlessness and also exhibited no stereotypes as such (Thomas et al., 2015). Her thinking pattern
showed that she is out of the risk of harming herself or her children but she revealed that she had
suicidal tendencies when she had her divorce few years back. However, she was found to be
logical where she stated that she has to live for her children and ca never harms them. Her mood
revealed that she was upset and hopeless about her life and her mood was quite low and she felt
teary while interacting. No cognitive issues were found while interacting with her.

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Processing of the collected information:
In this stage of the cycle, the professional needs to analyze the collected information.
Thereby she would be trying to identify the mental health issues, which the patient is suffering
from. The DSM-5 listing showed that the patient is suffering from major depression disorder
(Carlborg et al., 2015). The DSM-5 contains of 8 symptoms of depression, which can be used by
the professional to help in identifying whether the collected information shows any similarity to
the symptoms stated by DSM-5. Researchers are of the opinion that a patient needs to have 5
symptoms out of the 8 symptoms stated by DSM-5 to be diagnosed as suffering from depression
(Thornicroft et al., 2017). Processing of the information showed that the patient was suffering
from depressed moods as well as diminished interests in the activities which she used to enjoy
with friends and family members. She has been suffering from loss of pleasure in many activities
which she used to enjoy, disturbance of appetite and weight issues along with sleep disturbance.
She had also diminished ability in thinking or concentrating with feelings of fatigue and
worthlessness. Hence, she had been found to be suffering from clinical depression.
Identifying the problems:
Lack of financial stability was one of the concerning factor for her as she could not meet
the bill and could not suffice the wants of the children after cutting of the wages. Low mood and
her lack of participation had also brought issues in the intimate relationship that she shared with
Dave. She also cannot bond with the children because of her disorder. She has poor self-coping
and self-management abilities. She lost her appetite and faces disturbance in sleep. All these
factors need to be overcome to help her live better-quality life.

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Establishment of the goals:
Allison needs to be develop strengths such as self-coping and self-management abilities
and she also would needs to change her thinking patterns where she would be having a more
positive outlook than feeling helpless and hopeless about situations. Her financial issues should
be tackled and her relationships with Dave as well as the children should be strengthened.
Taking action:
The professional can undertake psychotherapy interventions like cognitive behavioral
therapies for treatment of Allison. It helps in altering the negative through process of the patients
and replace them with positive through process that empower them and encourage them to
develop better coping abilities in the situations (Bruce et al., 2015). Interpersonal therapies can
be also applied. This therapy believes that problems in depression can cause depression in
individuals. This would help her develop better relationship with Dave and also her children who
might help her overcome the stress she suffers due to depression. The professional can initiate
anti-depressant along with psychotherapy as this would help in developing the brain chemicals
whose disbalance cause depression (Gartlehner et al., 2015). The government had initiated a
number of employment schemes and as well as funding schemes for single parents and the
professionals should refer Allison to such agencies. She can also referred to peer support groups
where she can get support and guidance from people who have already gone through phases and
overcome them in depression.
Evaluating the goals:
The patient would be advised to continue follow-ups once every week where the
professional would be noting the changes required for overcoming depression. This sessions

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would be helping to understand whether her thought patterns had changes, whether she feels
empowered to manage her issues successfully and similar others. The professional can also use
depression assessment tools where the betterment of scores every week can give positive
answers to the professional about the success of the interventions.
Reflection:
This case study helped me in developing an idea about how MSE can help professionals
in collecting a dearth of information about patient and dhow it helps professional develop a
preliminary idea about the metal health issues the patient might be facing. I also realized that
clinical reasoning cycle helps professionals in undertaking a systematic approach in analyzing a
case, collecting cue, developing idea about the disorder, identify the root factors causing the
disorder, setting priorities and then applying interventions. I would be using the tools and
frameworks to provide bets care to patient and undertake appropriate clinical decisions ensuring
safety of the patient.
Conclusion:
The case study of Allison was analyzed with help of clinical reason cycle which helped in
providing the best interventions for the patients. This would help the patient to overcome her
mental turmoil and live better quality life.

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References:
Bruce, M. L., Raue, P. J., Reilly, C. F., Greenberg, R. L., Meyers, B. S., Banerjee, S., ... &
Rosas, V. H. (2015). Clinical effectiveness of integrating depression care management
into medicare home health: the Depression CAREPATH Randomized trial. JAMA
internal medicine, 175(1), 55-64.
Carlborg, A., Ferntoft, L., Thuresson, M., & Bodegard, J. (2015). Population study of disease
burden, management, and treatment of bipolar disorder in S weden: a retrospective
observational registry study. Bipolar disorders, 17(1), 76-85.
Gartlehner, G., Gaynes, B. N., Amick, H. R., Asher, G., Morgan, L. C., Coker-Schwimmer,
E., ... & Bann, C. (2015). Nonpharmacological versus pharmacological treatments for
adult patients with major depressive disorder.
Otte, C., Gold, S. M., Penninx, B. W., Pariante, C. M., Etkin, A., Fava, M., ... & Schatzberg,
A. F. (2016). Major depressive disorder. Nature Reviews Disease Primers, 2, 16065.
Ratanasiripong, P., Kaewboonchoo, O., Ratanasiripong, N., Hanklang, S., & Chumchai, P.
(2015). Biofeedback intervention for stress, anxiety, and depression among graduate
students in public health nursing. Nursing research and practice, 2015.
Thomas, S. J., Shin, M., McInnis, M. G., & Bostwick, J. R. (2015). Combination Therapy with
Monoamine Oxidase Inhibitors and Other Antidepressants or Stimulants: Strategies for
the Management of Treatment‐Resistant Depression. Pharmacotherapy: The Journal of
Human Pharmacology and Drug Therapy, 35(4), 433-449.

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Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., ...
& Bruffaerts, R. (2017). Undertreatment of people with major depressive disorder in 21
countries. The British Journal of Psychiatry, 210(2), 119-124.
Whooley, M. A. (2016). Screening for depression—a tale of two questions. JAMA internal
medicine, 176(4), 436-438.