Case Study: Intervention Planning for Depression and Anxiety Treatment

This case study focuses on a 45-year-old man, Jamie Green, suffering from depression and anxiety following a divorce, job loss, and substance abuse. The assignment details the development of a mental health intervention plan, including two primary goals: fostering hope and personal responsibility, and managing suicidal ideation. The intervention for the first goal involves the Wellness Recovery Action Plan (WRAP), a personalized wellness and recovery system designed to empower the patient and promote self-management. The case study justifies the use of WRAP by highlighting its potential to combat feelings of hopelessness and improve quality of life. The second goal utilizes solution-focused therapy to address suicidal ideation, focusing on identifying solutions and exceptions to the patient's problems rather than dwelling on their origins. The justification for this approach emphasizes its suitability for addressing the patient's specific challenges and promoting proactive problem-solving. The assignment provides a detailed application of both interventions, including the principles, processes, and anticipated outcomes, alongside an evaluation of the outcomes and the importance of continuous feedback. The case study demonstrates the application of mental health theories and practice frameworks in a real-world scenario.

Running head: INTERVENTION FOR MENTAL HEALTH PLANNING
INTERVENTION FOR MENTAL HEALTH PLANNING
Name of the student:
Name of the university:
Author note:

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INTERVENTION FOR MENTAL HEALTH PLANNING
Introduction:
The assignment is based on the application of evidence based interventions that would
suffice the healthcare needs of a mental health patient and thereby would help the patient to
achieve the potential to live fulfilling life. The mental health patient is a 45 year old man named
Jamie Green who is suffering from depression and anxiety for the past six months. He had
undergone a divorce 6 months back and in order to cope with that, he had started taking drugs
and alcohol. He had been expelled from his job as he could neither concentrate on his work and
was being absent on most of the days at the job. This added further to his suffering making him
feel hopeless and worthless in his life. He had lost interests from all activities and cannot cope
with the present stress. He has stopped eating as he complains that he has no appetite. His
brother seldom visits but he is quite busy with his job and family commitment in another city.
His brother had however managed him to bring him to the community mental health centre for
getting support for his brother’s health after Jamie had tried to commit suicide by overdosing
himself. This assignment would include developing treatment goals and will accordingly set
intervention plans for helping him overcome the mental health disorder of depression and
anxiety and live better quality life.

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Intervention planning:
Goal 1:
The main goal of the healthcare team would be to develop his feelings of hope as he finds
himself worthless and hopeless and feels that he has no potential to live happy and successful
lives. He needs to be guided in ways by which he can develop personal responsibility about his
own health so that he can maintain himself well. The treatment goal would be therefore to
develop hope and personal responsibility within the patient so that the ultimate outcome of the
patient health is that he recovers from his feelings of worthlessness and hopelessness and
develops the personal responsibility of taking care of him and live fulfilling life. The total time
frame would be 3 to 4 months.
Intervention planned:
WRAP can be described as the tool that helps in the recovery of an individual from
mental health disorders and the underpinning principles of this therapy supports the recovery
approach (o’Keffe et al., 2016). It can be described as the way of monitoring wellness in the
individuals as well as times of being less well and even the times when affected individuals go
through uncomfortable and distressing experiences (Canacott et al., 2019). The plan also gives
the entire freedom to the patient about how he would like to be supported by others. The
healthcare professionals engage in collaborative approach providing complete authority and
freedom to the patient to participate in a wellness planning process that would enable patient to
overcome the barriers to quality life and facilitate successful meaningful lives. A number or
principles govern the entire process of the WRAP (Mak et al., 2016). The first principle is hope
where people experiencing the mental health difficulties are seen to get well and thereby stay

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connected and thereby try to meet their dreams aspirations and goals. The second goal is
personal responsibility where the patient alone or with the help of the others can take up actions
and thereby perform what needs to be done for keeping themselves well (Slade & Wallace,
2017). The third principle is the education where the patients are given the opportunity to learn
about their own problems that they are experiencing so that they can make proper decisions
about all the aspects of life. The fourth principle is called the self-advocacy where patients are
taught of the ways by which they can approach to others so that they can get what they need,
want or deserve for supporting their recovery and wellness (Ashman et al., 2017). The fifth
principle is called support which includes receiving support from others in their wellness and
recovery plan and also providing support to others as this helps in feeling better.
Justification of the intervention:
It was seen that Jamie had lost all hopes in life and no more feels to be alive. The attempt
of committing suicides states that he no more wants to live as he thinks himself to have failed in
both his personal life due to the separation and professional life because of his termination. He
had therefore become hopeless thinking that he has nothing to live for in life. He has been
emotionally and finically broken which had made his life intolerable. Moreover social
withdrawal and lack of support from friends, families and communities had aggravated the
situation. In such situation, healthcare professionals need to undertake recovery based approach
where Jamie would be able to leave behind the various negative situations in life and develop
positivity to make his life better for the future and achieving the aspirations he had in life.
WRAP can be described as the personalized plan for wellness and recovery system that had been
born out of and rooted in the principle of self-determination (Olney et al., 2017). This approach
had been found to help affected individuals by a number of ways. It helps in decreasing as well

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as preventing intrusive as well as troubled feelings of behaviors. It also helps in personal
empowerment and also helps in improvement of the quality of life. It supports affected
individuals in achieving their own goals as well as dreams (Bayetti, Jadhav & Jain, 2016).
Moreover, Milstein et al.(2019) is of the opinion that WRAP can help affected individuals in
monitoring their uncomfortable feelings and distressed behaviors through that of planned
responses thereby helping in reduction, modification as well as elimination of the feelings. It has
been already found that Jamie is full of negative thoughts along with distressed feelings of
hopelessness and worthlessness and this had ultimately made him feel that he has no aim to live
in life. In such areas, WRAP would enable him in changing his negative thoughts, developing
empowerment, identifying his troubled feelings and take actions to modify them. This would
help in meeting the goal of developing hope and personal responsibility in Jamie to live better
quality life (Machtinger et al., 2019).
Application of the intervention:
The person who experiences symptoms of the mental health issue are the ones who
develop the WRAP plan themselves. He should be choosing supporters as well as other
healthcare professionals who would help them in developing his plan. However, the individual
should be in complete control of his own process. The affected person would learn the use of
WRAP through peer led as well as peer-engaged group procedures. It has been found that formal
WRAP group mainly comprises of about 10 to 15 participants and would be mainly led by two
trained co-facilitators who are actually the peers who have already experienced the use of the
WRAP for their own recovery. Pincus et al. (2016) opine that information gets delivered and
that the different skills are developed through effective discussions, lectures as well as individual
and group exercises.

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Evaluation of the outcome:
Participants are mainly encouraged and when possible they are also assisted in continuing
their meeting after 8 to 12 weeks period had ended as well as for supporting each other in using
and continuously revising their WRAP plans. Studies opine that personal WRAP plan can be
utilized as the tool that can be used for lifetime and also a voluntary WRAP group can also be
found to act as long term support resource for ensuring that the personalized recovery procedure
developed for patients remains sharp and help in building healthy and successful life in the
community (Davidson, 2018). Here, the professionals attending Jamie would continuously take
feedbacks from him as well as from the peer group support to assess whether betterments are
found in the mood of Jamie or whether changes are required in the WRAP plan.
Goal 2:
The important goal which needs to be set up is helping the individual fight the feelings of
suicidal intention to ensure his safety and longevity. It is found that he spends most of the time in
his home being socially withdrawn that makes him concentrate on his negative thinking
procedures making him vulnerable to develop suicidal tendencies. In such scenarios, risk
analysis reveals that he needs to be treated in ways by which his outcomes would be that he
would be able to control as well as manage his suicidal ideations in ways that prevents him from
undertaking any actions that would compromise his life.

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Intervention planned:
In order to manage the negative feelings as well as the suicidal ideations of Jamie,
solution focused therapy would be mainly applied. This therapy is mainly seen to concentrate on
the finding of different solutions in the present instances and also helps to explore the affected
individual’s hope for the future in order to find quicker resolution of one’s problems (Franklin,
2015). Studies are of the opinion that this method of counseling takes the approach that affected
individuals already know what they need to do for improving their lives and this with appropriate
questioning and coaching can help them in finding best solutions. The main principle of this
therapy is the finding of the “exceptions: in order to develop the best solutions to the different
sufferings and problems of the patients (Creswell et al., 2017). One of the principles that needs to
be followed by the SBFT therapists is that solution to a problem mainly found in the
“exceptions”. These are mainly the times when the affected individual is free of the problem or
when the affected individuals are taking steps in managing the problem (Miller, 2017). It is
belief that is imprinted in the therapy is that affected individuals are to certain extent motivated
in finding solutions and hence, this therapy mainly initiates with what the affected person is
currently doing for initiating behavioral and lifestyle change. It has been found that when the
client and the therapists have already discovered the exception, they would mainly work as the
team for finding out how the exception is different from that of the usual experiences of the
affected patients. Therapists would help in formulating a solution based in what makes the
exception scenario apart and help the patient in setting goals and implementing the solution
(Wells & Mckeig et al., 2016).

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Justification of the intervention:
It has been found that Jamie has already gone through both personal and professional
turmoil in the form of separation from wife as well as termination from his job. Moreover, he is
not having proper support that would help him in the times when he feels low. He has stopped
taking part in the activities that used to interest him. The solution focused therapy is justified
here because cultivating in the problems would not result in mitigating the issues but would
result in spending more time on the events which could not be modified or managed in the
present situation. Therefore, the focuses of this therapy mainly tries to be on finding the effective
solutions of the problems that are faced by the patients (Gonzalez et al., 2016). Jamie faces from
issues like developing negative thoughts, feelings of hopelessness and worthlessness, suicidal
ideation, lack of social support and social withdrawal. The solution focused therapy is apt for
Jamie as the therapist would work with him to find solutions in ways by which these problems
would be overcome rather than dissecting why the problems arose in the first place (Kim et al.,
2018). Jamie is already found to be motivated in taking initiatives to help him overcome the
disorder symptoms as per his brother. As this therapy requires an initial motivation to begin the
therapy with the client, this is the appropriate therapy for the patient.
Application of the intervention:
This therapy would be applied by the therapists where they would be asking specific
types of questions that help in guiding the situations. Studies are of the opinion that coping
questions can help in the demonstration to the affected individuals in the therapy their resiliency
as well as the number of ways by which they are capable of coping with challenges in their lives

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(Reddy et al., 2015). An example of coping question that can be asked to Jamie is “how are you
still managing in spite of such difficulties to fulfill your daily obligations?”. This kind of
question would help Jamie in identifying his skills in coping with adversity and would help him
in developing self-management skills to gather strength to overcome the negative problems.
Another set of question that the therapists can also ask is the miracle questions that help in
envisioning the future where the problem remains absent (Schmit et al., 2016). It has been found
that this line of questions would help in explaining how their lives would look different when the
problem would not exist. This would help the affected individuals in identifying small and
practical steps that they can take immediately for changes. For example, if Jamie is not able to
envisage what he aspires to achieve in the future or what kind of life he would like, the therapist
might ask her “what would be the three boons you would ask if genies comes in front of you”.
Another set of question that the therapist can ask is the scaling question that uses 0 to 10 for
assessing the present circumstances, progress and how well it is viewed by others (Mache et al.,
2016). These are used when less time is available and when therapists would be developing
insight into the hopefulness, motivation, and confidence of people in therapy
Evaluation of the outcome:
The patient’s mental health condition should be evaluated by the experts, from time to
time, through feedback and discussion sessions and such developments would be noted. For this,
it would help the therapists whether the therapy is helping in developing empowerment in the
patient and helping him to adopt the solutions. Outcomes of solutions should be also discussed in
the feedback sessions.

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Reflection on the interview:
Professional development:
While attending Jamie, both the therapies had sufficient positive outcomes on his mental
health conditions. We had engaged effectively with Jamie in developing his wellness and
recovery action plan and also included peer supports who had also been experienced in
developing and implementing the tool. Jamie was found to be happier as he was gradually
feeling that he was gaining control over his emotions. Initially, he felt aimless as he could not
understand how to initiate with the program planning but gradually with support from us and the
per supports, he was seen to gather confidence. In the follow-up sessions, it was seen that he was
participating involuntarily and it seemed that this process had helped him feel empowered and
take the control of his own life. Jamie had been able to successfully identify the stressors that
were affecting his mood and with the help of professionals and peers, effective coping strategies
had been developed that showed positive health outcomes. I noticed that the application of the
WRAP helped Jamie to decrease and prevent his intrusive and troubled feelings and even helped
in developing her empowerment. It was found that his quality of life had improved where he was
looking forward to wards new opportunities in life. I assisted him in every of the sessions and
witnessed how he was gradually developing positive outlook towards life. The therapy helped
him to develop personal responsibility where he was found to be responsibly maintaining his
daily activities and even took extra initiatives in meeting people in the society and socializing
with them. I tried to motivate Jamie in every ways by which he reaches out to us or to the others
for any amount of support he required in terms of recovery and wellness. To help him being in
constant touch with the peers and professionals, I also helped him to include him in social media
groups where peers supports and professionals remained connected with him through the social

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media to solve his queries and be in constant company when he felt low or needed guidance.
However, one of the areas that I faced issues was during the application of the solution-focused
therapies. Although I knew about the three categories of questions like coping questions, miracle
questions as well as scaling questions and understood the purpose of the questions, but in the real
life scenario, I could not ask the proper questions from the categories and hence the entre
episodes of application of the therapy somehow became haphazard and disorganized. My mentor
stated that with experience, this issue would get resolved.
Understanding the professional role:
During the treatment procedures, one of the things that had been identified was that the
solution focused therapy is a time saving procedure that helps in completion of the therapy
within a very short time. this makes it difficult for the healthcare professionals to allocate enough
time to the patient for developing strong bonds and to provide empathy and compassion to the
problems. Developing rapport and strong bond with the patient is extremely important in the
nursing profession and these values need to be maintained by nurses in order to ensure high
levels of patient satisfaction and greater adherence of the patients to the suggestions of the
professionals. However, it was seen that the SFBT therapy indeed is such fast paced that
professionals rarely get time in empathizing with the patient. However, the WRAP had helped in
maintaining some of the important values of nursing like maintaining the bioethical principles of
autonomy and dignity where nurses need to include patients in the care process and develop care
plans that align with the wishes of patients. As the WRAP process gives a lot of scope to the
patients to realize what they want to archive and also helps the patient to participate in his own
care and take decisions. This make patients feel respected as informed consent are taken.
However, intervention planning and implementation by us is different from the clinical experts in

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the multidisciplinary team is that we tend to get the scope of spending more time with the
patients than that of the others and so we are able to monitor the progress of the patient and how
well he is responding to the situations. Experts of the team are able to witness the patient for a
very short duration and this might not make them have the entire scenario about how patients is
responding to stresses in every situations. This helps us in evaluation whether the interventions
taken are working or not for the patient named Jamie.
Talking Therapy Key Theorist and
Theoretical Principles
The Goal of Therapy and
Practitioners Role
Specific Techniques
and Strategies Used
Wellness
Recovery
Action Plan
(WRAP®)
Mary Ellen Copeland is
the key theorist
The five principles are
development of hope,
personal responsibility,
education, self-advocacy
and support
This approach enables
affected individuals to
develop wellness and
recovery plan for their
health all by themselves
with the support from
healthcare professionals
and peer-support workers.
The main goal of the
therapy is decrease
troubled feelings, develop
empowerment, and develop
the hope to live better
quality life
Development of own
simple as well as safe
wellness tool,
developing a list of
things to be done
every day for staying
as well as possible,
identification of
upsetting events and
developing wellness
tools and action plans
to respond to them.
Developing a crisis
plan and then creating