Case Management and Program Development Report - Roger's Case

This report presents a case study of a 25-year-old client named Roger who struggles with chronic depression. The report details Roger's background, including his family situation, strengths, and weaknesses. It explores the complex support needs he requires, such as addressing his short temper, possessiveness, and emotional distress stemming from past hardships and a recent loss. The report examines the effects of various support systems and outlines SMART goals aimed at improving Roger's well-being, including specific strategies for increasing social interaction, managing self-harm tendencies, improving sleep, and addressing suicidal thoughts, along with the need to be his authentic self. The report also references relevant literature and discusses the types and causes of depression.

RUNNING HEAD: MANAGEMENT 0
Case management& program development
Management
8/17/2019

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INTRODUCTION
This report shall deal with the issues faced by the client, who encountered chronic
depression in his early stage of adulthood. It focuses on the description of the client including
strengths and weaknesses, client’s family situation, who look after the client and his physical
and emotional state. It further discusses about complex support needs provided to the client
from time to time and what effects it had on the client. Further, how his state of well-being is
achieved through these support providers. Also, it includes the SMART goals required in
order to achieve the objectives.
BACKGROUND
The description of the client includes name i.e. Roger who is twenty-five years of age
who is very much short tempered and possessive in nature and whose major strength is
always adjusting with any kind of people and putting on a smiling face always. He is an
interactive person and is often seen as widely participative in community activities. He is
loved by everyone at his workplace, by friends and his family members and is also a social
worker. Roger’s family background is very complex as they have been very poor since he
was born. The family has six members’ mother, father, two younger siblings and Roger. The
client’s parent had to walk from door to doors to educate Roger which influenced his
childhood. The issue he is facing is sourced from his childhood days where he saw his family
earning hard and not having food in the house for days.
The family had limited relatives which failed to help and those who did asked for a
benefit in return. He has seen worst days when his family member fell ill and had no money
for treatment. The client also lost his grandfather due to lack of money and cursed himself for
years for not being a good son. He has been facing such dilemmas and had a habit of keeping

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those to his own. The family is looked by Roger alone as he is established and earning well
amount. The client is very emotional due to his early days struggle and his loss of girlfriend
last year in a road accident. The chronic depression he is facing is due to the continuous issue
in the client’s personal life and his habit of not sharing with any people around him. It’s said
that the more one talk the better they feel which is what wrong with the client (Renner,
Arnoud , Frenk , & Jill , Schema therapy for chronic depression: Results of a multiple single
case series, 2016). The habit of being alone, crying when no one is watching, laughing in
front of people and having a big heart fir everyone at the workplace made him loved but it
came with a lot of consequences.
Complex Support Needs
The client has been facing feeling of sadness and hopelessness from a long time. The
short-temperedness of the client is due to the bad phase his family had to go through and the
suffering they had to face. The irritation or frustration on small matters and loss of interest in
simple pleasures has gone off board (Jobst, Brakemeier, Anna , & Franz , 2016). The client
has been facing issues of lack of sleep and stays up late all night. The lack of energy and
change in appetite are some serious aspects which need to look upon (Bus, Molendijk,
Tendolkar, & Penninx, 2016). The client is also been facing anxiety and restlessness since the
loss of his love. Also, a constant feeling of worthlessness or a feeling of guilt is in his eyes
which were never in his hands. The sense of loneliness and feeling miserably unhappy
without any reason is the constant problem being faced (Schramm, Levente , Ingo , & Josef
Bailer, 2017). There are several signs of suicide in the ways he has been handling things
lately, the client has been showing or faking happiness but he has been struggling with
personal failures from a long time (Domes, Ines , Martina , & Alexandra , 2016).

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The support needs which can be provided is talking to the client he is facing, making
aware about depression as a medical situation and making him comfortable with the personal
flaws. Seeking help from a mental health provider or psychologist is the best thing to give the
client relief (Domes, Claus , & Markus , The effect of oxytocin on attention to angry and
happy faces in chronic depression, 2016). The feeling of giving him help and supporting the
client at any cost with the alertness of listening to all the worries of client is the need of the
hour. There are several therapies which needs to be taken at the right time and shall give the
client a sense of mental peace (Negele, Johannes , Lisa , & Marianne, 2015).
The proper care includes sticking with the treatment, willing to listen to the client,
giving of positive reinforcement, providing a lesser-stress environment. There also existence
of several organizations which comes forward to help these people (Laws, Michael J. , Aline ,
& Daniel , 2017). Awareness has to be acknowledged about depression like it can happen at
any stage and mostly seen in teens in early age of 20s or adulthood starting from 30s (Flink,
Kirsi , Soili , & Virpi , 2018). The chronic mood and disorders of anxiety begins in
adulthood if there were anxiety issues at the time of childhood. Depression may not occur
individually but may come with other diseases as well such as diabetes, cancer, heart disease
and Parkinson’s disease (Cuijpers, Marcus , & Toshi , 2017).
Depression many a times makes conditions worse and may also arise as a side-effect
of other medications (Yu, Liu, Yong , Zi, & Jian, 2015). There are several types of
depression: major depression- these are those that interferes in day to day work of a person;
persistent depressive disorder- these are those which lasts for two years and are slightly less
severe; psychotic depression- these are those where person deals with depression adding to a
form of disturbance with reality; postpartum depression- these are kind which is faced by
women after giving birth to a child; Seasonal affective disorder- these are faced seasonally by
persons (Malan, Mark , Roland, & Markus , 2016). Not every depressed person experiences

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every symptom. Some individuals have just a few symptoms. Some individuals have a lot of
them (Forkmann, Eva, Tobias , & Elisabeth , 2016). Depending on the person and his or her
specific disease, the severity and frequency of symptoms and how long they last will differ.
Symptoms may also differ with the phase of the disease (Koenig, Michelle , Bruce , & Sally,
2015).
Smart goals
 Roger has been facing loneliness though he is surrounded with many people every
day. There is a need to join motivational lectures and doing meditation. Also, being
around with people he loves is the best therapy at this time.
Specific- The sense of belongingness is what Roger craves for. He needs to go and hang out
with people he actually loves and start being himself which he often forgets. Spending of four
hours a week with the people he loves will reduce his mental stress. This continuous activity
for four hours per week shall improve the quality of living of Roger. It shall be reluctantly
done for nonstop six months to have a better and impactful result on his life.
Measures- This activity four hours a week will benefit a lot. This shall be managed with the
office hours.
Attainable- A period of six months shall lead to better quality of life. The improvement for a
long term could be seen after completion of this period.
Relevant- Avoidance of negative people and acknowledging what the client really feels. Also,
sharing with people around him shall give him a better space. Opening up to people is the
best therapy he can get for now.

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Timely- A period of six months is a good time frame. This has to be done frequently and no
missing of routine shall be looked for.
 Roger has been harming himself physically for a while to let go of the anxiety factor
in him. He keeps a blade ready whenever he misses his silence around people. The
hurts himself to let go of the pain and agony of the situation in order to cope with the
demons he feels he possess.
Specific- The physical harm which he has been doing is cutting him to let go of the pain and
miseries. There is a need to have some time of his own and looking at the brighter side of life.
This shall be done by spending an hour every day of the week and doing it continuously. This
shall be achieved in three months to live a happy life.
Measurable – Spending an hour everyday leading to seven times a week to keep a check on
the anxiety (Chisholm, Kim , Peter, & Bruce , 2016).
Achievable - Three months is a time to achieve the goal.
Relevant- The listening to motivational saints and spending time with elderly persons can
actually improve the life shell of the person.
Timely- A period of four months is a good time frame to improve the living
 Roger has been sleep deprived from months. He is on pills to get some sleep which
are not helping him as of now. There is a need to surround him from positive things
while he goes to bed. He shall take sleep therapies to make his mind more quiet and
composed. The lack of sleep is influencing his thought process negatively.
Specific- the sense of calm sleep is the need of an hour and to check whether he
sleeps in the day time or not. Getting out of bed at 7 am every day and repairing the
relationship with family members will improve his mental state.

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Measurable- Every single day at night these therapies shall be practiced and no negative
thinking shall be acknowledged in these hours.
Achievable- 1 month can bring the change in the sleeping habits of a person. This shall be
continuously without any gap.
Relevant- Surrounding themselves at night with slow music and positive scenario shall make
him calmer and composed during sleep.
Timely- Six months is a good time frame. The practise of sound sleep can be ascertained
accordingly.
 Roger has been feeling suicidal thoughts and thinks of quitting his life.
Specific- The suicidal thoughts can be reduced by engaging in self-help groups and
communal groups meant for people who finds it difficult to have a purpose for the
life. Practising relaxation exercise every day is a target that is to be achieved
(Herrmann-Lingen, 2018).
Measurable- It has to be done once in a week. The more he shall engage with older people
and children’s, the more light he shall feel and happier he will be.
Achievable- Two months constantly can bring a change in a person’s mentality. The
positivity of life is often misunderstood which is what he has to realise and gain.
Relevant- The constant meeting of people with same issues and speaking one’s heart out in
front of these people can inspire a person to strive harder (Miller & Charles , 2016). The
more people he hangs out with shall help him to have a new perspective towards life and
others.
Timely- A period of six months is tenure when the thought process can be changed. There
has to be continuous check even after this period as life is the most important element.

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 Roger has a problem of faking a smile every time he is surrounded with people which
in turn affects him negatively because he cannot behave what he really feels. The
need of being oneself is an important task to achieve and realising of importance of
self-care shall him discover a new life with motives.
Specific- The sense of being oneself is an important thing for Roger to understand. The more
he shall be able to speak his heart out the more better he shall feel.
Measurable- It shall be measured twice a week. Its effect shall take time as it cannot be
learned so quickly but continuous implementation shall work in favour.
Achievable- One month is a time which can be managed along with the office daily routine.
The art of speaking what is in one’s mind has to admired and implemented on a regular basis.
It shall ultimately lead to change of behaviour in daily life.
Relevant- The continuous activity of being happy and content and not pleasing everyone
around is a task to achieve.
Timely- This can be achieved within one month and changes can be acknowledged.
Recommendations
Roger has been feeling a sense of hopelessness and has a feeling of not good at
anything he is doing. He is surrounded by so many people and still is not happy and content.
He has a problem of not showing what he really feels. He becomes introvert in the case when
he feels low and put himself behind the doors for days. The issue of not speaking his mind is
what is why he is so depressed.
Recommendation - He shall join depression support groups in order to let go whatever
he is holding from the past. He has to be quick and continuous in attending this group and be

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reluctant to change the mind-set he has been holding from the past. The feeling of self-care
and enough for everyone is what he needs to learn from the day one of the sessions. The
strategy to know and understand that everyone is different and cannot be same in terms of
feeling (Brockmeyer, Dominika, Martin, & Hinrich , 2015). The loss of his girlfriend cannot
be changed but moving on is the option he has to take to take care of his family. The support
group shall help him in leading a better and efficient life with a sense of belongingness.
Roger has been feeling suicidal thoughts as he has lost the purpose after the loss of his
girlfriend. The constant harming himself physically with a blade and having marks all over
his body which is hidden by the smile he fakes every time. The self-respect he is losing for
himself can be a threat for his existence. The mere keeping of everyone happy around him is
what he has to stop and find genuine person in life that can be with him every time.
Recommendation - As a manager, I would suggest to divert his mind time of anxiety
and giving up of hurting himself and acknowledging how important his life is for his family
and friends. He shall be sent to specialist of mental health services for a programme on
depression relaxation. There shall be therapies every two to three weeks (Mojtabai & Mark ,
2016). There shall also be follow up sessions over the months to have a check (Opie,
Itsiopoulos, Parletta, & Almudena , 2017). There shall also be reviewing of previous
treatments of depression by the client and what the impact of it on the client was.
Roger has been hallucinating for a while. He believes things which are not in actual
world. He feels as if he does not deserve love and is helpless which is why he is suffering this
much. He is not content with his life and feels everything unsatisfying around him.
Recommendation- The client shall go for ECT (electroconvulsive therapy) for the
treatment of depression (Olfson, Carlos , & Steven, Treatment of adult depression in the
United States, 2016). This doctor has to review the adequacy of previous treatment and shall

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discuss the pros and cons of the therapy first with the client (McPherson, Felicitas, Joel , &
Allan , 2018). Therefore building a relationship of trust is important. Love and sense of care
are things which could be given by family and friends. The more he shall be around positive
people the more early he shall be active accordingly. He shall see new people and make
friends with them instead of mourning for his girlfriend loss. The need of finding a new love
may make him feel better
Roger has been sleep deprived due to lack of calmness at the time of night. He
overthinks his life and end up blaming himself for the unfortunates. He takes care of
everyone but does not look after himself.
Recommendation- The client shall follow some sleeping rules which are often
dictated to the people who are sleep deprived. There shall be proper silence at the time of
night with no disturbance (Cox, Nathaniel , & Samantha, 2016). There are therapies which
help people to sleep in a composed manner. There are slow and medicated music which help
to have a peace of mind and sleep in a healthy environment.
Roger has a problem of not loving himself. He cares and nurtures about everyone
around him but not himself. He behaves he is fine but he is not. The act of being not he in
front of people has to be looked at and this requires change as soon as possible (Blom,
Susanna, Martin , & Malin , 2015).
Recommendation- There is an alarming need to understand the importance of self-
love and taking care of oneself first (Olfson, Tony , Carmela , & Jacquelyn , 2018). This has
to be understood through motivational lectures. There is no substitute for self-love and has to
be understood as soon as possible.

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