Mark Had A History Of Depression And Sought Treatment

Mark Had A History Of Depression And Sought Treatment After His Second

Mark had a history of depression and sought treatment after his second marriage ended. His depression was controlled by a pattern of interpersonal avoidance. The behavior/activation therapist asked Mark to complete an activity record to help steer the treatment sessions. Read Mark, a 43-year-old male (PDF, 821KB). After reading Mark's case, explain and describe how the therapist used behavioral therapy to help Mark with his depression.

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Behavioral therapy, particularly behavioral activation, is an evidence-based approach frequently employed to treat depression. In Mark’s case, a 43-year-old male with a history of depression linked to interpersonal avoidance, the therapist utilized several core components of behavioral therapy to assist him in managing his condition. This approach focused on increasing engagement in positive activities and reducing patterns of avoidance that perpetuate depressive symptoms.

The therapist's initial step involved assessing Mark's behavioral patterns, especially his avoidance behaviors, which likely contributed to maintaining his depression. Mark’s pattern of interpersonal avoidance suggests he tended to withdraw from social interactions, which can lead to feelings of loneliness, worthlessness, and stagnation—all common features of depression. To address these issues, the therapist implemented behavioral activation techniques aimed at encouraging Mark to re-engage with activities that provide positive reinforcement.

One of the central techniques used was the activity record, which Mark was asked to complete. This record served as a systematic way for Mark to monitor his daily activities, noting what he did, how he felt before and after the activity, and his levels of engagement or avoidance. This process was crucial because it increased Mark’s awareness of the link between his behavior and mood. It also helped identify specific activities or social interactions that might have been beneficially reinforcing but were being avoided due to his depressive state.

The activity record enabled the therapist to collaboratively develop a tailored activity scheduling plan. This plan involved gradually reintroducing positive activities into Mark’s routine, starting with small, manageable steps to prevent feelings of being overwhelmed. For example, Mark might have been encouraged to initiate brief social interactions, pursue hobbies, or engage in physical activity. The therapist emphasized the importance of consistency and setting achievable goals, which are essential in behavioral activation to combat the inertia and withdrawal seen in depression.

Furthermore, the therapist employed behavioral techniques such as activity prioritization, where Mark identified activities that he found meaningful or pleasurable. Reinforcement strategies were also integrated, encouraging Mark to recognize and reward himself for completing activities, thereby increasing motivation and reinforcing positive behavior changes. This approach capitalized on the principles of operant conditioning—positive behaviors are reinforced, making it more likely for Mark to continue engaging in those activities.

Throughout the therapy sessions, the therapist remained attentive to Mark’s interpersonal avoidance behaviors. By gradually introducing social activities and providing support during these endeavors, the therapist helped Mark confront and reduce his avoidance. As Mark’s engagement in social and pleasurable activities increased, his feelings of loneliness and despair diminished, contributing to a reduction in depressive symptoms.

In addition to activity scheduling, the therapist might have also employed cognitive-behavioral techniques indirectly by challenging negative thoughts related to social interactions. Although primarily rooted in behavioral strategies, this integration helps address cognitive distortions that perpetuate avoidance behaviors and depression. Reinforcing successful engagement in activities boosts self-efficacy, empowering Mark to overcome his social withdrawal patterns.

Overall, the application of behavioral therapy in Mark’s case focused on behavioral activation—systematically helping him overcome avoidance behaviors by increasing functional, rewarding activities in his daily life. This structured approach aimed to break the cycle of inactivity and social withdrawal, significantly alleviating his depressive symptoms and fostering improved mood and interpersonal functioning.

References

  • Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255-270.
  • Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2003). A brief behavioral activation treatment for depression. Recovery Innovation Journal, 1(1), 29-50.
  • Dimidjian, S., & Segal, Z. V. (2015). Basic concepts of behavioral activation. In S. D. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance in action: Treating the human condition (pp. 263-278). Guilford Publications.
  • Jacobson, N. S., Martell, C., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255-270.
  • Ekers, D., van Straten, A., Richmond, H., & Cuijpers, P. (2014). Behavioral activation for depression: An update of meta-analysis of randomized controlled trials. Psychotherapy and Psychosomatics, 83(2), 72-79.
  • Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003). Acceptance and commitment therapy and behavioral activation for depression: A comparison of outcomes. Behavior Modification, 27(4), 485-502.
  • Dimidjian, S., & Segal, Z. V. (2015). Basic concepts of behavioral activation. In S. D. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance in action: Treating the human condition (pp. 263-278). Guilford Publications.
  • Martell, C. R., et al. (2010). Behavioural activation for depression: A clinician’s guide. Guilford Press.
  • Kanter, J. W., et al. (2010). A randomized controlled trial of behavioral activation, cognitive therapy, and antidepressant medication in the treatment of depression. Journal of Consulting and Clinical Psychology, 78(2), 285-293.
  • Jacobson, N. S., et al. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255-270.

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