Dr. Dawn-Elise Snipes

Executive Director: AllCEUs.com

Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review and Happiness Isn’t Brain Surgery

~ Identify instruments to guide treatment planning

~ Identify the causes of depression

~ Identify behavioral interventions

~ Identify cognitive interventions

~ Identify Emotional Interventions

Effects of Depression on Treatment

~ The client with depressive symptoms may have difficulty in any or all of the following areas:

~ Ability to follow instructions and keep appointments.

~ Energy to participate in or maintain interest in program activities.

~ Motivation for change.

~ Ability to make appropriate decisions about treatment needs and goals.

~ Belief that he or she can be helped.

~ Responsiveness to reinforcements.

~ Ability to handle feelings.

~ Ability to handle relations with other clients.

~ Ability to attend to (and not disrupt) group activities.

~ Ability to avoid relapse after treatment is completed.

~ ASAM

~ Acute crisis and dangerousness

~ Biomedical conditions and complications

~ Emotional, behavioral or cognitive issues (See assessment instruments, next slide)

~ Readiness for change for EACH issue/objective

~ Improve mood

~ Address sleep hygiene

~ Improve nutrition

~ Cut out caffeine

~ Increase exercise

~ Relapse or continued problem potential

~ Recovery environment

Screening Instruments: Emotional

~ DSM V PROMIS

~ Severity Measure for Depression, Adult(Patient Health Questionnaire [PHQ-9])

~ Zung Self-Rating Depression Scale

~ Center for Epidemiologic Studies Depression Scale (CES-D), NIMH

~ Severity of Posttraumatic Stress Symptoms, Adult (National Stressful Events Survey PTSD Short Scale [NSESS])

~ Severity Measure for Generalized Anxiety Disorder, Adult

~ Attributional Style

~ Hardiness and Perceived Stress Scales

~ Stress Awareness/Hardiness

Causes of Depression

~ Biochemical imbalance

~ Norepinepherine (focus, motivation)

~ Serotonin (contentment, relaxation, pain, sleep, hunger, heart rate)

~ Dopamine (motivation/pleasure, memory, focus, pain)

Causes of Depression

~ What is causing the biochemical imbalance

~ Physical

~ Lack of quality sleep

~ Exhaustion/burnout

~ Poor nutrition

~ Chronic pain

~ Diabetes

~ Thyroid and sex hormone imbalances

~ Vitamin D deficiency

~ Hypocortisolism/Adrenal Fatigue

~ Anemia

~ Side effects of medications

~ Other illnesses such as MS, lupus, fibromyalgia, chronic fatigue, lyme disease, stroke…

Interventions Physical

~ Changing Behaviors

~ Identify a behavior that can be addressed:

~ Keep it simple and achievable.

~ Break big problems down into smaller, achievable components.

~ Identify the goal (outcome) the client would like to achieve:

~ Make the goal measurable so the client can know when he or she has achieved it.

~ Explore ways the client has achieved similar goals in the past.

~ Identify barriers (internal and environmental) to success and identify what parts the client can control.

~ Identify how those barriers can be overcome in specific behavioral terms. Make addressing the barrier something to do, rather than something not to do.

~ Identify supports and specific steps needed to achieve success

~ Elicit a commitment and take action to achieve the goal

~ Get a physical to rule out hormone imbalances, physical issues causing lack of energy, fatigue, difficulty concentrating, sadness, irritability

~ Address nutrition to provide