Date of Submission

2007

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Robert A. DiTomasso, Ph.D., ABPP

First Advisor

Elizabeth Gosch, Ph.D., Chairperson

Second Advisor

Virginia Salzer, Ph.D.

Third Advisor

Mark Salzer, Ph.D.

Abstract

Depressive Disorders impact an estimated 17.6 million Americans a year (National Institute of Mental Health, NIMH, 1999). It has been found, in fact, that major depressive disorders are the predominant illnesses among the population served in the community mental health population (Bailey, 1999; Blendon & Benson, 1998). Due to restrictions in funding in Medicaid and Medicare services, many mental health services have been either restricted or eliminated for the indigent population requiring treatment (Bailey, 1999). Recognizing the need for improved outpatient care for this underserved population, the NIMH increased funding to develop stronger relationships between research and clinical practice. The NIMH also concluded that the use of evidenced-based practices, especially the use of psychotherapy treatment manuals, might be helpful in the dissemination of translational research in community mental health settings (Wilson, 1995; Addis, 2002). However, empirically supported treatment manuals have been resisted in the clinical community due to fear of standardization by clinicians (Wilson, 1995; Addis, 2002). To better understand the potential advantages and disadvantages of translational research and evidenced-based practices, an empirically supported treatment manual was implemented in a community mental health center for the treatment of major depressive disorders in a single case study. The findings suggested that the client found the structured approach helpful, especially in applying the new skills to his everyday life. There were some questions pertaining to the success of the outcome of the treatment because of the variability of the data points related to the Beck Depression Inventory–II Scores. Based on anecdotal information gathered from the transcripts and from the therapist's process notes, the client felt that his depressive symptoms reduced and his quality of life improved. The client also successfully attended all sessions and completed 90% of his assigned homework activities. It is also important to note that the client and therapist maintained a strong therapeutic working relationship, which was measured by the Working Alliance-Short Form. It is proposed by this author and researcher to conduct an empirical study with a larger sample size, three interventions and a greater number of sessions to gain a greater understanding of the benefits of manual interventions in a community mental health center.

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