Intervention you Would Like to Practice - Term Paper Example

Intervention you would like to practice Intervention you would like to practice Introduction Depression is one of theleading psychological processes among the elderly. There is need for urgent innovation and the implementation of new methods in order to ensure that the number of suicide cases decrease and there is an improvement in the community’s quality of life. There has been a lot of skepticism on seeking help for depression as the majority of individuals are of the opinion that the new drug companies are simply taking advantage of them and furthermore, the diagnostics of this condition may be very complicated. One population that is also at high risk of depression is that of adolescence. The individuals in this population are undergoing many changes in their lives and are attempting to adapt to new changes in society. Furthermore, peer pressure leads them to questioning themselves and the morals which they were raised upon (Thepar et al., 2012). Researchers have also indicated that depression among this population is very under diagnosed and often attributed to the physiological changes taking place in these children. These individuals have a large part of their lives ahead of them hence intervention for this age group would be beneficial to society. The paper will assess the treatment of depression for adolescents in primary care settings and the benefits that are associated with this intervention. There are very few studies which are dedicated to this approach and these do not provide sufficient evidence to rule it out as a possible method. Literature review As mentioned above, the issue of treating depression among children in primary settings has been sparingly used in research. Stein et al., (2006) carried out a study on this subject with the aim to examine evidence and results from treatment of depression in this setting. In addition, the study was also aimed at evidence concerning educational, psychosocial and supportive studies that were utilized. The study was based on literature review and assessed whether there would be an improvement in depression when there was intervention from a primary care practitioner and whether or not there would be a difference in if medication was utilized. The researched used thirty seven studies that were related to treating depression. However, from these four studies there were only four which were directly related to treatment in a primary care setting. Evidence from these four studies indicated that they were very effective. There was also indirect evidence which was based on other psychosocial interventions such as efforts to increase the adherence to treatment, anticipatory guidance and studies that were carried out on adults. These all indicated that primary care was beneficial to the patient. The study concluded that treating depression in adolescence in a primary care setting is beneficial and should be carried out to achieve better results. The study also showed that there was improvement whether or not any medication was utilized. This further raises the question on the effectiveness of medical treatment for depression and if it is a necessary mode of treatment for depression. Research that was carried out by the National Institute of Mental Health shows that depression is a pressing problem today and the issue needs to be addressed especially after youths (2009). The data found by this institute illustrated that approximately eleven percent of individuals attain a depressive disorder before they reach eighteen year old. The National Comorbidity Survey-Adolescent Supplement also stated that this is likely to occur in boys than girls. The organization also stated that depression increases with age and the WHO published an article which showed that depression was the leading cause of disability among individuals who were between the ages of 15 and 44 years. The article also published the changes in public opinion and knowledge on the issue of adolescent depression. In the past people assumed that depression was not prevalent in youths however, this was proved to be inaccurate. The reason for this misconception is due to the fact that these adolescence show signs which are slightly different to those which are presented by adults. The signs which are shown by children may be mistaken as truancy or bad behavior. The article also published information from studies which suggested that the ideal treatment for adolescence who are suffering from depression was a combination of medication and psychotherapy. The National Institute of Mental Health also published an article which reviewed different treatment plans for adolescence who were suffering from depression. The institute funded the study which involved a multi site clinical research examining both the long and short term effectiveness of psychotherapy and anti depressant therapy. The study involved the use of both together and how this differed from when they were used individually. The study was carried out on a group of individuals between the 15 and 17 years. The study also illustrated that the combination yielded the best results. The aim of depression treatment is to ensure that there is an improvement of symptoms and this is a persistent and continuous process. Another study which was carried out by TADS utilized 439 adolescents who were randomly selected and divided into four groups which were given one of four treatments. The four intervention methods included cognitive behavioral therapy, antidepressants (fluoxetine), a combination of the two methods and a placebo. After a period of three months, the placebo group was discontinued and the other three groups continued with their treatment plan for six more months. This study was also in favor of the combination therapy. The results were attained by the assessment of teens who had participated in the study. They were assessed 4 times the following year and this was to check whether the improvements were sustained over a long period of time. At the end of the study eighty six percent of the participants regardless of the treatment plan had improved and fifty nine percent of the participants had reached full remission. The improvements in the participants were also found to be long term and continued the following year. In fact, there was an increase in the number of individuals who reached full remission. This study was very significant as it was indicative of the duration at which these treatment plans are effective and what are the chances there will be need for further intervention. Suicide is one of the main problems associated with depression among adolescents. Therefore, many studies have been targeted at assessing the risk factors that are associated with depression. The NIMH funded numerous researches on this aspect, and they all illustrated that there are very high chances of the affected individuals committing suicide. These analyses were published in the Journal of Clinical Psychiatry (2009) and they indicated that treatment among individuals who were depressed reduced the thoughts of suicide. The dilemma lies in the presentations in previous studies which illustrated that despite the effectiveness of anti depressants in reducing depressive mood, these drugs increased the amount of suicidal thought and hence the prevalence of suicide among individuals who were on this medication. There is need for further research to establish a connection between anti depressant medication and suicidal thoughts. Suggestions have been made by studies which indicated that this medication led to feelings of anxiety, irritability and agitation among adolescents which contributed to their suicidal thoughts. Therefore, based on these findings physicians who are treating adolescents with depression have been encouraged to closely monitor any behavioral changes especially in the first months of treatment. The timing of the suicide was also different which indicated that the effect of the medication and its connection to suicidal was mainly prevalent at a certain stage of treatment which suggested different time periods for monitoring. The problem in the issue of depression among the adolescents is the attainment of an effective treatment plan with minimal side effects. As mentioned above, intervention in a primary care setting has been found to be very effective. However, there is need to create an intervention plan which is effective in this primary care setting. The above mentioned studies should be carried out in a primary care setting and a comparison should be made when the same interventions are done in another environment. The problem of the issue also lies in the fact that the prevalence of depression among individuals in this age group is very high; hence most of the patients will not be given access to specialized services or a primary care physician. There could also be further studies on the effectiveness of group therapies carried out in a primary care setting by a clinician as this will help in reducing the number of primary care givers required. Studies also have to be dedicated on the difference in the intervention with and without medication in primary settings. This can help in reducing the prescription of medications which have been found to increase the likelihood of suicide. There is also need for research on the different substitutions that can be prescribed in replacement of anti depressants. There should also be research on the effectiveness of supportive therapy for individuals on anti depressants. Combinative therapy for adolescents in primary care is an effective intervention method as it enables all the effective therapeutic methods to be utilized. Firstly, studies have showed that the most effective method of treatment involves a combination of pharmaceutical and cognitive behavioral therapy. In addition, there are several side effects that have been associated with use of anti depressants and the presents of a clinicians enables the monitoring of any adverse effects that are experienced. Hence, if the adverse effects are avoided and the most effective treatment plans are utilized the best results are likely to be achieved. This method also creates possibilities for further research to be carried out on patients suffering from depression. Similar to other interventions during the course of treatment there may be a need to alter the treatment plan or to make some adjustments. This is even more important with psychological problems as it could be a life saving approach. In this intervention the patients will be kept in a hospital facility for a period of twelve months where they will receive the above mentioned treatment program. There will be documentation of improvements as well as negative response to the different therapeutic interventions which will be utilized. This also creates the possibility for support as many group members will receive this treatment together and will have the opportunity to speak and interact. There will also be less external distractions such as those which can further worsen the depression of the patient at home. This intervention will be assessed by analyzing the improvement of the patient in response to the treatment. This will be assessed on a weekly basis and there will also be an evaluation of the adverse effects that are observed during different stages of treatment. This will be compared with other studies that are carried out utilizing different treatment plans. The changes in the treatment plans during the year spent in the primary care setting will also be documented and the response of the patient will also be observed. All these factors will help in creating the ideal treatment for adolescents suffering from depression. Conclusion In summation, there are several treatment plans that have been suggested for depression. There were several factors which were implemented by the individuals and these include monotherapy involving pharmaceuticals or cognitive behavioral therapy, or the use of both means of treatment. However, one area that has no been fully assessed is that of treatment in a primary care setting. The few researches that have been carried out on the subject have indicated positive results and have shown improvement with or without the use of medication. However, as illustrated in the paper the problems lie in the fact that depression at this age has a high prevalence; hence, each adolescent who is suffering from depression is less likely to receive intervention in a primary care setting. There should be further studies aimed at making this possible as well as funding for the process. It has indicated positive results and could be helpful in innovating ne methods of treatment. References “Depressed Adolescents Respond Best to Combination Therapy”. (2007). National Institute of Mental Health. Retrieved from http://www.nimh.nih.gov/news/science-news/2007/depressed-adolescents-respond-best-to-combination-treatment.shtml “Long term Depression Treatment Leads to Sustained Recovery for Most Teens”. (2009). National Health of Mental Health. Retrieved from http://www.nimh.nih.gov/news/science-news/2009/long-term-depression-treatment-leads-to-sustained-recovery-for-most-teens.shtml “Searching for Risk Factors of Suicidal Events During Antidepressant Therapy”. (2009). National Institute of Mental Health. Retrieved from http://www.nimh.nih.gov/news/science-news/2009/searching-for-risk-factors-of-suicidal-events-during-antidepressant-treatment.shtml Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379(9820), 1056-1067. “Treatment for Adolescents with Depression Study”. (2009). National Instute of Mental Health. Retrieved from http://www.nimh.nih.gov/funding/clinical-trials-for-researchers/practical/tads/index.shtml Stein, R. E., Zitner, L. E., & Jensen, P. S. (2006). Interventions for adolescent depression in primary care. Pediatrics, 118(2), 669-682. Read More