Mary continues to be moderately depressed and shows no real change in her mood state.
Mary: GHQ-12 (No improvement) [PDF, 183KB]
What should the team do?
- The team continue to monitor Mary and work on enhancing her self-efficacy (her belief that she can achieve goals and targets).
- She is asked to re-consider trying an anti-depressant medication. She agrees to this in the short term. She finds this has a moderate beneficial effect on her mood and allows her to sleep better and improves her appetite.
- In addition they refer her to clinical neuropsychology services. The clinical neuropsychologist works with the occupational therapist in engaging Mary in a formal problem-solving intervention. Problem-solving deficits are often found in people with depression. In addition Mary also has problem-solving deficits due to her stroke. Mary finds that her improved problem-solving skills help her when she approaches new difficult situations. Her enhanced problem-solving skills reduce her tendency to fail in new situations thereby reducing the frequency of interpreting such failures in a negative and self-critical way.
- The clinical neuropsychologist also offers Mary and her family some time-limited sessions exploring how they are coping with changes in Mary’s skills and abilities. These sessions enhance Mary and her family’s understanding of her situation and the expectations they have about her recovery.
- When Mary is discharged her depression on the ward is highlighted in her discharge letter and her GP is asked to regularly review her medication. The stroke nurse who visits Mary at home also closely monitors her mood and completes further mood screening at regular intervals.
Page last reviewed: 25 Feb 2020
