MILD / MODERATE DEPRESSION
Week 0
INITIAL/SCREENING APPOINTMENT (GP)
Mrs Jones, a 34 year-old teacher, presents to her GP complaining of increasing lack of sleep and appetite and tearfulness for the past four or five weeks. A physical examination indicates no abnormalities. The GP asks the patient the two screening questions and following a positive response asks specific questions about symptoms, impact and risk and completes the ICD-10. The patient is asked to complete the screening tool (PHQ-9). Both scores are indicative of mild depression and this is discussed with the patient. The patient agrees she has been feeling a little fed-up and drinking slightly more alcohol than normal but isnt a risk and has no previous history. The patient shows some interest in psychological therapy, and the GP gives the patient an information leaflet on available therapies, and suggests the patient might wish to use some self help materials in the first instance. An appointment is made to see the graduate worker to discuss some guided self-help in more detail.
Week 2
GUIDED SELF-HELP SESSION 1 (GRADUATE WORKER)
The Graduate Worker briefly discusses the nature of the patients problems and possible materials that may be of use. They decide on a depression self-help book, and the Graduate Worker suggests scheduling pleasant activities more regularly, and shows the patient how the manual can help with this. They make an appointment for 2 weeks. This information is fed back to the GP by addition in the medical records.
Week 4
GUIDED SELF-HELP SESSION 2 (GRADUATE WORKER)
The patient and graduate worker discuss the patients use of the manual and any difficulties that have arisen. Other activities are also discussed. The patient continues to be concerned about her alcohol consumption so the graduate worker gives her contact details for the local voluntary alcohol support service. This information is added to the medical records.
Week 6
GUIDED SELF-HELP SESSION 3 (GRADUATE WORKER)
The patient and graduate worker continue to discuss the patients use of the manual. The patient did contact the voluntary alcohol service and has signed up for a support group.
Week 8
MONITORING SESSION (GRADUATE WORKER)
The graduate worker gets the patient to complete the PHQ-9. Scoring the questionnaire indicates that the patients problems have remitted. The patient is happy to continue using the manual and attending the voluntary support group. The results of the assessment are fed back to the GP and entered onto the medical record. The patient is removed from the graduate workers caseload.