Cognitive-Behavioral Therapy for a Refugee Mother With Depression and Anxiety

Abstract

This case study illustrates a short-term cognitive behavioral therapy (CBT) for a refugee single mother of a 4-year-old son to address depression and anxiety symptoms. Although she has histories of multiple trauma experiences such as sexual abuse and intimate partner violence, the client preferred to focus on current difficulties rather than trauma histories. As such, non-trauma-focused CBT utilizing psychoeducation, skill building, activity monitoring and scheduling, and cognitive restructuring is implemented over 10 individual sessions. The client’s progress was measured by the Depression Anxiety Stress Scale (DASS-21), the Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form (Q-LES-Q-SF), and a full-length Columbia-Suicide Severity Rating Scale (C-SSRS) at the intake, midpoint, and last session. The client showed improvement in all measures after the treatment, which corresponded with the client’s verbal reports during the session. This case illustrates the critical clinical decision-making points made by the therapist, and recommends the evidence-based practice protocol that considers empirically supported treatments for the comorbidity of depression and anxiety with multiple trauma experiences, the client preference, and contextual factors in addressing complex clinical presentations.

Social Support and Mental Well-Being of Newcomer Women and Children Living in Canada: A Scoping Review

“…Of the fourteen studies included in this review, the types of studies varied considerably, representing a diverse range of research methodologies. These included pilot studies [36,37], an exploratory sequential mixed-methods study [39], a scoping review [33], a case report [40], qualitative studies [29][30][31][32]34,36], a literature review [28], a case series [38], and a systematic review [35]. When considering the sample sizes of the studies, it was observed that 2 studies had fewer than 9 participants [36,40], 3 studies had a sample size ranging from 10 to 29 participants [30,31,39], and 4 studies had a larger sample size of more than 30 participants [17,29,34,37].…”

“…For one study, specific participant data were not available [32]. Four studies were either reviews or case series [28,33,35,38] Regarding the demographics of the participants, eight studies primarily focused on women [17,31,34,[36][37][38][39][40], five studies specifically included children [28][29][30]32,33], and one study involved both youths and women [35].…”

“…One article described a case study using cognitive behavioral therapy to help a 29-year-old single newcomer mother (who had a history of anxiety, depression and abusive relationships) to overcome her negative migratory experiences [40]. Therapy activities included a thought journal to track negative and distressing thoughts and an activity calendar to monitor tasks and behaviors.…”

“…It was found that 10 weekly individual sessions were effective in improving her scores from "extremely severe" to "mild" on a depression and anxiety scale. The woman also learned new skills to address depression and anxiety symptoms and planned to access a local women's resource center referred to her by the therapist [40].…”