Teresa is an 80-year old woman who you are seeing in an intake counseling session. You notice she appears disheveled and markedly thin. She came to see you to help her with sudden depression, hopelessness and feeling that life has lost meaning. She describes herself as a happy and content woman, who has enjoyed life until recently. Her husband died last year, and due to declining health, Teresa has moved in with her daughter and son-in-law about 8 months ago. She tells you that her daughter is often too busy to make her lunch, or take her shopping for new clothes or personal items. Quite often the daughter and son-in-law go out for dinner not leaving Teresa anything to eat. Teresa is embarrassed and hurt that her daughter is treating her like this but doesn't want to make a fuss. 

Complete CONFIDENTIAL REPORT - NOT SUBJECT TO PUBLIC DISCLOSURE

 

Answer:

History; Teresa is 80 years old, she has lost her husband recently after her husband's demise she came to stay with her daughter and son-in-law. She had a good and comfortable life with her husband; she had enjoyed her life fully.

Now she is being ill-treated by her daughter, she does not provide her food; she does not look after her personal needs.

Diagnosis; She had a full and happy life with her husband, now she is deprived of her home, she is getting ill-treated by her daughter and son-in-law, this environment has developed depression and hopelessness feeling in her because now she is old and depends on her daughter and her husband. As she is not getting any attention and proper food from her daughter she has become thin and shows a lack of interest in life. She is hurt because she is getting ill-treatment from her own daughter, whom she would have taken care of when she was born. She is suffering from hurt feelings. As she looks disheveled it shows she does not take care of her physical appearance or she does not have the means to buy for herself. She is thin maybe because of starvation. As she is economically dependent on her daughter, her helplessness has increased.

After studying her case the interpersonal therapy is suitable for her because her depression and hopelessness are the results of losing her husband, her own age factor, her dependency on daughter and lack of support or empathy from the daughter and son-in-law, the ill-treatment and negligence on the part of her daughter, even food is not properly given to her.

I would suggest and focuses on interpersonal therapy as it focuses on interpersonal conflict t and poor social support, and Teresa is facing both. Due to her age, she does not have much social life and there is a conflict of relation with the daughter. This therapy involves the important person in the patient's life, her daughter and son-in-law has to be included during the session for resolving the existing conflict

As she never showed any depression or other symptoms, her problems are due to interpersonal conflicts. This therapy is a brief, attachment-focused and deliberately one or two problems are taken and intense focus is given on the selected problems and try to resolve the interpersonal conflict that would automatically reduce the depression, as Teresa had recently lost her husband I would focus on making her adapt to the new environment because her depression is related to environment and change of situation. I would help in diffusing the conflict between the mother and daughter.

The technique involves is empathetic listening so the patient develops confidence and outlet for her emotions. The patient is helped in reexamining the situation that is called clarification. This therapy would help in looking into various approaches to making interpersonal adjustments by understanding the other's point of view and expectations.

Communication is very important to understand each other Teresa was continuously getting neglected by her daughter while going through various sessions the communication would resolve a number of misunderstandings. The vignette does not show any undue demand by Teresa but shows that her daughter is the busy whole day and neglects her mother, this situation can improve positively unless they have a conversation, Teresa is an old lady, and found to be undemanding the daughter should at least take care of her food and personal feelings. I would make her understand that "mother is after all mother"; we should never treat her like a burden. How busy we are starving our own mother is an unethical act.