Compare and contrast three different therapies utilized from the case study attached below:

Case Introduction

The client was a 58-year-old married White female with 4 years of college education and a career as a nurse. At the commencement of therapy, she was unemployed due to knee surgery and was not actively seeking employment.

Presenting Problems

Upon entering therapy, the client reported she was experiencing depressive and anxious symptoms. Among her depressive symptoms was a depressed mood that had been present for 2 years, starting with her breast cancer diagnosis. She also reported significant loss of energy and impaired concentration along with moderate feelings of worthlessness, hypersomnia, and a decrease in appetite. Generalized anxiety symptoms also were reported that included persistent and uncontrollable worry about a number of life areas such as work, family, finances, social issues, and personal health. Psychosomatic symptoms of anxiety included significant difficulty concentrating, becoming easily fatigued, moderate muscle tension, sleep difficulties, and mild irritability. The client reported the onset of anxiety symptoms about a year prior to entering therapy, precipitated by knee surgery that affected her ability to work. The client reported utilizing avoidant behaviors to try and reduce her anxious thoughts (e.g., thought suppression, watching television, sleeping excessively). These avoidant behaviors became linked to her depressed mood, which further inhibited her from engaging in previously rewarding overt behaviors. Another complication to this client's situation were two significant Axis III problems (i.e., a breast cancer diagnosis 2 years prior to therapy and knee surgery 1 year prior) that required her to reevaluate how current behavioral patterns and life goals might be changed as a function of these health issues. These precipitators increased anxiety about her future. Although some previously emitted positive behaviors had been discontinued due to avoidance and decreased motivation associated with depressed affect, decreased engagement in other previously reinforced behaviors (e.g., work activities, health behaviors) were more directly related to physical limitations.

History

As stated, the client's depressive and anxiety symptoms had been present for approximately 2 years and 1 year, respectively. The primary events proximal to the onset of these symptoms were the client's diagnosis of breast cancer 2 years earlier and difficulties recovering from knee surgery about a year earlier. The client was diagnosed with Stage 2 breast cancer (left laterality) with a tumor size of 2.1 cm. She had positive estrogen and progesterone receptor status and was negative for the HER-2/NEU gene. Subsequent to the cancer diagnosis, the client had a lumpectomy followed by radiation and chemotherapy. The client reported previous episodes of depression that included two psychiatric inpatient hospitalizations during the 1980s and one hospitalization for alcohol addiction (1989) that appeared to function as a maladaptive strategy to cope with memories of an abusive childhood. The client reported that her father frequently was physically abusive during her youth and that she often experienced migraine headaches and depressive affect which she associated with this abuse. The client indicated that vivid memories of her childhood abuse began to manifest during the 1980s and that alcohol abuse seemed to be the most effective strategy by which to inhibit these memories. She initially engaged in psychotherapy in the late 1980s and remained in therapy for about 5 years. The client reported great improvement following psychotherapy that focused on using cognitive-behavioral therapy to develop coping strategies to minimize the frequency and intensity of aversive thoughts and emotions related to early childhood abuse.