Behavioral Activation and CBT as an Intervention for Coexistent Major Depression and Social Phobia for a Biracial Client With Diabetes

Abstract

Major depressive disorder (MDD) and social anxiety disorder (SAD) frequently co-occur in individuals seeking treatment for either problem individually. Strong empirical support exists for the use of behavioral activation approaches for MDD and for cognitive-behavioral approaches for SAD, but these strategies may also work well when used concurrently to treat comorbid MDD and SAD. This study presents a biracial client seeking treatment for chronic MDD maintained in part by his symptoms associated with SAD, which also impacted service utilization in relation to diabetes. Behavioral activation treatment for depression (BATD) and cognitive-behavioral therapy for SAD were used integratively to simultaneously address MDD and SAD symptoms. Following nine sessions of treatment, the patient experienced dramatic changes in both anxiety and depression symptoms across all measures and successfully sought out and received medical treatment for his health problems. Data from this case study suggest an integrative approach for addressing co-occurring MDD and SAD symptoms.