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.