Treatment modality used and efficacy of the approach

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Part 1: Progress Note
The patient selected in week 3 was A.M., a 25-year-old Caucasian female who presented with suicidal tendencies and was diagnosed with Major depressive disorder. 
Treatment modality used and efficacy of the approach
In this case, the appropriate treatment modality used is Cognitive Behavioral Therapy (CBT) and engaging the patient to support groups. CBT is a psychotherapy that mainly focuses on altering and modifying the patient’s negative behavior associated with psychological distress and changing it into an adaptive behavior to maintain the patient's emotional well-being. CBT is highly effective and recommended for patients diagnosed with a major depressive disorder characterized by a constant feeling of loneliness and loss of interest and is associated with negative thoughts and behavior that could interfere with day-to-day activities (Hawley et al., 2017).
Another treatment modality used for this patient is having a support group. The support group provides a community of acceptance and belongingness for the patient wherein she can interact with other people who are also experiencing what she is going through. It is especially crucial for people with a major depressive disorder to gather hope and empowerment and support and healing from a source in which psychotherapy cannot provide. Depression worsened when an individual chose to be isolated and lonely since sustaining a perspective and maintaining an effort in dealing with the condition would be somewhat tricky. Thus, having a support group is essential for patients with a major depressive disorder to cope with their health situation through maintaining close and social relationships (Behler et al., 2017).
Progress and/or lack of progress toward the mutually agreed-upon client goals
Based on the assessment of the progress of the patient, the mutually agreed-upon goals are met. The patient showed significant results through the psychotherapy provided. The patient’s symptoms, such as stress, depression, and suicidal tendencies, were significantly improved. As shown by the PHQ 9, the patient test scores reduced from 20 to 15 in four weeks and from 15 to 9 in eight weeks of follow-up. Positive effects of the intervention were shown during the 4th week. The patient started playing the piano again as an alternative way whenever suicidal thoughts occur. She also enrolled in yoga classes as a way of managing both her positive and negative emotions. The patient further reported that her support group encouraged and empowered her, which helped her in the healing process. Additionally, the patient no longer had suicidal ideations and had returned to work four weeks ago. These results are considered the key indicators of the effectiveness of the treatment modalities used along with the patient's significant progress. 
Modification(s) of the treatment plan that was made based on progress/lack of progress
Since the treatment plan (CBT and support group) conducted on the patient has shown significant results regarding her MDD symptoms, modifications were not necessary and were not done.
Clinical impressions regarding diagnosis and/or symptoms
In assessing a patient’s symptoms, the clinical impressions include the use of clinical judgment and clinical decision-making in deducing treatment modalities. Furthermore, the PHQ-9 score was used to confirm the diagnosis for MDD and exclude bipolar disorder and other mental health disorders caused by depression. 
Relevant psychosocial information or changes from the original assessment
The patient is single and is working as a Physical therapist. There are no changes. 
Safety issues
Considering her suicidal ideations, the patient was advised to live with her mother and her youngest sibling to help her in daily chores as well as ensuring her safety.
Clinical emergencies/actions taken
No emergency actions were taken.
Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
Citalopram (Celexa) – 20mg PO qDay
Treatment compliance/lack of compliance
The patient was compliant with all her treatment plan. Both CBT and support group sessions are attended timely.
Clinical consultations
To ensure effective treatment is provided to the patient, clinical consultations include physical visits to her primary provider and therapist and phone calls, emails, and online video-chat whenever necessary.
Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc. )
Other medical health professionals involved in the care for the patient include a nutritionist and a family therapist. The nutritionist act as a guide for the patient in managing her diet and activities for her optimal health and to address her weight-loss issue. The family therapist guides...