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Quadrant Assignment and Planning

Once assessment is complete, the individual is categorized as possessing high or low knowledge and high or low motivation. Then the individual should be assigned a quadrant based on this categorization. Interventions and tools are available for individuals in each of these quadrants. The goal is to work with the depressed individual to move into a higher level on the quadrant, which indicates improved adherence intention.

Knowledge Tools

Encouraging the individual with depression to discuss his/her personal symptoms and diagnosis is critical to empowerment. As noted by WebMD,80 these are questions the individual might ask of his/her healthcare provider:

  • What are symptoms of depression?

  • What are symptoms of anxiety disorder?

  • What are symptoms of Bipolar Disorder? What is mania?

  • How often do the different symptoms usually appear?

  • Can the symptoms go away without intervention?

  • Do I need to take medications for treatment or are other options available?

  • When will I begin feeling differently?

  • What should I tell friends and family about my illness?

Engaging the individual in education may be challenging because of the impact of depression. Realistic goals must be set, and the individual must assume a reasonable amount of responsibility. However, do not create higher expectations or goals that the individual may not be able to attain. Here are some hints:

  • Break large tasks into small ones, an important part of realistic goal setting.

  • Help individuals with depression set some priorities, doing what they can as they can.

  • Encourage them to be with other people; suggest that they confide in someone and discuss depression.

  • Discuss activities that may make them feel better while encouraging participation — perhaps exercise.

  • Educate them regarding their mood, which may improve gradually, not immediately.

If the individual is in denial regarding mental illness, education about the disorder and the effects of medication non-adherence may not take place. Instead, identify goals with the individual and explore the effect of medication on achieving his/her goals. This step does not require acknowledgment of depression. Motivation may

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