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Liona Barrueco, a 13 year old Hispanic girl is seen in a

psychology clinic. She is a gifted and talented child, enrolled in private school. She expresses thoughts of suicide to a friend, who urges Liona to see the school psychologist. Upon consultation, she is thereby referred to a psychology clinic.


Suicidal thoughts
Feeling increasingly depressed Irritability, loss of energy and fatigue Loss of interest in pleasurable activities
(swimming, socializing)

Difficulty sleeping at nighttime Decreased appetite

Headaches Constant worrying and bickering Suicidal Gestures
Thoughts of drowning Wrist slashing- At one point, using a razor blade, Liona
scratched her wrist as a suicide gesture.

Which one of the following is not a symptom of depression, and by extension, was not present with Liona A. Fatigue or loss of energy B. Recurring thoughts of death or suicide C. Loss of empathy D. Increased Irritability E. Sleeping Issues


Conflicts with peers and family

Lead to Isolation and Insecurity. It is during these periods
where Liona most likely thinks suicide.

Home Life
Lionas home life (this seeming to be her trigger) was dysfunctional.
Her parents had gotten divorced when she was a small child and her
father was abusive. He frequently struck Lionas mother and on two occasions, hit Liona herself.

Lionas mother was unemployed and the family struggled financially. Liona received a scholarship to an expensive upper-middle-class
school in which there were few minorities, increasing her stress

Lionas father would sporadically exit and reenter Lionas life and
during these periods, fathered two more children. This exit/entering happened at multiple occasions and resulted in Liona resenting her father.

Liona also was angry over the fact that her mother, in times of need,
would still reach out to her father.

Biological Correlations:
Lionas father suffered from several psychological and
physical diseases such as: Ulcers, high blood cholestrol, lung problems, alcoholism, Hodgkinss disease and depression.

Lionas mother also suffered a depressive episode after

the divorce.

Maternal Aunt: Recurring periods of depression Paternal Grandmother: Recurring periods of


Axis I

296.22 Major depressive disorder, single episode moderate Axis II V71.09 No diagnosis on Axis II Axis III None Axis IV Disruption of family by divorce, health problems in family, poverty Axis V Global assessment of functioning= 58 (current)

Role Confusion
13 Year Old Daughter Mothers companion and protector
When her father came home she had to give up that role

Insecurities with being a minority student in a new school

Main Therapy was Interpersonal Psychotherapy

(IPT) Another therapy for depression is Cognitive Therapy

Clarified the expectations for Liona

Bolstered cultural identity among peers

Encouraged her to educate her classmates about her
Hispanic culture and language ~ Not just the curse words

Which one of the following treatments are used for depression ? A. Flooding B. Interpersonal Psychotherapy C. Cognitive Therapy D. A & B E. B & C