Katrina has been working with a patient in the outpatient oncology clinic. The patient, Norman, states he doesn’t know what to do. He is tired all the time, he can’t sleep, and nothing tastes good. His affect is flat, his speech is slow, and he barely makes eye contact. Katrina asks Norman if he still finds joy in anything, like seeing his grandchildren, who he has talked about at every visit before this. Norman states he is ashamed to say it but “No, actually it is so hard to be around them right now. I feel guilty about this. I must be a bad grandfather.” Katrina asks how long Norman has been feeling this way, and Norman tells her it started about a month ago and has gradually gotten worse. He describes the last two weeks as having been “the worst of my life.” Concerned,
Katrina asks Norman if it has gotten so bad that he has thought of ending his life or harming himself. Norman says he had the thought once but has been able to “shake it off.” Katrina should _____.
a. Conduct a risk assessment and safety plan and then refer Norman to a psychiatrist for an evaluation for possible antidepressants.
b. Provide psychoeducation highlighting the fact that many patients with cancer get depressed.
c. Refer Norman to a support group
d. Begin existential therapy immediately with Norman.
Ans: a
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