Supporting Patients During Initial Treatment for MDD

Seeking treatment for major depressive disorder (MDD) can be daunting, particularly for first-episode patients. In this video, Psych Congress Steering Committee member Saundra Jain, MA, PsyD, LPC, discusses how clinicians can support patients through the early stages of treatment for MDD. Jain underscores the importance of practicing with empathy, using holistic, integrative approaches to initial care, and leveraging evidence-based tools to improve patient engagement and outcomes throughout the treatment process.

For more expert insights, visit the MDD Learning Library.

• Initial treatment planning should be evidence-based and may incorporate medication, psychotherapy, and wellness or lifestyle interventions while prioritizing the patient’s experience of entering mental health care. 
• Treatment outcomes should extend beyond symptom reduction to include improved functioning and the patient’s goal of returning to their previous level of well-being, work, and relationships. 
• Routine, systematic use of scales and screeners can track treatment progress and is associated with improved outcomes, greater patient engagement, and more active participation in the treatment team.

Saundra Jain, MA, PsyD, LPC: Hi, everyone. My name is Saundra Jain, and I'm a happy member of the Psych Congress family and part of their Steering Committee. I serve as an adjunct clinical affiliate at the University of Texas in Austin, School of Nursing, and I also have a private practice in Dallas, Texas.

Psych Congress NP Institute: How should clinicians approach the initial encounter and treatment planning for a patient presenting with a first episode of major depressive disorder (MDD)?

Jain: Let's talk for just a minute about first episode MDD. When those patients come to see us, what do we need to know about treatments?

Before we do that, let's step back for a minute because that first encounter—just imagine. First time stepping into mental health, into psychiatry. It is that commitment to seek care, to acknowledge that they're there because they want to get better. That can be a risky proposition, because the first time is a little bit scary for most anything we do. 

So, part of the work is really being present for the patient. Because this is the beginning of their healing journey, we have many options available to us. These are based on evidence. The data guides us in these decisions.

We can look at medication interventions. We can look at different models of psychotherapy. And let's not forget, we can also bring into the treatment plan wellness interventions. Sometimes we call that lifestyle changes. It's all the same. It is how well a patient is doing. That is a high priority to patients in addition to reduction in symptoms.

PCNPI: How can clinicians expand their measures of outcome beyond symptoms to include the patient's perspective?

Jain: I think for all of us when we seek care, regardless of what the difficulty is, our main interest is feeling better, getting back to our old way of feeling, performing, work, our relationships. We want to feel like our old self, not the self that is challenged with whatever is in front of us. 

As clinicians, we certainly want to look at reduction in symptoms. We want to look at improvement in functionality. We begin to wonder; how do I begin to measure that? How do I keep watch over that to know that the patient and I are aligned in that ultimate goal?

I would say that we can revert to—or not really revert to, we can just have as a foundation of the work we do—using scales and screeners. We know that when clinicians use measurement-based care, outcomes are improved. The data is convincing on this point.

In addition to that, we also know that when we're routinely, systematically using scales and screeners, that patients are more engaged. They are more active members of the treatment team. So that would really be my go-to recommendation.

Saundra Jain, MA, PsyD, LPC, is an adjunct clinical affiliate in the School of Nursing at The University of Texas at Austin and a psychotherapist in private practice. Jain is a co-creator of WILD 5 – A Proven Path to Wellness and co-author of The Science and Practice of Wellness: Interventions for Happiness, Enthusiasm, Resilience, and Optimism (HERO). She is the co-creator of the Psychedelics and Wellness Survey (PAWS), exploring the intersection between psychedelics and wellness. She is the co-host of the newly launched podcast Happy Human 3.0, which explores how modern humans can move beyond merely surviving 21st-century stressors and begin to flourish by integrating neuroscience, positive psychiatry, and compassionate, human-centered care.

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