Background. Depression is one of the most common mental disorders worldwide. Despite a bulk of literature on the effective treatment for Major Depressive Disorder (MDD) has been published, the discussion regarding treatment for depression related to involvement in radical organization has remained sparse in recent publications. By the increase of radical organization involvement in society, additional research is needed. This clinical case study describes the assessment and treatment of a 26-year-old woman with MDD symptoms. Participant in this study reported symptoms of MDD such as, a sense of emptiness, worthlessness, insomnia, loss of energy, and recurrent suicidal ideation. These symptoms have been present during the last six months after she finished her study and had no activities outside. Moreover, she felt disappointed and regretted her life. She felt her life became more chaotic after she joined a radical organization two years ago. In addition, she was stalked by the organization member for almost six months after she decided to quit. This condition made her feel unsafe and depressed. At that time, she overcame her condition by keeping herself busy. However, when she has no activities, she couldn’t deal with it. Besides showing MDD symptoms, she also restricted interpersonal contact. She becomes relatively isolated and does not have an extensive social support that can help her weather crisis. Considering that counseling has been used by a mental health professional to help people develop more effective, satisfying, and productive ways of living, counseling may be a good fit for the treatment.

Methods. This research is using pre-post single subject design. The participant in this study was recruited from Student Counseling Center (Klinik Terpadu). Participant was monitored before, during, and after the intervention. For this research, Beck Depression Inventory (BDI) was use as the psychological measurement. Participant completed the assessment at the baseline and follow-up session. The data obtained from BDI is also supported by observation and interview during the session. Based on the interview, this case study is in accordance with humanistic approach. Therefore, counseling was chosen as a method for the treatment. Dealing with these symptoms, the intervention was held in five sessions (90 - 120 minutes each). By using counseling, the treatment aims to increase awareness due to her depression symptoms, develop healthy cognitive patterns and beliefs about self and the world that lead to alleviation and relapse prevention for the depression symptoms, develop a healthy interpersonal relationship, normalize mood and achieve an adaptive level of functioning. Data analysis was conducted qualitatively by comparing BDI score before and after the intervention.

Results. After five sessions of intervention and five months of follow-up, MDD symptoms displayed a clinically significant decrease. Depressive symptoms as measured by the Beck Depression Inventory (BDI) demonstrate a clinically significant reduction from 28 at pre-treatment to 10 at the five months follow-up. Besides measurement using BDI, the effectiveness of the treatment was also measured by interview and observation in every session. In the last session of intervention, participant reported that she no longer has suicidal ideation and tried to open up to her mother. Meanwhile, five months after the last session, participant conveyed that she is occupationally functioning and willing to open herself up, not only to her mother, but also her friends. She also has an awareness to develop her passion.

Conclusions. These findings provide evidence that counseling might be an effective treatment for patient with depressive symptoms.

Added-Values. Recently, radical organizations emerged to be one of the critical issues in the world, especially in Indonesia. Extreme doctrines developed by the organization have major impact on the member’s life. This condition could have traumatizing effect enough to trigger depression for the people involved in it. Therefore, research is required to develop the right treatment for depression. Furthermore, the intervention in this case study can also be replicated to be more systematic and more frequent to improve treatment effectiveness towards the participant.

Keywords: counseling; major depressive disorder; depression; radical organization

Word count: 640 words.