SMART Treatment Plan (Behavioral Health)

Identified Problem

• MDD, recurrent, moderate (F33.1), evidenced by anhedonia, hypersomnia, and occupational impairment (missed 4 workdays this month). PHQ-9 = 16.

Goal

• "I want to get out of bed on time and stop missing work."

SMART Objectives

1. Specific: Pt will utilize behavioral activation (BA) strategies to get out of bed by 07:30 on weekdays and engage in 15 mins of morning light exposure.
2. Measurable: Pt will log wake times and work attendance daily via mood-tracking app; target PHQ-9 reduction from 16 to < 10.
3. Achievable: Pt has previously maintained a 07:30 routine, possesses a light therapy box, and shows high motivation to retain employment.
4. Relevant: Directly targets hypersomnia and morning inertia to prevent job loss and restore baseline functioning.
5. Time-bound: Achieve >= 90% weekday wake-time adherence and zero unexcused work absences within 6 weeks (by 26/05/2026).

Planned Interventions

• Psychopharmacology: Initiate bupropion XL (Wellbutrin XL®) 150 mg PO QAM; assess tolerability and efficacy in 2 weeks for potential titration to 300 mg PO QAM.
• Psychotherapy: Weekly 45-min CBT/BA sessions focusing on sleep hygiene, activity scheduling, and cognitive restructuring of morning-related automatic negative thoughts.

Evaluation Criteria

• Review daily wake/attendance logs and repeat PHQ-9 at biweekly med checks (next appt 28/04/2026 at 10:00) and formal 6-week treatment plan review on 26/05/2026.