Painting Language Sandplay and Heart Bridge: Integrated Counseling for Patients with Recurrent Depression

This case report focuses on the counseling practice for Xiaomei, a 21-year-old junior student majoring in art education with recurrent depression. Due to family conflicts, relationship setbacks, and academic pressure, the client suffered from recurrent depression and anxiety symptoms, accompanied by self-harm behaviors and suicidal ideation, due to family conflicts, relationship setbacks, and academic pressure. She had previously discontinued medication without medical advice, resulting in symptom exacerbation. The counseling adopted an integrated approach, including cognitive therapy, painting psychological analysis, solution-focused coaching, and sandplay therapy, combined with pharmacotherapy. After 18 counseling sessions, the client’s emotional distress was alleviated and social functioning improved. Results showed significant reductions in anxiety and depression scale scores, cessation of self-harm behaviors, and gradual recovery of social support systems. However, deep-seated family trauma and relapse risks require long-term intervention. This study indicates that pharmacotherapy combined with integrated psychological counseling exerts positive effects on cases of recurrent depression, and the counselor’s professional growth is crucial for enhancing intervention effectiveness.