本文係針對一位長期負向思考、認知偏差而多次出現自傷行為，使個案和家人充滿無力感的憂鬱症患者之照護經驗，護理過程中依生理、心理、智能、社會及靈性等五大層面進行護理評估，確立個案有潛在危險性自傷、缺乏適應和解決問題之能力及家庭因應能力失調等健康問題，在建立治療性護病關係後透過十次的認知治療，鼓勵案姐參與治療計劃，個案得以改善情緒困擾、自傷行為及提升自我與家庭生活適應力。本篇報告闡明了護理人員在照顧憂鬱症患者時，可運用認知治療此一獨立性護理照護措施，有效幫助個案和家庭達到安適的狀態。

This case reports in a nursing experience of a patient with major depression, who makes herself and her family powerless due to a long termnegative thinking, with cognitive bias and self-harm behaviors many times. By using physical, psychological, mental, social and spiritual function assessments in the nursing process, the authors found out the patient's health problems included: risk for self mutilation, ineffective individual coping and ineffective family coping due to negative thinking and cognitive bias. After an established therapeutic nurse-patient relationship, the authors accomplished ten times cognitive therapies and also encouraged the patient's sister to participate in this therapeutic project. Finally, the patient improved her emotional problems, reduced self-mutilation behaviors and promoted her individual and family coping ability. This case report shows that when caring for major depressive disorder patients, nurses can even use cognitive therapy and independent nursing intervention to help patients and their families achieve a stable, and comfortable condition.