Design of a Maintenance Protocol based on Bipolar Neutrosophic Analysis for Severe Depression

Severe depression has been one of the leading causes of disability worldwide and maintains a high risk of relapses even after successful treatment, especially in medium-sized cities in Latin America. Therefore, this study focused on the design of a clinical maintenance protocol based on Acceptance and Commitment Therapy (ACT), aimed at young adults residing in Ambato, Ecuador, who had previously received Cognitive-Behavioral Therapy (CBT). To this end, a bipolar neutrosophic analysis of depression was conducted to determine the attributes that impact the identified patients and define the design of the proposal. The designed protocol was structured into eight group sessions, with an experiential approach centered on the six core processes of ACT. Evaluation strategies were also proposed to measure processes and outcomes. It was concluded that the protocol seeks to strengthen therapeutic continuity, reduce relapses, and promote sustained emotional well-being in young people with a history of depression.