2: General Approach to Psychiatric Care Flashcards
What is the role of the community mental health team
Look after those with serious or complex mental health needs in the community
What are three types of community mental health teams
- CRISIS team
- Assertive outreach teams
- Early Intervention Teams
What is crisis team
Individuals experiencing acute mental health crisis
What are assertive outreach teams
Those with complex mental health needs
What are early intervention teams
First-episode of psychosis
What are CAMHS
Look after under 18 year-olds
How can someone be referred to CMHT
CMHT is a secondary care service - can be referred from primary care, liaison psych, social services, police, IAPT
What is the care program approach
Package of care used by secondary mental health services
What are aspects of CPA
- Goals
- Strengths
- Support needs
- Difficulties
- Crisis plan
When are care programme approaches implemented
Implemented by secondary health services for individuals at high-risk of with a wide array of needs (suicide, self-harm, abuse, recent MHA detainment, crisis referral)
Who produces care programme approach
CMHT
Explain legal rights governing care program approach
All individuals detained under mental health act or with a community treatment order have a right to free aftercare under section 117
What is psychotherapy
Tasing therapy delivered by trained professional based on particular model
What are 4 favourable traits of psychotherapy
- Motivated
- Owns difficulties
- psychologically minded
- capacity for self-containment
What are 5 unfavourable traits for psychotherapy
- poor impulse control
- low tolerance for frustration
- impaired cognitive function
- substance-dependence
- active psychosis
Who can primary care refer to
IAPT (Primary-Care Service) or CMHT (Secondary-Care)
What is counselling
Focuses on the present - based around behaviour patterns
What is psychodynamic therapy
Derived from psychoanalysis. Focuses on development from childhood. It states that unconscious conflicts between feelings, wishes and what is acceptable when repressed cause problems. Focuses on content of dreams
What is CBT based on
Beck’s triad: cognitions influence feelings and behaviour
Who created attachment theory and what year
John Bowlby (1990)
What does attachment theory state
Children from attachments with their primary care giver in order to survive
Who described types of attachment
Mary Ainsworth - using stranger situation test
What is the main type of attachment
Secure attachment (65%)
Describe secure attachment
- Child is free to explore
- Parent is attentive to child’s needs
- Child knows there needs will be met
What adult personality does secure attachment lead to
Autonomous
What is insecure-avoidant attachment
- Child is not explorative
- Mum is disengaged
- Child does not feel needs will be met
What does avoidant attachment lead to in adult life
- Dismissing
What is insecure-ambivalent attachment
- Child is anxious and insecure
- Parents response is inconsistent
- Child does not feel needs will be met
What adult personality does ambivalent attachment result in
Preoccupied
What is disorganised attachment
- Child is depressed or angry
- Parent response is intrusive, erratic or frightening
- Child is severely confused and needs not met
What does disorganised attachment lead to
Fearful
What are the 3 parts of the therapeutic relationship
- Therapeutic alliance
- Transference
- Countertransferance
What is therapeutic alliance
Relationship formed between doctor and patient
What is simple therapeutic alliance
Mutual co-operation
What is complicated therapeutic alliance
Where patient has covert agenda which manifests in subconscious means
What is transferance
Patient projects parts of early relationships onto the practitioner - only parts of the relationship is projected. The other person is expected to play a complementary role
What is countertransference
Emotions and fantasies evoked in the other person (doctor) by the patients transferance. Easier to identify if not congruent with doctors personality
What is ECT used for
Treatment-resistant depression or psychosis
