7) Psychological Therapies and Interventions

Question 1

What is classical conditioning?

Answer 1

Associative learning - unconditioned stimulus (response given) paired to a conditioned stimulus then eventually the conditioned stimulus will lead to a response also.

i.e. Pavlov’s dogs

Question 2

What is operant conditioning?

Answer 2

The consequences of what you do affects how you will behave in the future - reward/punishment

Question 3

What are the four main groups of psychological therapies?

Answer 3

• Cognitive behavioural therapies
• Psychodynamic therapies
• Systemic therapies
• Humanistic therapies

Question 4

What are the three types of psychological therapies healthcare can offer according to Parry (1996)?

Answer 4

-Type A – psychological treatment as an
integral part of mental health care
-Type B – eclectic psychological therapy &
counselling
-Type C – formal psychotherapies

Question 5

What are three groups of Type C therapy (Parry, 1996) that can be given?

Answer 5

-Cognitive-behaviour therapy (CBT)
-Psychoanalytic/psychodynamic
therapies
-Systemic & family therapy

Question 6

Briefly describe cognitive-behaviour therapy (CBT)

Answer 6

Relieve symptoms by changing maladaptive thoughts, beliefs & behaviour

Question 7

What type of behavioural techniques can be used in cognitive-behaviour therapy (CBT)

Answer 7

• Exposure to scary thing
• Activity schedule - planning things and following through
• Reinforcement and reward
• Role play and modelling

Question 8

What type of cognitive techniques can be used in cognitive-behaviour therapy (CBT)

Answer 8

• Education (have a discussion and see what they believe)
• Monitoring (what are they thinking)
• Examining/challenging (why do you think that?)
• Behavioural experiments
• Deep rooted beliefs (schema) changes - changing their deep rooted stereotypes etc.

Question 9

What can cognitive-behaviour therapy (CBT) be used to treat?

Answer 9

• Depression
• Anxiety states (phobias, OCD, GAD, panic, PTSD, health anxiety, BDD)
• Eating disorders
• Sexual dysfunction
• Psychotic symptoms (along with other treatments like anti-psychotic medication)

Question 10

How useful is cognitive-behaviour therapy (CBT) in treating eating disorders?

Answer 10

• Benefits for bulimia, not so much for anorexia

- Targeting the idea that is deep rooted about why they feel they need to look the way they do

Question 11

What type of person is cognitive-behaviour therapy (CBT) most useful for?

Answer 11

-Patients keen to be active participants
-Can engage collaboratively
(keep diaries, complete homework tasks)
-Can accept a model emphasising thoughts/feelings
-Those who are able to articulate their problem(s) and are practically seeking solution(s) rather than nebulous wish to be happy

You as a patient do it, not, the doctor.

Question 12

How useful is cognitive-behaviour therapy (CBT) in treating psychoses?

Answer 12

-Distract from symptoms and
alter beliefs about abnormal perceptions
-Good at getting rid of issues with delusions and intensity of beliefs
-Useful for family problem solving
-Not useful on treating the negative symptoms of psychosis i.e. withdrawal

Question 13

What are the limitations of cognitive-behaviour therapy (CBT)?

Answer 13

• No evidence for individual people with other diseases
• Need to be delivered by experts
• Only slightly useful when the problem is complex

Question 14

What are the main focuses of psychodynamic and psychoanalytic therapies?

Answer 14

• Focal - conflicts arising from early experience that are re-enacted in adult life - using the patient/therapist relationship to fix problems (possibility of transference and counter-transference)
• Analytic - unconscious conflicts re-enacted and interpreted by the therapist,

Question 15

Briefly explain transference and counter transference.

Answer 15

Transference - an issue/feeling the patient has with someone in their life is “transferred” to the therapist.
Counter-transference is the therapist bringing in their issue/feeling and doing the same.

Question 16

What type of person is psychodynamic and psychoanalytic therapy most useful for?

Answer 16

• Patients with interpersonal difficulties and personality problems
• Capacity to tolerate mental pain
• Interested in self-exploration

Question 17

What type of person will find systemic, family-centred or humanistic therapies most useful?

Answer 17

• Mild to moderate difficulties related to: - life events, subclinical depression, mild anxiety/stress or marital/relationship difficulties
• Patient with recent onset of problem (< 1 year)

Question 18

What is the underlying belief of the cognitive therapy rationale i.e. what is the cognitive model of emotional response concerned about?

Answer 18

That we are not affected by what happens to us, but how we react to it. (your mood/choices/thoughts/feelings determines how you remember an event)

Question 19

What three things make up the negative cognitive triad?

Answer 19

• Negative view of self
• Negative view of world around
• Negative view of the future

Question 20

Suggest some common healing factors.

Answer 20

-An emotionally charged, confiding relationship with a helpful person
-A healing setting
-A rationale or myth that explains
symptoms and suggests a way forward
-A ritual or procedure requiring the active participation of the therapist and the patient
-Combating the patient’s sense of alienation6. -Inspiring the patient’s expectation of help
-Providing new learning experiences
-Arousing emotions
-Enhancing a sense of mastery or self- efficacy
-Providing opportunities for practice

Question 21

What is psychotherapy?

Answer 21

The systematic use of a relationship between a patient and a therapist - as opposed to physical and social methods - to produce changes in feelings, cognition and behaviour