Clinical Psychology in Practice

Question 1

What does the Mental Health Foundation say?

Answer 1

Mental health difficulties are one of the main causes of overall disease burden worldwide. Major depression is the second leading cause of disability worldwide and is associated with suicide and heart disease. It is estimated that 1 in 6 people the past week have experienced common mental health difficulties.

Question 2

What are the different levels of mental health service provisions in the NHS?

Answer 2

1. Primary care - e.g. GPs, mental health practitioners, pharmacists - something you can access yourself without referral.
2. Secondary care in the NHS, e.g. community mental health teams, early intervention services for psychosis. Need a referral from GP/mental health practitioner from primary care.
3. Tertiary care in the NHS, e.g. hospital/inpatient facilities.

Question 3

What is the stepped care model?

Answer 3

How you might be placed in mental health services. Steps 1-3 are primary care services. Step 4 is secondary care services, step 5 is tertiary care (involves advanced and complex procedures and treatments performed by medical specialists in facilities). Can be stepped up or down depending on level of need.

Question 4

What is the Improving Access to Psychological Therapies (IAPT) programme?

Answer 4

Where most likely to receive care if have a problem with anxiety or depression. Expressly offer therapies that have good research evidence. Don’t need to go through a GP - it is self-referral. Set up in 2008 to meet needs for improved mental health services across England.

Question 5

What are the three things IAPT services are characterised by?

Answer 5

1. They offer evidence-based psychological therapies.
2. Routine outcome monitoring - always collecting data (asking clients to complete questionnaire after every visit), can track how they’re doing from start to end of treatment, and can access service performance. Can use data for research purposes.
3. Focused supervision for clinicians to ensure high quality treatment.

Question 6

How do we understand people’s difficulties? (DSM-5)

Answer 6

Published by the American Psychiatric Association (APA). Defines clusters of symptoms that fall under a diagnosis of depression or panic disorder etc. Some people find that having a diagnosis helps them better understand their experiences. Some people find it unhelpful or stigmatizing to be given a label.

Question 7

What is a formulation?

Answer 7

Need to understand problems through formulation. A technique used to co-construct an understanding of how a person’s difficulties developed and what keeps them going (Johnstone, 2017). Diagnosis can be very stigmatizing, so for that reason should use formulation. Formulations are hypotheses and can change during the course of therapy. Draws attention to the service user’s resources and strengths in surviving what are challenging life situations.