Explanations Psychological Treatments Flashcards
1
Q
CBT - What is CBT?
A
What is CBT?
- Stands for Cognitive Behavioural Therapy - type of talking therapy focused on the present as opposed to the past.
2
Q
Interpersonal Therapy
A
Suitability?
- Take a brief history of presenting complaint, current symptoms
- Recent berevement? Circumstances and how long ago?
- Ongoing stressors? - difficult relationships with anyone? Any risk?
- Any other changes in life? Role transitions?
What is IPT?
- Is a special type of talking therapy which concentrates on the present rather than the past and looks at your personal web of relationships.
- The angle isn’t necessarily that these relationships are the cause but that they can influence and maintain mental illnesses.
3
Q
Systematic Desensitisation
A
What is Systematic Desensitisation?
- Type of therapy designed to get someone to unlearn their phobia at their own pace
- Sessions can take place at home or in clinic
- About 2/3 of people respond
Why do we use it? What illnesses is it used in?
- Based on the concept of reciprocal inhibition - relaxation inhibits anxiety and the two are mutually exclusive
How is it given?
- Usually 12-16 weekly sessions, 45 mins-1hour
- Patients are asked to form a heirachy of situations/stimuli that cause them anxiety
- Learn relaxation techniques e.g. abonminal breathing, progressive muscle relaxation, visualisation
- Break down situations into steps if needed. If very anxiety inducing can even start wiyth imagining.
- Start performing least anxious provoking situations + paired with relaxation exercises, anxiety will increase initially but if you stay with it will tail off and go down, next time quicker.
- Work way up heirarchy. Practice in between sessions daily.
What else does the patient need to know?
- Can be done at home (agoraphobia)
- Won’t be thrown in deep end, goal is to work up going at client’s pace
- As a behavioural technique part of CBT - see explanation of this
- Have some leaflets
4
Q
Exposure and Response Prevention - OCD
A
What is Exposure and Response Prevention?
- Part of CBT therapy for OCD
- Defined by Exposure - to thought, images, objects and situations that trigger anxiety and or/obsessions
- Response prevention - choosing not to act on compulsions once anxiety induced
Why do we use it? What illnesses is it used in?
- Works to break links between obsessional thoughts/impulses and compulsions performed to reduce the anxiety they cause.
- Very effective for OCD
How is it given?
- Given over 12 to 16 sessions, 45 minutes to an hour. May be homework exercises to practice in between sessions.
- Make a heirarchy of situations from least to most anxiety provoking
- During ERP excercises you will be gradually exposed to fearful situations without performing compulsions to relieve anxiety
- Done in a graded way as manageable for you.
- Ininitially anxiety/distress will go up but by sitting with it without perfoming compulsion you will find anxiety naturally decreases with time, over time link between obsession and compulsions weakens.
- Ultimate goal is habituation so patient can reduce discomfort from exposure to stimuli
What else does the patient need to know?
- Part of cognitive behaviour therapy - see explanation
- Here are some leaflets
5
Q
Cognitive Analytical Therapy - What is it?
A
What is Cognitive Analytical Therapy?
- A specialisied form of talking therapy, looks at the here and now and also how past relationships influence the present.
Why do we use it? What illnesses is it used in?
- Aims to change unhealthy specific patternts of thinking ways of coping learned from the past.
- Used for depression, neurotic disorders, personality disorders, self-harm.
- Identify faulty proceedures (learned behaviours):
- Traps - repetitive cycles of negative behaviour and consequences that self-perpetuate
- Dilemmas - false or unduly narrowed choices
- Snags - extreme pessimise about the future therefore halting a plan before it even starts
- 3 “R”s – Recognition, reformulation, revision ( last 2 formulated in story and picture form)
6
Q
Cognitive Analytical Therapy - What else does the patient need to know?
A
- Here are some leaflets
- Less focused on interpersonal relationships and transference than other psychotherapies
7
Q
Cognitive Analytical Therapy - How is it given?
A
- Therapy would usually be for 16 to 24 weekly sessions.
- Early sessions – orientation, keep a mood and feelings diary, begin a “psychotherapy file”
- Middle sessions – reformulation letter with narrative of life, identified repetitive maladaptive patterns and how to change
- Ending- recap and goodbye letters and possible review in 3 months.
8
Q
Cognitive Analytical Therapy - When is it used and how does it work?
A
- Aims to change unhealthy specific patternts of thinking ways of coping learned from the past.
- Used for depression, neurotic disorders, personality disorders, self-harm.
- Identify faulty proceedures (learned behaviours):
- Traps - repetitive cycles of negative behaviour and consequences that self-perpetuate
- Dilemmas - false or unduly narrowed choices
- Snags - extreme pessimism about the future therefore halting a plan before it even starts
- 3 “R”s – Recognition, reformulation, revision ( last 2 formulated in story and picture form)
9
Q
CBT - What else does the patient need to know?
A
- Does require effort to attend regularly and do homework in between
- Top-up CBT can be given sometimes later on
- Here is some leaflets and a video
10
Q
CBT - How is it given? What is the theory?
A
- A total of 12-16 sessions usually delivered, weekly and lasting 50 minutes each.
- Early on focus is on identifirying problematic thoughts/behaviours/emotions.core beliefs, building a relationship with therapist.
- Later therapist will ask client to do homework - may include keeping a mood or thought diary. Behaviour therapy includes trying to avoid safety behaviours, using relaxation techniques, activity scheduling and assertiveness training. Progress reviewed during sessions.
- Towards the end will think about triggers and relapse preventions, taught coping strategies for future negative experiences.
11
Q
CBT - How does it work?
A
- In CBT the basic principle is that the was we think in turn affects are feeling, behaviours and physical sensations. These each feed into each other and can perpetuate negative cycles.
- CBT seeks to break those links by changing our thoughts ‘cognitions’ and behaviours.
- For example cognitive techniques include indentifying negative thoughts, maladaptive assumptions and beliefs you have, challenging their validity and coming up with new more positive versions.
- Behavioural techniques include things like rehearsal to anticipate challenges, graded exposure, increased activity scheduling, diversion or distraction techniques and behavioural experiments. Aim is to learn skills you can use when therapy is over.
12
Q
CBT - When do we use it? How effective is it?
A
- Used for many conditions including depression, anxiety, PTSD even pain.
- Shown to be just as just as effective as medication for moderate depression.
13
Q
Interpersonal Therapy - How is it given?
A
- 16-20 weekly sessions
- Stage 1 - develop relationship, inventory of interpersonal relationships
- Stage 2 - therapist analyses ways client communicates, agreed problem areas and then gives advice and new skills practiced through role play. Also work through issues of loss and to intentify a new role.
- Stage 3 - reinforce skills learned, identify resources to use for interpersonal issues in the future
14
Q
Interpersonal Therapy - Why do we use it? What illnesses is it used in?
A
- Focus is on one of four main areas – grief, role transitions, interpersonal deficits ( eg unfulfilling relationships) and interpersonal disputes ( differing roles and expectations in relationships)
- Goal is to reduce suffering caused by relationships - either by improving interpersonal functioning or changing expectations.
- Suitable for mild-moderate depression but not severe of BPD (also HIV, bulimia)
15
Q
Beck’s Cognitive Triad of Depression
A
- Cognitive triad:
- Negative personal view
- Negative interpretation of experiences
- Negative view of the future
