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Semester 3 > HealthPsych Session 5 > Flashcards

HealthPsych Session 5 Flashcards

1
Q

Why do more elderly relatives tend to die in hospital now than they did historically?

A

Relatives at home feel unable to provide home care due to lack of support and advice as well as having concerns about pain management

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2
Q

What is the result of medicalisation of death?

A

Death is more unfamiliar so people tend to find it harder to accept

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3
Q

How have life expectancy and healthy life expectancy changed?

A

Life expectancy has increased but healthy life expectancy has not to the same extent so a significant proportion of life is in ill health

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4
Q

Describe the 3 main patterns of dying.

A

Gradual death: slow decrease in ability and health
Catastrophic death: through sudden and unexpected events
Premature death: in children/young adults through accident or illness

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5
Q

What are the stages in the 5-stage grief model?

A 
Denial
Anger
Bargaining
Depression
Acceptance
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6
Q

Should a period of denial be allowed for people experiencing grief?

A

Yes, can be a helpful coping mechanism

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7
Q

Should pts be hurried out of the depression stage of the 5-stage grief model?

A

No, offer support instead

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8
Q

What is grief?

A

Set of psychological and physical reactions to bereavement which is a normal reaction to overwhelming loss where normal functioning no longer holds

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9
Q

What is the process of grief?

A

Disbelief and shock –> developing awareness –> resolution

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10
Q

What other event does dealing with grief have common elements with?

A

Terminal diagnosis

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11
Q

Are psychological interventions helpful in grief?

A

Only in high risk people

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12
Q

What factors lead to complication of the grief process?

A

Expression of grief discouraged

Ending of grief discouraged

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13
Q

What can result from an interrupted grief process?

A

Anxiety
Depression
PTSD

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14
Q

What type of stress is bereavement?

A

Severe form

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15
Q

What are the physical symptoms of bereavement?

A 
SoB
Palpitations
Fatigue
GI symptoms
Decreased immune function
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16
Q

What are the behavioural symptoms of bereavement?

A

Insomnia
Irritability
Crying
Social withdrawal

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17
Q

What are the emotional symptoms of bereavement?

A 
Depression
Anxiety
Anger
Guilt
Loneliness
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18
Q

What are the cognitive symptoms of bereavement?

A 
Reduced concentration
Memory loss
Preoccupation
Hopelessness
Disturbance of identity
Visual and auditory hallucinations
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19
Q

What are the outcomes of bereavement within 2 years?

A

85% have adjusted and are experiencing minimal grief

15% experiencing chronic grief (anxiety, depression, PTSD)

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20
Q

What are the risk factors for not adjusting to bereavement?

A 
Prior bereavements
Mental health
Type of loss (young, traumatic, if person was caring for deceased)
Lack of social support
Additional stressors
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21
Q

What is palliative care?

A

A shift of focus away from medical management towards improving QoL by managing emotional and physical symptoms and supporting pts to live productively so they are in control and retain dignity

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22
Q

What are we less exposed to death as a population?

A

Death has become medicalised as the majority of people now die in hospital despite wanting to die at home

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23
Q

Describe type A psychological therapies.

A

Treatment gives as an integral part of mental health care by GP/district nurse using psychotherapy techniques

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24
Q

Describe type B psychological therapies.

A

Eclectic psychological therapy and counselling taking ideas from different branches of formal therapies

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25
Q

Describe type C psychological therapies.

A

Formal psychotherapists e.g. regular CBT sessions

26
Q

What types of psychological therapies does the NHS use?

A

CBT
Psychoanalytical/psychodynamic
Systemic
Family

27
Q

What is CBT?

A

Pragmatic combination of concepts and techniques to relieve symptoms by changing maladaptive thoughts, beliefs and behaviour (not situations but view we take of them is causing upset)

28
Q

What behavioural techniques are used in CBT?

A

Graded exposure to feared situations
Activity scheduling
Reinforcement

29
Q

Why does avoidance of stimulus perpetuate fear?

A

Association develops between feeling bad in presence of stimulus and feeling better once it is removed (operant conditioning)

30
Q

What cognitive techniques are used in CBT?

A 
Education of cause of problem
Monitoring of thoughts, feelings etc
Examining/challenging -ve thoughts
Behavioural experiments to test beliefs
Cognitive rehearsal
31
Q

What is CBT the first line treatment for?

A

Depression
Anxiety states: phobias, OCD, generalised anxiety disorder, panic, PTSD, health anxiety, body dystrophic disorder
Eating disorders
Sexual dysfunction

32
Q

What is CBT used as an adjunctive Tx for?

A

Psychotic symptoms (+anti-psychotic medication)

33
Q

How does CBT work as an adjunct to medication in psychotic symptoms?

A

Decreases impact of -ve symptoms
Distracts from symptoms
Decreases preoccupation with delusions and intensity of beliefs
Alters beliefs about abnormal perceptions

34
Q

Who is CBT suitable for?

A

Pts who are keen to be active participants
Pts who engage collaboratively
Can accept model emphasising thoughts and feelings
Able to articulate problems
Practically seeking solutions to problems

35
Q

Is CBT suitable for pts with a nebulous wish to be happy?

A

No

36
Q

What are the limitations of CBT?

A

Findings of efficacy are usually from homogenous populations with limited comorbidities
Delivered by expert practioners (challenge for routine practice)
Circumscribed benefits in complex and diffuse problems

37
Q

What do focal psychoanalytical/psychodynamic therapies identify?

A

Conflicts arising from an early experience which is re-enacted in adult life

38
Q

What does focal psychoanalytical/psychodynamic therapy use to resolve conflicts?

A

Relationship with therapist and pt

39
Q

What is the purpose of analytical psychoanalytical/psychodynamic therapy?

A

Long term approach to re-enact and interpret unconscious conflicts underlying symptoms using the relationship with the therapist

40
Q

What is transferance?

A

Unconscious redirection of feelings towards one person to another e.g. smiling at a stranger that reminds you of a friend

41
Q

What is counter-transferance?

A

Emotional reaction of analyst to subject contribution

42
Q

Who is psychoanalytical/psychodynamic therapy suitable for?

A

Interpersonal difficulties and personality problems
Capacity to tolerate mental/emotional pain
Interest in self-exploration

43
Q

What does classical psychoanalytical therapy need to be effective which means it is not used routinely in the NHS?

A

To be daily over a prolonged period of time

44
Q

What is systemic and family therapy?

A

Approach focused on relational context to address patterns is interaction and meaning to facilitate resources in the system as a whole

45
Q

Why is family therapy used to treat children?

A

Treatment in isolation –> return of original behaviours once back in family environment

46
Q

What does humanistic/client-centred therapy rely on?

A

General counselling skills: warmth, empathy, unconditional +ve regard to enable reflection

47
Q

What is humanistic/client-centred therapy effective in?

A

Scoping with immediate crises where there is already motivation and willingness to problem solve

48
Q

Who is humanistic/client-centred therapy suitable for?

A

Mild to moderate difficulties related to life events
Subclinical depression
Mild anxiety/stress
Marital/relationship difficulties

All with recent onset of

49
Q

What problem factors should be considered when choosing a psychological therapy?

A

Nature
Chronicity
Severity
Complexity

50
Q

What patient factors should be considered when choosing a psychological therapy?

A

Psychological mindedness
Pain tolerance
Preference for short or long term focus
Exploratory work

51
Q

What is the -ve cognitive triad?

A
  • ve view of self
  • ve view of surrounding world
  • ve view of future
52
Q

What leads to development of the -ve cognitive triad?

A

Early experience –> core beliefs (may be unbalanced) –> assumptions –> critical incident activates assumptions –> -ve automatic thoughts

53
Q

What is the rationale behind CBT?

A

Event/situation –> thought –> emotion

Not situations but our view of them that cause upset

54
Q

When do anxiety systems become problematic?

A

Perceived danger doesn’t exist

55
Q

What causes anxiety in terms of brain function?

A

Unable to distinguish between physical and psychological threat so responds to false alarm

56
Q

How does CBT treat anxiety?

A

Decreases avoidance
Ceases safety-seeking behaviour
Exposure –> habituation and testing with subsequent change of beliefs by real-life experiments

57
Q

Give some examples of anxiety disorders.

A 
Panic disorder +/- agoraphobia
Social anxiety disorder
Specific phobias
Health anxiety
OCD
BDD
PTSD
GAD
58
Q

What are the 10 common healing factors?

A

Emotionally charged, confiding relationship with helpful person
Healing setting
Rationale/myth that explains symptoms and suggests way forward
Ritual/procedure requiring active therapist and pt participation
Combatting pt’s sense of alienation
Inspiring pt’s expectation of help
Providing new learning experiences
Arousing emotions
Enhancing sense of self-efficacy
Providing opportunities for practice

59
Q

How does a healing setting aid healing?

A

Ritualistic aspect focuses on activity

60
Q

How does providing new learning experiences aid healing?

A

Essentially unlearn and replace with corrected experience

Semester 3 (50 decks)

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