Introduction to Clinical Psychology Flashcards
Are mental health problems an issue in society?
Yes
Major depression is the second leading cause of disability - world-wide and is associated with suicide and heart disease
1 in 6 experience MH difficulties in the past week
What are the types of service provisions?
Primary care in the NHS - GP’s, mental health practitioners, pharmacists
Secondary care in the NHS - community mental health teams, early intervention services
Tertiary care in the NHS - hospital, inpatient facilities
What is the stepped care model?
There are steps 1-5, which include primary care, secondary care and tertiary care in the NHS
Means you can provide an appropriate level of care which isn’t too burdening
What is the improving access to psychological therapies programme?
If seeking help for anxiety and depression, you can access treatment through an IAPT service
IAPT was set up in 2008 to meet needs for improved mental health services across England
Can refer yourself via the website
Over the phone, books or computers for help
What are IAPT services characterised by?
They offer evidence-based psychological therapies - has to be based on research
Routine outcome monitoring - always collecting data as to how the services are doing in terms of treatment people - for individuals using the service, for assessing service performance, for research
Focussed supervision for clinicians to ensure high quality treatment
How do we understand people’s difficulties?
DSM-5 - defines clusters of symptoms that fall under a diagnosis of depression or panic disorder
Some people find that having a diagnosis helps them better understand their experiences - some people find it so unhelpful or stigmatising to be given a label
What is formulation?
A technique used to co-construct and understand how a person’s difficulties developed and what keeps them going - formulations are hypotheses and chance during the course of therapy
Lots of formulation models
A psychological understanding of the development and maintenance of an individuals problems
What is a psychological well being practitioner?
Based in IAPT services PWPs provide a range of evidence-based psychological interventions including: Guided self-help based on CBT principles Online psychological treatment programs Psychoeducation groups and workshops
1 year, trainee 4 days a week and studying 1 day a week
What is a high intensity CBT therapist?
High intensity CBT therapist
These jobs are based in IAPT services in the NHS
Therapists provide a range of evidence-based psychological interventions including:
CBT for depression/anxiety disorders
Mindfulness based cognitive therapy
Behavioral couples therapy
And more
1 year, trainee 3 days a week, studying 2 days
What is clinical psychology?
Clinical psychology involves the application of psychological theories to understand, prevent and alleviate distress
must meet criteria to call yourself one
CP’s work with:
adults, children/families, people with intellectual disabilities, people in forensic settings, older people
What do clinical psychologists do?
Work in a range of settings across a range of client groups, conducting a range of activities, not just therapy
Might work privately
Activities include: psychological therapy psychometric assessment team working and support colleagues understanding individuals and organisations supervision of psychologists writing reports evaluating their work training psychological work
Where to CP work?
cafes hospitals community clinics people's homes care homes universities psychology depts inpatient units and prisons
Do CP work in teams?
They often work in multidisciplinary teams, including other disciplines: team manager psychiatrists mental health nurses social workers occupational therapists community support workers secretarial and support staff psychotherapists, counsellors and counselling psychologists
What are the models of practise?
Scientist practitioners
- applying psychological science to clinical practise
CPs are trained in empirical research skills and evidence, work as applied scientists, training courses emphasise scientific knowledge
Reflective practitioners
- ability to reflect on the work they are doing, general reflection and self-reflection (think about own history, assumptions and how it affects practise)
Developing hypothesis - what might explain their difficulties and be contributing to them
Critical practitioners - applying a critical lens to their practise, ensure practise doesn’t cause social inequality e.g. reflecting on use of language
What are the 4 key tasks?
Assessment
Formulation
Intervention
Evaluation
What are the methods of assessment?
Clinical interview (client, family)
Psychometrics (questionnaire, neuropsychological tests)
Self-monitoring (diary sheets, record form)
Observation (school, residence)
Different assessment process depending on the person (e.g. if severe intellectual disability might not be able to community so use observation)
What does formulation draw upon?
Individual history and characteristics
Psychological theory and research
Want to explain the problem in terms of development (how did it begin?) and maintenance (what keeps it going?)
Good formulation should involve combination of scientific understanding of psychological processes and the individuals history
What are formulations based on?
The BioPsychoSocial model
different levels and factors useful to consider
focus on psychological (thoughts, emotions) and social (family, relationships, society), less on the biological (genetics)
What is the 5 P model?
Presenting problem - the mental health problem Predisposing factors (early experiences) Precipitant events (trigger/cause) Perpetuating (maintaining factors) Protective factors
What does treatment usually involve?
Helping people to understand and modify unhelpful cognitions and behaviours - based on scientific psychology models
CBT highlights the importance of cognitions and how these are influenced by mood, bodily sensations and behaviour
What is CBT formulation?
Understands a problem an individual is presenting in terms of:
cognitions (beliefs and negative thoughts)
behaviours (learned responses and reinforcements)
emotions (moods and feelings)
physiology (bodily sensations and physical problems)
What are interventions?
Intended to help someone get better - depends on the problem
Psychological interventions are psychological - not drugs or social care
may be talking therapies, behavioural programs, self-help, activity scheduling)
methods need to have evidence base
What are some examples of interventions?
Understanding normalising relaxation exercise weighing the evidence likelihood and consequences reducing avoidance connecting with others learning from experiences
What is an evaluation?
Occurs after an intervention, to ensure it is actually working
Involves getting feedback from patients - formal or informal (asking, observing, questionnaires - client satisfaction, symptom reduction)
Evaluated based on how well they reduce symptoms of mental health problems
