Introduction to Clinical Psychology Flashcards

1
Q

Are mental health problems an issue in society?

A

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

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2
Q

What are the types of service provisions?

A

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

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3
Q

What is the stepped care model?

A

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

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4
Q

What is the improving access to psychological therapies programme?

A

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

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5
Q

What are IAPT services characterised by?

A

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

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6
Q

How do we understand people’s difficulties?

A

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

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7
Q

What is formulation?

A

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

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8
Q

What is a psychological well being practitioner?

A
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

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9
Q

What is a high intensity CBT therapist?

A

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

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10
Q

What is clinical psychology?

A

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

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11
Q

What do clinical psychologists do?

A

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
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12
Q

Where to CP work?

A
cafes
hospitals
community clinics
people's homes
care homes
universities
psychology depts
inpatient units and prisons
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13
Q

Do CP work in teams?

A
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
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14
Q

What are the models of practise?

A

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

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15
Q

What are the 4 key tasks?

A

Assessment
Formulation
Intervention
Evaluation

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16
Q

What are the methods of assessment?

A

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)

17
Q

What does formulation draw upon?

A

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

18
Q

What are formulations based on?

A

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)

19
Q

What is the 5 P model?

A
Presenting problem - the mental health problem
Predisposing factors (early experiences)
Precipitant events (trigger/cause)
Perpetuating (maintaining factors) 
Protective factors
20
Q

What does treatment usually involve?

A

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

21
Q

What is CBT formulation?

A

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)

22
Q

What are interventions?

A

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

23
Q

What are some examples of interventions?

A
Understanding
normalising
relaxation
exercise
weighing the evidence likelihood and consequences
reducing avoidance
connecting with others
learning from experiences
24
Q

What is an evaluation?

A

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

25
Q

What are the big 3 therapeutic organisations?

A

Psychodynamic psychotherapy
CBT
Systematic family therapy

26
Q

What is psychodynamic psychotherapy?

A

First developed by Freud
Emphasised the importance of different motivational forces within the mind and how these can be in conflict
Focussed on unconscious thoughts and feelings and how these can cause mental health problems in some people

27
Q

What is the systematic family therapy?

A

Developed by Gregory Bateson
Based on the idea that people can only be understood within the ecological context
Applied communication and system theories, as well as mathematical models to family
People do not exist in vacuums, all behaviour has meaning in terms of relationships

28
Q

What are the 5 steps?

A

GP nurse – recognition and assessment (primary care)

Primary care team – focus = mild depression, watchful watching, guided self help (primary care)

Primary care teams – moderate/severe depression, medication, psychological interventions (primary care)

MH specialists, crisis teams – those at sig risk, treatment resistant, medication, complex interventions (secondary)

Inpatient care, crisis teams – risk to life, ECT, medication, CBT (tertiary)