Lecture 4

Question 1

What are the psychosocial typologies of illness?

Answer 1

• Onset
• Course
• Outcome
• Incapacitation

Question 2

What are the two types of onset?

Answer 2

1. Acute - Stroke
2. Gradual - Parkinsons

Question 3

What are the three types of course?

Answer 3

1. Progressive - Alzheimers
2. Constant - Spinal cord injury
3. Relapsing - Asthma

Question 4

What are the four kinds of outcomes?

Answer 4

1. Nonfatal
2. Shortened lifespan
3. Sudden death
4. Fatal

Question 5

What is incapacitation?

Answer 5

• Incapacitation can result from impairment of cognition (alzheimers), sensation (blindness), movement (multiple sclerosis), energy (cardiovascular disease), disfigurment (severe burns), or social stigma (AIDS)
  
  • None
  • Mild
  • Moderate
  • Severe

Question 6

What are the phases of illness?

Answer 6

• Crisis
• Chronic
• Terminal

Question 7

What is the timeline of illness?

Answer 7

• Prediagnosis with symptoms
• Diagnosis
• Initial adjustment period
• Chronic “long haul”
• Preterminal
• Death
• Mourning and resolution of loss

Question 8

What is medical family therapy?

Answer 8

• Medical family therapy is a family-centered systemic practice to counseling and therapy for the patient and family during and throughout the course of an illness or chronic health problem
• Fundamental assumption
  
  • All health and relationship problems are biological, psychological, and social in nature

Question 9

What are the three ways in which psycho/social intersects with biological illnesses?

Answer 9

1. Psychosocial issues as a result of a physical illness (breast cancer leading to depression, identity issues, facing mortality)
2. Mental health symptoms a function of an ailment (hyperthyroidism associated with anxiety symptoms)
3. Public health issues. Why do some populations get sicker? Die quicker?

Question 10

What are the two goals for medical family therapy?

Answer 10

1. Agency - Active involvement in and commitment to one’s own care
2. Communion - Establishing a sense of connection with family members, friends, and healthcare professionals

Question 11

What are the elements of agency?

Answer 11

• Helping patients and family members have active involvement in care through:
  
  • Making personal choices in managing illness and the health care system
  • Setting limits on the amount of control an illness has over their lives
  • Setting boundaries between family members and healthcare team members

Question 12

What is evidence-based practice?

Answer 12

Evidence-based practice is the integration of best research evidence with clinical expertise and patient values

Question 13

What are the 5 A’s of evidence-based practices?

Answer 13

1. Ask
2. Acquire
3. Appraise
4. Apply
5. Analyze and Adjust

Question 14

Elements of ask?

Answer 14

• Create a question that can be answered by the literature
  
  • Narrowing down your question
  • Coming up with keywords
  • Want questions that are specific but not so specific that you can’t find answers

Question 15

Elements of acquire?

Answer 15

• Locate the best evidence to answer the question
• Need to have knowledge of various databases
• Acquisition of research requires time and access to databases

Question 16

Elements of appraise?

Answer 16

• Evaluate the literature
• Develop skills necessary to evaluate primary sources of data, understanding analyses and types of research design

Question 17

Elements of apply?

Answer 17

• Integrating clinical appraisal with our clinical expertise, client preferences, and context
• Clinical expertise: therapist’s unique skills and experiences
• Client preferences: values, concerns, and expectations that clients bring to the clinical encounter
• At this stage, collaborating with clients to decide how to move forward

Question 18

Elements of analyze and adjust?

Answer 18

• Evaluating the effectiveness and efficiency of the chosen treatment
• Asking “is what we are doing helping?”
• Evaluation is usually not a one-time event, and is usually a continuous part of therapy

Question 19

Examples of EVPs?

Answer 19

• Cognitive-Behavioral Therapy
• Acceptance Commitment Therapy
• Dialectical Behavioral Therapy
• Motivational Interviewing
• Functioning Family Therapy
• Multidimensional Family Therapy
• Multisystemic Family Therapy
• Emotionally Focused Couple’s Therapy
• Integrative Behavioral Couple’s Therapy
• Parent-Child Interaction Therapy
• Maudsley family therapy approach for eating disorders