liason psych day 2 and 3 Flashcards
what happens in CBT
cognitive behavioural therapy - - it looks at what you think and what you do and how this affects the way you feel. a therapist will investigate your thoughts, behaviours, emotions and bodily sensations.
Sometimes, through no fault of their own, people get ‘stuck’ in vicious cycles: the things they do to solve a problem can inadvertently keep it going.
CBT is about finding out what is keeping us ‘stuck’ and making changes in our thinking and actions in order to improve the way we feel. It is a collaborative therapy and needs your active
participation in order to be helpful. There is a lot of evidence to show it is an effective treatment.
who provides psychological therapies
- Psychological therapy is not just provided by clinical psychologists
- Range of practitioners offering psychological therapy- Psychologist/ Psychotherapist / Psychiatrists / Psychological practitioners / (High & Low intensity workers- IAPT)
- Psychological therapy is provided in different service contexts - Improving access to Psychological therapies (IAPT) & Secondary care.
- Psychological Intervention has a number of formats e.g. individual, group, family therapy, consultation.
- Motivation - In direct therapy the client/ system needs to have some motivation to want to engage.
3 main psychological therapies offered in the NHS
- Psychodynamic Psychotherapy
- Cognitive Behavioural Therapy
- Systemic Therapy (of which there are many flavours)
whats the basic idea behind Psychodynamic Psychotherapy
- Everyone adopts defensive mechanisms in order to avoid mental pain or conflict.
- Defense mechanisms vary from being wholly conscious to out of conscious awareness (unconscious).
- Defense mechanisms are on a continuum - some more destructive than others / operate more or less of the time.
- The End product of Defense mechanisms are usually a maladaptive behavior / symptom.
- Often behavior / symptom is damaging to others / self.
- Relational effect - Symptom’s led to a setting up of vicious circle between individuals and those they are in contact with.
- Individuals may be aware of symptoms or self destructive behaviors but they may not be able to control them.
whats the method of Psychodynamic Psychotherapy
- The Frame- Patient must feel safe and contained in order to be able to begin talking
- Create safety - same time / place – e.g same room/ clothes
- Freud talked of the Idea of a ‘ blank canvas’
- Use of therapeutic relationship e.g. Patient acts out maladaptive relational patterns- therapist comments to provide insight
- Relationship with the therapist is a key vehicle of change.
- Usually weekly practice by psychotherapists, psychoanalysts, clinical psychologists or those with extra training e.g. doctor with psychodynamic training.
- Face patient / no couch.
- Mostly a contract of sessions not open ended.
what is the theory behind CBT
- Based on Cognitive Theory – developed by Aaron Beck .
- Early childhood experiences lead to schema or core beliefs about oneself, others and the world
- Critical incidents can activate these schema
- Schema’s activate thinking errors
- the schema is the lens through which we percieve events in our lives. a flawed lens leads to a flawed, and possibly damaging perception.
- Situations can lead to negative automatic thoughts
- Thoughts - feelings – behaviours
- If you change the schema & challenge automatic thoughts then the theory says the feelings will change / improve.
CBT thechnique
- Sharing the Formulation- Rationale for treatment
- Socratic questioning – questions that enable the client to ‘ discover the ideas themselves’.
- Thought diaries - diaries recoding negative automatic thoughts
- Thought Challenging - questioning or gathering evidence to challenge the veracity / evidence for negative automatic thoughts / unhelpful thinking styles
- Behavioural experiments- experiments to provide evidence to challenge NATS or beliefs
- Homework Tasks- can be experiments/ fact finding missions/ diaries.
the basic ideas behindSystemic Therapy
Circularity
•move from linear explanation of problems to circular
Communication
•Central to how difficulties develop and resolve
•All behaviour is communication
•Language important
Context
•Problems do not occur in isolation need to consider context
•Context gives meaning
•Multiple contexts - different schools prioritise different contexts
Relational
- Problems are not located within the individual
- Problems understood within the system
- People exist in relationships
- The person is not the problem the problem is the problem
- Problems located outside of person
why might an individual self harm
the most common reason is to escape from overwhelming distress and unbearable emotions.
What is Personality Disorder?
an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the culture of the individual who exhibits it
Inflexible and pervasive across a broad range of personal and social situations
Leads to distress or impairment of personal and social functioning
has an onset in adolescence or early adulthood
Cannot make diagnosis before 18 (ICD-10)
Is not better accounted for as a manifestation or consequence of another mental disorder
Not due to direct physiological effects of a substance or a general medical condition
How does personality disorder develop?
Biopsychosocial Model Biological sensitivities (‘bio’)
Early childhood experiences with important others (‘psycho’)
Social and Environmental factors (‘social’)
Adult Personality
what is Attachment theory
Attachment theory: John Bowlby 1960s
‘Attachment’ refers to the behaviour of infants in relation to a primary attachment figure (parent)
Different types of attachment relationship
Influences patterns of relationships later in life
Importance of Early Attachment
Initial/ early attachment forms the template for the development of subsequent social + emotional relationships
Attachment forms the basis of a child’s development of emotional regulation, which is essential for :
Stable sense of self
Stable and fulfilling relationships
what are the different types of personality disorder
CLUSTER A
Schizoid
Schizotypal
Paranoid
CLUSTER B Antisocial / Dissocial Borderline / Emotionally Unstable Histrionic Narcissistic
CLUSTER C
Anxious / Avoidant
Dependent
Anankastic / Obsessive-Compulsive
what is type A Schizoid PD
Few if any activities provide pleasure
Emotionally cold and detached
Limited capacity to express warmth / tender feelings or anger to others
Indifference to praise / criticism
Excessive preoccupation with fantasy / introspection
Lack of interest in friends / relationships
Insensitive to social norms
