Notes Flashcards
What does it mean to be healthy?
“a complete state of physical, mental and social wellbeing… not merely the absence of disease or infirmity” (World Health Orginisation, 1946, p. xi)
What are some critiques of the World Health Orginisation (1946, p. xi) definition of health
- May be too broad
- Not just presence or absence of symptoms, but how the individual interprets/exeriences them
- No mention of socio-economic health and cultural influences
What is Wellbeing?
The overall state of being comfortable, healthy, and happy, both physically and psychologically (Wilroth, 2023)
What are the 6 dimensions of wellbeing
- Physical
- Mental/Emotional
- Social
- Environmental
- Occupational
- Spiritual
Which out of the 6 dimensions is this:
state of ones body - encompassing aspects e.g nutrition, exercise, sleep and overall health
Physical
Which, out of the 6, dimension is this:
state of ones mind- involving emotional regulation, resilience and psychological health
Mental/Emotional
Which, out of the 6, dimension is this:
quality of relationships and social connections
Social
Which, out of the 6, dimension is this:
state of the external surroundings, including impact of the environment on health and overall satisfaction
Environmental
Which, out of the 6, dimension is this:
satisfaction and fulfilment derived from work
Occupational
Which, out of the 6, dimension is this:
sense of purpose, meaning and connection to something greater than oneself
Spiritual
Subjective vs Objective Wellbeing
Subjective:
individuals personal assessment of their life and overall wellbeing
Objective:
measurable indicators such as physical health, income, and social relationships that contribute to overall wellbeing
Early concepts of illness (History):
(3000 BC)
What was the treatment of abnormal behaviour attributed to supernatural explanations (such as possession)
Trephining- allowed evil spirits to escape the head
Early concepts of illness (History):
What did Hippocrates (460-377 BC) establish?
Note: he was a Greek physician of the classical period
Humoral theory:
the body contained four different fluids i.e humours that can being a state of balance (good health) or imbalance (illness)
Mind concerned with thoughts, perceptions, and feelings - little to no relationship to the body and its state of health
Early concepts of illness (History):
- What are the four humours?
- Who came up with the theory of them?
- Yellow bile (fire), hot/dry
- Blood (air), hot/wet
- Phlegm (water), wet/cold
- Black bile (earth), dry/cold
- Hippocrates (460-377 BC)
Early concepts of illness (History):
What did the Greek physician Galen (129-216 AD) establish?
During the roman empire, aware of disease localisation
Early concepts of illness (History):
What period of time did science, maths and medicine flourish?
Islamic Golden Age (750-1300)
Early concepts of illness (History):
What period in history did progression in understanding health seem to be going backwards?
Hint: Back to supernatural explanations for widespread disease
Middle Ages (concept of illness): 5th-14th Century
Early concepts of illness (History):
What theories were maintained during the Middle ages (5th-14th century)?
Maintained humoural theory but upheld causes of disease (including God punishing people for their behaviour)
Early concepts of illness (History):
What period of time was credited for producing new ideas and significant change?
Renaissance (17th-19th Century)
Early concepts of illness (History):
Renaissance concept of illness used a term “Bedlam” meaning crazy- what did this term refer to?
Individuals that acted ‘abnormally’, also the name of the first asylum used to contain people that fit that description
Early concepts of illness (History):
What period of time is credited to have rapid acceleration in medial and scientific knowledge?
19th-19th century, enlightenment and scientific revolution
Early concepts of illness (History):
What did the enlightenment and scientific revolution (17th-19th century) find?
Found surges in
- intellectual reason
- individualism
- challenged supernatural and religious understandings/structures
Early concepts of illness (History):
What is Wilhelm Wundt (1832-1920) credited for?
The birth of psychology - campaigned to make psychology an individual form of health.
Which model was found after the long-standing mind/body belief split?
Biomedical model
Biomedical model
- Traditional view of western medicine
- Health = absence of disease
- Disease in conceptualised as a biological
process (absence of psychological and
social influences)
- Disease in conceptualised as a biological
Psychosomatic Medicine
- Psychoanalytic school of thought that looks at researching psychosomatic medicine (early 1900s)
What model is this: theory is that patterns of personality are linked to specific illness
Psychosomatic Medicine
Which model brought about the formation of the DSM-1 (1952)?
a) Biomedical model
b) psychosomatic medicine
c) Humanitarian reform
d) Information age
c - humaintarian reform (1950s-1970s)
Which model introduced the biopsychosocial model?
Humanitarian reform (1950s-1970s)
Key points on the Humanitarian Reform (1950s-1970s)
- introduced the biopsychosocial model
- formation of the DSM-1 (1952)
- Reformation for deinstitutionalisation from asylums (focus on community health care)
What model saw a surge of new technologies that shaped the modern world
Information Age (1970s-now)
Which model refined holistic psychopharmacology options- creating more subjective and individualistic treatment for patients?
a) Biomedical model
b) Psychosomatic medicine
c) Humanitarian reform
d) Information age
Information age (1970s-now)
What is EBP?
Evidence-based practice
Evidence is used to determine or demonstrate an assertion of truth
EBP integrates SCP, What does that stand for?
S: scientific evidence
C: clinical experience
P: patient values
What is the purpose of EBP?
- improve quality, effectiveness and appropriateness of clinical practice
- reduce variation in practice patterns, gaps between knowledge and application to care
- substantiate the care provided to clients
- shared decision making w/. client
- framework for quality care
Why is research important for EBP?
- The goal of the research process is to provide reasonable answers to interesting questions (i.e., evidence!)
- EBP relies on critical thinking skills and includes:
- evaluating research findings (i.e., evidence)
- awareness of bias
- ethical practice
- clinical reasoning and logic
What is EMINENCE-based practice?
Health-related fields seem to rely on experience → however, theres no evidence to support this
What is a link between eminence-based practice and pseudoscience
Modern comeback from 1800s:
- Physiognomy: attempt to read personality from facial features
- Phrenology: personality traits are represented by different parts
What are some of the contemporary issues with media, marketing and self-help?
Social media: destigmatise BUT still lots of misinformation
“Self-help”: industry influenced by media and marketing - encourages using resources that provide personal monetary gain for the seller - utilises the word “may” to not hold accountability (dodgy stuff fr)
Influences to biases and thoughts can cause individuals to form personal beliefs and belief systems
The statement refers to Individual psychology and cognitive biases… How is this a threat to critical thinking?
- Confirmation bias
- ‘My side’ bias
- Attentional bias
Anchoring/insufficient adjustment bias - influence of anecdotes over statistics
OVERALL: access to simplified, condensed, consumable info doesn’t give the same help as clinical practice (duh)
What is confirmation bias?
search for evidence that confirms beliefs and discount other evidence that may discredit it
What is ‘My side’ bias
evaluate situations from a personal perspective
What is attentional bias?
drawn to our emotional responses, neglecting objective data
What is anchoring / insufficient adjustment bias
Overly influenced by one past reference of information
“Practice” part of EBP, What are the AAAA?
1 . Accountability
2 . Advocacy
3 . Alturism
4. Autonomy
Which AAAA (Practice part of EBP) is this:
Practitioners need a high degree of legal accountability
accountability (duh its legit in the definition)
Which AAAA (Practice part of EBP) is this:
using good evidence to support their client
advocacy
Which AAAA (Practice part of EBP) is this:
always seek to do the best for your clients by using evidence that improves outcomes
Alturism
Which AAAA (Practice part of EBP) is this:
independent professional judgement to support your clients
autonomy
What are the 6 steps of the hierarchy of evidence?
Research:
1. Intervention: does the treatment work?
2. Diagnosis
3. Prognosis: what is the outcome of a condition?
4. Aetiology: cause of the condition?
5. Epidemiology: what is the trend of risk?
6. Experiences
Qualitative research
provides findings in words → used for questions about experiences : anti-positivist (not everything can be measured in number)
Quantitative research
provides findings in numbers → needed for studies about interventions, diagnose tests etc: positivist (things can be numeric)
Selecting a qualitative method: Understanding human experience
(note: further info in notes + diagram)
Phenomenological methods
(What is the human experience of…)
Selecting a qualitative method: Uncovering social processes
(note: further info in notes + diagram)
Grounded theory
(what is the theoretical explanation for people’s reaction to…)
Selecting a qualitative method: Learning cultural patterns
(note: further info in notes + diagram)
Ethnographic method
(How does this cultural group express their pattern of…)
Selecting a qualitative method: Capturing unique stories
(note: further info in notes + diagram)
Case study method
(What are the details and complexities of the story of…)
Observational research (non experimental) is an example of a quantitative research… What are some related study methods?
Prospective studies and Retrospective studies
Prospective studies
(observational research)
begin with participants that don’t have a condition → longitudinal study to see if it develops
Retrospective studies
(observational research)
begin with participants who have the condition and look back to see if you can identify why these participants have the condition
Aetiological claims: if we cannot use experimental methods, there are six criteria that need to be met…
example: How do we know that chronic pain causes depression?
- A “dose-response relationship” exists between chronic pain and depression
- Chronic pain precedes the onset of depression
- A cause-and-effect relationship between chronic pain and depression is physiologically plausible
- Relevant research data consistently reveal a relationship w/ depression and chronic pain
- Strength of that correlation is relatively high
- Studies revealing correlation are well designed
What is the “Hierarchy of evidence”?
a framework for ranking evidence that evaluates health research - indicating which studies should be given most weight in an evaluation
What is the order (top to bottom) of the “Hierarchy of evidence” ?
(note: elaboration and diagram in notes)
- Systematic reviews
- Randomised controlled trials
- Cohort studies
- Case-control studies
- Case series, case reports
- Editorials , expert opinion
“Hierarchy of evidence”: Systematic Review (SR)
What rank is it (out of 6)?
What is it?
Rank: 1
Comprehensive and transparent literature review that uses explicit and systematic methods to
- identify
- select
- critically appraise
- synthesise
all available evidence
“Hierarchy of evidence”: Randomised Control Trial (RCT)
What rank is it (out of 6)?
What is it?
Rank: 2
rigorous design of health research… determine whether a cause-effect relation exists between the treatment and outcome
- participants randomised to receive on of the treatment arms
- randomisation balances risk factors
Describe the process of a randomised control trial (RCT)
(note: elaboration and diagram in notes- more useful)
Population recruitment
↓
Becomes sample
assessed for eligibility - if not they’re excluded
↓
Eligible sample = baseline assessment + random allocation
↓.
Grouped into…
Control: start/end of treatment assessment
OR
treatment
“Hierarchy of evidence”: Non-randomised Control Trial (hint, apart of RCT)
What rank is it (out of 6)?
What is it?
Rank: 2
compare control and treatment group outcomes
- Study lacks the random allocation of participants to either control or treatment group
“Hierarchy of evidence”: Cohort studies
What rank is it (out of 6)?
What is it?
Rank: 3
Longitudinal study of a group (often share a common trait/experience). Followed to study and track outcomes of a intervention/exposure
- good for cause-and-effect relationships
“Hierarchy of evidence”: Case-control studies
What rank is it (out of 6)?
What is it?
Rank: 4
compare a group with a certain disease or outcome (cases) with another group who do not have the outcome or disease (control)
“Hierarchy of evidence”: Case series
What rank is it (out of 6)?
What is it?
Rank: 5
(Aka time series or before and after study
for more rare conditions where only a few people are affected. Researcher measures participants at the start and end of the intervention (no control treatment allocated)
“Hierarchy of evidence”: Case study/report
What rank is it (out of 6)?
What is it?
Rank: 5
(n=1 study), qualitative or quantitative evaluation of one case (often measured before and after an intervention)
“Hierarchy of evidence”: Expert opinion
What rank is it (out of 6)?
What is it?
Rank: 6
Low-level evidence since there is capacity for bias (but still has value)
Meta-analysis (MA)
objective statistical method used to combine and analyse the results of ,multiple independent studies on a specific topic
Benefits of a Meta-analysis (MA)
- more precise estimate of effect size
- increases the generalisability of the results of individual studies
- identify patterns
- establish consistency
- determine overall measure of a treatment’s effect
Limitations of a Meta-analysis (MA)
- dependence on study quality
- trust in accuracy of raw data
- complexity surrounding its methodology and interpretation
*different to systematic review as this contacts the researchers and asks for their raw data so you can run the research yourself - more subjective
Interval validity vs external validity
Internal = truth in the study
External = truth in real life
*Note: generalisation can lead from internal to external
Threats to internal validity: (hint… theres 8)
- Placebo effect (focus for today tho)
- Hwthorne effect
- Natural recovery or maturation
- Bias from assessor
- Recall bias
- Process of treatment
- Performance bias
- Rosenthal effect
Placebo effect
Improvement due only to experiencing an intervention or event, whether real or not
- a ritual of intervention
- estimated to be around 30% improvement
Placebo impact people psychologically and physically by altering neurotransmitters, hormones, and endorphins
Key term: Interviewing
Gathering data, Providing information, suggesting workable solutions to resolve concern
Key term: Coaching
Parterining with others in a thought-provoking and creative process to inspire the maximisation of personal and professional potential
Key term: Counselling
Intensive, personal → listening and developing strategies for change and growth
Define a ‘Therapeutic alliance’
Use of effective skills to seek and assist others
- review their problems and their options/choices to deal with these problems
Key term: Psychotherapy
Deep-seated individual issues, require more time for resolution
What are dual purposes of a therapeutic alliance
- provide opportunities to develop coping skills (internalised empowerment)
- increase of self-understanding and self-control
- decreased emotional distress
- progress toward self-identified goals
attending: S.O.L.E.R
S: Sit Squarely
O: adopt an Open Posture
L: Lean forward
E: maintain Eye contact
R: be Relaxed and natural
attending: S.U.R.E.T.Y
S: Sit at an angle
U: Uncross legs and arms
R: Relax
E: maintain Eye contact
T: Touch
Y: use Your intuition
The Skilled Helper Model stages
Egan (1990s) - Model to help and focus on a problem
Stage 1: Current scenario (Exploration stage)
Stage 2: Preferred scenario (Challenges stage)
Stage 3: Getting there (Planning stage)
- sub-stage: reality testing and options
Stage 4: Committing to action (Action stage)
What are the two forms of reflection
- reflection-IN-action
- quick thinking while you’re engaged in an activity - reflection-ON-action
- when you consider the activity afterward
What is the reflective journey
1) Thinking –> 2) Writing –> 3) Practice
Gibbs reflective model
(1998)
A reflective cycle
1. description
2. feelings
3. evaluation
4. conclusions
5. action
Rolfe’s model of reflection
(2001)
What?
Descriptive level of reflection
So what?
Theory and knowledge - deeper critical analysis and evaluation
Now what?
Action-oriented level of reflection
Johns’ model for structures reflection
(2006)
- looking in (focus on oneself)
- looking out (environment/external factors)
Similarities between cultures
- perspectives on helping others
- positive growth
- emphasise the expression of feelings
Differences between cultures: Holism
some cultures may see health as affecting the “whole” human. Not differentiating between physical and mental health/illness
Differences between cultures: Individualism vs Collectivism
Individualism: Introspectively examine (self-analysis) of yourself
Collectivism: “we” consciousness, emotional dependence, collective identity, group solidarity
Definition of culture
“Unique meaning and information system, shared by a group and transmitted across generations, that allows the group to meet basic needs of survival pursue happiness and wellbeing, and derive meaning from life” (Matsumoto & Juang, 2016, p. 1293)
- Normative and learned behaviour centred - on values and beliefs
Kidd and Teagle (2012) layers of culture
- Individual (sense of personhood)
- Social (collective sense of belonging)
- Culture (sense of belonging to a distinct ethic, culture or subcultural group)
EDI
Empathy, Diversity and Inclusion
CRRR
Culturally Responsive, Relevant and Reinforcing
Explain CRRR
- Cultural responsibility
- Recognition of social structures, marginalise and privilege - Cultural relevance
- understand other cultures (encourage discussion and education) - Cultural reinforcement
- celebration, respect, value, and honour cultures
What is stress?
Any circumstance that threatens (or is perceived to threaten) one’s wellbeing and taxes one’s coping ability
Folkman and Lazarus (1984) findings of stress
- Stress is cumulative in nature… minor stresses can add up to be just as stressful as a major traumatic event
Three parts of stress
- stress as a stimulus
- stress as a result of cognitive appraisal (evaluate)
- Stress as a response (psychological, emotional, behavioural)
- Stress as a stimulus (Three parts of stress)
- Catastrophic events (e.g natural disaster)
- Major life events (e.g losing or starting a job)
- Daily hassles/everyday demands (e.g traffic, deadlines)
How is a major life event (stimulus of stress) measured?
Life Change Units (LCU)
- Eustress: desirable
- Distress: not desirable
- Stress as a result of cognitive appraisal: evaluate (Three parts of stress)
Subjective experience… the internal state that changes due to an individuals appraisals
- Transactional Model of Stress
- Primary appraisal process: evaluation of situation
2 .Secondary appraisal process: evaluation of individual coping abilities
Primary appraisal process of stress
Person considers the quality and nature of the stimulus event
Three kinds of possible stressors:
- threaten harm/loss?
- set a challange
- considered benign
Secondary appraisal process of stress
assessment of one’s resources and abilities to cope with the stressor (coping potential)
- Stress as a response: emotional (Three parts of stress)
Emotional: link with cognitive appraisal and emotions experienced as a function of a stressor
*Note: Yerkes Dodson Law (1908) diagram in notes of the levels of stress and task perfomance
What factors influence appraisal of stress?
- Imminent: when it will happen
- Unexpected time in life
- Unpredictable
- Ambiguous (e.g starting a new job)
- Potentially risky or harm involved
- Undesirable
- Low perceived control
- Life change
Types of stress
- Acute (short-term)
- Intermittent
- Chonic
- Stress as a response: Psychological (Three parts of stress)
Four Fs: Fight-Flight-Freeze-Fawning
Hans Selye (1951):
effect of chronic stressors and general adaption syndrome (GAS)
1. Alarm stage: recognition of stress
2. Resistance stage: prolonged and physiological arousal
3. Exhaustion stage: body’s resources depleted
- Stress as a response: Behavioural (Three parts of stress)
Acts that master, reduce, tolerate or avoid the demands created by stress…
Two suggested coping styles
- Emotion-focused (or palliative coping): thoughts and actions with goal to relieve emotional impact of stress
- Problem-focused coping: effort to improve person-environment relationship by changing the cause of the stress
Stress management techniques
- personality/perception: assertiveness training, though stopping etc.
- cognitive reappraisal
- Stress inoculation training
- humour
- Environment/lifestyle: habit, exercise
- biological responses: breathing, meditation
Steps of stress inoculation training
- Education: framework to understand stress
- Rehearsal: cognitive self-statements as a form of coping and problem solving
- Application: use of information and skills in actual stress simulations
Impacts of humour on stress
Good sense of humour leads to…
- Less threatening appraisals of stressful events
- Increase experience of positive emotions
- rewarding social relations, greater social support
- takes self less seriously than others
… wellness, reduced effects from stressful life events
Stress management: Environment/lifestyle
Taking care of time management, proper nutrition, exercise, alternative to frustrating goals, stopping bad habits… leads to improvement
What is grit?
A disposition or trait; individual difference factor (each persons level varies)
- demonstrates perseverance or passion for longterm goals (Duckworth et al., 2007)
Biological responses to stress management
breathing exercises, biofeedback
- relaxation response
- meditation
- progressive relaxation
Two aspects of grit
- Perseverance of effort
- Consistency of interests
Perseverance of effort (Aspect of grit)
Maintain effort working towards a goal or outcome, despite challenges or difficulties attaining the goal
Consistency of interests (Aspect of grit)
Ability to persist with and/or have passion for a similar set of interests over time
Benefits of grit
Association with…
Employment outcomes
- job performance
- fewer career changes
- less burnout at work
- greater engagement at work
Wellbeing outcomes
- positive wellbeing and life satisfaction
- positive traits e.g optimism, gratitude, prosocial behaviour
Physical health outcomes:
- positive outcome from regular exercise routine
- ability to cope with significant illness
Datu (2021): OPAH model (mechanisms of action of grit)
*Note: diagram in notes
Can lead to achievement outcomes via:
Grit
↓
putting in the work (behavioural effort)
OR activating desire to achieve (adaptive motivation)
OR using the right approach (cognitive resourcefulness)
Other factors not stated
Improvement in wellbeing via:
Grit
↓
Satisfy inherent/competency needs
OR encouraging adaptive emotion regulation
OR facilitating positive cognitions - positive thoughts
Factors of academic success
- self-beliefs (efficacy, confidence)
- school climate (feeling of safety, disciplinary)
“Blind persistence” or “inappropriate persistence” or “inevitable failure”
when persistence becomes problematic
- unattainable goal can be detrimental for wellbeing if not learning from experience and constantly facing failure
Adaptive self-regulation
Beneficial when individual monitors progress and adjusts their behaviour or plan (goal adjustment can be important)
Goal adjustment tendencies
- Goal disengagement
(e.g easy to let go of goal) - Goal reengagement
(e.g holding a number of goals, adopting new)
Overview of resilience
Resilience differs from other similar terms as it:
- Is the outcome of successful coping to stressors
- Can be operationalised into recovery trajectories
- May or may not require adaptation
- Often requires grit and perseverance
‘Achievement’ outcomes vs ‘wellbeing’ outcomes
E.g goal is to get a HD in a hard unit, or ‘wellbeing’ goal: i want to be able to have an effective study session etc.
Howard & Crayne (2019) - defined 3 aspects of persistence
- Persistence despite difficulties
- Persistence despite fear
- Inappropriate persistence: persistence towards an unrewarding or worthless goal
History of resilience: Philosophical roots
Positive psychology - shift from deficit model → strength-based models
Humanistic phisoloshy (e.g Mazlor or Rogers) - emphasises individuals strengths, sense of autonomy, and capacity for positive change
Existential philosophies (e.g Nietzsche, Viktor Frankly) - emphasis on the human capacity to find meaning despite suffering
History of resilience: Origins
- Physical sciences (objects ability to ‘bounce-back’ to its original shape after experiencing strong forces
- Ecology (ecosystems ability to adapt and survive despite disturbances)
- Psychology
Three categories of definitions (Resilience)
Resilience as a…
1. Trait = determined by fixed personal and environmental characteristics
- Process = dynamic process involved
- Outcome = result of dynamic person-situation interactions
Resilience: Four waves of inquiry
*Note: associated RQs in notes
- Traits and environmental factors
- Mediating and moderating processes
- Active intervention
- Multi-system frameworks
First wave: traits and environmental factors
Resilience is the ability to maintain a stable equilibrium, adaptive stress resistance, thrive in the face of adversity
A shortlist of resilience correlates: protective traits (First wave)
- Cognitive capacity, problem solving skills
- Self-regulation ability
- Future orientation
- Dispositional optimism, hope, and positive emotionality
- Challenge appraisal (as a trait)
- Meaning, coherence, and spirituality
- Self-efficacy, locus of control
Second wave: developmental systems and processes
Resilience is:
a dynamic process that is influences by neural and psychological self-organisations, process encompassing positive adaption to adversity
Note: further study of lecture notes
A shortlist of resilience correlates: protective enviroment (First wave)
- Close relationships with others
- Supportive friendship and romantic attachments
- Parents with protective traits
- Safe environment, with nature and financial resources
The outcome-based approach
Resilience is:
an outcome of successful adaption to adversity, maintain or quick recovery of mental health during and after the stressor
Models of resilience: Operationalising adversity
Approach 1: dosage-response models
Approach 2: Event characteristics
Approach 3: appraisal models
*Note: STUDY content on lecture notes
Measurement approaches
- Contact (e.g family, individual, workplace)
- Measurement focus (e.g definition of resilience)
- Observed vs self reported
- Conceptualisation of construct
Models of resilience: Multi-systems model of resilience
Resilience as an outcome of dynamical interactions between the individual and their socio-ecological context
*Note: STUDY content on lecture notes
Models of resilience: Metatheory of resilience
Resilience as a process of reintegration to homeostasis
*Note: STUDY content on lecture notes
Models of resilience: Resilience model of family, stress, adjustment, and adaption
context specific model of resilience - draws on family systems perspective to understand how families manage stress and adjustment
*Note: STUDY content on lecture notes
Models of resilience: Multilevel model of team resilience
context specific model of resilience - applies resilience to the study of team functioning
*Note: STUDY content on lecture notes
Models of resilience: Systematic self-reflection model
aims to explain HOW resilience can be built via exposure to stressors
*Note: STUDY content on lecture slides
Building resilience - intervention
What is being targeted?
How those capacities are built
Effective interventions
*Note: STUDY content on lecture slides
Five primary coping insights
- Understanding that anticipated efficiency of resilient capacities
- Understand the time course of reactions
- Understand that stressors are opportunities for growth
- Understand one’s resilience capacity repertoire
- Understanding the relationships between reactions
Capacities for resilience (systematic self-reflection model)
goal of self reflection = build specific capacities
- resilience beliefs
- flexible coping repertoire
- Coping resources
*Note: STUDY content on lecture slides
Post-traumatic growth
Previous look of resilience = return to pre-adveristy functioning (before the stressor)
Post-traumatic growth = can benifit from having encountered trauma and tragedy
*Note: STUDY content on lecture slides
Adapting to adversity
key roles impacting/affected by resilience:
1. individual characteristics
2. interpersonal relationships
3. individual behaviours
4. environmental factors
*Note: STUDY content on lecture slides
What is mindfulness?
- present-moment awareness or attention or focus
- Lack of judgement or reactivity
*Note: STUDY content on lecture slides
Measuring individuals’ typical, dispositional, level of mindfulness via self-report questions shows…
mindfulness is associated with
Greater well-being
Better mental health
Emotional regulation skill
Different pattern of neural (brain region) activation
Self-control
Mindfulness meditation
focus attention on breathing or particular spots of the body - noticing any thoughts, physical sensations, distractions that arise but not getting attached (let them come and go)
Concentrative meditation
focusing attention on a single object or place
Guided meditation
focusing on content (chant, mandala, concept, feeling, etc.)
mindfulness meditation
present-moment focus with non-judgemental awareness
Self-care
Activities and practices that are deliberately chosen to engage in on a regular basis to maintain and enhance our health and wellbeing
What can self-care prevent
burnout, psychological distress, protect and support wellbeing during distress
Engaging in self-care: Posluns and Gall (2020)
- awareness
- balance
- flexibility
- physical health
- social support
- spirituality
Impacts/costs of developments on diet and health
Shift to eating processed foods (biscuits, crisps, soft-drinks, etc.)
Shift to eating out (especially at fast-food)
Uses marketing ploys, no control over how it’s made/prepared, often contains lots of sugar, salt and fat
Consequences of dietary shifts
Increase in metabolic disease
- Weight gain, type II diabetes + other lifestyle related diseases (poor mental health, neurodegenerative disease of old age)
Forms of malnutrition
- wasting
- stunting
- micronutrient deficiencies
- underweight
Psychology of starvation
People who starve can become depressed, highly egocentric, engage in immoral acts (behaviour that isn’t regarded as normal- theft, fraud, murder, cannibalism, prostitution… All to secure food)
Motives of weight loss dieting
- physical appearance
- health consequences
What are 3 sources of fuel that the body uses (in relation to diet and health)?
carbohydrates, fats, and proteins
Alternatives to weight loss dieting
Behaviour therapy and exercise (goal setting, craving lapse management, understanding appetite)
Medication - central (phentermine, topiramate, semaglutide [Ozempic]), Peripheral (orlistat)
Bariatric surgery
Dietary pattern as a treatment
- reduce depression
- ketogenic diet for paediatric epilepsy
- longevity of age
Psychoanalysis
relies on analytic processes to access unconscious conflicts that cause neurotic anxiety that manifest in defence mechanisms
What is psychotherapy
engagement between therapist and client with the focus to bring about change via the therapeutic alliance
Person-centred therapy
relies on relationship between therapist and client to confront incongruence
Becks ABC model of CBT
A = activating event
B = belief/thoughts
C = Consequence (emotional and/or behavioural)
Cognitive behavioural therapy
CBT relies on problem solving and change unhelpful conditions that underlie maladaptive behaviours
Challenging thinking
- identify negative thought
- look for evidence that surrounds the thought
- come up with a realistic thought based on the evidence
Theoretical concepts
the role of schemas in emotional disturbance affects all levels of information processing in adulthood
Goal: challenge cognitive distortions by identifying automatic negative thoughts
CBT model
situation - thought - emotion - behaviour
systematic desensitisation
- help client to build anxiety hierarchy
- train client in deep muscle relaxation and cognitive restructuring
- Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus
Exposure therapy
- determine problem
- construct hierarchy of situation inducing feared response
- a) imagine the fear, b) in vivio - gradual exposure, c) flooding exposure to fear
- repeat exposure to fear whilst leaning to tolerant and eventually become comfortable with the stimuli
Operant conditioning
Socialisation teaches “right” and “wrong” behaviour through positive/negative reinforcement and punishment
Reinforcement = increase response to pleasant outcome
Punishment = decrease response to unpleasant outcome
Positive = stimulus is delivered
negative = stimulus is removed
Aversion therapy
An averse (undesirable) stimulus is paired with a stimulus that elicits an undesirable response
Observational learning
social-cognitive-behaviour approach to learning through modelling, behavioural rehearsal and shaping
Mind-body connection
Biofeedback can give an idea on emotions e.g anxiety = increased heart rate
What is a case conceptualization in CBT according to Persons (2012)?
A hypothesis about the psychological mechanisms that cause and maintain an individual’s symptoms and problems.
When is a case conceptualization particularly useful in CBT?
It is useful in cases of comorbidity, absence of a treatment manual for a specific disorder, involvement of a multidisciplinary team, or issues like non-adherence or deterioration of the therapeutic relationship.
What are the key components of a case conceptualization?
Includes assessments of client concerns, establishing a treatment plan with goal setting, identifying treatment obstacles, and ongoing assessment of client progress.
What roles do case conceptualizations serve in CBT?
They guide assessment and treatment decision-making, highlight specific risk and protective factors, facilitate collaboration on goals, and provide feedback to support client and family.
What is the process of developing a case conceptualization in CBT?
Starts with a thorough assessment (Step 1), followed by developing an initial conceptualization based on working hypotheses (Step 2), setting up experiments to test these hypotheses (Step 3), and continuously revising the conceptualization (Step 4).
What is the purpose of Socratic dialogue in CBT?
To help clients identify and explore negative thoughts, opening up inquiry to help them realize these thoughts are just ideas and that multiple perspectives are possible.
What typically occurs in the first session of CBT
Assessment, diagnosis, and goal setting through psychoeducation, where the therapist explains the nature and process of CBT while building rapport.
What is the focus of the middle sessions in CBT?
Teaching clients to identify, evaluate, and replace negative automatic thoughts with healthier cognitions, supported by behavioral strategies like exposure and relaxation.
What is the focus of the final sessions in CBT?
Solidifying gains and focusing on preventing recurrence, ensuring the client is equipped to maintain their progress independently.
How are homework tasks used in CBT?
Clients are given realistic challenges to directly address inappropriate cognitive beliefs, which can lead to long-term cognitive and behavioral changes if successfully completed.
What does EFiT stand for?
Emotion-Focused Individual therapy
EFiT core principles
emphasis on processing and expressing emotions to achieve resolution (understand and work with emotions)
- core emotions are pivotal in shaping intricate framework that guide perceptions and interactions with the world
EFiT stages
- Engagement and assessment
- Emotional awareness and expression
- Regulation and transformation
- Consolidation and integration
EFiT goals
create a safe and empathetic environment where clients can explore and express their emotions fully - leads to increased self awareness and growth
EFiT stage 2: emotional awareness and expression
Encourage client to identify and express their emotions (explores underlying feelings), de-regulation of overwhelming emotions (calming exercising, grounding, validate emotions)
EFiT stage 1: engagement and assessment
build therapeutic alliance and understand the client’s emotional landscape
EFiT stage 3: regulation and transformation
helping the client regulate intense emotions and transform maladaptive emotional patterns
EFiT stage 4: Consolidation and integration
Solidify changes made in therapy - allow the client to integrate new emotional insight into daily life
Emotions
are instinctive and intuitive physiological and psychological reactions that are experience subjectively in response to stimuli
Solution-focused Brief Therapy (SFBT) core principles
focuses on identifying solutions and building on strengths rather than dwelling on problems… through looking at their stages of readiness
The stages of behaviour change (SFBT)
(Top to Bottom)
Maintenance - works to sustain the behaviour change
Action - practices the desired behaviour
Preparation - intends to take action
Contemplation - aware of the problem and of the desired behaviour change
Pre contemplation - unaware of the problem
Four core principles fo SFBT
- build rapport through empathy - so client can safely identify, exam, and resolve ambivalence about changing behaviours
- Rolling with “resistance” - avoid eliciting it by not confronting client’s ambivalence about change (assist them to explore their concerns)
- Develop discrepancy between current situation and goals
- Supporting self-efficacy (increasing individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments)
The role of autonomy (vs. authority)
Central as true power for change stems from the client (empower them by the idea that change occurs from them) - therapeutic alliance is a collaborative effort to make change
Techniques to support self-efficacy (SFBT)
- identify clients strengths and resources
- assume willingness and capacity to change
- collaborative relo. rather than authoritative (fosters power)
- meet the client at their model of the world
Talk elements of SFBT: Solution-focused process model (Grant, 2022)
- Change talk
- Solution talk
- Strategy talk
OARS for solution-focused process model
O: open ended questions - invite elaboration and deep thinking
A: affirmations - statements that recognise clients’ strengths
R: reflection - check in w/ the client (listening and feeling)
S: summaries - communicate interest, understanding and call attention to important elements of the discussion
Preparatory change talk: DARN (SFBT)
D: desire (I want to change)
A: ability (I can change)
R: reason (its important to change)
N: need (i should change)
“Change talk” (SFBT)
Includes statements by the client that reveal consideration of, motivation for, or commitment to change
The Miracle Question (Shazer et al. 2021) (SFBT)
Future oriented, identify existing solutions, clarify goals, give clues to strategies
- socratic and open ended
“Lets imagine that after you leave here, you go to bed, and when you are asleep a miracle happens… and your problems are solved… but because you are asleep, you didn’t know the miracle had happen… so tomorrow morning, how will you know the miracle has happened?… What will be different that will tell you that this miracle has occurred? What will you be doing differently?”
Implementing Change Talk: CAT
C: commitment (I will make changes)
A: activation (I am ready, prepared, willing to change)
T: taking steps (I am taking specific actions to change)
