Other therapeutic models

Question 1

Interpersonal therapy

Answer 1

• aims to improve interpersonal functioning
• 12-16 sessions
• gives sick role to patient
• here and now
• illness is a medical disorder but interpersonal problems can contribute
• all close relationships are inventoried
• in IPT the therapist is an explicit ally and advocate for the patient
• looks at role transitions, interpersonal disputes, grief and interpersonal deficits

Question 2

Indications for IPT

Answer 2

• comparable to imipramine
• less effective than CBT in patients with depression and comorbid personality disorders
• mild-moderate depression
• bulimia nervossa

Question 3

Dialectical behavioural therapy

Answer 3

• Marsha Lineham
• developed as treatment for Borderline Personality Disorder, especially to reduce self-harm
  1. group skills training
  2. individual therapy
  3. phone consultantions
  4. consultation team

Question 4

Key techniques in DBT

Answer 4

• DICE
• Distress tolerance
• Interpersonal effectiveness training
• Core mindfulness training
• Emotion regulation skills

DBT also involves social skills training and validation

Question 5

Cognitive Analytic Therapy

Answer 5

• Anthony Ryle
• can be used in depression, anxiety, personality disorders
• two theroretical concepts
  1. procedural sequence model
  2. role repertoires

Question 6

Procedural sequence model

Answer 6

• an attempt to understand aim-directed action
• traps- negative assumptions that produce consequences which then reinforce assumptions
• dilemmas- person acts as though available actions or roles are limited or polarised
• snags: appropriate goals or roles are abandoned because others would oppose them or they are thought to be forbidden

Question 7

Restricted Role Repertoire

Answer 7

• undue restriction in the total number/variety of procedural sequences (repertoire) may occur due to the impoverished environment, childhood etc
• these lead to neurotic difficulties

Question 8

Treatment in cognitive analytic therapy

Answer 8

• 16-24 sessions
• initial phase: exploration of traps, dilemmas and snags
• middle phase: working through problems with the use of diagrams exploring target problem procedures
• ending phase: both patient and therapist write goodbye letters

Question 9

CAT and EUPD

Answer 9

• in EUPD people deploy a small numnber of highly maladaptive reciprocal roles
• EUPD patients show oversensitiity to stimuli resulting in changes (hair-trigger) when changing roles
• capacity for conscious self-reflection and self-control are also impaired in borderline states

Question 10

Transactional Analysis

Answer 10

• Eric Berne
• examines interactions between people
• 3 main ego-states people consistently use:
• Parent
• Adult
• Child

Question 11

Humanistic psychotherapy

Answer 11

• originally promoted as a third force in psychotherapy
• humanistic therpaists believe that each of us has the responsibility for finding meaning in our own lives
• therapy is seen only as a way to help people to make their own choices and resolve their own dilemmas- by increasing emotional awareness
• therapist-client relationship is very important
• Client-Centred therapy
• Gestalt therapy

Question 12

Client-centred therapy

Answer 12

• Carl Rogers
• humanistic
• non-directive
• notion of self concept
• unconditional positive regard
• Q-sort technique-person sorting cards with statements on into piles

Question 13

Gestalt therapy

Answer 13

• Perls and Goodman
• Humanistic
• exisitention, focuses the patient in the present and personal responisibility
• phenomenological method- raises self awareness
• dialogical relationship: ‘presence’ is created
• field theoretic strategies-focus on realities
• experiential freedom- try something new

Question 14

Mentalisation-Based therapy

Answer 14

• derived from attachment theory
• mentalising is the capacity to perceive others and ones own actions and emotional states as meaningful
• focuses on the patient’s current mental state to build up representations of mental states
• therapy creates a ‘transitional area of relatedness’

Question 15

Eye Movement Desensitisation and Reprocessing

Answer 15

• Shapiro
• when trauma occurs it seems to get locked in the nervous system with the original picture, sounds, thoughts and feelings
• eye movements used in EMDR ‘unlock the nervous system’ (desensitise) and allow the brain to correctly process the experience
• used in PTSD

Question 16

Transtheoretical Model

Answer 16

• Prochaska and DiClemente
• 6 stages of change
  1. precontemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
  6. relapse
• each stage can be moved back and forth

Question 17

Motivational interviewing

Answer 17

• often used with TTM and stages of change
• Miller and ROllnick- from substance abuse
• working with the patient
• resolving ambivalence
• change coming from the patient
  1. express emphathy
  2. develop discrepancy
  3. avoid argumentation
  4. roll with resistance
  5. support self-efficacy

Question 18

Behavioural couples therapy

Answer 18

• specific intervention for alcoholism
• works directly to increase relationship factors conducive to abstinence
• 15-20 sessions
• one day at a time
• ‘catch your partner doing something nice’

Question 19

Acceptance and commitment therapy

Answer 19

-part of CBT
-draws upon a basic account of language (relational frame theory)
-works on the way people relate to their thinking and feeling rather than directly trying to challenge or change this
-cognitive fusion: I think I am useless and this means I dont do anything
-experiential avoidance: I feel anxious and so I avoid it
-

Question 20

Strategies in acceptance and commitment therapy

Answer 20

• acceptance: taking a position of non-judgemental awareness towards thoughts, feeling, sensations
• cognitive defusion- I will try to step back and observe my thoughts
• contact with the present moment
• self-as context
• values
• committed action
• therapist is like a coach
• similar to CBT

Question 21

Mindfulness-Based Cognitive therapy

Answer 21

• Segal and Teasdale
• developed for people vulnerable to repeated episodes of depression
• small changes in mood can lead to large scale negative thoughts that can trigger a relapse
• 8 weeks of mindfulness classes: focus on changing the relationship to thoughts, feelings and body sensations rather than trying to change them themselves
• education
• links between thoughts, emotions and bodily sensations
• evidenced with 44% reduction in depressive relapse risk