Psychological approaches to common mental health problems

Question 1

Common mental health disorders?

Answer 1

1 Affective/anxiety disorders

2 Substance misuse disorders

3 DISORDERS OF REACTION TO PSYCHOLOGICAL STRESS

Question 2

Common mental health disorders - Affective/anxiety disorders?

Answer 2

1) Major Depressive Disorder (MDD)
2) Generalised Anxiety Disorder (GAD)
3) Panic Disorder and Phobic Anxiety Disorders
4) Obsessive-Compulsive Disorder (OCD)

Question 3

Common mental health disorders - Substance misuse disorders?

Answer 3

1) Due to use of ALCOHOL
2) Due to use of TOBACCO
3) Due to use of OPIOIDS/BENZOS/STIMULANTS

Question 4

Common mental health disorders - Disorders of reaction to psychological stress?

Answer 4

Post traumatic stress disorder (PTSD)

Question 5

What is cognitive behavioural therapy good for?

Answer 5

Particularly good for depression, anxiety, phobias, OCD, PTSD

Question 6

Overview of Cognitive behavioural therapy?

Answer 6

> How our thoughts relate to our feelings and behaviour (Beck, 1979)

> Particularly good for depression, anxiety, phobias, OCD, PTSD

> Focus on here and now

> Short-term

> Problem focussed, goal oriented

> Individual, group, self-help book or computer programme

Question 7

What is CBT?

Answer 7

> Identify thoughts, feelings and behaviours

> Assess whether thoughts are unrealistic / unhelpful (thinking errors)

- Automatic negative thoughts
- Unrealistic beliefs
- Cognitive distortions
- Catastrophizing 
- Black and white / all or nothing thinking
- Perfectionism 

> Identify what can change

> Client engages in “homework” which challenges the unrealistic or unhelpful thoughts (thinking errors)

- Graded exposure
- Response prevention

Question 8

Avoidance in depression - social withdrawal?

Answer 8

> Not taking on challenging tasks

> Sitting around the house

> Spending excessive time in bed

Question 9

Avoidance in depression - non-social avoidance?

Answer 9

> Not thinking about relationship problems

> Not making decisions about the future

> Not taking opportunities

> Not being serious about work / studies

Question 10

Avoidance in depression - cognitive avoidance?

Answer 10

> Watching rubbish on television

> Playing computer games

> Gambling

> Comfort-eating

> Excessive exercise

Question 11

Avoidance in depression - avoidance by distraction?

Answer 11

Use of alcohol and other substances

Question 12

What is behavioural action?

Answer 12

Behavioural therapy is an action-based therapy that looks to foster positive behaviour change. It is effective within depression

Question 13

Behavioural Activation

Theory and Rationale?

Answer 13

Focus on avoided activities:

- as a guide for activity scheduling
- for a functional analysis of cognitive processes that involve avoidance

Focus on what predicts and maintains an unhelpful response by various reinforcers

Client taught to analyse unintended consequences of their way of responding

Question 14

What can interpersonal psychotherapy used for?

Answer 14

Depression

Anxiety

Question 15

Interpersonal therapy - Strengths?

Answer 15

A grade evidence for treating depression

No formal homework – may be preferable

Client can continue to practise skills beyond the sessions ending

Question 16

Interpersonal therapy - Limitations?

Answer 16

Requires degree of ability to reflect – may be difficult for some

Where poor social networks – limited interpersonal support

Question 17

What is interpersonal therapy?

Answer 17

A central idea in IPT is that psychological symptoms, such as depressed mood, can be understood as a response to current difficulties in our everyday interactions with others. In turn, the depressed mood can also affect the quality of these interactions. When a person is able to interact more effectively with others, their psychological symptoms often improve.

IPT can typically focus on the following relationship areas:

> Conflict with another person
Life changes that affect how you feel about yourself and others
Grief and loss
Difficulty in starting or keeping relationships going

Question 18

What is interpersonal therapy?

Answer 18

A central idea in IPT is that psychological symptoms, such as depressed mood, can be understood as a response to current difficulties in our everyday interactions with others. In turn, the depressed mood can also affect the quality of these interactions. When a person is able to interact more effectively with others, their psychological symptoms often improve.

IPT can typically focus on the following relationship areas:

> Conflict with another person
Life changes that affect how you feel about yourself and others
Grief and loss
Difficulty in starting or keeping relationships going

Question 19

What is motivational interviewing (MI)?

Answer 19

MI uses a guiding style to engage clients, clarify their strengths and aspirations, evoke their own motivations for change and promote autonomy in decision making

Question 20

Four general principles of motivational interviewing?

Answer 20

R - resist the urge to change the individual’s course of action through didactic means (avoid argument)

U - understand it’s the individual’s reasons for change, not those of the practitioner, that will elicit a change in behaviour (self-efficacy)

L - listening is important; the solutions lie within the individual, not the practitioner (express empathy)

E - empower the individual to understand that they have the ability to change their behaviour

Question 21

Stages of Change?

Answer 21

1) Pre-contemplation
2) Contemplation
3) Planning
4) Action
5) Maintenance

Question 22

Stages of Change - Pre-contemplation?

Answer 22

In denial

Question 23

Stages of Change - Contemplation?

Answer 23

Ambivalence – 6 months to a lifetime! – information - risk screening - pros and cons

Question 24

Stages of Change - Planning?

Answer 24

“I have a problem – how can I change” – options for change / build confidence and motivation

Question 25

Stages of Change - Action?

Answer 25

‘this is what I am doing ‘– preventing relapse and coping strategies / strategies to maintain goals encouragement in failures

Question 26

Stages of Change - Maintenance?

Answer 26

Coping strategies / weak points / emergencies/ slips back protocols

Question 27

How many people suffer from a mental disorder at some point?

Answer 27

1 In 4