Psychological Approaches to Mental Health Problems

Question 1

What are affective/ anxiety disorders?

Answer 1

• Major Depressive Disorder (MDD)
• Generalised Anxiety Disorder (GAD)
• Panic Disorder and Phobic Anxiety Disorders
• Obsessive-Compulsive Disorder (OCD

Question 2

What are some common substance misuse disorders?

Answer 2

• due to use of ALCOHOL
• due to use of TOBACCO
• due to use of OPIOIDS/BENZOS/STIMULANTS

Question 3

Name a disorder of reaction to stress

Answer 3

POST TRAUMATIC STRESS DISORDER (PTSD)

Question 4

Cognitive behavioural therapy is about how our how our thoughts relate to our feelings and behaviour (Beck, 1979)

What is it particularly good at treating?

Answer 4

Particularly good for

• depression
• anxiety
• phobias
• OCD
• PTSD

Question 5

Cognitive behavioural therapy is about how our how our thoughts relate to our feelings and behaviour (Beck, 1979)

What does the therapy focus on?

Answer 5

• Focus on here and now
• Short-term
• Problem focussed, goal oriented

Question 6

Cognitive behavioural therapy is about how our how our thoughts relate to our feelings and behaviour (Beck, 1979)

What are the key features of CBT?

Answer 6

Therapist helps client:

• Identify thoughts, feelings and behaviours
• Assess whether thoughts are unrealistic / unhelpful
  
  • Automatic negative thoughts
  • Unrealistic beliefs
  • Cognitive distortions
• Identify what can change

Client engages in “homework” which challenges the unrealistic or unhelpful thoughts

• Graded exposure
• Response prevention

Question 7

A psychological treatment other than CBT is behaviour activation.

What is it useful in treating?

Answer 7

• Depression – activities function as avoidance and escape from aversive thoughts, feelings and external situations (Ferster, 1973)
• RCT (Jacobson et al., 1996) found activity scheduling alone for depression as effective as CBT for depression

Question 8

A psychological treatment other than CBT is behaviour activation.

What is the theory and rationale behind behaviour activation?

Answer 8

• 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 9

Another psychological treatment other than CBT and behaviour activation is interpersonal psychotherapy (IPT)

What is it effective in treating?

Answer 9

1. Depression
2. Anxiety

• Time limited (12-16 weeks)
• Focused on the present

Question 10

What are the key features of interpersonal therapy (IPT)?

Answer 10

Depression often follows a disturbing change in or contingent with significant I-P event

• a complicated bereavement
• a dispute
• a role transition
• an interpersonal
• “sick role” given
• construct an “interpersonal map”
  
  • Identify the interpersonal context
• “focus area’’ maintained – depressive symptoms linked to interpersonal events (weekly)

GOAL!

1. reduce depressive symptoms

2 improve interpersonal functioning

Question 11

What are the strengths of interpersonal therapy?

Answer 11

• A grade evidence for treating depression
• No formal homework – may be preferable
• Client can continue to practise skills beyond the sessions ending

Question 12

What are the limitations of interpersonal therapy?

Answer 12

• Requires degree of ability to reflect – may be difficult for some
• Where poor social networks – limited interpersonal support

Question 13

Name 4 psychological treatments?

Answer 13

1. CBT
2. Behaviour activation
3. Interpersonal psychotherapy
4. Motivational interviewing

Question 14

There are 4 psychological treatment;

1. CBT
2. Behaviour activation
3. Interpersonal psychotherapy
4. Motivational interviewing

What is motivational interviewing useful for?

Answer 14

Treating problem drinking

• Promotes behaviour change in a wide range of health care settings
• More effective than - advice giving
• Used where behaviour change is being considered, when patient may be unmotivated or ambivalent to change

Question 15

There are 4 psychological treatment;

1. CBT
2. Behaviour activation
3. Interpersonal psychotherapy
4. Motivational interviewing

Motivational interviewing is useful for treating problem drinking.

Where is it used most effectively?

Answer 15

Used where behaviour change is being considered, when patient may be unmotivated or ambivalent to change

Question 16

There are 4 psychological treatment;

1. CBT
2. Behaviour activation
3. Interpersonal psychotherapy
4. Motivational interviewing

Motivational interviewing is useful for treating problem drinking.

What are the principles?

Answer 16

• Express empathy
  
  • Understand person’s predicament
• Avoid argument
  
  • If challenging patient’s position – makes defensive
• Support self-efficacy
  
  • Patient sets agenda, generates what they might consider changing

Question 17

There are 4 psychological treatment;

1. CBT
2. Behaviour activation
3. Interpersonal psychotherapy
4. Motivational interviewing

Motivational interviewing is useful for treating problem drinking.

What are the 5 stages of change?

Answer 17

1. Pre-contemplation – ‘who me?’ – ‘happy users’ – denial!! - here if you need us.
2. Contemplation – ambivalence – 6 months to a lifetime! – information - risk screening - pros and cons
3. Planning /determination – ‘I have a problem – how can I change’ – options for change / build confidence and motivation
4. Action – ‘this is what I am doing ‘– preventing relapse and coping strategies / strategies to maintain goals
5. Maintenance – coping strategies / weak points / emergencies/ slips back protocols