Psychological therapies Flashcards
How does CBT work?
Situation (problem/event etc) leads to physical feelings + emotions + thoughts + actions
These components can be helpful and unhelpful and interact with each other in positive/negative ways - works with negative aspects that are seen to trap you in a negative cycle
Breaks down overwhelming current problems into smaller parts
- given exercises to improve these parts to shift the negative patterns and improve how you feel
What happens during CBT?
Weekly//fortnightly sessions of 30-60 minutes for 5-20(+) sessions (6wks-6months)
Works with problem areas and productive things to change them; given homework and chances to reflect on progress with the aim to consistently apply better management skills in daily life
What conditions are CBT useful for?
Depression - most effective psychotherapy for moderate-severe depression; as effective as antidepressants for some types Anxiety; panic disorder; phobias PTSD OCD Eating disorders Sleep problems - insomnia Alcohol misuse IBS/CFS - improve coping
What are some pros and cons of CBT?
Pros - better than medication alone; shorter course than other therapies; highly structured - different types (group/online); good for skills after therapy is over
Cons - requires commitment; can be time consuming; might not be suitable for complex needs/learning difficulties; may experience periods of discomfort/anxiety; doesnt address wider problems in systems/families/day-to-day; may not address underlying causes
What is psychoanalytic psychotherapy?
Tries to understand the reasons behind the symptoms, emotional stress and relationship difficulties - how the past impacts you experiences of the now and your expectations of the future
Operates on the assumption that part of our mind is outside of conscious awareness and patterns laid down in childhood affect the events that occur in the unconscious
What does psychoanalytic therapy involve?
50 minute sessions in the same place/time on a weekly basis; time course is variable depending on the issues you are working through
Encouraged to talk freely about feelings/experiences/memories/dreams/anxieties/fantasies/wishes - therapist will listen and periodically feedback to you their interpretations; therapists will also be guided by the development of the relationship that develops between you both
What problems is psychoanalytic therapy useful for?
Family problems are too much to bear
Stress is difficult to deal with/recover from
Lonely/empty/depressed/anxious/panicky/despair/disappointment
Eating/drinking/sex/sexuality concerns
Interpersonal relationship problems
Self harm/worthlessness/suicidal ideation
Physical problems that are not easily explained or dont fit a diagnosis
What are some pros and cons to psychoanalytic therapy?
Pros - addresses root causes of psychological distress, encourages free expression, you direct what is talked about, benefits can increase over time
Cons - less structured than CBT, long commitment required, can be expensive, some may not wish to delve into past, requires interpretation from therapist (lacks objectivity), reliant on theoretical constructs ie unconscious mind
What is Eye Movement Desensitisation and Reprogramming (EMDR)?
Theory that the memories created during a traumatic experience are not stored properly and so cause the flashbacks and anxiety
Patient moves their eyes in various movement patterns in 15-30 second bursts whilst attempting to recall the memory
Hand tapping or other small movements also used, possibly instead of
Process is called dual processing and is thought to help with the proper storage of the memory (like what the fuck kinda explanation is that??)
When should EMDR be used?
Trauma based therapies ie PTSD
What therapies are indicated for in OCD?
Exposure and Response Prevention + Cognitive Therapy (types of CBT)
What does Exposure and Response Therapy involve?
Stops compulsive behaviours from strengthening each other
If you stay in a stressful situation long enough you gradually become used to it and your anxiety goes away – puts people in these circumstances and prevents them from performing usual compulsive rituals and waits for anxiety to subside
Needs to be done daily for 1-2wks, for as long as it take for anxiety to fall to less than half of its worst each time c.30-60 mins at start
¾ people who complete are helped a lot; ¼ will develop symptoms again and will need extra treatment; ¼ will never try or finish ERP
What does Cognitive Therapy involve?
Change your reaction to the thoughts instead of trying to get rid of them
Stop fighting the thoughts – odd thoughts are normal and trying to get rid of them doesn’t work
Learn to notice when these thoughts arise and keep record of what kinds of thoughts occur, then try and challenge them by finding evidence; assessing how useful the thought is; what another way to look at the situation might be; what the best/worst/most realistic outcomes would look like; how would I advise a friend in a similar situation and why might I not give the same advice to myself?
What is dialectical behavioural therapy and why is it used in BPD?
Principles:
In BPD you are particularly emotionally vulnerable – low levels of stress can you extremely anxious + typically grew up in an environment where emotions were dismissed by those around you → these factors cause a vicious cycle
Goals:
Break this cycle through validation – your emotions are valid, real and acceptable
Dialectics – school of philosophy that says most things in life are rarely black and white and that it’s important to be open to ideas and opinions that contradict your own
Run as weekly one on one and group sessions in partnership with a therapist
1st line for women with a history of self-harm and suicidal behaviour
What is mentalisation-based therapy and why is it used in BPD?
Principles:
People with BPD have a poor capacity to mentalise i.e. think about thinking, about your own thoughts/beliefs and assess whether they are useful, realistic or grounded in reality; also involves the recognition that others have their own thoughts, emotions, needs etc and that your interpretation of their mental states might not be accurate
Goals:
Improving one’s ability to recognise mental states in self and others
May initially be given in hospital with daily individual sessions and sessions with others with BPD; course lasting 18 months – some centres encourage patients to remain as inpatients in this time
What is a democratic therapeutic community and why is it used in antisocial PD?
Community based programmes, becoming increasingly popular in prisons
Social therapy aiming to address an individual’s risk of offending as well as their emotional and psychological needs
Large and small therapy groups and focuses on community issues – creating an environment where staff and prisoners contribute to the decisions of the community
Opportunities for educational and vocational work
Treatment length recommendation 18 months as people need enough time to make change and put into practice
Self motivation is required – participation in democratic processes
What is counselling?
A short term, problem oriented psychotherapy services where you talk in confidence with a counsellor who will help you find ways to deal with difficulties in your life
What does the NHS offer counselling for?
Depression - mild-moderate, who have tried self help
Management of feelings surrounding chronic disease
Chronic pain
Addiction
Fertility problems
Usually lasts 6-12 sessions
What is behavioural activation therapy?
Works with people with depression to help them take simple practical steps towards enjoying life again
Aims to increase motivation and learn problem solving skills
1-2-1/group/phone - 16-20 sessions
What is interpersonal therapy?
Helps people with depression address problems in their relationships with family/partners/friends - fix interpersonal relationships = reduce depression
Usually offered if CBT hasnt worked or for severe depression
16-20 sessions
What is mindfulness?
“knowing directly what is going on inside and outside ourselves, moment by moment” - tools to help you connect with your body and mind and its experiences and thoughts, to help us be more present and to understand ourselves better
“thoughts are simply mental events that do not have to control us”
Key points - notice the everyday, keep it regular, try new things, watch your thoughts and feelings and name them, free yourself from past and future - practice all like hell
Meditation, tai-chi, yoga, mindful activities that you can get lost in ie bread baking, sport etc
What are creative therapies?
Talking therapy + creative exploration
Different media – paint, chalk, crayons, sculpture; role play, movement
What is created is seen as an outer expression of our inner emotions
I.e. in an image, the inter-relationship of size, shape, line, space, tone, colour etc all; reveal elements of a clients perceived reality
Who benefits from creative therapies?
Clients who have difficulties expressing themselves including those with learning difficulties, refugees (without an extensive English vocabulary) and other people who have experienced trauma
In non-clinical settings can be very useful with children and adolescents as well as adults, couples, groups etc
