Psychological Therapies Flashcards
Outline the morbidity and mortality of common mental health disorders?
Significant morbidity - 1 in 10 lost work days due to mental health.
Mortality is also very significant - suicide is the commonest cause of death in men under 50 years old.
What are the most common mental health disorders?
- Affective/Anxiety Disorders
- Substance Misuse Disorders
- Disorders of reaction to Psychological Stress
What are the main specific illnesses under “Affective/Anxiety Disorders”?
- Major Depressive Disorders (MDD)
- Generalised Anxiety Disorder (GAD)
- Panic Disorder and Phobic Anxiety Disorders
- Obsessive-Compulsive Disorders (OCD)
What are the main specific illnesses under ”Substance Misuse Disorders?”
- due to use of alcohol
- due to use of tobacco
- due to use of Opioids/Benzos/Stimulants
What is the main disorder under the “disorders of reactions to stress”?
Post Traumatic Stress Disorder (PTSD)
What are the issues in terms of availability for psychological therapies?
Availability is limited.
The reality is that treatment in the primary care setting is the most viable option.
What is Cognitive Behavioural Therapy (CBT)?
What is it good at treating?
Therapy that aims to relate a patients thoughts, feelings and behaviours.
Particularly good for depression, anxiety, phobias, OCD, PTSD.
It focuses on the “here and now” rather than a patient’s previous experiences, in a short term goal-orientated way.
Outline how a therapist can help a client through CBT.
(types of thoughts etc.)
What do clients then do to help themselves?
- Identify thoughts, feelings and behaviours.
- Assess whether thoughts are unrealistic/unhelpful (thinking errors)
- Automatic negative thoughts
- Unrealistic beliefs
- Cognitive distortions
- Catastrophising
- Black and White/”All or Nothing” thinking
- Identify what can change
- Clients engage in “homework” which challenges the unrealistic or unhelpful thoughts (thinking errors)
- Graded exposure
- Response prevention
What is behavioural activation?
Why is this beneficial?
a therapy that encourages patients with depression to approach activities they may have been avoiding.
- Collaborative / empathic / non judgmental
- Structured agenda – review progress
- Small changes – build to long term goals
This is beneficial because the activities allow for an escape from the aversive thoughts, feelings and external situations.
It has been found that this can be as effective as CBT for treating depression.
What is the focus of Behavioural Activation?
Focuses on activities the patient tends to avoid and uses this as a guide for activity scheduling,
and for functional analysis of cognitive processes that involve avoidance. (AKA why they avoid things)
The client is then taught to analyse the unintended consequences of their way of responding.
What are the commonly seen types of withdrawal in depression?
- Social withdrawal
- Not answering calls
- Avoiding friends
- Non-social avoidance
- Sitting around at home
- Excessive time in bed
- Cognitive avoidance
- Not thinking about relationship issues
- Not making decisions about the future
- Not being serious about work/study
- Avoidance by distraction
- TV / Gaming
- Gambling
- Comfort eating
- Excessive exercise
- Emotional avoidance
- Alcohol and substance use
What is interpersonal therapy?
Treats?
A brief, attachment-focused psychotherapy that centres on resolving interpersonal problems and symptomatic recovery
Used to treat depression/anxiety for 12-16 weeks, focussing on the present.
What types of events can depression follow from?
(These can be a target for interpersonal psychotherapy)
- Complicated bereavement
- Dispute
- Role transition
- Interpersonal deficit
Outline interpersonal therapy in practice.
- “sick role” given
- construct an “interpersonal map”
- Identify the interpersonal context
- “focus area’’ maintained – depressive symptoms linked to interpersonal events (weekly)
Goal:
- Reduce depressive symptoms
- Improve interpersonal functioning
What are the strengths and weaknesses of interpersonal therapy?
Strengths
- good evidence it treats depression
- No formal homework - which may be preferred.
- Client can continue to practice skills beyond the end of the session.
