Psychological Therapies

Question 1

What are the most common mental health problems?

Answer 1

1 - Affective/anxiety disorders

2 - Substance misuse disorders

3 - Disorders of reaction to psychological stress

Question 2

What conditions are classed as affective/anxiety disorders?

Answer 2

• Major Depressive Disorder
• Generalised anxiety disorder
• Panic disorder and phobic anxiety disorders
• OCD

Question 3

What are the most common substances that cause substance misuse disorders?

Answer 3

1 - Alcohol

2 - Tobacco

3 - Opioids/benzos/stimulants

Question 4

What is the most common disorder of reactions to stress?

Answer 4

PTSD

Question 5

What evidence-based guidelines must psychological therapies be based on?

Answer 5

• NICE
• SIGN
• MATRIX

Question 6

What is the basic idea behind CBT?

Answer 6

• Our thoughts relate to our feelings and behaviour
• Short-term
• Focus on here and now
• Problem focused, goal oriented

Question 7

For what conditions are CBT particularly effective?

Answer 7

• Depression
• Anxiety
• OCD
• Phobias
• PTSD

Question 8

In what way do thoughts connect with behaviours and feelings?

Answer 8

Question 9

What does the therapist help the client with during CBT?

Answer 9

• Identify thoughts, feelings and behaviours
• Assess whether the thoughts are unrealistic/unhelpful (thinking errors)
• Identify what can be changed

Question 10

What are examples of some common thinking errors?

Answer 10

• Automatic thinking errors
• Unrealistic beliefs
• Catastrophizing
• Black and white thinking
• Perfectionism

Question 11

What is the patient required to do during CBT?

Answer 11

• Engage in homework which challenges unrealistic or unhelpful thinking errors
• Homework involves:
  1) Graded exposure
  2) Response prevention

Question 12

Apart from CBT, what other behavioural methods can be used in the treatment of affective disorders?

Answer 12

Behavioural activation - understanding how avoidance precipitates certain behaviours and scheduling activities that the patient has been avoiding

Interpersonal Psychotherapy (IPT) - Identify inter-personal events which preluded the affective disorder and aim to improve interpersonal functioning

Question 13

What are some of the categories of avoidance that depressed patients often engage in?

Answer 13

1 - Social withdrawal (not answering phone, avoiding friends)

2 - Non-social withdrawal (not taking on challenging tasks, sitting around the house)

3 - Cognitive avoidance (not thinking about relationship problems, not making decisions about future)

4 - Avoidance by distraction (watching rubbish on TV, playing computer games etc.)

5 - Emotional avoidance (use of alcohol and drugs)

Question 14

What are the steps involved in behavioural activation treatment?

Answer 14

1 - Collaborative/non-judgmental approach

2 - Set a structured agenda - review progress

3 - Make small changes and build towards long term goals

Question 15

What are the benefits of IPT?

Answer 15

1 - A grade evidence for treating depression

2 - No formal homework

3 - Client can continue to practice skills after sessions

Question 16

What is motivational interviewing and its principles?

Answer 16

1 - Express sympathy to understand the patients predicament

2 - Avoid argument if challenging the patients position

3 - Support the patients self-efficacy

Question 17

What are the stages of change according to Prochaska and DiClemente?

Answer 17

1 - Pre-contemplation

2 - Contemplation

3 - Planning

4 - Action

5 - Maintenance

Question 18

When addressing excessive alcohol use, what is a good model/approach to use?

Answer 18

Alcohol brief intervention:

1 - Raise the issue

2 - Screen and give feedback (explain associated risks etc.)

3 - Listen for readiness to change (‘what are your feelings about drinking?’)

4 - Choose a suitable approach (information & advice, enhance motivation, coping strategies, build confidence)