Psychological Therapies

Question 1

What is the most common cause of death in men <50y?

Answer 1

Suicide

Question 2

What things can be helped with psychological therapies?

Answer 2

Anxiety/affective disorders, OCD, panic disorder, phobias
Substance misuse
PTSD

Question 3

How long does it take to get access to psychological therapies in the UK?

Answer 3

HEAT targets up to 18 weeks

Question 4

What is sometimes the reality when trying to delivery psychological therapies?

Answer 4

Waiting time too long

Medication must be given by GP

Question 5

What is the basis of CBT?

Answer 5

Thinking about how our thoughts relate to our behaviours

Focussing on here and now, it is problem centered and goal orientated

Question 6

How long term is CBT?

Answer 6

12 weeks usually

Quite short term

Question 7

What does CBT usually additionally involve?

Answer 7

Homework

Question 8

What goes on during CBT sessions?

Answer 8

Therapist helps client to identify thoughts, feelings and behaviours and try to see whether their thoughts are unrealistic/unhelpful (thinking errors) 
Identifying changes to be made
Graded exposure 
Response prevention (to ensure no slip backs)

Question 9

What are examples of thinking errors?

Answer 9

Automatic negative thoughts
Unrealistic beliefs
Cognitive distortions (set beliefs that are not true)
Catastrophizing
Black and white/all or nothing
Perfectionism
Mind reading (i.e. I can tell they were thinking that about me)

Question 10

What evidence does CBT have?

Answer 10

Grade A

Question 11

What does behavioural activation involve?

Answer 11

It focuses on eliminate harmful and self-destructive behaviours
In depression activities function as avoidance from aversive thoughts and BA involves scheduling activities to push people out of that pattern
Clients taught to analyse unintended consequences of their way of responding
It involves small changes to build long term goals

Question 12

How effective is behavioural activation?

Answer 12

As effective as CBT for depression

Question 13

What are the types of avoidance in depression? Give examples of each

Answer 13

Social withdrawal: avoiding friends/not answering the phone
Cognitive avoidance: not thinking about problems/making decisions about the future/taking opportunities
Non-social avoidance: not taking on challenging tasks/sitting around the house
Avoidance by distraction: watching rubbish on TV/gambling/excessive exercise
Emotional avoidance: substance misuse

Question 14

What is interpersonal therapy?

Answer 14

Time limited (12-16 weeks) treatment that aims to improve understanding of problematic IP relationships and thereby help with the patients mood

(i.e. how our affect relates to our interpersonal events)

Question 15

How effective is interpersonal therapy?

Answer 15

Grade A rating

Question 16

Depression often follows a disturbing change in or contingent with significant IP event, give examples of these

Answer 16

Complicated bereavement
A dispute
A role transition
An IP deficit

Question 17

What is involved in IP therapy?

Answer 17

Constructing an IP map
Focus area maintained
Goals are to reduced depressive symptoms and improve IP functioning

Question 18

What are the pros of IP therapy?

Answer 18

No formal homework

Taught skills for life

Question 19

What are the cons of IP therapy?

Answer 19

Requires ability to reflect

Poor social networks - limited IP support

Question 20

When may you use motivational interviewing?

Answer 20

Where behaviour change is being considered but patient unmotivated/ambivalent to change

Question 21

What is the aim of motivational interviewing?

Answer 21

Help patients identify problems and solutions, while promoting a sense of optimism and self-efficacy to change behaviour

Question 22

What are the three principles of MI?

Answer 22

Express empathy
Avoid argument
Support self-efficacy

Question 23

What are the stages of change?

Answer 23

Pre-contemplating (happy users)
Contemplating (give information, pros and cons etc.)
Planning
Action
Maintenance - prevent relapse/slip back protocols/weak points