Psychological Therapies

Question 1

name 3 categories of mental health disorders

Answer 1

affective/anxiety disorders
substance misuse disorders
disorders of reaction to psychological

Question 2

name affective/anxiety disorders

Answer 2

a. Major depressive disorder – MDD
b. Generalised anxiety disorder – GAD
c. Panic disorder and phobic anxiety disorders
d. Obsessive compulsive disorder

Question 3

name substance misuse disorders

Answer 3

alcohol
tobacco
opioids/benzos/stimulants

Question 4

name a disorder of reaction to psychological stress

Answer 4

PTSD

Question 5

what does CBT aim to do?

Answer 5

Relate thoughts to feelings and behaviour

Question 6

what is CBT good for?

Answer 6

Depression
anxiety
phobias
OCD
PTSD

Question 7

what does CBT focus on?

Answer 7

Here and now

problem focussed, goal orientated

Question 8

how many sessions of CBT has been demonstrated to be enough?

Answer 8

8-12

Question 9

how may CBT be delivered?

Answer 9

individual
group
book
computer programme

Question 10

what does CBT help clients do?

Answer 10

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

Question 11

why and what type of homework is part of CBT?

Answer 11

challenges the unrealistic or unhelpful thoughts
graded exposure
response prevention

Question 12

discuss behavioural activation

Answer 12

• Depression
o Activities function as avoidance and escape from aversive thoughts, feelings and
external situations
• RCT found that activity scheduling alone for depression is as effective as CBT for depression
• Focus on avoided activities
o As a guide for activity scheduling
o For 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
• Collaborative/empathic/non-judgmental
• Structured agenda – review progress
• Small changes – build to long term goals

Question 13

what kinds of avoidance are found in depression?

Answer 13

social withdrawal
non-social avoidance
cognitive avoidance
avoidance by distraction
emotional avoidance

Question 14

give examples of social avoidance

Answer 14

not answering phone

avoiding friends

Question 15

give examples of non-social avoidance

Answer 15

not taking on challenging tasks
sitting around the house
spending excessive time in bed

Question 16

give examples of cognitive avoidance

Answer 16

not thinking about relationship problems
not making decisions about the future
not taking opportunities
not being serious about work/studies

Question 17

give examples of avoidance by distraction

Answer 17

watching rubbish on TV
playing computer games
gambling
comfort eating
excessive exercise

Question 18

give examples of emotional avoidance

Answer 18

use of alcohol and other substances

Question 19

discuss interpersonal therapy

Answer 19

• Focused on the present
• Depression often follows a disturbing change in or contingent with significant IP event
o A complicated bereavement
o A dispute
o A role transition
o An interpersonal
• Sick role given
• Construct an interpersonal map
o Identify the interpersonal context
• Focus area maintained
o Depressive symptoms linked to interpersonal events (weekly)
• Goal
o Reduce depressive symptoms
o Improve interpersonal
• Strengths
o A grade evidence for treating depression
o No formal homework – may be preferable
o Client can continue to practice skills beyond the sessions
• Limitations
o Requires degree of ability to reflect which may be difficult for some
o Where poor social networks – limited interpersonal support

Question 20

what is interpersonal therapy useful for?

Answer 20

depression

anxiety

Question 21

how long does a course of interpersonal therapy last?

Answer 21

12-16 weeks

Question 22

discuss motivational interviewing

Answer 22

• Promotes behaviour change in a wide range of healthcare settings
• More effective than advice giving
• Used where behaviour change is being considered, when patient may be unmotivated or
ambivalent to change
• Principles
o Express empathy
§ Understand a person’s predicament
o Avoid argument
§ If challenging patients position – makes defensive
o Support self-efficacy
§ Patient sets agenda, generates what they might consider changing
• Cycle of change
o Precontemplation – here if you need us
o Contemplation – ambivalence, 6 moths to a lifetime, information, risk screening, pros
and cons
o Planning – options for change/build confidence and motivation
o Action – preventing relapse and coping strategies/strategies to maintain goals,
encouragement in failures
o Maintenance – coping strategies/weak points/emergency/slip back protocols