Psychological therapy

Question 1

Mental health disorders indicated for psychological therapy

Answer 1

• Affective anxiety disorders
  
  • Major Depressive Disorder
  • Generalised Anxiety Disorder
  • Panic Disorder and Phobic Anxiety Disorder
  • Obsessive-Compulsive Disorder (OCD)
• Substance misuse disorder
  
  • Alcohol
  • Tobacco
  • Opioids/ bentos/ stimulants
• Post-traumatic stress disorder (PTSD)

Question 2

Cognitive Behavioural Therapy

Answer 2

• How thoughts relate to feelings and behaviours
• Indicated for depression, phobias, OCD and PTSD
• Focuses on the present
• Short-term
• Problem-focused, goal oriented
• Settings: individual, group, self-help book or computerised

Question 3

Mechanism of action in CBT

Answer 3

• Identify thoughts, feelings and behaviours
• Assess whether the thoughts are unrealistic/ unhelpful (thinking errors)
• Identify what can be changed
• Engages in ‘homework’ to challenge these unrealised/ unhelpful thoughts (thinking errors)

Question 4

Thinking error

Answer 4

• Automatic negative thoughts
• Unrealistic beliefs
• Cognitive distortions
• Catastrophising
• Black and white thinking
• Perfectionism

Question 5

Behavioural activation

Answer 5

• Activities functioning as a mechanism to avoid and escape from aversive thoughts, feelings and external situations
• Scheduling activities standalone can be as effective as CBT for depression

Question 6

Mechanism of action in Behaviour Activation

Answer 6

• Focus on avoided activities to guide activity scheduling
• Analysis of the processes behind avoidance behaviour
• Focus on triggers of unhelpful response
• Client taught to self-analyse their response

Question 7

Behavioural Activation Avoidance Activities

Answer 7

• Social withdrawal
  
  • Not answering calls
  • Avoiding friends
• Non-social avoidance
  
  • Spending excessive time in bed
  • Sitting around the house
• Cognitive avoidance
  
  • Not making decisions about future
  • Not taking opportunities
  • Not being serious about work/ studies
• Avoidance by distraction
  
  • Watching TV
  • Playing video games
  • Comfort eating
  • Gambling
  • Excessive exercise
• Emotional avoidance → using alcohol and other substances

Question 8

Interpersonal therapy

Answer 8

• Indicated for depression and anxiety
• Time limited (12-16 weeks)
• Focused on the present
• Rated as effective as CBT
• Theorises that mental health conditions follow a change caused by large I-P event (bereavement, dispute, role transition, interpersonal deficit)

Question 9

Mechanism of action of Interpersonal therapy

Answer 9

• ‘sick role’ given to client
• Constructs an ‘interpersonal map’
• Goal is to maintain focus areas to reduce depressive symptoms
• Improve interpersonal functioning
• Requires degree of reflection
• Difficult where there is poor social network

Question 10

Motivational interviewing

Answer 10

• Expressing empathy → understanding their situation
• Avoids argument
• Support self-efficacy → patient sets agenda and creates change