Psychosocial interventions Flashcards
What is the idea of the continuum model of psychosis?
There’s a continuum between normality and psychosis, and only the extreme end constitutes a disoreder
- psychotic experiences are common and present to different degrees (7% prevalence)
What characterises the psychological approach to psychosis?
Approach psychosis in terms of distressing experiences or symptoms (not as a disease state)
What does talking therapy focuses on?
Isolating the
- experiences
- beliefs
- behaviours
that distress people
What characterises the CBT approach?
Individualised, case formulation approach
- apply cognitive model as template
- Events and experiences -> Appraisal -> Symptoms
- > thoughts, feelings, behaviours
What is the role of voices in the psychological approach to psychosis?
It’s not the voices, it’s the beliefs associated to them:
- appraisal mediates the relationship between voices and distress
- most important in predicting distress
- > How they think and act about these voices will impact the frequency of occurence
What does the cognitive model of psychotic symptoms by Garety and colleagues (2001, 2007) suggest?
Bio-psychosocial vulnerability
- Trigger
- > Emotional changes + Basic cognitive dysfunction and anomalous experiences
- > Appraisal of experience
- > Positive symptoms
- > Maintaining factors
- reasoning and attributions
- dysfunctional schemas
- emotional processes
- appraisal of psychosis
What influences the appraisal of psychotic experiences influenced according to Garety and colleagues (2001, 2007)
- Reasoning and attributional biases
- Dysfunctional schemas of self and world
- Isolation and adverse environments
What are the mechanisms of CBT?
- Establish links between thoughts, feelings, behaviours
- Re-evaluate/reframe people’s perceptions, beliefs, thinking styles and unhelpful behaviours related to distressing psychotic experiences and emotional problems
What can CBT change?
- Appraisal of experience
- Thinking and reasoning biases
- Social environments and reducing negative effects of adverse environments
- How one responds to their experiences (in the maintenance of stress)
What can’t CBT change?
Fundamental psychotic experiences
What are the requirements of CBT for psychosis?
It needs to be
- flexible
- collaborative (to plan effective strategies)
What is the main goal?
Bring about desired change
- patient needs to identify the problems and want to change them
What are the four goals of CBT for psychosis?
- CBT is about management, coping and increasing quality of life (not cure and treatment)
- Emphasis on engagement (open-minded therapeutic stance on patient’s experiences)
- Focus on valued goals (desired changes)
- Individualised formulation approach
What is it important to have an individualised formulation approach in CBT for psychosis?
- Psychotic experiences are heterogeneous
- Continuum of severity within same symptom
- There are secondary disturbances (anxiety, depression)
What are the areas of focus in CBT for psychosis?
- Coping with social, physical or cognitive disability
- Social exclusion
- Make sense of psychosis, how to integrate it with view-of-self
- Direct management of psychotic symptoms and experiences
- Management of emotional problems
- Addressing interpersonal issues
- Staying well (prevention from future relapses)
