Psychotherapies Flashcards
What is psychotherapy?
Systematic use of a relationship between a pt and a therapist- as opposed to physical & social methods- to produce changes in feelings, cognition & behaviour.
State some common characteristics of all psychotherapies
- An intense confiding relationship with a helpful person
- A rationale containing an explanation of the pt’s distress
- Provision of new information about nature & origins of pt’s problems and the ways of dealing with them
- Development of hope in the pt that they will be helped
- Opportunities to experience success during treatment
- Facilitation of emotional arousal
Only some psychotherapies involve active collabortion between pt & therapist; true or false?
False; all psychotherapies involve active collaboration between pt & therapist
Which type of pt’s make best candidates for psychotherapy?
*HINT: 3 things they must be able to do
- Able to verbalise their problems
- Psychologically minded: able to see that psychological processes could contribute to their problems
- Well-motivated: take some degree of responsibility for the resolution of their problems
State some examples of pschyotherapies
- Cognitive behavioural therapy (CBT)
- Psychodynamic psychotherapy
- Interpersonal therapy (IPT)
- Eye movement desensitation & reprocessing (EMDR)
- Dialectical behavioural therapy (DBT)
State the two most commonly used forms of psychotherapy
- Cognitive behavioural therapy (CBT)
- Psychodynamic psychotherapy
*NOTE: there are many other psychotherapies derived from these
The choice of psychotherapy depends on various factors; state some
- Illness
- Patient factors
- Preference
- Background history
- Family
- What they have tried before
- Local availability
- Practitioner experience
Explain how CBT works
Cognitive behavioural therapy (CBT) is a type of talking treatment which is based on the fundamental principle that what you think affects how you feel emotionally and physically and alters behavoiur.
It combines cognitive therapy (examining the things you think) and behaviour therapy (examining the things you do).
Aim of CBT is to help people identify and challenge negative thoughts or behaviours- this helps them to break the cycle and allow people to better control their thoughts, emotion, bodily sensations and behaviours. Also teaches people coping strategies.
For example:
- In depression pt may view themselves negativley so misinterpret others perception of them (thinking they too think negatively of them). This makes them feel sad and anxious. Stop doing activities they enjoy. Feel more low in mood and view themselves more negatively.
- In depression pt may have anhedonia and lack of energy so stop doing activities they enjoyed, this exacerbates the feelings of depression and anxiety.
Image demonstrates the thought proces that CBT targets
CBT can be delivered in a variety of formats; state some examples
- Self-help via books/workbooks
- Computer programmes (including online)
- Groups
- Individual
What is the average number of CBT sessions prescribed? (give a range)
6-20
State some indications for CBT
- Mild-moderate depression
- Bipolar affective disorder
- Anxiety disorders (phobias, GAD, OCD, panic, PTSD, BDD)
- Eating disorders
- Substance misuse disorders
- Sexual dysfunction
- Schizophrenia
Can also be used for chronic medical conditions e.g. fibromyalgia, chronic fatigue syndrome, fibromyalgia
The five areas approach is a model of assessment and management that uses CBT; what is the 5 areas approach?
Idea that you should gather information on each of the five areas to figure how it is all interlinked. This can help both the pt understand themselves better and you understand them. Once you better understand them it can aid your management e.g. if pt has significant life, relationship etc problems then it’s unlikely that just medication will work. It is based on the model of CBD.
Five areas:
- Environment (life situation, relationships, practical problems)
- Altered thinking
- Altered emotions/mood
- Altered physical feelings/symptoms
- Altered behaviours/activities
Explain how psychodynamic psychotherapy works
Psychodynamic therapy is based on the idea there are unconscious thoughts and emotions that drive behavior. These unconscious thoughts & emotions are due to past experiences- be this relationships, unresovled conflicts or childhood experiences. If a person has maladaptive/unhealthy thoughts, feelings & behaviours, becoming aware of the unconscious thoughts & emotions that are causing those can help them change them.
One of main techniques used is transferance.
One of the key aspects of psychodynamic therapy is transference and co-transference. Describe each of these
To understand transference & counter transference think of two people sat in a room. One person triggers the unconscious of the other person resulting in emotional and behaviour responses; these responses are based on previous experiences which have formed our unconscious.
Transference: unconscious transfer of feelings & attitudes from the patient’s past into the therapist (therapist triggers the unconscious of the pt)
Counter transference: unconscious transfer of feelings & attitudes from the therapist’s past into the patient (patient triggers the unconscious of the therapist)
An example: therapist presents themselves in a particular way and this triggers the patients unconscious because the therapist is presenting themselves in a similar way to pt’s abusive father. Pt becomes anxious, withdrawn, scared and thinks negatively of themselves.
*NOTE: if counter-transference occurs it makes it difficult to understand and treat the patients problem hence therapists must have psychodynamic therapy themselves so that they are aware of things that may trigger an emotional or behavioural response in themselves.
For each of the following discuss what kind of psychotherapies would be appropriate:
- Adverse life eents
- Depression
- PTSD
- Schizophrenia
- Eating disorders
- Anxiety disorders
- Substance misuse
- Borderline personality disorder
*NOTE: counselling & psychotherapy not same- slightly different. Question phrased for ease.
Numerous behavioural therapies exist; describe the following behavioural therapies:
- Relaxation training
- Systematic desensitisation
- Flooding
- Exposure & response prevention (ERP)
- Behavioural activation
What kind of behavioural therapy is this an example of?
Systematic desensitisation
State some examples of common defence mechanisms recognised in the psychodynamic therapy
In psychodynamic theory, a psychological defense mechanism is a technique that is used by a person’s ego to protect them against potential anxieties
