Psychotherapy Flashcards
What is Psychotherapy?
the systematic use of a relationship between a pt and therapist - as opposed to physical and social methods, to produce changes in feelings, cognition and behaviour
What is improving access to psychological therapies (IAPT)?
*2006
aim of project was to increase provision of evidence based treatments for anxiety and depression, by primary care.
What does psychotherapy aim to do?
support patients in changing the way they interact with and perceive the world, to come to terms with past stressors and cope with current and future stressors
What are some indications of psychotherapy?
- mild to moderate depressive illness
- BPD
- neurotic illness
- schizophrenia
- ED
- PD
*specifics for learning disabilities, psychosexual problems and substance misuse etc
What are some principles of psychotherapy?
develop therapeutic relationship
listen to pt concerns
empathetic approach
provide information, support and advice
allow emotion expression
encourage self help
Differentiate between the Id, Ego and Super ego.
Id - primitive part, acts on impulses, no concept of time or others, needs immediate gratification
Ego - rational compromising part, can be logically reasoned with, introduces defence mechanisms
Super ego - all about rules, guilt complex, similar to Id in demands but opposing views
What is Repression?
deployed by ego to stop disturbing thoughts from becoming conscious
What is denial?
blocking external events from awareness
What is projection?
attributing unacceptable thoughts, feelings or motives to another person
What is displacement?
satisfying an impulse with a substitute object
What is regression?
acting child-like when facing stress
What is sublimation?
satisfying an impulse, but in a socially acceptable way
What is transference and countertransference?
transference - unconscious transfer of feelings and attitudes from past into the therapist
counter - all the feelings the therapist has in relation to the patient
What is dialectical behavioural therapy?
establishing a balance between acceptance and change, using a mix of CBT, behaviourism and mindfulness
What does DBT entail?
- mindfulness
- distress tolerance - help cope with feelings
(using STOP skill, 5-4-3-2-1) - emotional regulation - identify and understand
- Interpersonal effectiveness - getting along with others while asserting your own needs
What is systemic family therapy?
make sense of the world through relationships, focusing on the whole family system rather than individuals, focusing on relational context, addressing patterns of interaction and meaning
What might be important to consider when thinking of referring a patient for CBT?
active Tx requiring pt understanding and collaboration. pt motivated to participate and able to recognise, articulate and link their thoughts and emotions
What is the rationale CBT is based on?
disorder not caused by life events, but the way pt views these events, holding silent assumptions leading to negative automatic thoughts or cognitive distortions
What is the aim of CBT?
help identify and challenge their automatic negative thoughts and then to modify any abnormal underlying core beliefs to reduce relapse
*by replacing them with accurate thoughts, functional behaviours
How might CBT be delivered?
individuals basis, groups, self help via books or computer programmes (online)
What are some indications for CBT?
mild-moderate depression
ED
anxiety disorders
BPD
chronic medical conditions
What is behavioural therapies based on?
learning theory, operant conditioning, reinforcing behaviour based on positive consequences for the individual, preventing negative consequences
What is exposure and response prevention?
patients repeatedly exposed to the situation which causes them anxiety and prevention of acting out on compulsion
*level of anxiety decreases as time goes on
What are some other behavioural therapies?
- systemic desensitisation: used for phobic anxiety disorders, gradual exposure to hierarchy of anxious situations
- flooding: unlike SD, rapid exposure without attempt to reduce anxiety before, not common
What is the rationale behind psychodynamic therapy?
childhood experiences, past unresolved conflicts and previous relationships influence individuals current situation
What does psychodynamic therapy aim to achieve?
unconscious explored using free association (whatever comes to mind) and the therapist then interprets, with defence mechanisms explored –> change maladaptive behaviours
*use transference and counter-transference
What is psychoeducation?
delivery of information to people in order to help them understand and cope with their mental illness
*informed of name and nature
*causes of illness
*helpful services
*self-help
What is counselling and its purpose?
form of relieving distress, by means of active dialogue to help client find their own solutions to problems, while being guided to do so
What are the indications for counselling?
adjustment disorder
mild depression
pathological grief
childhood sexual abuse
other trauma like rape or pregnancy loss
substance misuse
What is interpersonal therapy?
focus is on the interpersonal problem, such as complicated bereavement, relationship difficulties, adopting techniques to focus on difficulties that arise in relationship and impact on individual
What are four interpersonal problems IPT deals with?
grief at loss of relationships
role disputed within relationships
managing changes in relationships
interpersonal deficits
What is the role in eye movement desensitisation and reprocessing?
help access and process traumatic memories with recalling emotionally traumatic material while focusing on external stimulus (of moving finger)
for PTSD
What is the purpose of dialectical behavioural therapy?
type of CBT that provides individuals coping strategies rather than deliberate self harm when faced with emotional instability
What are some formats of psychotherapy?
individual
couples
family: schizo, depression, BPD, conduct disorder
group: bereavement, substance misuse, chronic conditions
