Psychotherapy

Question 1

Define the following phrases by Winnicott:

a) Good enough mother

b) Holding environment

c) Transitional object

d) False-self

Answer 1

a) A mother who can respond appropriately to a child’s concerns but not so immediately that there is no space for them to tolerate frustration

b) A physical and psychic space between caregiver and child that is there when needed for the child to explore

c) The first “not me” (i.e not the mother) item that the child can use to help navigate distress

d) When growing up a child may show spontaneous behaviour (true-self) “not good enough mothers” not respond appropriately/sensitively to this behaviour and impose their own values (ideal child) onto the child. The child then develops a sense of self on the basis of compliance (false-self)

Question 2

In which 4 areas does interpersonal therapy interpret problems with social functioning to arise?

Answer 2

• Grief
• Role transitions
• Interpersonal deficits
• Role disputes

n.b IPT runs for 10-16 1hr sessions
- It deposits that interpersonal factors can heavily weigh on psychological problems
- Using attachment theory it aims to help the patient understand their childhood attachment patterns shape their adult expectations and current relational difficulties

Question 3

What is the structure for a course of IPT?

Answer 3

Phase 1 - Identification of the problem, sessions 1-3

Phase 2 - Working on the target problem area

Phase 3 - Termination

Question 4

Outline some aims of supportive psychotherapy

Answer 4

• Establishing a therapeutic alliance taking into account psychological/practical engagement barriers
• Increasing awareness of transference
• Holding and containing
• Promoting adjusting and stability by reducing relapses and inappropriate use of services
• Facilitating maturation of defence mechanisms

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Question 5

Which individuals were attributed to the following terms?

Hypnosis
Group dynamics
Group psychotherapy

Answer 5

Hypnosis - Braid

Group dynamics - Lewin

Group psychotherapy - Moreno

Question 6

Who came up with motivational interviewing?

Answer 6

Miller

Question 7

Describe cognitive analytical therapy

Answer 7

• Created by Joseph Ryle
• Mixture of cognitive and psychodynamic psychotherapy
• Postulates that psychodynamic therapy finds problems early on and focusses on the repeated strategies to solve these problems. These strategies fail to be revised in 3 ways

Traps - A flawed thinking pattern / coping strategy that aggravates the underlying issue. Negative assumptions generate acts and then confirm assumptions.

Dilemmas - the individual feels the choice of action is limited to few polarised options.
Snags - the individual feels unable to act out on an option due to fear of it not working or harming someone. It is a restricted thinking pattern that causes appropriate goals to be abandoned as they are unacceptable (self/other)

CAT uses a procedural sequence model. First the problem or issue is appraised - a plan of action/options discussed - plan is put into place - plan evaluated. Letter is summarised and sent to the patient

CAT identifies reciprocal role procedures (observed patterns of how we relate to other people) - once defined visually presented using a sequential diagrammatic reformulation.

Question 8

Who came up with behavioural activation?

Answer 8

Christopher Martell

Question 9

For depression with co-morbid personality disorder which is more effective CBT or IPT?

Answer 9

CBT

Question 10

How long does multi-system therapy last?

Answer 10

3 -5 months

Based on Bronfenbrenners model and sees the young person embedded in multiple systems, mainly the family, the peer group, the school and the community.

Question 11

What are the four main values of therapeutic communities?

Answer 11

Democratisation
Permissiveness
Communalism
Reality confrontation

Question 12

Which part the structural mind prevents unacceptable thoughts and impulses from entering the conscious mind through a repressive barrier?

Answer 12

Preconscious - it sends unacceptable thoughts and images back into the unconscious

Question 13

Which form of therapies have been shown to reduce mental health distress in caregivers?

Answer 13

Manualised interventions

Question 14

What stance does the therapist take in IPT?

Answer 14

An advocating stance - to encourage the patient to see situations in a different light

Question 15

Who came up with systematic desensitisation?

Answer 15

Wolpe

Question 16

Franz Alexander and Thomas French developed…

Answer 16

brief psychodynamic therapy

Question 17

Interpersonal therapy has an evidence base for depression and which other eating disorder?

Answer 17

Bulimia Nervosa