Psychotherapy Flashcards
What is the basic principle of psychotherapy?
Systematic use of relationships (pt to therapist, pt to pt, pt to relatives/friends) to produce changes in feelings, cognition, and behaviour.
What are the three types of psychotherapies?
Type A
Type B
Type C
What are Type A therapies?
Psychological treatments as an integral part of MH care, in a wider healthcare setting eg GP, CPN
What are Type B therapies?
Eclectic psychological therapies.
Pick and chose from all schools of thought to fit the pt
What are Type C therapies?
Formal psychotherapies
What type c specialist therapies are there?
CBT Psychodynamic therapies Systematic therapy Family therapy Group therapy
What is the concept of psychoanalysis?
If you let a patient talk uninterupted, evidence will eventually come to the surface for what the problem is that a patient has.
What is the id?
The aprt of the mind containing basic urges and primitive drives
What is the ego?
The rational part of a personality
What is a super-ego?
The part of the mind that works on the principle of morality
What is repression?
A defense mechanism of the mind - preventing disturbing thoughts from becoming conscious
What is denial?
A defense mechanism of the mind - refusal to accept reality or fact, acting as if a painful event, thought or feeling did not exist. Characteristic of childhood.
What is projection?
A defense mechanism of the mind - attribute unacceptable thoughts etc to another person.
i.e. You think someone hates you because of how they look at you, but they look at you that way because you disliked them before and didn’t hide it. Their “hate” is as a direct result of your “hate”
What is displacement?
A defense mechanism of the mind where pts satisfy impulses with substitute objects. Often anger is displaced.
e.g. harming a pet/damaging an object instead of harming a human who you feel aggressive towards
What is regression?
A defense mechanism of the mind where the pt goes back to an earlier state of development e.g. childhood
What is sublimation?
A defense mechanism of the mind where the pt satifies impulses by doing socially acceptable things eg sport
What is the theory of attachment?
The first relationship provides the infant with an attachment template, which is carried forward into life and relationships in future
What is transference?
unconscious transfer of feelings and attitudes from pt to therapist
What is counter-transference?
The feelings the therapist has in relation to the pt - important to analyse this to help understand the pt
What conditions do behavioural therapies work best on?
Anxiety disorders, OCD, eating disorders, depression, sexual dysfunction
What is the basic principle of behavioural therapy?
Gradual but prolonged exposure to a stimulus causes distress levels inresponse to stimulus to decrease over time
What are the 2 main problems with behavioural therapies?
- Pts have to volunteer and engage.
- There needs to be a stimulus that the pt responds to identified
What is a good way for the pt to trust the therapist and get engaged in the therapy?
If the therapist does the thing to i.e. not making the patient do anything they wouldn’t do, normalises it
What is another big part of behavioural therapies?
Challenging/testing beliefs
What are the 3 cognitive aspects to depression?
- Negative views about the world
- Negative views about self
- Negative views about the future
What is the cycle of behaviour in depression?
Depression -> decreased total activity -> loss of activites that make you happy ->rumination -> feel worse -> increased depression
What is the focus of systemic and family therapy?
Relationships, interactions, and meaning of both.
Who is systemic and family therapy used for most?
Children
Who else can systemic/family therapy be benefitial for? Why?
Schizophrenic pts as they can often relapse if they go back into a highly emotionally charged family environment
Name the characteristics of psychotherapies
- Intense and confiding pt-therapist relationship
- Explain pts distress and management
- Inform pt about their condition
- Give the pt hope
- Facilitate emotional arousal
- Experience success to encourage pt
In panic disorders, what psychotherapy is used?
CBT
In agoraphobia, what psychotherapy is used?
CBT with graded exposure therapy
In generalised anxiety disorder, what psychotherapy is used?
CBT
In social anxiety disorder, what psychotherapy is used?
CBT with exposure
In specific phobias, what psychotherapy is used?
CBT is firstline with graded exposure therapy
In OCD, what psychotherapy is used?
Graded exposure and response prevention therapy, and CBT
In PTSD, what psychotherapy is used?
Trauma focused CBT
Eye movement desensitization and reprocessing (EMDR)
In adjustment disorders, what psychotherapy is used?
Supportive psychotherapy to enhance capacity to cope with stressor
In schizophrenia, what psychotherapy is used?
CBT can be offered alongside a course of oral antipsychotics
Family therapy if relevant
In anorexia nervosa, what psychotherapy is used?
CBT and interpersonal psychotherapy
Dialectical behavioural therapy
Family therapy may also help
In bulimia nervosa, what psychotherapy is used?
CBT and interpersonal psychotherapy
In ADHD, what psychotherapy is used?
CBT and family therapy may be helpful
In childhood conduct disorders, what psychotherapy is used?
CBT to develop problem solving skills
Family therapy may help children and parents understand each other better
Systemic therapy also useful i.e. involving school and community workers
In personality disorders, what psychotherapy is used?
Therapeutic communities
CBT
Cognitive analytic therapy
Interpersonal therapy
Dialectical behavioural therapy
What is a therapeutic community?
Group led therapy to help people integrate better
In mild/subclinical depression, what psychotherapy is used?
CBT and/or group CBT
Group activity programmes
Can psychotherapy be used in treatment of drug addiction?
Yes - keeps them engaged, but shouldnt be for long periods of time (keep it brief).
Motivational interviewing often helpful
In moderate/severe depression, what psychotherapy is used?
Interpersonal therapy
Behavioural activation
Behavioural couples therapy
