Psychotherapy Flashcards
Why give psychotherapy
Help with distressing symptoms
Alter disturbed patterns of behaviour
Improve interpersonal relationships
Better cope with the stresses of life
Aim of psychotherapy
Develops a therapeutic relationship
Facilitates understanding of self and others
Facilitate tolerance of emotional arousal
Develop new skills
Aims to treat current symptoms and behaviors in a way which allows the patient to manage future problems
What does psychotherapy need to work
Technique/model
Therapeutic relationship and alliance
Patient strength, motivation and circumstances
- capacity to reflect and engage
- needs a stable home life to allow engagement
CBT - concepts
Thoughts, feelings, physical sensations and behaviours are interconnected
Negative thoughts and feelings can trap you in a vicious cycle
These automatic negative thoughts often reinforce an underlying deeply held belief about yourself
CBT - Types of automatic negative thoughts
Jumping to conclusions Mental filter All or nothing mentality Over-generalisation Disqualifying the positive Magnification and minimisation Personalisation Emotional reasoning Labelling
CBT - Dysfunction of thoughts in anxiety/depression
Everyone experiences negative thoughts In anxiety/depression - experienced more frequently - harder to challenge - helpful/balancing thoughts are crowded out
CBT approach
Focus on the here and now Problem focused Specific strategies to challenge thoughts Homework - small task More directive than other therapies
CBT - 5 area’s model
A life situation, relationship or practical problem
- causes an unhelpful interaction between the following areas
altered thinking (unrealistic, extremely unhelpful thoughts)
+
altered physical sensation/symptoms
+
altered behaviour (reduced activity, avoiding things or doing something unhelpful)
+
altered emotions
CBT - management of which conditions
Depression Anxiety OCD Eating disorders Phobias Panic
Psychodynamic psychotherapy - description
Less structures than CBT
- patient talks first
- requires longer therapy (months/years)
For personality disorders and recurrent depression
What are transference and counter-transference
Transference
- transfering past relations model/feelings into the current one
Counter-transference
- the feeling the doctor has after talking to the patient
Psychodynamic psychotherapy - aims
Improve insight
- identify unhelpful unconscious processes and defence mechanisms
- improve management of distress (transform neurotic misery into common unhappiness)
Defence mechanisms - description
Protect us from emotional distress by preventing the unconscious becoming conscious
- putting anxious thoughts to the back of the head in normal people
Can be on a spectrum from conscious to unconscious
Everyone uses them
- not always pathological
Defence mechanisms - examples
Projection - attributing unacceptable thoughts/feelings to someone else
Splitting - all good/all bad
Repression - (unconscious) vs suppression (conscious) forgetting
Intellectualisation - focus on facts, ignoring emotional content
Rationalisation - rational justification/excuses for behaviour
Sublimation - unacceptable feelings/thoughts into an acceptable channel
Family therapy - description
Mainly in CAMHS
Delivered by one or two therapists (one watches from outside the room)
Uses concept of the system
- family unit tends to be self-maintaining and to resist change (good or bad)
Idea is that we each have an impact on how the group functions, so that change in one person will change the functioning of the entire group
