Psychotherapy Flashcards
What does psychosocial treatment entail?
counselling and social support i.e. education, housing, finances
What is the ‘recovery model’?
to get people recovered and back to work as best as possible
Who is the person who leads the MDT for psychosocial care?
a ‘care-coordinator’ usually a nurse of some sort
What is IAPT
improving access to psychological therapy
it is the biggest therapy across the country
scheme used to self-refer or for GPs to refer patients to
Mainly offers CBT
What may counselling be used for?
Patients adjusting to life events, illnesses or losses and in mixed anxiety/depression in specific groups i.e. postnatal mothers, bereavement
What is PTSD helped by?
trauma focused CBT and EMDR eye movement desensitisation and reprocessing
what is depression and anxiety helped by?
CBT
What is the best psychotherapy for bulimia?
CBT
Give 3 therapies used in children w anorexia and 2 in adults w anorexia
Children: CBT, interpersonal therapy and family therapy (latter especially). Adults MANTRA and SSCM
What can personality disorders be helped by?
Dialectic behavioural therapy
What does CBT help with? what does it focus on?
Helps change unhelpful thoughts and actions which occur during times of distress. This changes how we feel about the world, people, and ourselves. Focusses on problems in the here and now, rather than past distresses.
How long is CBT treatment for usually?
5-20 weeks
on a weekly basis lasting 30-60mins
what are the 3 waves of CBT
- Behavioural therapy
- CBT
- Combines mindfulness w CBT
Give 3 specific and 3 general indications of CBT
Specific:
Depression, GAD, phobias, OCD, PTSD, bulimia
General:
if pt prefers psychological rx, if no improvement on meds, if SE of meds too much
What is psychoanalytic/psychodynamic therapy founded on?
Freuds theory that uncovering past trauma will resolve present day sx
What are the 3 key concepts underlying psychoanalytic therapy?
The unconscious, psychological defence mechanisms, transference/countertransference
Describe ‘the unconscious’
a person’s behaviour is influenced by unconscious factors (thoughts, feelings, fantasies)
What are psychological defence mechanisms? give 2 psychotic defences, 2 immature defences and 2 mature defences
Psychological vulnerabilities being shielded by certain defences
Over-reactive defences lead to trouble
Psychotic: delusion, paranoia, denial
Immature: schizoid, dissociation, acting out, hypochondriasis, passive aggression
Mature: altruism, humour, suppression
What is transference and countertransference? how many errors arise from these?
transference: when a pt transfers feelings from important ppl in their early lives onto the therapist
Countertransference: Therapist reacting to patients based on their past.
If the therapist acts as though the patient were a significant person in their early lives it leads to problems (i.e. if their mother was an alcoholic they will hate alcoholics)
What does psychoanalytic therapy focus on and what does it help the pt do?
making connections between the past and the present
helps the pt become more aware of unconscious processes giving rise to their sx
What is seen as part of the focus of the work of psychoanalytic therapy?
therapeutic relationship w the therapist
patterns of relating to others can then be worked on
Give 3 specific indications of psychoanalytic therapy
dissociative and conversion disorders depression psychosomatic disorders relationship problems grief
Where is counselling often done?What does it do?
primary care, it allows pts to identify their own problems and come up with their own answers
Who does counselling involve? what is it used to do?
2 people talking to find a solution to a problem
it is used to help people cope w recent events they have found difficult, it doesn’t aim to change someone
Give 3 specific forms of counselling and 2 approaches
career, bereavement and pre-conception
can be person-person, email or phone
when is counselling indicated?
current problems and stresses (i.e. acute psychological distress or in response to life-events or relationship problems)
can be used for brief anxiety disorders when anxiolytics aren’t indicated
what is family therapy? when is it often used?
family attending together
often used in CAMHS
what does family therapy work on?
Works on a family’s strengths to help family members think about and try different ways of behaving w each other
give 2 things that family therapy sessions focus on
maintaining and solving problems, getting the family to discuss the problems putting strains on the relationship
what is group psychotherapy?
it is a therapist working w several people at a time
How can group psychotherapy help a pt change?
can be confronted by the effect their behaviour and beliefs have on others and can be protected during their attempt to change
what type of therapy is delivered in group psychotherapy
any, but usually psychoanalytic
the group is used to explore interpersonal relationships and develop new ways of interacting, leading to change
what 3 things make a patient suitable for group psychotherapy
voluntarily enter
high expectation from group
adequate verbal and conceptual changes
what are 4 specific indications and 3 CIs for group psychotherapy
specific: personality disorders, addictions, victims of childhood sexual abuse, major medical illness i.e. cancer
contraindications:
severe depression, hypochondriacs, acute schizophrenia, extreme antisocial behaviour as this can normalise it
What is the technique of group psychotherapy
group of 6-8 balanced for age and sex
can be closed or accept new pts
group goes through phases where they develop
focuses on the here and now not outside problems
what is dialectic behavioural therapy? what is it most aimed at?
combination of CBT and behavioural therapy
individual and group sessions are combined
mostly for personality disorders
What does DBT help to do?
helps balance accepting who you are and making positive change
helps pts learn to manage difficult emotions by letting them experience, recognise and accept them
What is interpersonal therapy and what does it help to do ?
aims to help a pt understand how problems may be connected w the way their relationships work
helps strengthen relationships and find better ways of coping
What is cognitive analytic therapy?
integration of cognitive and psychoanalytic therepaies
What does the patient do in cognitive analytic therapy and how does it help?
patient describes how problems have developed from events in their life and personal experiences
they then focus on ways of coping and how to improve
Give 3 things exposure therapy is used for
Phobias
OCT
PTSD
What does exposure therapy work on
works on troubling thoughts or memories under safe supported conditions w a therapist
What is exposure therapy used in combination with?
w learning techniques to avoid performing compulsive rituals or to work through trauma
Fundamentally, what type of therapy is exposure therapy?
behavioural - avoidance maintains sx, confronting relieves anxiety
What is psychoeducation? when is it used?
helping people understand their condition, used ij all therapy!
Give 3 ways of psychoeducation?
clinical setting
classroom
self help
support groups
What is EMDR and when is it used?
eye movement desensitisation and reprocessing, uses rapid, voluntary eye movements to reduce anxiety w PTSD
What is MANTRA and SSCM
Model of anorexia nervosa treatment for adults
Specialist supportive clinical management
