Stress, Coping, Pain, Children, Communication, psychotherapy, children

Question 0

What are some of the impacts of stress of mental health?

What theory is linked to depression, aniexty, low motivation and a downward spiral of illness?

Answer 0

Overgenalisation
Catastrophising
Personalisation (all your fault)
Rumination- worry focusing on bad feelings and experiences from the past
Sleep deprivation, aniexty, and depression

Lack of control and learnt helplessness- dogs shocks, know cant do it, didnt even give it a go just go shocked

Question 1

What are the positive and negatives surrounding the physiological response of stress

Answer 1

Used for survival, low levels push performance

Modern day life lead to exhaustion- daily hassles and chronic stressors, linked to increased risk of cardiac death, cortisol- decreased immune system, coping methods e.g. Binge is unhealthy behaviours. Physical- increased Bp- atherosclerosis

Question 2

What is the tranasactional model of stress?

Answer 2

The demands (stressors)- life events, daily hassles, chronic stressors (illness) and resources (personality, social support, coping skills)
Are weighed up in a process of appraisal…
Primary- threat? Severity? Secondary- resources do in have?
To give or not to give a stress response

Question 3

What is the process of reappraisal?

Answer 3

Once tried cope with situation, situation is re-evaluated. Whether next time can be less or more stressed

Question 4

What are some of the symptoms of stress?

Answer 4

• headaches
• mood changes
• sweating
• sexual problems
• stomach/ change in bowel habitis

Question 5

What are some of the strategies to cope with stress and give an example?

Answer 5

Cognitive testing- hypothesis testing
Behavioural- skills training e.g. Time management
Emotional- emotional disclosure, social support
Physical- exercise, relaxation training
Non- cognitive strategies- drugs

Question 6

What is coping

Answer 6

Finding ways to mange events/ experiences that are appraised as threats or demands, that exceed a person’s available resources. So as to avoid stress (transactional model)

Question 7

Give some examples of what patients have to cope with…illness and otherwise in their lives

Answer 7

Diagnosis, physical impact, treatment, hospitalisation, adjustment, social problems (money, housing, relationship)
Family (bearavement, marriage, preggers)
Work place (retirement, rise), financial

Question 8

What are the two main ways to deal threat (cope) in the short term?

Answer 8

Emotional focused coping (changing the emotion)- passive decreasing the effect of the situation in you

• behavioural- find a distraction- smoking, alcohol
• cognitive- change how you think denial, focus on +ve of situation

Problem focusing coping (change problem or resources) active
Reduce demands and expand resources to cope- buy a mobility chair

Question 9

What are four main ways to help a patient cope in the LONG TERM?

Answer 9

Increase social support
Increase patient control- pain management
Reduce uncertainty
Stress management techniques (see other card)

Patients may not admit they arent coping dont want to seem wingy, avoid stigma, feeling of inadquacy and a burden

Question 10

Why is important to help patients with chronic illnesses cope with their condition/ conditions?

Answer 10

There is a high incidence of depression with chronic illnesses

Question 11

What is the definition of pain? And what is the difference between acute and chronic pain?

Answer 11

A unpleasant sensory or emotional experience that is assosicated with actual or potential tissue damage or is described in terms of such damage
Acute- short, attention, there for as long as healing, action to take
Chronic- >3 months, no-ongoing damage,

Question 12

What is the gate control theory of pain?

Answer 12

Messages between the brain and damaged tissue or nerve messages pass through gates in the dorsal horn of the spinal cord.
Things that open and close the gates. Open cause pain. Close stop pain. Psychological factors included so

Open- injury, sensitivity, -ve beliefs, minimal involvement in life, fear, aneixty, secondary gains sympathy- operant conditioning. Classical conditioning- sight of doctor fear

Close: medication, active, meaning (soldiers), distraction, exercise, counter stimulation

Question 13

What are limitations of the gate control theory of pain?

Answer 13

There is little structural evidence to support

Question 14

What is the bio-medical model of pain? And what is its limitation?

Answer 14

Tissue damage leads to pain (not psychological application)
Limitations
Some people feel pain without damage, or after healing, placebo effect, amputees experiencing pain

Question 15

What are the principles and aims of pain management programmes?

Answer 15

Helping patient take control of pain, rather than being pain in control, it is not about cure. So focusing on the physical and psychological wellbeing rather than the disease/ tissue damage
- improve fitness, address fears, help relax, mindfulness, group all in same boat, improve communication skills

Question 16

What is pschotherapy?

Answer 16

The systematic use of a relationship between and patient and a therapist to produce changes in feelings, cognition and behaviour.
The type you use depends on the problem and the individal

Question 17

What are the four psychological interventions currently used?

Answer 17

Cognitive behavioural therapy (CBT)
Psychoanalystic/psychodynamic therapies
Systemic and family therapy
Humanistic/ client- centred therapy

Question 18

What CBT/ what does involve?

Changing the way a you perceive/ or act towards a stressor

Answer 18

relieving symptoms but tackling current problems and modifying dysfunctional thinking, beliefs and behaviour. Uses a mixture of behavioural and cognitive principles. Aims to faulty change thoughts around a irrational though such as stress

It involves an active approach so exposing patient gradually, role play, reinforcement and reward

Look at negative thoughts, talk to patients about models, cognitive rehearsal of coping with difficult situations, hypothesis testing, monitoring of thoughts, behaviours

Question 19

Who is CBT suitable for?

Answer 19

People irrational -Depression, aneixty, phobias, eating disorders, schizophrenia
The person must engage collaboratively, accept model, have goals and want to see solutions (contemplation or preparation phases)

Cant change stimulus

Question 20

What are the limitations of CBT?

Answer 20

Evidence there not for the extremes of people evidence limited
Has to be delivered by expert practitioners which is a challenge for GP
Limited good if problem complex and loads

Question 21

What is the ideology behind psychoanalytic/psychodynamic therapies?

Answer 21

Addressing unconscious conflicts and aims to resolve previous painful experiences. So looking in the past to make deep seated changes in personality and emotional development

Searching in unconscious mind

Question 22

What does psychoanalytic/psychodynamic involve?

Answer 22

It is a long term commitment, feelings are explored in a safe, non judgemental environment,

Free association- talking about whatever comes to your head

Therapeutic transference- transfer thoughts, feelings connected with influential figures in your life (mum) onto your therapist

Interpretation- the therapist is passive mostly but interrupts with thoughts of topics to discuss around what has been said

Question 23

Who is psychoanalytic/psychodynamic suitable for? What must they must be for it to work?

Answer 23

People with interpersonal/ personality problems

Person must be capable to experience mental pain (looking into past) and be interested in self exploration, good relationship with therapist, time,

Question 24

What is humanist therapy? What does it mean?

What is it suitable for? When might it be used?

Answer 24

Basis is around general good counselling skills warmth, empathy, unconditional positive regard
Usually used in immediate crisis- stress, life events, aniexty, mild depression
Studies suggest more effective on women since emotional focused coping

Question 25

What is systemic/family therapy? What is its basis? When is most likely to be used?

Answer 25

Used in more than one person often used in children within a family
Instead of focusing on the individual looks into interactions with family members, patterns and meaning to it

Question 26

What is bowlby attachment theory?

Answer 26

Distress is experienced in the infants away from primary care giver whilst still being given food. Attachment is not just about elements of survival. Security and comfort attracts infant to stay with mother
But :( simplistic, often >1 primary care giver, fathers,

Question 27

What are the stages of social development of babies suggested by schaffer?

Answer 27

Preference to human faces
Reward care givers
Strangers/non strangers- but still any adult can look after
7-8 months specific attachments formed

Question 28

What types of attachment seen in children? And what can happen why this attachment isn’t seen in a child?

Answer 28

Secure- mother is sensitive and responsive to child (talks, accepts role)

Insecure- carer is avoidance, disorganised (not always there), ambivalent (mother not sending the same signals all the time, so clingy) child may have separation aneixty, increased aggression, clingy, bed wetting, reattachment, physical impact- dont want to play, eat less

Question 29

What stages may a child go through during separation due to hospitalisation?

Answer 29

Protest (distress, look for mother), despair (withdrawn, helpless), deattachement (interested in surrounding, may smile and be sociable) but when carer returns remote and apathetic attachment damaged. Young child (>3) lack ability to keep carers picture in head and may blame them self link leaving negative behavior, and have limited vocab to express feelings

Question 30

What implications are there is problems with children and sepration during hospital stays?
Give examples of good practice with children in hospital

Answer 30

Poor adherence, child’s experience of pain increased, adverse effects from stress.
o Parent/carer access, attachment objects (e.g. teddy), home-like environment, play, continuity in staff, trained staff (specialist paediatric nurses), reassure not punished/abandoned
o Social referencing – reassure parents

Question 31

What are pigets stages of child develop

Answer 31

Sensor motor (0-2)- senses, developing motor and cognition, developing understanding objects exist event when dont see them

Pre-operational (2-7) language development, imagination, symbolic thought, egocentric-not other points of view, lack concept of conservation same amount of squash in container.Single classification

Concrete operation (7-12): think logically, conservation of number, mass, weight, decreased ecgocentrism, multiple classification

Formal operarional (12+): abstract logic, hypothetic deductive reasoning what if, what will happen

Question 32

What is vgotskys theory of social development?

Answer 32

This is additional to pegets (4 mental stages)

• The child’s development is not individualistic it is a social interaction
• Child is an apprentice and learns through shared problem solving
• With help of siblings/parents allows child to achieve more highly than they would do if they were left by themself