Therapies Flashcards
What is FORMULATION?
- the process of making sense of a person’s difficulties in the context of their relationships, social circumstances, life events and the sense that they have made of them
- like a personal story or narrative that a psychologist or other professional draws up with an individual (and in some cases their family & carer)
What happens in FORMULATION?
- co-construct the personal meaning of the client’s life story
- summarise the client’s core problems in the context of psychological theory and evidence
- and thus indicate the best path to recovery
- developing a shared understanding of what is going on
- not like a diagnosis by focusing on the deficits
- instead, focus on the strengths and talents in surviving
Important thing to remember about FORMULATION?!
> It is an ADDITION to diagnosis, not an ALTERNATIVE to diagnosis
> Culture plays a big part!
FORMULATION and Culture
- really needs to be taken into account!
- should be considered with every service user
- there are certain disadvantaged group
> black and minority ethnic groups
> refugee and asylum seeker populations - language and religion - may be contributing barriers to treatment
> certain things / questions may not be or get asked
> these could be crucial for future reference
Cultural Formulation Model
- have to take into account the cultural identity of the service user -> language preference and degree of involvement with both the culture of origin and host culture!
- for the service user, it has to be their preferred explanation of their difficulties!
- cultural factors relate to both stresses and levels of support in the service user’s psychosocial environment
- cultural elements of the relationship between the individual and the clinician and their impact of the therapeutic relationship
Describe COGNITIVE BEHAVIOURAL THERAPY - background information
- an umbrella term - not a specific approach
- there are multiple approaches
Behaviour therapy:
- Behaviour Modification Therapy; Classical / Operant Conditioning
Cognitive therapies:
- psychotherapy owned at changing way of thinking
What are the different variations of CBT?
Rational Emotive Behaviour Therapy Rational Behaviour Therapy Rational Living Therapy Cognitive Therapy Dialectic Behaviour Therapy
Beck et al (1979) - COGNITIVE BEHAVIOUR THERAPY
- negative emotions are elicited by cognitive processes developed through influences of learning & temperament
- adverse life events elicit automatic processing - viewed as the causal factor
- -> starts off these repetitive negative thoughts
- cognitive triad!!!
- focus on examination of cognitive beliefs and developing rational responses to negative automatic thoughts
Diagnosis vs Formulation - Johnstone (2011)
DIAGNOSIS
- removes meaning
- removes agency (‘sick role’)
- removes social context
- individualises
- keeps relationships stuck
- expert-derived
- stigmatising
- emphasis on pathology
- culture and value blind
- medical consequences
- social consequences
Diagnosis vs Formulation - Johnstone (2011)
FORMULATION
- creates meaning
- promotes agency
- includes social contexts
- includes relationships
- promotes relationship change
- collaborative
- non-stigmatising
- includes strengths
- culture and value aware
- no medical consequences
- no social consequences
Beck - Cognitive Triad
Negative automatic thoughts centre around our understanding of:
- ourselves
- others (the world)
- future
Maintained by:
- cognitive biases
- negative self-schemas
Beck (1993) - CBT quote
“is best viewed as the application of the cognitive model of a particular disorder with a use of variety of techniques designed to modify dysfunctional beliefs and faulty information processing characteristic of each disorder”
Forman and Herbert (2006) - what are the fundamental aspects of the CBT model?
- theory of aetiology
- therapeutic strategies / techniques
- desired outcomes
Depression and CBT
- how does CBT apply to this disorder?
- negative view of the self, others and the future
- core beliefs - helplessness, failure, incompetence and feeling unloved
Negative triad associated with depression:
- SELF - “I am incompetent / unlovable”
- OTHERS - “People do not care about me”
- FUTURE - “The future is bleak”
Anxiety and CBT
- how does CBT apply to this disorder?
- overestimation of physical and psychological threats
- core beliefs - risk, dangerousness, uncontrollability
Negative triad associated with anxiety:
- SELF - “I’m unable to protect myself”
- OTHERS - “People will humiliate me”
- FUTURE - “It’s a matter of time before I am embarrassed”
