UNIT 4 AOS2 - SAC 2

Question 1

Explain mental wellbeing.

Answer 1

Mental Wellbeing = refers to our mental health. That is our state of mind, our enjoyment of life, and our ability to cope with the normal stresses of everyday life and develop to our potential.

• When we are in a positive state of mental health, we think, feel and behave in ways that enable us to cope with change and challenge.
• Mental wellbeing is JUST as important as physical wellbeing.
• It is a dynamic state which means it does not stay the same - it varies a lot over time.
• For ATSI people in particular, there are important cultural determinants of mental wellbeing and overall wellbeing.

Question 2

List the Ways of Considering Mental Wellbeing.

Answer 2

1 - Levels of functioning
2 - Resilience
3 - Social and Emotional Wellbeing (SEWB)

Question 3

Explain Levels of Functioning.

Answer 3

Functioning = how well an individual independently performs or ‘functions’ in their environment. This is most observable in the demands of everyday life - eg. going to work/school, making decisions etc.

• Functioning may range from a high level at one extreme through a moderate level of functioning (e.g. which may be due to a temporary mental health problem) to a low level (e.g. poor or impaired functioning) at the other extreme.

Level of functioning tends to correspond with how well or adaptively a person is meeting the challenges of living across a range of areas such as the following:
- Daily living skills e.g. participation in self-care and independent living activities such as personal hygiene, dressing, eating,
- Interpersonal relationships
- Emotions
- Cognitive skills
- School and work/occupational settings
- Leisure/recreational activities

The behaviour of a person with high level of functioning is what we call ADAPTIVE = it enables the individual to ADJUST to the environment appropriately and effectively.

In contrast, MALADAPTIVE behaviours = those which are detrimental, counterproductive or otherwise interfere with the individual’s ability to successfully adjust to the environment to fulfill their role in society. That is, a low level of functioning.
This is often seen in a person experiencing mental illness.

Question 4

Explain Resilience.

Answer 4

Resilience = The ability to successfully cope with and manage change and uncertainty. It means bouncing back from adversity or difficult experiences and restoring positive functioning.

• High levels of resilience are linked to positive mental health and vice versa.

These characteristics include:
- A strong belief in their abilities to accomplish tasks and succeed (i.e. high self-efficacy)
- High self-esteem
- Approaching adversity with a sense of optimism, opportunity, hope
- Being adaptable and flexible
- Being organised
- Having problem-solving skills
- Having the ability to make realistic plans and carry them out.

EG. Refugees and asylum seekers tend to have a high level of resilience which helps them to adapt and recover from the adversity they experience in seeking a new life in a new country.

Question 5

Explain Social and Emotional Wellbeing (SEWB).

Answer 5

SEWB = The term social and emotional wellbeing (SEWB) is a multidimensional and holistic concept used by Aboriginal and Torres Strait Islander people to describe the physical, social, emotional, spiritual and cultural wellbeing of a person.

The SEWB refers to the wellbeing of the individual AND the wellbeing of their family and entire community. This reflects the collectivist culture of Aboriginal and Torres Strait Islander peoples and encapsulates all elements of being an Aboriginal and Torres Strait Islander that are not evident in the mainstream view of mental health and wellbeing.

• SEWB is a preferred term for many Aboriginal and Torres Strait Islander people, rather than speaking of mental wellbeing in isolation.
• Mental wellbeing is only one “element of being” that affects SEWB.

The SEWB Framework is an example of self- determination
- The framework was developed by, with and for Aboriginal and Torres Strait Islander people and communities.

Question 6

Outline the layers of SEWB.

Answer 6

Can be understood as containing 4 layers:

1. Self: the individual embedded within the framework.
2. The 7 elements of being in which the self is embedded.
3. The broader contextual determinants of the quality of connections.
4. The fluctuating experiences and changing expressions that mean the quality and strength of connections are continually changing and adapting over time.

Question 7

List the elements that are interrelated and overlap in SEWB

Answer 7

• Connection to body and behaviours.
• Connection to mind and emotions.
• Connection to family and kinship.
• Connection to community.
• Connection to culture.
• Connection to Country.
• Connection to spirit, spirituality and ancestors.

Question 8

Explain the connection to body and behaviours.

Answer 8

Involves all aspects of physical health and wellbeing, especially feeling a strong and positive connection to one’s body and appreciating everything it allows us to do and experience in life. This domain is interrelated with all other domains. For example, a strong and positive connection for this domain can help one feel stronger and more closely connected mentally, culturally and spiritually.

Question 9

Explain connection to mind and emotions.

Answer 9

Emphasises the individual’s personal experience of their mental wellbeing (or mental ill-health) and their ability to manage thoughts and feelings. Intimately linked with spirituality..

This is probable the one most linked to a western understanding of wellbeing.

Question 10

Explain connection to family and kinships.

Answer 10

Recognises that family and kinship systems have always been central to the functioning of traditional and contemporary Aboriginal and Torres Strait Islander peoples’ lives. These systems are complex and diverse, maintain interconnectedness through cultural ties and caring relationships, and provide a strong sense of belonging.

Question 11

Explain connection to community.

Answer 11

Emphasises a connection to a communal space that can take many forms and provides opportunities for individuals and families to connect with each other, support each other, and work together.

Question 12

Explain connection to culture.

Answer 12

Refers to one’s secure sense of cultural identity and cultural values through connection to Aboriginal and Torres Strait Islander heritage. Includes all knowledge systems, ways of knowing, and cultural traditions and practices. Provides a sense of continuity with the past and helps underpin a strong identity.

Question 13

Explain connection to Country.

Answer 13

Country refers to an area where Aboriginal and Torres Strait Islander people have a traditional or spiritual association and the deep sense of belonging this brings. This domain recognises that the relationship with Country underpins all other forms of relational wellbeing. Being on and caring for Country has positive physical and mental health outcomes for Aboriginal and Torres Strait Islander people.

Question 14

Explain connection to spirit, spirituality and ancestors.

Answer 14

Recognises the sacred and interconnective relationship between Country, human and non-human beings, as well as the past, present and future. Includes knowledge and belief systems, and the Dreaming. Aboriginal and Torres Strait Islander peoples’ world views are grounded in spirituality and connection to ancestors. These connections also provide a sense of purpose and belonging.

Question 15

List and explain the Mental Health Continuum.

Answer 15

Mentally Healthy = in a generally positive state of mental wellbeing. Having the ability to cope with and manage life’s challenges, working productively, striving to fulfil one’s goals and potential, and having a sense of connection to others and the community in general.

Mental Health Problem = negatively affects the way a person thinks, feels and/or behaves, but typically to a lesser extent and of a shorter duration than a mental disorder.

Mentally Unwell = also called mental illness/disorder, is a mental health state that involves a combination of thoughts, feelings and/or behaviours which are usually associated with significant personal distress and impair the ability to function effectively in everyday life.

Question 16

Explain the Mental Health Continuum.

Answer 16

• There is widespread support for the concept of a continuum but there is no universally agreed set of terminology to apply to it.
• Essentially though, it is agreed that a person’s location on the continuum is unstable and can change day-to-day or week to week.
• Even a person with a diagnosed disorder can find themselves up the mentally well end of the continuum if their health is well managed and they are in a good space.

Question 17

Explain and list the internal factors.

Answer 17

Where we sit on that continuum is influenced by a range of internal and external factors.

INTERNAL FACTORS = influences that originate inside or within a person. These might be BIOLOGICAL or PSYCHOLOGICAL factors.

• BIOLOGICAL FACTORS = physiological influences which are often not under our control (eg. genetics, hormones, fight flight freeze, brain and nervous system functioning etc.) Diet and Sleep hygiene also fall into this category.
• PSYCHOLOGICAL FACTORS = influences associated with mental processes such as beliefs, attitudes, perception, prior learnings, problem solving skills, emotional responses etc.

Question 18

Explain external factors.

Answer 18

EXTERNAL FACTORS = influences that originate outside a person.

These can include:
- School and work related factors.
- The range and quality of our interpersonal relationships.
- The amount and type of support available to us from others when needed.
- Exposure to stressors.
- Level of education and/or income.
- Housing.
- Risks of violence.
- Access to healthcare.
- Exposure to social stigma.
- Cultural influences such as values and traditions.

Question 19

List the 4 D’s.

Answer 19

• Dysfunction
• Distress
• Duration
• Deviance

Question 20

Define stress.

Answer 20

Stress (RECAP) = a state of physiological arousal produced by internal or external stressors that are perceived by the individual as challenging or exceeding their ability to or resources to cope. The here and now.

Question 21

Explain anxiety.

Answer 21

Anxiety = a state of physiological arousal associated with feelings of apprehension, worry uneasiness that something is wrong or that something unpleasant is about to happen. The Future.

• It is normal for everyone to experience anxiety in some situations. Eg. Before giving a speech.
• Anxiety can be positive – makes us more alert and our reactions faster (like in fight/flight).
• Eg. Mild anxiety can make us slow down when running on a slippery floor.
• Should be brief and temporary - if extended can be disabling.
• Similar effects to extended stress: poor judgment, concentration etc.

Question 22

Explain an anxiety disorder.

Answer 22

Anxiety Disorder = used to describe a group of disorders characterised by chronic feelings of anxiety, distress, nervousness and apprehension or fear about the future, with a negative affect.

• Prolonged or severe experience of anxiety can indicate presence of an anxiety disorder.
• Diagnosis occurs when the level of anxiety is so severe it significantly interferes with daily life. There are a number of different Anxiety Disorders.

Question 23

Explain a phobia.

Answer 23

Phobia = is an excessive or unreasonable (irrational) fear directed towards a particular object, situation or event that causes significant distress or interferes with everyday functioning.

• Most people with phobias are aware that they are being irrational.
• They affect 3% of Australia’s population, women more than men.

Question 24

Explain a Specific Phobia.

Answer 24

Specific Phobia = is a disorder characterised by a marked or persistent fear or anxiety about a specific object, activity or situation, often leading to avoidance behaviour.

Exposure to (or anticipated exposure to) a person’s phobic stimulus generally leads to a PANIC ATTACK = a period of sudden onset of intense fear or terror, often associated with feelings of impending doom.

A person might then experience:
- Shortness of breath or smothering sensations;
- A racing or pounding heart;
- Sweating;
- Trembling;
- Tightness in the chest;
- Feeling dizzy, unsteady, lightheaded or faint;
- Nausea; and
- Feelings of going crazy, losing control or even dying.

Question 25

Explain Anticipatory Anxiety.

Answer 25

Anticipatory Anxiety = the gradual rise in anxiety level as a person thinks about or ’anticipates’ being exposed to a phobic stimulus in the future.

Most people have experienced a mild form of this before a presentation to an audience or a big test. For those with a phobia, however, the anxiety may be debilitating.

Question 26

List the general categories of phobias.

Answer 26

Generally, the phobias fall into one of the following five categories:

1. Of animals (spiders, snakes, birds etc.)
2. Of situations (lifts, bridges, enclosed spaces, flying, tunnels etc.)
3. Of blood, injections or injury (operations, injections, watching or experiencing etc.)
4. Of Natural Environments (heights, darkness, thunder, water etc.)
5. Other Phobias (choking, vomiting, loud noises, clowns, dying etc.

Question 27

List the Factors Contributing to the Development of a Specific Phobia.

Answer 27

A) Biological Contributing Factors
B) Psychological Contributing Factors
C) Socio-Cultural Contributing Factors

Question 28

Explain Biological Contributing Factors.

Answer 28

• Research has shown that biological factors can contribute to Phobias.
• Some people are genetically predisposed to specific fears and higher than normal anxiety levels. (Eg. If one identical twin has an anxiety disorder, the other is more likely to have one that non identical twins or other siblings.)

We study 2 biological factors that contribute to specific phobias and phobic reactions.
1. The role of the brain’s neurochemistry, specifically the neurotransmitter called GABA and the effect a dysfunctional GABA system can have.
2. Long Term Potentiation

Question 29

Explain the Role of GABA.

Answer 29

• GABA and Glutamate are naturally occurring NEUROTRANSMITTERS that carry messages between neurons in the brain. The most common ones.
• GABA is an INHIBITORY neurotransmitter that works to make postsynaptic (receiving) neurons LESS likely to fire. (Inhibits firing).
• Glutamate is an EXCITATORY neurotransmitter that works to make postsynaptic neurons MORE likely to fire. (Also aids learning and memory as we know).
• The INHIBITORY action of GABA counterbalances the excitatory activity of glutamate. One of its roles is to assist the brain to maintain neuronal at an optimal level - balanced with Glutamate.
• Researchers have hypothesised that some people develop anxiety disorders (such as a Phobia) because they have a dysfunctional GABA system – a failure to produce, release or receive the correct amount of GABA that is needed to regulate neuronal transmission in the brain.
• That is, low levels of GABA lead to an imbalance in neurotransmitters which can lead to anxiety.
• Eg. For example, in one study, it was found that participants with a diagnosed panic disorder had a GABA level that was 22% lower than that of control group participants with no history of Panic Disorder.

Question 30

Explain the Role of Long Term Potentiation.

Answer 30

Role of Long Term Potentiation = The long lasting strengthening of synaptic connections, resulting in enhanced or more effective neurotransmission across the synapse.

• The development of Phobias is substantially influenced by learning through experience.
• Retention of fearful or anxiety provoking experiences is significantly influenced by changes to the connections between neurons.
• LTP Plays an important role in learning and memory of fear.
• LTP would therefore strengthen the association between fear and anxiety and the phobic stimulus.
• The more the memory/association is accessed, the more it is strengthened!
• As the Amygdala is involved in conditioned fear responses, it is likely that the LTP occurs within the amygdala and will involve other relevant structures.

Question 31

List the Psychological Contributing Factors.

Answer 31

• Behavioural Model (Role of learning and Experience)
• Cognitive Model (Emphasis on roles of ‘distorted’ ways of thinking)

Question 32

Explain the Behavioural Model.

Answer 32

According to the BEHAVIOURAL MODEL, phobias are learned through experience and may be acquired, maintained or modified by environmental consequences such as rewards and punishments.

A specific phobia may be precipitated through CLASSICAL CONDITIONING and then perpetuated through OPERANT CONDITIONING.

This is made up of
1. Precipitation by Classical Conditioning
2. Perpetuation by Operant Conditioning

Question 33

Explain Precipitation by Classical Conditioning.

Answer 33

Precipitation = to cause an event or situation to occur suddenly or unexpectedly

• Little Albert - The LA experiment is a strong example of a classically conditioned phobia/fear.
• By associating the sound of the loud noise with the presence of the white rat, Albert was Classically Conditioned to FEAR the white rat and other white items. Similar experiments have been conducted using rats and electric shocks to produce a fear response in the rats.

If we think back to Carina and her fear of cats, her first negative experience with the cats and then the subsequent ones acted as precipitating factors which led to her development of the phobia.

NS - Cats
UCS - Cat jumping out in front of car
UCR - Fear
CS - Cats
CR - Fear/Phobia

Question 34

Explain Perpetuation by Operant Conditioning.

Answer 34

Perpetuation = the continuation or preservation of a situation. To keep something going.

• After acquisition through classical conditioning, the phobia can be maintained and therefore perpetuated through operant conditioning.
• Eg. If the person with a cat phobia begins to AVOID all cats, this avoidance reduces or removes the unpleasant feelings of fear and anxiety, so avoidance is negatively reinforced, meaning it will be more likely to occur again, thus PERPETUATING the phobia.

Question 35

Explain the Cognitive Model.

Answer 35

People with phobias tend to have a COGNITIVE BIAS of some sort = a tendency to think in a way that involves errors of judgement and decision making.

• This model focuses on how the individual processes information about the phobic stimulus and related events.
• Eg. Explanations of phobias from a cognitive perspective tend to examine how people with phobias tend to think about their phobic stimulus – perceptions, beliefs, memories etc.

There are two different types of cognitive BIAS:
1. Memory Bias
2. Catastrophic thinking

Question 36

Explain Memory Bias.

Answer 36

Memory Bias = Refers to the distorting influences of present knowledge, beliefs and feelings on the recollection of previous experiences.

• For example, a person with a phobia of horses will tend to remember the one and only time they were chased by a horse but forget all of the other times when horses showed no response to their presence.

Question 37

Explain Catastrophic Thinking.

Answer 37

Catastrophic Thinking = Negative thinking where an object or event is perceived as being far more threatening, dangerous or insufferable than it really is and will result in the worst possible outcome. (Catastrophising)

• When catastrophic thinking occurs, individuals experience heightened feelings of helplessness and grossly underestimate their ability to cope with the situation.
• For example, a person may think ‘if this rat turns towards me, there is nothing I can do to stop it biting me’.

Question 38

List the Social Contributing Factors.

Answer 38

Two main socio-cultural factors which are said to contribute to phobias:

1. Specific environmental triggers
2. Stigma around seeking treatment

Question 39

Explain Specific Environmental Triggers.

Answer 39

Specific Environmental Triggers = A specific object or situation in the environment that produces an extreme fear response (Creates the phobia).

• Many with phobias report having experienced some sort of traumatic experience to do with their phobic stimulus.
• Eg. Carina’s fear of cats stemmed from a negative experience with the cat jumping in front of her family car.
• Eg. A fear of ferris wheels after having
  ridden one on a windy day.
• These ‘specific’ incidents in the environment’ produced or ‘triggered’ an extreme fear response.

Question 40

Explain the Stigma Around Seeking Treatment.

Answer 40

Stigma Around Seeking Treatment = a mark or sign of shame, disgrace or disapproval typically associated with a particular characteristic or attribute that sets a person apart, such as skin colour, cultural background, a disability or a mental health disorder.

Question 41

Define Evidence Based.

Answer 41

Evidence Based = Treatments that have been found to be effective on the basis of valid and reliable research studies.

Question 42

List the Evidence Based Interventions in the Treatment of Specific Phobia.

Answer 42

Biological:
1. Medications that target GABA dysfunction (Benzodiazepines)
2. Relaxation Techniques: Breathing Retraining

Psychological:
1. Cognitive Behavioural Therapy
2. Systematic Desensitisation

Social:
1. Psychoeducation for families and supporters

Question 43

List and explain the Biological Management of Specific Phobias.

Answer 43

Biological interventions target bodily (‘biological’) mechanisms believed to be contributing to a phobia or its symptoms.

The two types of therapies we learn about are:
1. Medications that target GABA dysfunction (Benzodiazepines)
2. Relaxation Techniques: Breathing Retraining

Question 44

Explain Medications that target GABA dysfunction (Benzodiazepines).

Answer 44

Benzodiazepines = group of drugs that work on the central nervous system, acting on GABA receptors in the brain to increase GABA’s inhibitory effects and make post-synaptic neurons resistant to excitation - commonly called sedatives eg. Valium, Xanax, Serepax.

• Where a person with a GABA dysfunction experiences anxiety, Benzodiazepines act like GABA to slow everything down and reduce the phobic response.
• A person may use them whilst exposed to their phobic stimulus, or in anticipation of it.
  Eg, Flying.

**Not seen as a good long term solution as they don’t combat the cause of the phobia and don’t teach the person any management strategies.

• Benzodiazepines are GABA AGONISTS meaning they stimulate the activity between the neurons, acting like GABA to reduce the firing of the neurons and reduce the symptoms of anxiety/has a calming affect.

Question 45

Explain Relaxation Techniques.

Answer 45

Breathing retraining = anxiety management technique that involves teaching correct breathing habits to people with a specific phobia.

• When anticipating or exposed to a phobic stimulus, so it may also help to reduce anxiety or alleviate some of its symptoms.
• An appropriate breathing pattern generally involves slow, regular breaths in through the nose and out the mouth at a controlled rate as opposed to fast and/or irregular, shallow ‘chest breathing’ or the rapid, deep breathing of hyperventilation.
• The goal is to return breathing to ‘normal’ and maintain the correct balance of oxygen and carbon dioxide in the blood.

Question 46

List and explain the Psychological Management of Specific Phobias.

Answer 46

• For some people, having a phobia can severely disrupt their everyday life.
• They may go to great lengths to avoid whatever it is that causes them anxiety.
• If the phobic stimulus is difficult to avoid, then the individual may seek advice from a mental health professional.

The two types of therapies we learn about are:
1. Cognitive Behavioural Therapy (CBT)
2. Systematic Desensitisation

Question 47

Explain Cognitive Behavioural Therapy.

Answer 47

Cognitive Behavioural Therapy = aims to identify, assess and correct faulty patterns of thinking that may then be affecting mental health and wellbeing. Changes to thought patterns leads to changes in behaviour.

COGNITIVE THERAPY - A type of ‘talking therapy’ that focuses on individuals thoughts, beliefs and attitudes. Helps people to give meaning to their thought patterns, to understand the way they reason etc.

BEHAVIOURAL THERAPY – Clinical application of learning theories such as classical conditioning and operant conditioning. Deals directly with maladaptive (dysfunctional) behaviours such as avoidance and reduced activity levels.

• CBT – a combination of the two of these. Emphasis on one or the other depends on the disorder.
• Eg. More emphasis on behavioural for OCD whereas more emphasis on cognitive for depression.
• Focuses on the here and now – not what has happened in the past.

Question 48

Explain Cognitive Behavioural Therapy for Specific Phobias.

Answer 48

• Aim is to assist client to develop new understanding of phobic stimulus – no to be feared.
• Clients are asked to identify the fear provoking thoughts and cognitive biases (which we learnt about…) that they have.
• Eg. Fear that all birds will attack.
• Client encouraged to look at evidence for and against their fear cognitions.
• Gather info about the stimulus (research).
• Eg. Info about spiders and poisonous varieties.
• Clients are then encouraged to participate in a behavioural experiment to test out the accuracy of their cognitive distortions. Clients then realise the irrationality of their fear.

In summary…..
1. Identify negative thought patterns and behaviours
2. Change negative thought patterns
3. Which will then lead to a change in behaviour

Question 49

Explain Systematic Desensitization.

Answer 49

Systematic Desensitization = A Behaviour therapy technique that attempts to replace an undesirable response, such as fear, with a relaxation response through conditioning; the individual learns to associate being relaxed with the fear arousing stimulus with a series of graded steps.

• Uses Classical Conditioning principles.
  Involves unlearning the connection between anxiety and the phobic stimulus, and reassociating feelings of relaxation (and safety) with that stimulus.
• 3 step process – which gradually desensitizes the client.

Question 50

Explain the Systematic Desensitization 3-step process.

Answer 50

Systematic Desensitization 3 Step Process:
1. Teach client a relaxation strategy: to use to decrease physiological symptoms of anxiety when confronted by a phobic stimulus.
Perhaps using mental imagery or the slow breathing technique (SBT).
2. Breaking down the Anxiety producing object or situation into a sequence arranged from least to most anxiety producing (like graduated exposure). (10-15 stages ideally.
Ranked on a 100 point scale).
3. The systematic graduated pairing of items on the hierarchy with relaxation by working upward, one step at a time. These sessions continue until client is able to master those items at the top, and phobia is extinguished.

***This is often a 4 mark exam question.
1. Learn a relaxation/breathing technique.
2. Break down phobic stimulus into stages.
3. Progressively practice technique alongside each step until no longer anxiety inducing.
4. Stop only when Phobia is Extinguished.

Question 51

Explain Psychoeducation for families and supporters.

Answer 51

Psychoeducation = the provision and explanation of information about a mental disorder to individuals diagnosed with the disorder to increase knowledge and understanding of their disorder and its treatment.

• Don’t encourage avoidance behaviours
• Challenge unrealistic thoughts

Question 52

Explain and list the Protective Factors.

Answer 52

Protective Factors = any characteristic or event that enhances and protects mental wellbeing and reduces the likelihood of the occurrence or recurrence of mental ill health.

BIOLOGICAL
Adequate nutrition/hydration
Adequate sleep

PSYCHOLOGICAL
Cognitive behavioural strategies
Mindfulness meditation

SOCIAL
Support from family, friends and community

Question 53

Explain Biological Protective Factors.

Answer 53

Most people know that eating well and drinking lots of water is vital to good physical health and contributes to an overall healthier lifestyle. An adequate diet, including food and water, is important to proper body functioning.

1. Adequate nutritional intake and hydration
2. Adequate sleep

The main guidelines, according to various mental health providers such as beyond Blue, ReachOut and Headspace are:
- Eat a VARIETY of foods
- Drink LOTS of water
- Don’t skip breakfast and try to eat regularly throughout the day
- Don’t rely on vitamin/mineral supplements
- Avoid heavily processed foods with surplus salt, sugar or fat
- Don’t rely on drugs and/or alcohol

Question 54

Explain Adequate nutritional intake and hydration (biological factors).

Answer 54

Eating/drinking well not only reduces the risk of physical health problems such as cardiovascular disease and diabetes, but it can also help with sleep, energy levels, mood and mental health. We tend to generally feel better and have an overall sense of wellbeing when we eat well.

Question 55

Explain Adequate sleep (biological factors).

Answer 55

Inadequate or poor sleep can adversely affect mental health by impairing affective, behavioural and cognitive functioning.

• While we sleep, the body undergoes repair and replenishes depleted resources. It also triggers release of growth hormones.
• Sleep is an essential, naturally occurring, involuntary process, without which we cannot function at our best.
• We cannot avoid the need for sleep. Eventually our body shuts down and we sleep whether we want to or not.

Question 56

Explain the Cognitive Behavioural Strategies (psychological factors).

Answer 56

Cognitive behavioural strategies - Remember we learnt CBT in Phobias?
Cognitive behavioural strategies are techniques drawn from cognitive behavioural therapy (CBT) to identify, assess and correct faulty patterns of thinking or problem behaviours that may be negatively affecting mental health and wellbeing.

1. Cognitive restructuring = CBT technique that may be used to help the individual identify their cognitive biases and other distorted ways of thinking, refute them, and then modify them so that they are adaptive and reasonable.
2. Behaviour activation = CBT technique to help an individual identify and schedule activities that promote enjoyment or reduce stress; also called activity scheduling.

BA = Steps typically include:
1. Monitor Current Activities
2. List activities associated with enjoyment
3. Plan to do enjoyable activities
4. Complete the planned activities
5. Evaluate the schedule

Question 57

Explain and list the Psychological Factors.

Answer 57

People who are mentally healthy usually think logically and clearly and tend to have a positive view of themselves and life in general.

1. Cognitive behavioural strategies
   - Cognitive restructuring
   - Behaviour activation
2. Mindfulness Meditation

Question 58

Explain Mindfulness Meditation (psychological factors).

Answer 58

Mindfulness Meditation = a type of meditation in which a person focuses attention on their breathing, whilst thoughts, feelings, and sensations are experienced freely as they arise; involves paying attention, noticing, experiencing, doing and being, right here, right now.

• It promotes mental wellbeing and can be used as a therapeutic intervention to provide relaxation and relief from stress or anxiety.
• It cannot treat mental ill-health on its own and should not be relied upon to do so. To be used in combination with other interventions.

Question 59

Explain the Social Protective Factors.

Answer 59

Support from family, friends and community = Social support generally refers to the assistance, care or empathy provided by people to each other.

The people who provide social support can vary and include anyone with whom we may have a relatively stable or ongoing relationship. It is most beneficial when it is authentic, energising and uplifting.

Tips on how to provide EFFECTIVE social support:
1. Validate first, reframe second
2. Avoid downward spirals
3. Be authentic and energising
4. Listen well
5. Be responsive, not dismissive

Question 60

Explain Culture.

Answer 60

Culture = generally refers to the way of life of a particular group, society or community that sets it apart from other groups, communities and societies.

Culture includes such things as the language, knowledge systems, customs, beliefs, values, attitudes, norms about what is right and wrong, food, art, dance and music, as well as any other features which distinguish it from other groups, societies or communities.

Question 61

Explain Cultural Determinants.

Answer 61

Cultural determinants of mental wellbeing = protective factors that help maintain strong connections to culture, strengthen cultural identity, enhance resilience and contribute to the maintenance of good mental wellbeing.

These include, but are not limited to,
- Cultural continuity;
- Self-determination;
- Connection to Country;
- Language;
- Family,
- Kinship and community;
- Cultural expression; and
- Cultural beliefs and knowledge.

Question 62

Explain Cultural Continuity.

Answer 62

Cultural Continuity = the preservation of all things to do with culture over time, and the sense of history, identity and belonging this provides.

• It involves intergenerational maintenance of and transmission of cultural knowledge and practices.
• This ensures maintenance of cultural connection which is integral to ATSI Social and Emotional Wellbeing (SEWB).

Question 63

Explain Self Determination.

Answer 63

Self Determination = the human right to freely determine or control one’s political status and freely pursue one’s cultural, social and economic development.

In relation to mental wellbeing, self-determination specifically means that ATSI peoples are authorised and empowered to take ownership and responsibility for designing, delivering and evaluating policy and services on their own terms. It is more than consultation.

Question 64

Explain the Indigenous Voice to Parliament.

Answer 64

• The Aboriginal and Torres Strait Islander Voice may enhance self-determination by providing Aboriginal and Torres Strait Islander peoples with a say.
• The Aboriginal and Torres Strait Islander Voice may enhance cultural continuity for these peoples as it aims to permanently recognise the 60,000+ years of continuous connection to this land.