Week 5 - Death and Psychological Interventions Flashcards
1
Q
Describe diversity in patterns of dying
A
- Death rates are falling in England and Wales
- On average, women live longer
- Death rates are highest in older age groups
- Wealthier people tend to live longer
- 3 main patterns of dying:
- – Gradual death:
- With a slow decline in ability and health
- – Catastrophic death:
- Through sudden or unexpected events
- – Premature death:
- In children and young adults
- Through accidents or illness
- Each death is different, even if the underlying cause is the same
2
Q
What is the 5 stages of grief model?
A
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
3
Q
Describe grief
A
- Grief = a set of psychological and physical reactions to bereavement
- The grieving process:
- – Disbelief and shock in early stages
- – Developing awareness
- – Resolution
- Each person experiences the grieving process differently
- – Can be reassuring to know that grief passes through various stages and for most people grief will lessen and end
4
Q
What are the symptoms of bereavement?
A
- Physical
- – E.g. shortness of breath, palpitations, fatigue, digestive symptoms, reduced immune function
- Behavioural
- – E.g. insomnia, irritability, crying, social withdrawal
- Emotional
- – E.g. depression, anxiety, anger, guilt, loneliness
- Cognitive
- – E.g. lack of concentration, memory loss, preoccupation, hopelessness, disturbance of identity, visual and auditory hallucinations
5
Q
What are the risk factors for chronic grief?
A
- Prior bereavements
- Mental health
- Type of loss
— Young person
— Nature of death (e.g. violent, suicide)
— Caring status - Lack of social support
- Stress
About 15% are experiencing chronic grief within 2 years of bereavement
6
Q
What are the aims of palliative care?
A
- Improve quality of care
- Manage emotional and physical symptoms
- Support patients to live productively
- Give patients some control
7
Q
What are the main psychological therapies used within the NHS?
A
- Cognitive behavioural therapy
- Psychoanalytic/psychodynamic therapies
- Systemic and family therapy
8
Q
Describe systemic and family therapy
A
- For individuals, couples, families, children
- Focuses on relational context
- Addresses patterns of interaction and meaning
- Aims to facilitate resources within the system as a whole
9
Q
Describe psychoanalytic/psychodynamic therapies
A
- Conflicts arising from early experiences that are re-enacted in adult life
- Use the relationship with the therapist to resolve these
- Allows unconscious conflicts to be re-enacted and interpreted in relationship with therapist
- Therapy explores feelings
- Attempts to enhance insight of difficulties and help incorporate painful previous experiences
- Suitable for people with:
- – Interpersonal difficulties and personality problems
- Requires:
- – Capacity to tolerate mental/emotional pain
- – Interest in self-exploration
10
Q
Describe humanistic/client-centred therapy
A
- Relies on general counselling skills
- – Warmth, empathy, unconditional positive regard
- Can help people coping with immediate crises where there is already motivation and willingness to problem solve
- Suitable for:
- Mild to moderate difficulties related to:
- – Life events
- – Subclinical depression
- – Mild anxiety/stress
- – Marital/relationship difficulties
- – Recent onset (
11
Q
What cognitive techniques are used in CBT?
A
- Education
- Monitoring
- – Of thoughts, behaviours, feelings, contexts
- – To develop awareness of their inter-relationship
- Examining/challenging negative thoughts
- – Negative thoughts
- Behavioural experiments
- Cognitive rehearsal of coping with difficult situations
12
Q
What behavioural techniques are used in CBT?
A
- Graded exposure to feared situations
- – We try to avoid/get rid of the stimulus
- – This continued avoidance can perpetuate the problem, ingraining the fear
- Activity scheduling
- – Get people to do things that will cause them pleasure
- Reinforcement
13
Q
What is cognitive behavioural therapy?
A
- Pragmatic combination of concepts and techniques from cognitive and behavioural therapy
- Relieve symptoms by changing maladaptive thoughts, beliefs and behaviour
14
Q
Which mental health conditions is CBT likely to be effective for?
A
First line of treatment for: - Depression - Anxiety states - Eating disorders - Sexual dysfunction Evidence of efficacy for: - Depression - OCD - Anxiety - PTSD - Eating disorders - Schizophrenia
15
Q
What kind of patients is CBT suitable for?
A
Patients who:
- Are keen to be active participants
- Can engage collaboratively
- Can accept a model emphasising thoughts/feelings
- Are able to articulate their problems and are practically seeking solutions
