10. CBT for Psychosis Flashcards
(38 cards)
The cognitive element of CBT is about m____ p____ - everything that goes on in your m____ e.g. d____, m____, images, thoughts, a____
mental processes, mind
dreams, memories, attention
The behaviour part of CBT is everything you d___- refers to a____ and i____, what you s____, how you a____, what you do or don’t do
do, action, inaction, say, act
The therapy part of CBT is a “s____ approach to c____ a problem, i____, or i____ condition”
systematic, combating, illness, irregular
The way you think and b____ in r____ to experiences determines d____, f____ and n____
behave, response, distress, function, need
CBT aims to:
1. promote u____ of psychosis
2. reduce d____ and d____
3. promote more p____ responses/adjustment
- understanding
- distress, disability
- positive
Psychological models view delusions as :
1. On a c____ with normal beliefs
2. M____ (involves c____, p____ and d____)
3. Attempts to make s____ of a____ experiences
4. Mediated by a____
5. Involve r____ and a____ biases
6. Influenced by e____ processes
- continuum
- Multidimensional (involves conviction, preoccupation and distress)
- sense, anomalous
- appraisals
- reasoning, attributional
- emotional
Participants’ explanations of Nielsen’s experiment:
1. My hand was controlled by an o____ p____ f____ - I don’t know what it was, but I could feel it
2. I looked to see if there were e____ on my hand, but I couldn’t see any: they were there, but I was d____ about them
- outside physical force
- electrodes, deceived
There were differences in the appraisals of anomalous experiences in diagnosed and undiagnosed pts. The undiagnosed group made more n____, s____ and p____ appraisals for the experiences, while the diagnosed group tended to make p____ appraisals
normalising, spiritual, psychological
personalising (other people)
Paranoid participants have an exaggerated s____-s____ bias (they take c____ for p____ events and b____ others for n____ events). More specifically, they have an e____, p____ a____ style.
self-serving, credit, positive, blame, negative
external, personalising attributional
When people who had hallucinations but were delusion-free at time one were followed up, it was found those with d____ had a f____-fold increase in developing delusions __ years later. This implies e____ are involved at the f____ stage.
distress, four (18.75% vs 4.35%), 4
emotions, formation
Key elements of working with a client in CBTP:
1. E____ is crucial in psychosis (empathy, genuineness)
2. S____ g____ (beliefs and expectations)
3. Take client s____, regardless of c____
4. F____ i____ (be creative, gentle, collaborative, engage with what is d____, not what is a____)
- engagement
- shared goals
- seriously, content
- facilitate intervention, distressing, abnormal
Using CBTp approaches:
1. Continuum of beliefs and experiences –> n____
2. Attempts to explain anomalous experiences –> provide p____ a____
3. Mediated by appraisals, reasoning and thinking biases, behaviour –> r____appraisals and a____ biases/behaviour
4. Influenced by emotional processes –> v____ distress, a____ emotions (esp. a____) and emotional r____
- normalise
- plausible alternatives
- reframe, address
- validate, address, anxiety, responses
All of the Randomised Controlled CBTp Trials (RCT’s) selected in recent meta-anlyses reported s____ r____ and most reported g____ f____ as primary outcomes (mean effect size on positive symptoms: 0.__)
symptom reduction
global function
0.4
One key effectiveness issue of CBTp with challenges with e____:
1. Patients with psychosis are often not h____-s____
2. Patients may not view their problems as p____ or m____ health related or requiring therapy
3. Patients’ symptoms may negatively affect e____
4. These factors can lead to e____ d____ and p____ outcomes
engagement
1. help-seeking
2. psychological, mental
3. engagement
4. early disengagement, poorer
A key effectiveness issue of CBTp is the challenge of w____ o____:
1. CBT effects often measured as symptom c____ then focus is on thinking p____, d___ or impact on f____
2. This may affect o____ as what changes may not be what is m____
which outcome
1. change, patterns, distress, function
2. outcomes, measured
A key effectiveness issue of CBTp is challenge of service user’s p____:
1. B____ CBT approaches may have multiple potential t____/g____ for therapy
2. G____ must be s____ and a____ with the patient
3. G____ may d____ from one patient to another
4. Patient g____ may not be what is measured
priorities
1. Broad, targets/goals
2. Goals, shared, agreed
4. goals, differ
5. goals
The service user concept of recovery involves i____ conditions and e____ condition.
I_____ = h____, h____, e____ and c____.
E____ = h____ r____, p____ v____ of h____ and r____ o____ s____
internal, external
internal = hope, healing, empowerment, connection
external = human rights, positive value of healing, recovery oriented services
CBT targets are c____ with s____ u____
collaborative, service users
An exploration of the factor structure revealed that the items with the highest loadings could be conceptualised as those likely to yield more i____ c____ and the goals of a more r____ and b____ (coping) nature; whereas those with the lower loadings (with the exception of feeling s____ and s____) were those more reminiscent of c____ outcomes and processes of c____ in CBTp
immediate changes
recovery, behavioural
safe, secure
cognitive, change
A key effectiveness issue of CBTp is which CBT intervention?:
1. There are d____ t____ of CBT - standard CBT is often g____, b____ and f____ driven
2. G____-based behavioural CBT is delivered in a g____ setting and is not p____
3. I____, t____ interventionist-causal CBT is focused on specific m____ maintaining specific s____ and is often b____
4. Some types seem more e____ than others
- different types, general, broad, formulation
- Group, group, personalised
- Intensive, targeted, mechanisms, symptoms, briefer
- effective
Worry periods involve two parts that aim to help patients see that worry is in their c____:
1. Planning a t____ and p____ to worry
2. Planning how to p____ worry until the worry period
control
1. time, place
2. postpone
Worry periods exercise includes boosting times you’re starting to worry with other activities:
1. A____
2. Making c____ with someone
3. Thinking of something d____
4. R____
5. P____ s____
6. __ ways to w____
- Activities
- contact
- different
- relaxation
- problem solving
- 5, wellbeing
Results from a worry period study:
1. Significant reduction in w____
2. Significant reduction in p____ d____
3. Significant improvements in w____, CHOICE, and overall s____
- worry
- persecutory delusion
- wellbeing, symptoms
Self-confidence Pilot Study Results:
Improvements in…
1. Negative s____-b____
2. P____
3. W____
4. CHOICE
5. Positive s____-b____
6. Negative s____ c____
7. S____-e____
8. D____
negative self-beliefs
paranoia
Well-being
CHOICE
Positive self-beliefs
Negative social comparison
Self-esteem
Depression
