Exam 3: Week 15 Flashcards
(77 cards)
1
Q
what are the most common stressors?
A
work and money and the economy
2
Q
types of work stress interventions? (3)
A
- primary intervention
- secondary interventions
- tertiary interventions
3
Q
Primary interventions
A
reduce the sources of stress at work ⇒ job redesign
4
Q
examples of primary interventions? (2)
A
- job crafting
- job redesign
5
Q
job crafting
A
employee trying to change characteristics and nature of their job
- employee first
6
Q
job redesign
A
employer tries to redesign the job to make it less stressful
- organization first
7
Q
secondary interventions
A
teach skills for coping with stress ⇒ stress management programs
- Most common
8
Q
types of secondary work stress interventions? (3)
A
- cognitive behavioral (CBT)
- relaxation, yoga, mindfulness, meditation, deep breathing
- Exercise, journaling, time management ⇒ less common
9
Q
Cognitive behavioral (CBT)
A
teaching skills for modifying maladaptive thoughts
10
Q
Relaxation, yoga, mindfulness, meditation, deep breathing
A
try to reduce states that are the physiological opposite of stress
11
Q
which is the most effective: telecommuting, Flex Time, relaxation time
A
relaxation time
12
Q
are single or multiple component secondary stress intervention more effective?
A
single
- Each component added reduced the effectiveness of the intervention
13
Q
which single component stress reduction technique is the most effective?
A
CBT compared to relaxation
14
Q
is internet CBT or face to face CBT more effective?
A
they are equally effective
15
Q
tertiary interventions
A
treat health conditions ⇒ employee assistant programs
16
Q
Exam question: the meta-analysis of work stress interventions found that interventions are most effective if:
- They are primary interventions
- If they include multiple components
- If they include just one component
- If they are tertiary interventions
A
If they include just one component
17
Q
who developed cognitive behavioral therapy
A
Aaron beck in the 1960s and the most practiced and researched form of psychotherapy in the world
18
Q
CBT model
A
it’s not the events that happen to use but how we think about them that is important
- Situation ⇒ thoughts ⇒ emotions ⇒ behaviors ⇒ physical reaction
19
Q
Thought record
A
recording a situation, what automatic thoughts followed, what emotions one had, and how the situation can be interpreted
20
Q
Mindfulness
A
ability to direct and sustain one’s attention to the present moment in an accepting and nonjudgmental ay
- Experiencing the present moment with compassion and openness ⇒ reduces tendency to avoid which is generally unhelpful
21
Q
Re-perceiving
A
standing back and taking a more objective view of your emotions
- Changing ones relationships with thoughts rather than the thoughts themselves (as in CBT)
22
Q
Mindfulness based stress reduction (MBSR)
A
eight week group workshop taught by certified trainers with group meetings, homework, and instruction
23
Q
3 formal techniques for MBSR
A
- mindfulness meditation
- body scanning
- hatha yoga
24
Q
body scanning
A
quietly lying on one’s back and focusing one’s attention on various regions of the body
25
who developed MBSR?
developed by Jon Kabat Zinn in 1979 ⇒ prof Med, molecular biologist
26
is mindfulness or evidence based therapies (CBT) more effective?
they work about the same
- Just as effective as EBT ⇒ one exception seemed more effective for smoking compared to others
- May not be quite as good for anxiety
27
5 factor mindfulness questionnaire sub scale
- Observing ⇒ staying alert to body sensations
- Describing ⇒ words to describe feelings
- Acting with awareness ⇒ reverse scored as not paying attention
- Non Judging ⇒ reverse scored some of thoughts are abnormal and bad
- Nonreactivity ⇒ distressing thoughts and images noticed without reacting
28
what was the strongest mediator between mindfulness based interventions and changes in mental health outcomes?
decreases in reactivity to thoughts and emotions
29
who developed progressive muscle relaxation?
Edmund Jacobson in 1920s and 30s
- muscular tension common in his internal medicine patients (MD)
- stress and relaxation are incompatible
30
progressive muscle relaxation
PMR is systematic tensing and relaxing of muscle groups
- Tension: inhale and purposely tense up or tighten hard the selected muscle group and hold the tension for 5-10 seconds
- Relax: exhale while quickly but gently letting go and releasing tension and being still or 15-20 seconds before moving on to the next muscle group
31
Exam question: which of the following statements about mindfulness is most accurate?
- As a new therapy, it has not received much research attention
- Many studies support its efficacy
- Awareness is the most effective component
- It was developed by aaron beck
Many studies support its efficacy
32
what are the 3 steps for phases of trauma recovery
1. immediate phase
2. acute phase
3. chronic phase
33
how long is the immediate phase?
0-48 hours
- Many people report significant distress during this period
34
how long is the acute phase?
A few days to 1 month post trauma
- Distress diminishes greatly for most people during this phase
35
how long is the chronic phase?
1 month +
- 5-10% of people develop PTSD
36
Critical incident stress debriefing (CISD)
single session for about 3 hours within a few hours or days after trauma
- Goals is to prevent PTSD and is widely used
37
7 steps of CISD
- assessment phase
- fact phase
- thought phase
- reaction phase
- symptoms phase
- teaching phase
- re-entry phase
38
assessment phase
leaders and facilitators tailor the program for the situation, the people, and the needs of the group
39
fact phase
participant share a brief account of the events from their point of view, focused on facts and not emotions
40
thought phase
group vents thoughts and feelings about the incident
41
reaction phase
discuss impact of event ⇒ facilitators prompt participants to share the worst aspect of the event
42
symptoms phase
participants share physical, emotional, behavioral, and cognitive symptoms they've been experiencing
43
teaching phase
facilitators help the group understand their reactions and provide stress management and self care tools
44
re-entry phase
group leaders summarize the takeaways from the sesion, provide information about the next steps and additional resources
45
how effective is CISD?
has negative effects
- PTSD symptoms decreased more if you did nothing than if you provided debriefing
- treatment that causes harm
46
why isn't debriefing helpful? (3)
- Early emotional processing of trauma might interfere with the natural processing of the event ⇒ might suggest that normal levels of distress are maladaptive and require professional intervention
- Might lead people to bypass their normal sources of support ⇒ people say it's helpful because their distress lessened even though they may have done better without it
- Not everyone will need it ⇒ only 5-10% of people develop PTSD
47
is CISD recommended in expert treatment guidelines?
No
- more recent meta analysis of CISD found no effect of CISD vs no treatment
- research support/treatment is potentially harmful
- Children adolescent intervention has evidence not to recommend
- Adult insufficient evidence to recommend
- Do not offer psychologically focused debriefing for the prevention or treatment of PTSD
48
what method is recommended after trauma?
psychological first aid
49
what are steps of psychological first aid? (8)
- Contact and engagement ⇒ ask about immediate needs
- Safety and comfort ⇒ ensure immediate physical safety and help survivors who have a missing family member
- Stabilization ⇒ stabilize emotionally overwhelmed survivors
- Information gathering current needs and concerns ⇒ nature and severity of experiences during the disaster
- Practical assistance ⇒ discuss action plans
- Connection with social supports ⇒ encourage use of immediately available support persons
- Information on coping ⇒ teach simple relaxation techniques
- Referrals
50
acute phase
criteria for acute stress disorder (ASD) in DSM-V
- Criterion A: exposure to actual or threatened death, serious injury, or sexual violation ⇒ same as PTSD
- Criterion B: at least 9+ symptoms from any of the 5 categories ⇒ intrusion, negative mood, dissociation, avoidance, nad arousal
- Criterion C: duration of 3 days to 1 month after trauma exposure
- Criterion D: clinically significant distress or impairment ⇒ prevalence of 15%
51
what are cognitive behavioral interventions effective in preventing for people with ASD?
PTSD
- trauma focused CBT is more effective than supportive counseling in preventing PTSD for those with ASD symptoms
- treatment guidelines also support use of various forms of CBT for preventing PTSD in those with trauma symptoms
52
ISTSS prevention and treatment guidelines (3)
- Cognitive behavioral therapy with a trauma focus (CBT-T)
- General CBT
- EMDR (eye movement desensitization and reprocessing)
53
NICE guidelines (4)
- Cognitive processing therapy
- Narrative exposure therapy
- Cognitive therapy for PTSD
- Prolonged exposure therapy
54
Exam question: critical incident stress debriefing…
- Is recommended for treating acute trauma symptoms
- Is recommended for treating immediate trauma symptoms
- Is not recommended for treating immediate trauma symptoms
- Is effective for preventing PTSD
Is not recommended for treating immediate trauma symptoms
55
what are APA clinical practice guidelines for PTSD recommendations based on? (4)
- Strength of evidence, mostly based on RCTs
- Treatment outcomes and the balance of benefits vs harms and burdens of interventions
- Patient values and preferences
- Applicability of the evidence to various treatment populations
56
apa recommendation categories (3)
- strongly recommended
- conditionally recommended
- other categories
57
what are strongly recommended therapies? (4)
all variants of CBT
- Cognitive processing therapy
- Prolonged exposure
- Cognitive behavioral therapy
- Cognitive therapy
58
what are conditionally recommended therapies? (3)
- Eye movement desensitization and reprocessing (EMDR)
- Brief eclectic psychotherapy
- Narrative exposure therapy
59
Brief eclectic psychotherapy
combines CBT with a psychodynamic approach and focuses on changing shame and guilt
- Emphasizes the relationship between the patient and therapist
60
Narrative exposure therapy
helps individuals establish a coherent life narrative in which to contextualize traumatic experiences
- Used in group treatment for refugees
61
what are other APA categories? (3)
- Insufficient evidence
- Conditional against
- Strong against
62
are medications strongly recommended?
No, but some are conditionally recommended
63
what are recommendations based on for PTSD and ASD? (4)
- Confidence in the quality of the evidence
- Balance of desirable and undesirable outcomes
- Patient values and preferences
- Other considerations as appropriate ⇒ resource use, equity, acceptability, feasibility, subgroup considerations
64
recommendation categories for PTSD and ASD? (5)
- Strong for
- weak for
- Neither for or against
- weak against
- strong against
65
strongly recommended treatments? (3)
- Cognitive processing therapy (APA)
- Prolonged exposure (APA)
- Eye movement desensitization and reprocessing (non APA)
66
is psychotherapy or medications recommended?
psychotherapy over medication
- both are effective
- When both treatment modalities are available and feasible, the work group recommends the use of the indicated psychotherapies over the indicated pharmacotherapies
- Psychotherapy more effective, especially for long term outcomes
67
3 most recommended treatments for PTSD
1. prolonged exposure
2. cognitive processing therapy
3. eye movement desensitization and reprocessing (EMDR)
68
Prolonged exposure
typically 10-15 90 minute sessions with imaginal exposure and in vivo exposure
69
who developed prolonged exposure
Developed by Edna Foa, PhD in 1990s
70
what are components of prolonged exposure? (2)
- imaginal exposure
- in vivo exposure
71
imaginal exposure
Client repeatedly and vividly describes the trauma in present tense to therapist
- Learns that the memories themselves are not dangerous
- Habituation
72
in vivo exposure
Confronting feared peoples, places, objects in real life
- Hierarchy of feared situations
- Learn to approach these situations without anxiety
73
Cognitive procesing therapy (CPT)
for treatment of rape related PTSD but modified for other groups and focuses more on changing thoughts and interpretations of the event
- Self blame, overgeneralization, etc.
- Also involves exposure ⇒ writing a detailed account of the trauma and read it daily
74
who developed cognitive processing therapy?
Developed by Patricia Resick, PhD in 1990s
75
Eye movement desensitization and reprocessing (EMDR)
clients describe trauma memory while paying attention to a back and forth movement or sound
- Eye movements are proposed to facilitate information processing and integration
- EMDR focuses directly on the memory and is intended to change the way that the memory is stored in the brain
- Has been controversial ⇒ not clear that the eye movements add anything and mechanism of change may just be exposure
- Training not as readily available because it is a proprietary treatment ⇒ get training from a certified EMDR person and costs $1,400
76
who developed EMDR?
Developed by Francine Shapiro, PhD in 1980s
77
end card
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