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Depression & Anxiety Treatment LICBT > General > Flashcards

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1
Q

Guided self help is effective for mild-moderate depression

A

Anderson et al 2005

Gellatly et al 2007

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2
Q

Guided self-help methods

A

Books Brosan and Hogan 2006
Worksheets CCI
E-CBT Mood gym

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3
Q

Factors impacting on attendance

A

Stigma
Symptoms
Disability
Motivation

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4
Q

During assessment you should attain…

A 
Problem
Exploring symptoms
Maintaining factors
Expectations
Goals
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5
Q

4 recommended LICBT Treatments recommended by NICE 2009b

A

BA
Cognitive
problem solving
Sleep hygiene

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6
Q

Three deciding factors in LICBT intervention decision

A

Client choice
Goals
Symptom target

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7
Q

PWP Training Review (2015)

A

Problem statement review

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8
Q

Pavlov

A

Classical condition

Phobias: baby Albert, learning via association

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9
Q

Behaviour

A

Pavlov

Skinner

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10
Q

Cognitive

A

Beck

Ellis

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11
Q

Beck

A

Cognition

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12
Q

Ellis

A

Belief base

Emotional response

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13
Q

Reflection learning through

A

Gibbs 1988

Kolb 2014

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14
Q

Benefits of a problem statement

A

Time keeping

Silent member

Negativity

Over disclosure

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15
Q

Cognitive strategies are used in LICBT to…

A

Challenge negative thoughts and unhelpful thinking patterns

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16
Q

Depression key features:

A

Lack of motivation

Negative thinking

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17
Q

CBT model of depression suggests…

A

depressed people show cognitive biases or systemic thinking errors (Beck et al 1979) aka unhelpful thinking styles

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18
Q

Unhelpful thinking style (4 areas)

A

Westbrook et al 2007
Self-reproach eg taking things personally, self-criticism and name-calling

Intuitive thinking eg mind reading, making negative predictions about the future, basing reasoning on emotional responses

selective attention eg overgeneralising, discounting positives, taking all responsibility, magnifying negative events

Extreme thinking eg all or nothing thinking, unrealistic standards & catastrophising

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19
Q

An example of a GSH material to challenge negative thoughts

A

Beck et al 1979
Greenberger & Padesky 1995

Thought records

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20
Q

Negative triad

A

Beck et al 1979

Thoughts develop and are reinforced habitually and enter frequently into patients’ minds - NAT

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21
Q

Purpose of a thought diary

A

Client to become aware of thoughts and secondly to evaluate their validity… client therefore is encouraged to find a more balanced alternative preventing vicious cycles

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22
Q

Mynors-Wallis & Lau 2010

A

Most work happens between sessions

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23
Q

Kupfer 1991

A

At least half of people who recover from depression will relapse

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24
Q

Anxiety is…

A

the assumption that something is more dangerous than it really is

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25
Most treatment will include...
Assessment of the anxiety and an agreement on the goals to be worked on Psycho-ed Skills to better enable the client to manage Some form of exposure to the situation or object Relapse management
26
Clearest support for LICBT evidence working with Anxiety is for...
Social anxiety & panic
27
Furmark et al 2009 | Abramowitz et al 2009
Found significant results for a range of LICBT interventions for social anxiety
28
Robinson et al 2010
Strong results for evidence for the use of LICBT for panic
29
Tolin et al 2011
OCD can be treated using exposure techniques effectively
30
NICE guidelines for GAD
LICBT should be administered as a first line treatment, supported by Wilkinson 2011
31
Coull & Morris 2011
Comprehensive review of controlled trials, demonstrated some success but overall varying results- LICBT lacks longitudinal follow up reported within studies - However they did not include diagnoses that were not confidently presented thus mild to moderate symptoms were not included
32
Newman et al 2003
LICBT is most effective for motivated clients
33
Gellatly et al 2007
LICBT is only effective for anxiety if continued support is offered
34
Typical structure of anxiety LICBT treatment
1. Assessment of current difficulties 2. Match presentations to treatment options 3. Self-help sheets to psychoeducate around treatment options and the condition - If the symptoms do not correlate with a specific diagnosis, the symptoms/experiences themselves can be worked on White et al 1992
35
Cave & Dunwoodie 2012
services have different treatment options depending on locality
36
White et al 1992
Stress course- generic course- non-specific diagnosis
37
Roth &Piling 2007
Standards set for Goal Setting SMART type idea
38
Measuring goals...
It is important to agree with the client collaboratively how they are going to measure the success of their treatment
39
Eckam & Shean 1997
High levels of anxiety that does not habituate should be HICBT
40
Larun et al 2009
Exercise is effective treatment for mild to moderate anxiety although research is limited Very few mental health services provide this as an option
41
Herring et al 2011a, 2012
exercise is effective treatment
42
Herring et al 2011b
Prescribed exercise for GAD
43
Abrantes et al 2009
Prescribed exercise for OCD
44
Brooks et al 1998
Prescribed exercise for panic
45
Newman & Motta 2007
Prescribed exercise for children and adolescents effective
46
Knapen et al 2009
Prescribed exercise for working aged adults
47
Chodzko-Zajko et al 2009
Prescribed exercise for Older adults effective
48
Roth & Holmes 1987
Intensity of exercise is irrelevant
49
Beaulac et al 2011 Mnemonic
Exercise can prevent CMH problems ``` Collaborative working is important factor in effectivity particular when considering physical exercise Mnemonic Assess Advise Agree Assist Arrange ```
50
Which pathways does exercise work on?
Cog and physical
51
Sabourin et al 2008
How exercise helps mental health/anxiety. Physical - Habituating anxiety of physical arousal eg heart rate Cog- helps the client to understand the situation without it being threat based i.e. exercise induced
52
Strohle 2008
Exercise increases sense of mastery, distraction and change of self-concept
53
Petrella & Lattanzio 2002
Treatment compliance can be an issue, recommend regular brief practitioner support to improve compliance and outcomes
54
Cognitive treatments for anxiety
thought records- raise awareness of typical anxious thoughts, thoughts can be a trigger for anxiety and so this is the rationale behind it thought challenging - CR, provides rationale for behavioural responses worry time Behavioural Experiments- as it is developing new information and relearning
55
Nelson & Hayes 1981
For LICBT awareness and self-monitoring may result in spontaneous change in thought content
56
Olson & Winchester 2008
monitoring the frequency of a thought may increase the occurrence - think cognitive priming
57
Clark et al 1991
Priming tends to occur when a thought is suppressed rather than monitoring alone
58
Clark 1995
Cognitive treatments encourage...logical analysis and empirical hypothesis testing which leads to realignment of their thinking with reality
59
When is behavioural treatment favoured over cognitive?
When the best evidence available reaffirms the anxious thought eg speaking in public having had a bad experience
60
Bennett-Levy et al 2004
Behavioural experiments: in-between sessions derived from a cognitive formulation primary purpose- obtain new information, testing validity and beliefs
61
Holly et al 2010
BE are powerful when bringing change in unhelpful thinking and related behaviours as they offer reflective and active parts
62
Kolb 1984
Benefits of reflection
63
Bystritsky et al 2005
Prediction of medication compliance - help to cope? - does it work? - are they addictive? - physically better?
64
Beck 2001
Specific targeted questions should be asked around medication - fears - impact medication has on decisions review unhelpful beliefs using CR
65
Evans &Spelman 1983
Half of the people taking MH meds will stop taking their mediation when they start to feel better
66
Enhancing compliance
Psycho-ed - rationale - delay onset - time course - side effects - problems with relapse if they are withdrawn too quickly - concerns about addictions and cravings
67
Mitchell & Selmes 2007
``` medication compliance as a goal: - basic communication -stratefy-specific interventions -reminders evaluating adherence ```
68
Goals for relapse prevention
preventing it increasing wellness developing skills to promote and sustain wellbeing

Depression & Anxiety Treatment LICBT (15 decks)

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