Flashcards in Global Mental Health Deck (15)
What was Engel's 1977 biopsychosocial model of health?
Behaviours, thoughts, and feelings may influence a physical state
State at least 5 evidence-based psychological interventions for mental disorders
Cognitive analytical therapy (CAT), interpersonal psychotherapy, brief solution focussed therapy, psychodynamic psychotherapy, cognitive behavioural therapy (CBT), eye movement desensitisation and reprogramming (EMDR), family therapy, dialetical behavioural therapy (DBT), motivational interviewing
Describe the rationale behind CBT
Thoughts, feelings, and behaviour are all interconnected - so thinking and behaving more positively results in more positive feelings
Why does CBT require adapting to be used in lower income countries?
Relative lack of resources, different languages and linguistic structures, more family and group oriented culture, hierarchical patient-therapist relationship, patients may need to travel long distances to obtain healthcare so may not be able to attend multiple appointments, poor service organisation
Give 2 situations in which CBT may not be effective for depression
When it is the result of a bereavement, or when it is the result of a genuine fear (e.g. bullying or persecution)
Why might group CBT be more effective than individual CBT in LICs?
It is more cost effective and fits the collectivist culture of many LICs
State at least 3 adaptations for CBT in LICs
Group therapy, delivery by non-specialists, more behavioural and less cognitive, more directive approach, incorporating existing cultural and religious coping strategies, family involvement
Why is a more directive approach useful for CBT in LICs?
It is more consistent with the hierarchical relationship between patients and clinicians and may be quicker to deliver
Why is it more effective to focus on the behavioural aspect than the cognitive aspect of CBT in LICs?
Easier to explain and quicker to understand (Richards et al, 2016)
Why is family involvement important in CBT in LICs?
Consistent with the family-oriented culture, and families can remind the patient of the CBT techniques
Give at least 4 positive effects of religion on mental health
Finding meaning in life, social support and reduced isolation, promotion of positive affect, positive social guidance (e.g. teaching moderation), external attribution of negative events (e.g. blame devil), more positive appraisal of negative events, promoting o sustaining help in hopeless circumstances
State some alternative therapies to CBT in LICs
Medications, supportive therapy, practical problem solving and adocacy, family therapy, dialetical behaviour therapy
Describe radical acceptance
Accepting a painful reality that cannot be helped and accepting that life is still worth living despite the pain
State some distress tolerance techniques
Positive distraction, relaxation techniques, helping others, prayer, mindfulness