HealthPsych Session 5 Flashcards Preview

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Flashcards in HealthPsych Session 5 Deck (60):
1

Why do more elderly relatives tend to die in hospital now than they did historically?

Relatives at home feel unable to provide home care due to lack of support and advice as well as having concerns about pain management

2

What is the result of medicalisation of death?

Death is more unfamiliar so people tend to find it harder to accept

3

How have life expectancy and healthy life expectancy changed?

Life expectancy has increased but healthy life expectancy has not to the same extent so a significant proportion of life is in ill health

4

Describe the 3 main patterns of dying.

Gradual death: slow decrease in ability and health
Catastrophic death: through sudden and unexpected events
Premature death: in children/young adults through accident or illness

5

What are the stages in the 5-stage grief model?

Denial
Anger
Bargaining
Depression
Acceptance

6

Should a period of denial be allowed for people experiencing grief?

Yes, can be a helpful coping mechanism

7

Should pts be hurried out of the depression stage of the 5-stage grief model?

No, offer support instead

8

What is grief?

Set of psychological and physical reactions to bereavement which is a normal reaction to overwhelming loss where normal functioning no longer holds

9

What is the process of grief?

Disbelief and shock --> developing awareness --> resolution

10

What other event does dealing with grief have common elements with?

Terminal diagnosis

11

Are psychological interventions helpful in grief?

Only in high risk people

12

What factors lead to complication of the grief process?

Expression of grief discouraged
Ending of grief discouraged

13

What can result from an interrupted grief process?

Anxiety
Depression
PTSD

14

What type of stress is bereavement?

Severe form

15

What are the physical symptoms of bereavement?

SoB
Palpitations
Fatigue
GI symptoms
Decreased immune function

16

What are the behavioural symptoms of bereavement?

Insomnia
Irritability
Crying
Social withdrawal

17

What are the emotional symptoms of bereavement?

Depression
Anxiety
Anger
Guilt
Loneliness

18

What are the cognitive symptoms of bereavement?

Reduced concentration
Memory loss
Preoccupation
Hopelessness
Disturbance of identity
Visual and auditory hallucinations

19

What are the outcomes of bereavement within 2 years?

85% have adjusted and are experiencing minimal grief
15% experiencing chronic grief (anxiety, depression, PTSD)

20

What are the risk factors for not adjusting to bereavement?

Prior bereavements
Mental health
Type of loss (young, traumatic, if person was caring for deceased)
Lack of social support
Additional stressors

21

What is palliative care?

A shift of focus away from medical management towards improving QoL by managing emotional and physical symptoms and supporting pts to live productively so they are in control and retain dignity

22

What are we less exposed to death as a population?

Death has become medicalised as the majority of people now die in hospital despite wanting to die at home

23

Describe type A psychological therapies.

Treatment gives as an integral part of mental health care by GP/district nurse using psychotherapy techniques

24

Describe type B psychological therapies.

Eclectic psychological therapy and counselling taking ideas from different branches of formal therapies

25

Describe type C psychological therapies.

Formal psychotherapists e.g. regular CBT sessions

26

What types of psychological therapies does the NHS use?

CBT
Psychoanalytical/psychodynamic
Systemic
Family

27

What is CBT?

Pragmatic combination of concepts and techniques to relieve symptoms by changing maladaptive thoughts, beliefs and behaviour (not situations but view we take of them is causing upset)

28

What behavioural techniques are used in CBT?

Graded exposure to feared situations
Activity scheduling
Reinforcement

29

Why does avoidance of stimulus perpetuate fear?

Association develops between feeling bad in presence of stimulus and feeling better once it is removed (operant conditioning)

30

What cognitive techniques are used in CBT?

Education of cause of problem
Monitoring of thoughts, feelings etc
Examining/challenging -ve thoughts
Behavioural experiments to test beliefs
Cognitive rehearsal

31

What is CBT the first line treatment for?

Depression
Anxiety states: phobias, OCD, generalised anxiety disorder, panic, PTSD, health anxiety, body dystrophic disorder
Eating disorders
Sexual dysfunction

32

What is CBT used as an adjunctive Tx for?

Psychotic symptoms (+anti-psychotic medication)

33

How does CBT work as an adjunct to medication in psychotic symptoms?

Decreases impact of -ve symptoms
Distracts from symptoms
Decreases preoccupation with delusions and intensity of beliefs
Alters beliefs about abnormal perceptions

34

Who is CBT suitable for?

Pts who are keen to be active participants
Pts who engage collaboratively
Can accept model emphasising thoughts and feelings
Able to articulate problems
Practically seeking solutions to problems

35

Is CBT suitable for pts with a nebulous wish to be happy?

No

36

What are the limitations of CBT?

Findings of efficacy are usually from homogenous populations with limited comorbidities
Delivered by expert practioners (challenge for routine practice)
Circumscribed benefits in complex and diffuse problems

37

What do focal psychoanalytical/psychodynamic therapies identify?

Conflicts arising from an early experience which is re-enacted in adult life

38

What does focal psychoanalytical/psychodynamic therapy use to resolve conflicts?

Relationship with therapist and pt

39

What is the purpose of analytical psychoanalytical/psychodynamic therapy?

Long term approach to re-enact and interpret unconscious conflicts underlying symptoms using the relationship with the therapist

40

What is transferance?

Unconscious redirection of feelings towards one person to another e.g. smiling at a stranger that reminds you of a friend

41

What is counter-transferance?

Emotional reaction of analyst to subject contribution

42

Who is psychoanalytical/psychodynamic therapy suitable for?

Interpersonal difficulties and personality problems
Capacity to tolerate mental/emotional pain
Interest in self-exploration

43

What does classical psychoanalytical therapy need to be effective which means it is not used routinely in the NHS?

To be daily over a prolonged period of time

44

What is systemic and family therapy?

Approach focused on relational context to address patterns is interaction and meaning to facilitate resources in the system as a whole

45

Why is family therapy used to treat children?

Treatment in isolation --> return of original behaviours once back in family environment

46

What does humanistic/client-centred therapy rely on?

General counselling skills: warmth, empathy, unconditional +ve regard to enable reflection

47

What is humanistic/client-centred therapy effective in?

Scoping with immediate crises where there is already motivation and willingness to problem solve

48

Who is humanistic/client-centred therapy suitable for?

Mild to moderate difficulties related to life events
Subclinical depression
Mild anxiety/stress
Marital/relationship difficulties

All with recent onset of

49

What problem factors should be considered when choosing a psychological therapy?

Nature
Chronicity
Severity
Complexity

50

What patient factors should be considered when choosing a psychological therapy?

Psychological mindedness
Pain tolerance
Preference for short or long term focus
Exploratory work

51

What is the -ve cognitive triad?

-ve view of self
-ve view of surrounding world
-ve view of future

52

What leads to development of the -ve cognitive triad?

Early experience --> core beliefs (may be unbalanced) --> assumptions --> critical incident activates assumptions --> -ve automatic thoughts

53

What is the rationale behind CBT?

Event/situation --> thought --> emotion
Not situations but our view of them that cause upset

54

When do anxiety systems become problematic?

Perceived danger doesn't exist

55

What causes anxiety in terms of brain function?

Unable to distinguish between physical and psychological threat so responds to false alarm

56

How does CBT treat anxiety?

Decreases avoidance
Ceases safety-seeking behaviour
Exposure --> habituation and testing with subsequent change of beliefs by real-life experiments

57

Give some examples of anxiety disorders.

Panic disorder +/- agoraphobia
Social anxiety disorder
Specific phobias
Health anxiety
OCD
BDD
PTSD
GAD

58

What are the 10 common healing factors?

Emotionally charged, confiding relationship with helpful person
Healing setting
Rationale/myth that explains symptoms and suggests way forward
Ritual/procedure requiring active therapist and pt participation
Combatting pt's sense of alienation
Inspiring pt's expectation of help
Providing new learning experiences
Arousing emotions
Enhancing sense of self-efficacy
Providing opportunities for practice

59

How does a healing setting aid healing?

Ritualistic aspect focuses on activity

60

How does providing new learning experiences aid healing?

Essentially unlearn and replace with corrected experience