Flashcards in HPHD Stress, Coping and Psychological Therapies Deck (20):
What are the differences between the biomedical and the biopsychosocial models?
The biomedical model doesnt take into account and psychological or social factors - illness understood in terms of biological processed and treatment is physical interventions eg drugs, surgery and
The biopsychosocial model recognises the importance of behaviour, emotions and social support in the treatment of medical conditions, and that they are all interlinked.
What are the physiological responses to stress?
Activates fight or flight via the action of catecholamines (adrenaline and noradrenaline).
A certain level of stress is needed for productivity however a long term stress response is damaging - leads to resistance and exhaustion (unable to maintain body functions)
What is the transactional model of stress?
Describes how we weigh up our resources to our stressors.
The demands/stressors may include daily hassles, life events, chronic stressors
The resources to cope with these stressors may include personality, coping skills, social support.
If we think our demands are greater than our resources to cope with them, this leads to a stress response.
How does stress negatively impact on health?
- acute stress = hypertension
- increases risk of having an MI
- more likely to have common cold
- rumination (dwelling on negative thoughts)
- cognitive distortions eg overgeneralising, catastrophising
- low motivation
- anxiety and depression
- coping mechanisms can increase unhealthy behaviour eg smoking
Describe the main differences between emotion focussed and problem focussed coping?
Emotion focusses coping relies on changing the emotion eg distracting by talking to friends, alcohol
or changing cognitive approach eg denial there is a problem
Problem focussed coping involves changing the problem or the resources you have to deal with it.
eg reducing the demands of a stressful situation by finding a way to cope with feelings or expanding resources eg social network, assistive equipment
What are some ways to aid coping?
- recognising and increasing social support eg patient groups, community resources
- increasing personal control eg pain management, involve pts in care planning, CBT
- preparing for stressful events to reduce uncertainty eg via effective communication, be responsive to individual preferences
Why are patients with chronic health problems at increased risk of mental health problems?
Anxiety and depression 2-3x more common in people with chronic or life threatening illness.
- have emotional response to diagnosis
- have physical impact eg limited mobility
- treatment may give them anxiety or discomfort
- may be hospitalised and therefore loss of autonomy and privacy, removal of support network
What is anxiety?
A response to a threat. It mains function is to protect - however problems arise when the perceived danger doesnt exist eg its a psychological threat.
May inc feelings of panic or dread which when sustained can lead to unhelpful thinking patterns eg interpreting ambiguous info as threatening
What is depression?
A response to loss, failure or helplessness eg loss of identity, loss of physical capacity, neg experiences of illness
Characterised by persistent low mood, sadness, loss of interest, feelings of worthlessness
Co-morbid depression can exacerbate pain and distress associated with other physical health problems
What are some of the barriers to recognising psychological problems in patients?
- symptoms can be missed eg can be attributed to condition or treatment
- patients may not disclose symptoms eg want to avoid stigma, fear of judgement, embarrassed, fear of treatments
- health care professionals may avoid asking because they dont want to label people, have time constraints, feel it is out of their role
What are the different types of psychological therapies?
(Type A, B, C)
Type A: psychological treatment as an integral part of mental health care, not labelled as having therapy eg general support and guidance
Type B: eclectic psychological therapy and counselling eg utilising multiple therapies
Type C: formal pscyhotherapies eg CBT
What is CBT?
Cognitive behavioural therapy - a combination of concepts from cognitive therapy and behavioural therapy. Acts to relieve symptoms by changing maladaptive thoughts, feelings and behaviours.
It is not the situations that upset us, but the view we take of them
Give some examples of behavioural and cognitive techniques used in CBT
- graded exposure to feared situations (put you in contact with fear to make anxiety better)
- activity scheduling, good for depression
- examining and challenging neg thoughts
- rehearsal of coping with difficult situations
- monitoring of thoughts, feelings and behaviours to develop awareness of connections
What conditions is CBT good for?
- anxiety states - reduces avoidance, cease of safety seeking behaviours, EXPOSURE, test beliefs
- eating disorders especially bulimia
- sexual dysfunction
- can be used as adjunctive treatment with anti-psychotic medication for psychotic symptoms
Outline the NICE guidelines for treatment of anxiety and depression
Step 1: Recognition of problem
Active monitoring, referral, education an advice about sleep
Step 2: Low intensity intervention
Guided self help based on CBT, structured physical activity
Step 3: High intensity intervention
CBT, counselling, medication
Who is CBT good for?
Patients keen to be active participants who are practically seeking solutions.
They need to engage and complete diaries and homework tasks
Accept they have to face some of their fearful situations
List the different types of therapies used within the NHS
- psychodynamic therapies
- systemic and family therapies
What are psychodynamic therapies and who would they be useful for?
Can be focal (identify conflicts arising from early experience which are re-enacted in adult life) and analytic (interpreting unconscious conflicts with therapist)
Relies on the relationship with the therapist
Suitable for interpersonal difficulties and personality problems. Need to have the capacity to tolerate emotional pain
What are systemic and family therapies and who are they suitable for?
They address patterns of interaction and meaning and act to facilitate resources within the system as a whole eg a family.
Used particularly in child psychiatry, and can be used in couples as well