Psychotherapies Flashcards
(35 cards)
What mental health conditions can psychotherapies be used for?
Psychotherapies can be used for a variety of psychiatric illnesses, including mild to moderate depressive illness, bipolar affective disorder, neurotic illness, schizophrenia, eating disorders and personality disorders
What is the most common psychotherapy?
The most commonly used forms of psychotherapy are cognitive behavioural therapy (CBT) and psychodynamic psychotherapy . There are many other psychotherapies derived from these.
What are the principles of psychotherapy?
What is improving access to psychological therapies (IAPT)?
Improving access to psychological therapies (IAPT) is a UK initiative developed in 2006. The aim of the project was to increase the provision of evidence-based treatments (recommended by NICE) for anxiety and depression, by primary care organisations.
What are the indications of cognitive behavioural therapy (CBT)?
Mild– moderate depressive illness, eating disorders, anxiety disorders, BPAD, substance misuse disorders, schizophrenia and other psychotic disorders as an adjunct to pharmacotherapy, as well as chronic medical conditions (such as fibromyalgia, chronic fatigue syndrome) or chronic pain.
Briefly describe the rationale of CBT
Treatment is based on the idea that the disorder is not caused by life events, but by the way the patient views these events. It is a short-term, collaborative therapy, focused on the ‘here and now’, the goals of which are symptom relief and the development of new skills to sustain recovery. Some people hold unhelpful core beliefs or ‘silent assumptions’ that they learn from early, traumatic life experiences. These people are more vulnerable to depression. When exposed to stress at a later date, these core beliefs are activated and they have negative automatic thoughts or cognitive distortions
What is the aim of CBT?
The aim of CBT is initially to help individuals to identify and challenge their automatic negative thoughts and then to modify any abnormal underlying core beliefs. The latter is important in reducing risk of relapse
What is the mode of delivery for CBT?
CBT can be delivered on an individual basis, in groups , or as self-help via books or computer programmes (including online). It is usually fairly brief (6– 20 sessions).
Briefly describe the rationale of behavioural therapies
Behavioural therapies are based on the learning theory , and particularly operant conditioning. Operant conditioning states that behaviour is reinforced if it has positive consequences for the individua and it prevents any negative consequences.
Give examples of behavioural therapies
- Relaxation training
- Systemic desensitisation
- Flooding
- Exposure and response prevention (ERP)
- Behavioural activation
Briefly describe relaxation training
This is particularly useful for those with stress-related and anxiety disorders. Here, the patient is asked to use techniques causing muscle relaxation during times of stress or anxiety. The patient also learns to put themselves in situations that they find relaxing, such as walking in the fields.
Briefly describe systemic desensitisation
This is often used for phobic anxiety disorders. In this therapy, an individual is gradually exposed to a hierarchy of anxiety-producing situations
Briefly describe flooding
Unlike systemic desensitization, flooding therapy involves the patient rapidly being exposed to the phobic object without any attempt to reduce anxiety beforehand. They are required to continue exposure until the associated anxiety diminishes. It is not a technique commonly used.
Briefly describe exposure and response prevention (ERP)
This therapy can be used for a variety of anxiety disorders but is particularly useful for OCD and phobias. Patients are repeatedly exposed to the situation which causes them anxiety (e.g. exposure to dirt) and are prevented from performing the compulsive actions which lessens that anxiety (e.g. washing their hands). After initial anxiety on exposure, the levels of anxiety gradually habituate and decline.
Briefly describe behavioural activation
This therapy is used for depressive illness. The rationale behind it is that patients avoid doing certain things as they feel they will not enjoy them or fear failure in completing them. Behavioural activation involves making realistic and achievable plans to carry out activities and then gradually increasing the amount of activity.
What are the indications of psychodynamic therapy?
Dissociative disorders, somatoform disorders, psychosexual disorders, certain personality disorders, chronic dysthymia and recurrent depression.
Briefly describe the rationale of psychodynamic therapy
It is based upon the idea that childhood experiences, past unresolved conflicts and previous relationships significantly influence an individual’s current situation. It is based on psychoanalytic principles.
What are the aims of psychodynamic therapy?
The unconscious is explored using free association (the client says whatever comes to their mind) and the therapist then interprets these statements. Conflicts and defence mechanisms (e.g. denial, projection) are explored and the client subsequently develops insight in order to change their maladaptive behaviour.
What are the 2 key therapeutic tools used in psychodynamic therapy?
Key therapeutic tools:
- Transference: the patient re-experiences the strong emotions from early important relationships, in their relationship with the therapist. When the current emotions are positive it is said to be positive transference and vice versa for negative emotions.
- Counter-transference: the therapist is affected by powerful emotions felt by the patient during therapy and reflects what the patient is feeling.
What is the mode of delivery of psychodynamic therapy?
Psychoanalysis is an intense therapy that usually involves between one and five 50-minute sessions per week, possibly for a number of years. This is a much longer duration than in CBT.
Give examples of psychotherapies
- Simple forms of psychotherpy
- Psychoeducation
- Counselling
- Supportive psychotherpy
- Problem-solving therapy
- Relatively new psychotherapies
- Interpersonal therapy (IPT)
- Eye movement desensitization and reprocessing (EMDR)
- Dialectical behavioural therapy (DBT)
- Cognitive analytic therapy (CAT)
Briefly describe psychoeducation
Psychoeducation (PE) is the delivery of information to people in order to help them understand and cope with their mental illness.
It is usual to inform the patient of:
- The name and nature of their illness;
- Likely causes of the illness, in their particular case;
- What the health services can do to help them;
- What they can do to help themselves (self-help).
PE may take place individually or in groups, and will usually take the person’s own strengths and coping strategies into account.
Briefly describe counselling
Counselling is a form of relieving distress and is undertaken by means of active dialogue between the counsellor and the client. It is less technically complicated than other forms of psychotherapy and can range from sympathetic listening to active advice on problem solving.
What are the indications of counselling?
Adjustment disorder; mild depressive illness; normal and pathological grief; childhood sexual abuse; other forms of trauma (e.g. rape, postnatal depression, pregnancy loss and stillbirth); substance misuse; chronic medical conditions; and prior to decision making, e.g. genetic testing or HIV testing.
