Therapy Flashcards
(50 cards)
Maudsley model for anorexia
Phase 1
Focus on refeeding to reduce risk of death and health damage
Initial family meal with therapist. Parents asked to get child to eat one more mouthful than they want to
Therapist interrupt any parental structure that erode parental authority, inconsistency, relying on siblings
Review shopping
Systematic approach/therapy
It sees any social group as a “system”
Each and every person’s behaviour affects others
It looks for:conflict, coalitions, codependency, split
No objective truth, everyone’s interpretation affects their role in the system
Maudsley mode for anorexia
Phase 2
Negotiating a new relationship
Shift focus on refeeding to on family relationship
Negotiate to allow adolescent to have responsibility for eating
Peer relationship and sexuality explored in relationship to food
Maudsley model for anorexia
Phase 3
Adolescent issues and finish
Continue focus on adolescent social world
Counselling and psychotherapy
An interactive client beneficial relationship set up to approach a client issues. These issues can be social, cultural, and emotional. A client can be a person, or a family group, or an institution
Counselling psychology aims to work with clients to examine mental health issue and explore the underlying problems that may have caused them
Clinical psychology
Aims to reduce psychological distress and to enhance and promote psychological wellbeing
They deal with mental and physical health problems including anxiety, depression, addition
Carl Rogers therapy
Therapist (congruence)
Client (incongruence)
Unconditional positive regard
Empathic understanding of client’s internal world
Therapist use clarification and reflection
Historical perspective of therapy
- Freudian psychoanalysis (unconscious)
- Skinner behaviourism (conditioning)
- Rogers person-centred
- Cognitive therapy
- Beck CBT
3 different schools in NHS
- Psychoanalytic
- Systematic
- Cognitive behavioural
4: overall of these 3–person centered therapy
The Dodo effect
States that different therapies are all generally equally as effective and cannot be judged in the same way that medical treatment are
It is the therapeutic alliance that is the key to a successful therapy
More than just the content of a therapy is important when considering whether it will work
Key feature;
- therapist factor (how experienced the therapist are)
- therapy factor (how the boundary)
- client factor (what he believes)
== therapy efficacy ( it’s not about which school is better than other)
Evidence based practice
Theoretical research –> professional consensus –> clinical guideline + clinical judgement (at the time of therapy) = clinical practise
Practice based evidence = efficacy of use of a certain therapy
Who does therapy
Clinical psychology Counselling psychologist Psychiatrist Counsellor CBT therapist/ family therapist IAPT low intensity therapist Mental health workers Nurse therapist
Formulation in psychological therapy
Explanation of current difficulty accusing go specific psychological theory
- to help patient understand their difficulties in a psychological way
- to structure information in a theoretically guided way
- to provide a working hypothesis to guide psychological intervention
Psychoanalytic psychotherapy
Explore of the cause of distress by seeking to understand unconscious process that lead to internal conflict and anxiety
Target: Unconscious process & internal conflict –>anxiety
Therapist interpret client’s internal world in relation to past
Therapist as expert making interpretation on client’s situation
Need to be able to cope with anxiety
Behavioural therapy
Identification of problem behaviour and changing environment/ trigger to replace behaviour with healthier one
Has structured sessions
Target: problem behaviour
Therapy: learning theory and animal studies
Analyze problem behaviour and alter behaviour
Good for learning disabilities, depression substance misuse
Cognitive behaviour therapy
Identification of thinking patterns that keep problem behaviour going. Testing out new ways of thinking and behaviour to change these cycles
Targets: situation ->thoughts-> feelings-> behaviour
Theory: information processing model: change thinking to change feeling
Structure; structured session toward goals, behavioural experiment and skill learning
Views therapeutic relationship as test ground for new skills and behaviours
Client and therapist as collaborators working toward a common goal
Good for particular identifiable problem
Systematic therapy
Understand problem in a context and focus on shifting dynamics in relationships to improve problem
Target: observable interaction within a system
Theory; problem fundamentally interpersonal, not situated in person
Structure; reflecting teams, communication pattern
Looking from another perspective
Often more than one therapist
Person centred therapy
Humanists therapy focus on self-development, growth and responsibilities. They seek to help individual recognize their strength, creativity and choice in the “here and now”
Target; person growth rather than pathology
Theory; 3rd wave in psychology development. Emphasis in subjective meaning
Structure: helping people to fulfil their own inherent “self-actualizing tendencies”
See the client as the driving force for change
Good for working toward better quality of life
-dementia
3rd wave cognitive Behavioural therapy
Target: thinking process vs thought content (how they think rather than what they think)
Theory: 3rd major development in CBT
Structure; focus on relationship with thoughts vs arguing with content.
Use or exercise, de-centring, mindfulness
Good for working toward better quality of life ( not specific problem focus)
Psychodynamic therapy
Allows the client to explore why a difficulty might have developed
Cultural formation approach in acute psychiatry
The difference from exciting DSM IV CF
Capture cultural identity in different way
For all ethnic group, not exclusively for minority ethnic group
A clinical interactive use of the CF, narratives from CF interview are circulated both to patient and carers, to the clinical team; and developed further as well as integrated into clinical care
Evidence of CF
1)cultural formation interviews have some clinical efficacy: improved both assessment and rapport with patients
2) complexity of setting, sample size
3) did not improve outcome or patient satisfaction score
What is cultural formulation in acute psychiatry ?
An approach that involve a sustained and continuing cultural dialogue between patient and clinician
A method that seeks to enhance therapeutic engagement and enrich clinical assessment for patients of all cultural backgrounds
Aimed at eliciting a structured narrative account of suffering, deploying the metaphor of “culture”
Allows patient an opportunity to systematically narrate their suffering in their own cultural vocabulary
Enable clinician to reflect how their own cultural identity might influence engagement, assessment, diagnosis and treatment
Actualize patient’s concept of culture, not clinician’s assumption of culture
Requires innovation in individual settings to be determined by local context, problem, and desired outcome
Cultural formulation is NOT
Not a technical fix
Does not yield a score or generate psychometric score
Not a one off interview that can solve the problem of “culture”
Not a diagnostic instrument it a standardized interview to be cloned
Does not replace a diagnosis and treatment plan, but enhances it
Not for exclusive use with Black and Minority Ethnic patient
