Week 5.2: Psychological therapies for mood disorders

Question 1

A type of therapy that focuses on changing negative thought patterns and behaviors.

Developed by Aaron Beck in the 1980s.

Answer 1

Cognitive Behavioral Therapy (CBT)

Question 2

A therapy that focuses on improving interpersonal relationships and social functioning.

Addresses interpersonal conflicts and role transitions, grief and loss, and social skills.

Answer 2

Interpersonal Therapy (IPT)

Question 3

A therapy that aims to increase engagement in positive activities to improve mood.

Pros: Simple to administer, useful for patient engagement, especially for those with disrupted daily routines.

Evidence Base: Less extensive than CBT and IPT but still effective for the right individuals.

Answer 3

Behavioral Activation

Question 4

Therapy that involves both the individual with depression and their partner, focusing on their relationship.

Systemic Tradition: Considers the wider social network and relationships surrounding the individual.

Answer 4

Behavioral Couples Therapy

Question 5

Combines mindfulness practices with cognitive therapy techniques.

Origin: Based on Jon Kabat-Zinn’s mindfulness-based stress reduction program, adapted by Zindel Segal, Mark Williams, and John Teasdale.

Answer 5

Mindfulness-Based Cognitive Therapy (MBCT)

Question 6

Focuses on unconscious processes and past experiences affecting current behavior.

One of the oldest forms of therapy, developed by Sigmund Freud.

Modern Adaptation: DIT (Dynamic Interpersonal Therapy) is a shorter form, delivered in 16 sessions.

Answer 6

Psychodynamic Therapy

Question 7

A person-centered approach that explores an individual’s circumstances to find more resourceful ways of living.

Can vary widely but generally focuses on providing support and guidance.

Answer 7

Counseling

Question 8

What are the types of depression?

Answer 8

1) Sub-threshold Depression
2) Mild-Moderate Depression
3) Moderate-Severe Depression
4) Chronic Depression
5) Treatment-Resistant Depression

Question 9

Includes symptoms like low mood and low self-esteem but does not meet the clinical threshold for a diagnosis of depression.

Answer 9

Sub-threshold Depression

Question 10

The most frequently seen form of depression.

Symptoms:
Low mood
Low self-esteem
Loss of pleasure (anhedonia)
Changes in appetite
Sleep disturbances
Difficulty making decisions
Fatigue

Answer 10

Mild-Moderate Depression

Question 11

Builds on the symptoms of mild to moderate depression but with a more severe impact on daily functioning.

Symptoms:
Intense feelings of worthlessness
Thoughts of death
Suicide plans or attempts

Answer 11

Moderate-Severe Depression

Question 12

Can vary in severity but is characterized by multiple episodes and frequent relapses.

Persistent and long-lasting, requiring ongoing management.

Answer 12

Chronic Depression

Question 13

Typically moderate to severe depression that does not improve despite trying two or more different courses of antidepressants.

Requires alternative treatment strategies due to lack of response to standard treatments.

Answer 13

Treatment-Resistant Depression

Question 14

What are the components of CBT?

Answer 14

Cognitive: Addressing and monitoring distressing thoughts and beliefs.
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Behavioral: Activity scheduling to increase engagement in reinforcing activities and reduce avoidance behaviors.

Question 15

What is involved in Functional Analysis?

Answer 15

Antecedents: What happens before a behavior.

Behaviors: The behavior itself and its function.

Consequences: What happens as a result of the behavior.

Question 16

Increasing engagement in activities that provide a sense of mastery and achievement.

Important for boosting mood and reducing avoidance behaviors.

Answer 16

Activity Scheduling

Question 17

These behaviors can maintain depression, so reducing it is a key goal in both CBT and Behavioral Activation.

Answer 17

Avoidance Behaviors

Question 18

A technique used in Behavioral Activation to understand the antecedents, behaviors, and consequences of actions, including avoidant behaviors.

Answer 18

Functional Analysis

Question 18

What are the components of MBCT?

Answer 18

Mindfulness Meditation
Psychoeducation and CBT Skills
Autopilot Mode
Decentering
Self-Compassion

Question 19

Teaches mindfulness practices to help individuals become aware of their thoughts and feelings.

Answer 19

Mindfulness Meditation

Question 20

ecaps basic CBT skills for managing depression.

Answer 20

Psychoeducation and CBT Skills

Question 21

A mental state where a person goes through their daily activities without being fully aware of their thoughts and actions. This can lead to repetitive, unhelpful thought patterns, especially in depression.

Example: Driving to work and not remembering the journey because your mind was elsewhere, or automatically thinking “I’m a failure” without questioning it.

Answer 21

Autopilot Mode

Question 22

Encourages stepping outside of automatic thought processes to respond more objectively and healthily.

Answer 22

Decentering

Question 23

What is the focus of Couples Therapy?

Answer 23

Interactions: Understands how interactions contribute to depression.

Supportive Behaviors: Increases supportive behaviors and decreases conflict-inducing behaviors.

Question 24

What are the components of Psychodynamic Therapy?

Answer 24

Transference and Countertransference Past Conflicts

Question 25

This occurs when a patient projects feelings and attitudes from past relationships onto the therapist. For example, a patient might start feeling and behaving towards the therapist as they did towards a parent or significant other. Example: A patient who had a critical parent might perceive the therapist as critical, even if the therapist is supportive, and react defensively.

Answer 25

Transference

Question 25

This occurs when the therapist projects their own feelings and attitudes onto the patient. It can be a reaction to the patient's transference or arise from the therapist's own personal history. Example: A therapist who had a nurturing relationship with their own child might feel overly protective towards a patient who reminds them of their child.

Answer 25

Countertransference

Question 26

What are the factors to consider in choosing the appropriate therapy for patients?

Answer 26

1) Effectiveness (short and long-term) 2) Type of depression (suitability and severity) 3) Availability (local resources and waiting lists) 4) Duration and trajectory of symptoms (previous episodes) 5) Previous treatment/diagnosis 6) Adherence and potential adverse effects 7) Treatment preferences and priorities (patient and therapist) 8) Risk management

Question 26

Helps clinicians choose the best therapies based on research and economic considerations. Covers both physical and mental health disorders.

Answer 26

NICE (National Institute of Care/Clinical Excellence) Guidelines

Question 27

Patients use evidence-based materials with limited therapist support.

Answer 27

Guided Self-Help

Question 27

Are treatments for mild to moderate depression that require less time and resources compared to high-intensity interventions.

Answer 27

Low-intensity Interventions

Question 28

What are the main types of low-intensity interventions?

Answer 28

Guided Self-Help Computerized CBT Group CBT

Question 29

Delivered via DVD or the internet with limited therapist support.

Answer 29

Computerized CBT

Question 30

Focuses on teaching techniques and coping strategies in a group setting.

Answer 30

Group CBT

Question 31

Is a form of Cognitive Behavioral Therapy (CBT) where the therapy sessions are conducted one-on-one between the therapist and the patient. This personalized approach allows the therapist to tailor the treatment specifically to the individual's needs, focusing on their unique thoughts, behaviors, and experiences.

Answer 31

Individual CBT