2388433
Descrição
FlashCards por Anna Walker, atualizado more than 1 year ago
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Criado por Anna Walker
mais de 9 anos atrás
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| Questão | Responda |
| What is psychoeducation? | Simply the education of patients (+/- carers) of the nature of their illness, the likely causes of their illness, what health services can do to help them, and what they can do to help themselves. It is closely related to several "core psychological techniques";the provision of info, explanation and advice, active endorsement, encouragement and facilitation of self-help. Often involves bibliotherapy and is often considered to be the first level of stepped care. |
| Describe a stepped approach to psychological care. | Most pts will start with level 1 treatment (simple, cheap, quite keen to provide) and if it fails will move to level 2 etc. Treatment algorithms may dictate that a pt misses out 1 or more levels based on a clear clinical need. LEVEL ONE: Basic info about disorder and self-help approaches - booklets, books or Internet (minimal input from professionals). LEVEL TWO: May involve group treatment or supported computerised delivery or a psychological treatment. LEVEL THREE: May involve individual treatment, that is face to face and one to one. Finally, there may be a further level, for the very few treatment-resistant pts who need specialist or particularly intensive treatments. |
| Describe the different types of formal psychological treatments | These are discrete psychological interventions which are separate to routine clinical care and for which pts would usually be referred to another healthcare professional, such as a clinical psychologist or specialist nurse. They include PROBLEM SOLVING TREATMENT, which is useful for pts with adjustment disorders, depression and deliberate self-harm, BEHAVIOURAL and COGNITIVE THERAPIES, which are used to alter patterns of behaviour and thinking that predispose to certain psychiatric disorders, which can prevent recovery from those disorders. These can be combined to form a common psychological treatment known as CBT. DYNAMIC PSYCHOTHERAPY enables pts to recognise unconscious determinants of their behaviour and thereby gain more control over it. GROUP TREATMENT are used either as a 1st step in psychological treatment or when the group nature of the intervention may be particularly helpful, such as in personality disorders. COUPLE and FAMILY TREATMENTS are used when the core problem appears to be related to the couple's relationship or family interactions. |
| Describe how a problem-solving approach might work. | Aim is to help pts to solve stressful problems and to make changes in their lives. Problem solving is used as the main treatment for acute reactions to stress and for adjustment disorders, and as an add-on to other treatments for psychiatric disorders in which associated life problems need to be resolved. Useful for problems requiring: a decision (eg whether a pregnancy is to be terminated or an unhappy marriage brought to an end), adjustment to new circumstances (eg bereavement or the discovery of terminal illness, or a big move) and change from an unsatisfactory way of life to a healthier one (eg as part of treatment for dependence on alcohol or drugs). Pts are encouraged to identify their problems and options themselves. |
| What does it mean if a pt is in crisis and what are the aims and techniques of crisis intervention? | Pts are said to be in crisis when overwhelmed by stressful events or adverse circumstances: those who have harmed themselves, victims of physical or sexual assault and people involved in natural or man-made disasters. These patients are highly aroused and usually require some additional help toto calm down before they can concentrate effectively on problem solving. Crisis intervention is prompt, brief and goal-directed. The risk of suicide and self-harming should be assessed at each meeting. The therapist encourages the patient to express their distress within a supportive setting. |
| List the different strategies used in Behavioural Therapy. | Distraction. Relaxation training. Graded exposure (particularly for phobias). Response prevention (for obsessional rituals). Thought stopping (for obsessional thoughts with no associated rituals - at first a distracting stimulus is used until patients are able to do it without a stimulus). Assertiveness training (for those who are abnormally shy). Self-control techniques (eg for excessive eating or smoking. Two stages - self monitoring of the behaviour, then self-reinforcement; or rewarding oneself when a goal is achieved). Contingency management (used to control abnormal behaviour that is reinforced unwittingly by others - eg parents who attend more to a child who has temper tantrums. Aims to instead ignore the undesirable behaviour and reward desirable behaviour). |
| List the different strategies used in Cognitive Therapy. | Proceeds through 4 stages: 1. Identifying maladaptive thinking - ask patients to keep a diary called a 'dysfunctional thought record'. 2. Challenging the maladaptive thinking by correcting misunderstandings with accurate information and pointing out illogical ways of reasoning. 3. Devise more realistic alternatives to the maladaptive thinking. 4. Test out these alternatives. |
| What kind of problems are commonly treated with CBT? | Anxiety management. Panic disorder (where the patient is convinced that some of the physical symptoms are not caused by anxiety but are due to a serious illness, leading to further anxiety). Depressive disorder. |
| What is dynamic psychotherapy? | The focus of this therapy is on aspects of the problem and of the self that the patient was previously unaware of (unconscious aspects). May be brief and only focused on a few specific problems - 'brief focal dynamic psychotherapy' - or long term and dealing with a broader range of problems - 'long-term dynamic psycotherapy'. |
| What kind of patients could be referred for brief focal dynamic psychotherapy? What are the potential concerns? | Main indications are problems of low self-esteem and difficulties in forming relationships, either of which may be accompanied by emotional disorders, eating disorders or sexual disorders. Patients need to be insightful and willing to consider links between their present difficulties and events at earlier stages of their lives. This kind of therapy tends to give rise to intense emotional relationships between the patient and therapist (transference). It is important to reduce this intensity before the planned end of treatment, otherwise patients are left in a dependent state, making it difficult to end the therapy. |
| What kind of patients could be referred for long-term dynamic psychotherapy? | This therapy aims to change long-standing patterns of thinking and behaviour that contribute to personal and relationship problems and may be associated with psychiatric disorder. Includes free association, recall of dreams and discussion of their meaning and interpretation of transference, used here as a model of the patient's relationship with their parents. These methods are seldom used, however. |
| What is a therapeutic community? | This uses group methods not just for support but also to modify personality. Patients reside in the community for many months, living and working together, and attending small and large groups in which they discuss problems in relationships and try to help each other to recognise and resolve their problems. Has been used mainly for personality disorders characterised by aggressive or antisocial behaviour. |
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