Low Intensity Treatments For Common Mental Health Problems (P_BKPSIN)
Institution
Vrije Universiteit Amsterdam (VU)
This document contains over 100 practice questions for the elective Low Intensity Treatments of the third year of psychology. The questions are open-ended and the answers are explained extensively. All questions are based on the literature and lectures.
,Questions
Week 1
1. What is LICBT?
Low intensity cognitive behavioural therapy (LICBT) is a form of cognitive-behavioural
therapy (CBT) suitable for treating mild to moderate common mental problems.
Recently, it has also been increasingly used to help clients with long-term physical
complaints.
2. What is psychoanalytic psychotherapy?
A form of therapy in which unconscious conflicts are tackled. These conflicts arise from
the different needs of the id, ego, and superego. The id consists of basic impulses and
drives, such as eating and sexual behaviour. The superego is the conscience and consists
of norms and values that are taught by society. The ego acts as a manager in between by
finding a compromise between the needs of the id, the superego, and the outside world.
The ego pushes conflicts between the id and superego into the unconscious when the
conflicts spiral out of control. This can lead to psychological complaints. A
psychoanalyst helps clients by making them aware of unconscious conflicts.
Psychoanalytic techniques include free association and dream analysis.
3. How is CBT related to psychoanalytic psychotherapy?
Aaron Beck was originally a psychoanalyst. During free association sessions, he found
that his clients often worried about what he thought of them. He found out that people
with depressive symptoms suffered just as much from this in daily life and that these
thoughts were often irrational. He called these thoughts negative automatic thoughts.
By asking clients certain questions (e.g., 'what is the evidence for…') he tried to correct
these thoughts. The depressive symptoms quickly improved as Beck's clients learned to
gain an alternative perspective on their negative automatic thoughts.
4. How is CBT related to behaviourism?
Pavlov and Skinner came up with classical and operant conditioning. Certain mental
problems can also be learned. For example, a specific phobia may have arisen through
classical conditioning and be maintained through operant conditioning. Deconditioning
(systematic desensitization) can therefore be used in the treatment of a specific phobia.
5. Beck's cognitive approach and Pavlov's and Skinner's behavioural theory approach come
together to form CBT. What are three major differences between the psychoanalytic approach
(which Beck started with) and CBT?
• While psychoanalytic psychotherapy mainly focuses on the client's past, CBT
focuses on the present (how complaints are maintained).
• Another major difference with the psychoanalytic approach is that CBT is
operationalized fairly precisely. This ensures that care providers can perform
CBT in the same way.
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, • In addition, the collaboration between the client and care provider is important
in CBT. For example, the care provider shares information about CBT and the
client shares information about the complaints. The counsellor sets goals
together with the client. The counsellor does not give suggestions or instruct.
Instead, the counsellor asks specific questions that help the client gain insight
into possible solutions.
6. LICBT stems from traditional, or high intensity, cognitive behavioural therapy (HICBT).
What are the similarities?
Like HICBT, LICBT is focused on the present, LICBT is clearly structured and LICBT
is characterized by a collaboration between client and counsellor.
7. LICBT stems from traditional, or high intensity, cognitive behavioural therapy (HICBT).
What are the differences?
One major difference is that LICBT usually consists of just six to eight sessions, each
lasting about 30 minutes. LICBT can also be offered in groups. In addition, LICBT uses
self-help material and digital programs. Finally, LICBT is specifically intended for
people who are in the early development of psychological complaints. By offering these
people LICBT, the problems don't develop further.
8. Psychological help must be offered from a stepped care approach. What does this mean?
This means that the mildest form of help is first tried out before looking at more
intensive forms of help. For example, a client can be offered LICBT and if this does not
work, HICBT is offered.
9. What is a matched care approach?
In a matched care approach, an attempt is made to directly 'match' a client to a certain
level of care.
10. What is IAPT?
The accessibility of psychological help is an important point for attention. In the United
Kingdom, the Improving Access to Psychological Therapies (IAPT) service is set up.
This service makes it easy for people in the UK to get help for common psychological
complaints. This help consists of approximately five sessions. A new profession has also
emerged from this; the Psychological Wellbeing Practitioner (PWP). This care provider
mainly offers LICBT.
11. Not everyone responds equally well to therapy. However, several client characteristics
predict a good outcome. These characteristics include being able to recognize the problems,
being motivated to carry out therapeutic assignments independently and having a stable
enough life to be able to focus on a main problem. It is important to notice these features
early on. Why is this important?
Failed treatment often has negative consequences for the client's mental health.
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, 12. What did self-help books look like in the past?
In the past, these were fictional books where the reader would have to identify with the
main character. Based on this, the reader would then adjust their thoughts, feelings and
behaviours.
13. What do self-help books look like today?
Today, self-help books are more like interactive therapy manuals. The intention here is
that the reader implements the therapy himself. Self-help books are standardized and
generally contain information, case studies and worksheets.
14. What are the benefits of self-help books?
A major advantage of self-help books is their flexibility. Clients can read the book
whenever they want and can always read parts again. In addition, the use of self-help
books shows clients their own strengths, as clients themselves bring about change.
Finally, it is nice for clients that they can receive cheap remote help in this way.
15. What is known about the effectiveness of self-help books?
In general, the use of self-help books is effective (for anxiety disorders, depression and
obsessive-compulsive disorders, but also for long-term physical complaints). The
greatest effect is achieved in people from a non-clinical population, with the guidance of
a psychologist and when the material is based on CBT.
16. What is CCBT?
Computerized cognitive behavioural therapy. CCBT usually consists of various
interactive media, such as videos and online diaries. The program usually consists of six
to eight sessions that would be offered weekly in regular CBT. CCBT has the same
benefits as self-help books and also appears to be effective in treating depression and
anxiety disorders.
17. What are the two disadvantages of self-help? And what solutions are available for this?
The risks associated with the use of self-help are reduced by allowing the care provider
to choose which equipment to use. This is because the care provider can continue to
monitor the client (remotely) and because the client does not have to self-diagnose and
does not have to search for material that fits the diagnosis. Clients are more likely to
misdiagnose themselves and will have difficulty assessing the quality of the material.
Furthermore, guidance with self-help is important to complete the self-help program.
Terminating these types of programs early can actually make the complaints worse.
18. What nine factors contribute to the progress of clients in group therapy?
• Hope. Clients see the progress of their group mates.
• Recognition. Clients see others with similar problems.
• Information. Clients share information and advice.
• Altruism. Clients help each other.
• Interpersonal learning. Clients learn to recognize and change dysfunctional
relationships with others.
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