Improving Access to Psychological Therapy IAPT Steve Skinner + Sean Mc Goldrick
CBT within IAPT Aims- What is CBT CBT within IAPT/What we treat How we treat
How CBT can help Cognitive Behavioural Therapy (CBT) looks at the way we feel, think and behave and how these link together. CBT has been tested and is shown to be effective in helping to balance unhelpful moods. www.sxc.hu/.../ba/ba1969/1200966_happy_cloud.jpg static-p3.fotolia.com/jpg/00/02/53/56/400_f_2...
Understanding CBT Short term therapy Focuses on here and now. Targets Thoughts +Behaviours Socratic questioning Structured Agenda setting Homework = a central feature/related to therapy outcomes.
CBT Model Thought Behaviour Feeling Body symptoms
CBT- IAPT Disorders (Mild to moderate) Depression GAD Social anxiety Specific phobia Panic disorder OCD PTSD
IAPT- Depression Sad Numb Headaches Guilty Tearful Poor libido Irritability Poor Concentration Depression Pessimis Lack of confidence Lethargy m Self Loathing Insomnia Feeling isolated Poor memory Overeating/Non appetite Thoughts that you would be better off dead or harming yourself
IAPT- GAD Generalised Anxiety Worry, not linked to any particular cause or situation. e.g. constant feelings of anxiety no matter who your with, where you are or what s going on.
Specific Phobias Distress related to particular objects or situations..
Panic Disorder Panic people often catastrophically misinterpret physical symptoms i.e. heart racing = I m having a heart attack. This can lead to a panic attack (characterised by hyperventilation, dizziness, heart palpitations). Unlike other types of anxiety problems panic disorder doesn't not require a trigger and can appear out of the blue i.e. on waking/middle of the night.
IAPT Social anxiety Distress experienced in social situations Not liking meetings/ worry about what people are thinking of you.
IAPT- OCD Unwanted thoughts and behaviours which somebody feels forced to perform. e.g. Washing their hands every time they come into contact with another person.
CBT- How we Treat? Thoughts. How do they make you feel? Nobody likes me I m hopeless I m a failure People will notice Everything always goes wrong for me I m going to get hurt The plane will crash I ll be sick
Do Thoughts cause us problems? Fortune telling Mind reading I should/ I must Thinking Errors Labelling Jumping to conclusions Catastrophising
Which distortion? This is the worst day ever blowing out of proportion =
Which distortions? Something bad is going to happen I m a failure She doesn t like me I will fail my driving test
Balanced Thinking Are thoughts facts or opinions? A Balanced Thought is one that isn't purely negative. evidence for + evidence against..
CBT- How we treat? Behaviours e.g. Avoidance Avoiding an object/situation because of the feelings, emotions and physical symptoms that occur. Avoidance maintains the cycle. Avoidance prevents us finding out thoughts are untrue or that behaviour and physical sensations can be controlled.
Treatment for avoidance: Graded exposure
Will CBT be successful? We don t JUST focus on the disorder cause. How important are maintenance factors? How important is motivation? How important is Homework?
Cause or Maintenance factors?
Maintenance factors Distorted Thought Dysfunctional Behaviour
CBT- learning/homework + Relapse Prevention Skill learning- as with every skill you will get better with practise! Using techniques Not using techniques
Which of these famous people suffered from depression Abraham Lincoln, Winston Churchill, Agatha Christie, John Lennon, Kirsten Dunst, J.K. Rowling, Bill Oddie
Question s?
Why Do We Have Anxiety? Fight or Flight www.paniccure.com/images/fight-or-flight-72.jpg
Effects of Anxiety Fight / Flight Anxiety Heart beats fast to increase blood supply to muscles. Blood diverted from non-vital processes into muscles. Breathe more quickly to increase oxygen to muscles. Tense muscles to get ready. Alert, focused attention to spot signs of danger. Increase in sweating to cool body. Anxiety side effects Palpitations. Dizziness, stomach cramps, indigestion, numbness. Hyperventilation. Aching, pins and needles in arms and legs. Hyper vigilance, chronic worrying. Poor concentration and memory. Excessive sweating.