Clinical Psychology-Introduction__and_Overview zz

jefflee

[size=24b]　　　　　　　　INTRODUCTION　TO
　　　　　　　CLINICAL PSYCHOLOGY
　　　　　　　　　Lecture one[/i:ad81b04f1b][/sizeb]

[size=18b]　　　　　　?　?For copyright issues, please do not
　　　　　　?　?e this for purposes other than a
　　　　　　?　?ading material, many thx, Jung[/sizeb]

jefflee

　　　　　Aims[/size:3b3881cdb8]

[size=188]• Overview of main psychological disorders
(Mental Health Problems)
• Understanding of causes from a
psychological perspective
• Introduction to psychological therapies[/size8]

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[listf]
3[/size:d5e893c32f]
Commonly asked questions[/size:d5e893c32f]

[size=22:d5e893c32f] Why did you get into it? [/sizef]
(accusing)[/size:d5e893c32f]

[size=22:d5e893c32f] can you read MY mind? [/sizef]
(defensive, and [/size:d5e893c32f]
egocentric)[/size:d5e893c32f]

[size=22:d5e893c32f] It MUST be miserable? [/sizef]
(judgmental)[/size:d5e893c32f]

[size=22:d5e893c32f] Is it different to psychiatry? [/sizef]
(engaging?)[/size:d5e893c32f]

[size=22:d5e893c32f] …..any other?[/sizef]

Clinical Psychology[/size:d5e893c32f]

[size=19:d5e893c32f] Deals with disorders in which there are a mix of [/sizef]
emotional, cognitive and behavioural issues[/size:d5e893c32f]

[size=19:d5e893c32f] Aims to provide an understanding of:[/sizef]
– Causes of MHP[/size:d5e893c32f]
– the features and symptoms[/size:d5e893c32f]
– The prevalence of MHP [/size:d5e893c32f]
– Treatment approaches[/size:d5e893c32f]
[/list:d5e893c32f]

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[listb]
4[/size:e5eef50feb]
Clinical Psychology[/size:e5eef50feb]

[size=22:e5eef50feb] Services provided in:[/sizeb]
– Adult Mental Health[/size:e5eef50feb]
– Child & Adolescent[/size:e5eef50feb]
– Learning Disability[/size:e5eef50feb]
– Older Adults[/size:e5eef50feb]
– Neuropsychology[/size:e5eef50feb]
– Forensic[/size:e5eef50feb]
– Physical Health[/size:e5eef50feb]

Scale of mental health problems (MHP)[/size:e5eef50feb]

[size=19:e5eef50feb] WHO survey of 25,000 people in 14 countries:[/sizeb]

[size=16:e5eef50feb] 25% had a MHP, e.g.[/sizeb]
– 10% had depression[/size:e5eef50feb]
– 8% an anxiety disorder[/size:e5eef50feb]
– 3% had harmful use of alcohol[/size:e5eef50feb]
[/list:e5eef50feb]

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[lista]
5[/size:4085d3407a]
Scale of MHP (2) [/size:4085d3407a]

[size=19:4085d3407a] In the UK[/sizea]
– 20% of all adults at any one time have some mental [/size:4085d3407a]
health problem (MHP)[/size:4085d3407a]
– 55% of all adults will, at some point, be clinically[/size:4085d3407a]
depressed[/size:4085d3407a]
– 3-6% of all adults will have important symptoms of [/size:4085d3407a]
anxiety [/size:4085d3407a]
– 1% lifetime risk of schizophrenia[/size:4085d3407a]
– 2-3% of population have a major drug dependence [/size:4085d3407a]
– 1% of adolescent women have significant Anorexia[/size:4085d3407a]

Scale of MHP (3)[/size:4085d3407a]

[size=16:4085d3407a] 40% of all consultations with GP's are to do with a MHP[/sizea]

[size=16:4085d3407a] 5% of all deaths (under75 years) are due to suicide – 5,000 [/sizea]
annually in UK[/size:4085d3407a]

[size=16:4085d3407a] Suicide a major cause of death in group 15 to 25 age[/sizea]

[size=16:4085d3407a] symptoms such as poor sleep, fatigue and worry affect half [/sizea]
[size=16:4085d3407a]the population at any one time and does not necessarily [/i:4085d3407a]
lead to  a MHP ("…wishing you good mental health")[/size:4085d3407a]
[/list:4085d3407a]

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[listc]
6[/size:3cb289160c]
Clinical Psychology: [/size:3cb289160c]
Interventions[/size:3cb289160c]
– What kind of treatment works for what kinds of [/size:3cb289160c]
problems for what kinds of people, when, why and how[/size:3cb289160c]
– Does depression last a lifetime or can it be treated by a [/size:3cb289160c]
"talking therapy", a drug, or both?[/size:3cb289160c]
– does family therapy rather than individual counselling [/size:3cb289160c]
help someone be recover from symptoms of bulimia?[/size:3cb289160c]
– Could early parenting style affect adolescent offending  [/size:3cb289160c]
behaviour? could this be changed by parental counselling?[/size:3cb289160c]
– the answers  might be complex, but there is evidence that [/size:3cb289160c]
[size=13:3cb289160c]interventions work[/i:3cb289160c]

Referral letter[/size:3cb289160c]

[size=17:3cb289160c] "CB is a very pleasant young man. He suffered a [/sizec]
severe head injury on **/97. He also suffered [/size:3cb289160c]
orthopaedic injuries to his legs. His recovery has [/size:3cb289160c]
[size=19:3cb289160c]been remarkable. He is now fully mobile. His IQ [/i:3cb289160c]
is unaffected. However, his memory for current [/size:3cb289160c]
events and past life appears limited. He has taken [/size:3cb289160c]
to staying at home, barely socialises, and seems to [/size:3cb289160c]
need to check locks, cookers etc. before leaving [/size:3cb289160c]
the house…I believe some psychological [/size:3cb289160c]
intervention of some form may be helpful…"[/size:3cb289160c]
– Consultant Neurologist Dr Redwood[/size:3cb289160c]
[/list:3cb289160c]

jefflee

全贴上算了 sigh 不知道有人看没有。。

jefflee

[list1]
7[/size:d4a9810361]
[size=23:d4a9810361]Case illustration: CB Assessment[/b:d4a9810361]

[size=14:d4a9810361] Pre-injury :  Systems analyst[/size1]

[size=14:d4a9810361] Traumatic Brain Injury in a road accident (RTA) aged 23[/size1]

[size=14:d4a9810361] Coma 4 weeks[/size1]

[size=14:d4a9810361] Cognitive function (thinking, reasoning etc.) fine[/size1]

[size=14:d4a9810361] Dense retrograde amnesia[/size1]
– I.e. limited memory for [/size:d4a9810361]
[list1]

[size=14:d4a9810361] People, even relatives[/size1]

[size=14:d4a9810361] events from childhood through to the accident[/size1]

[size=14:d4a9810361] own likes or dislikes (but for Man.Utd)[/size1]
[/list:d4a9810361]

[size=14:d4a9810361] Poor anterograde memory (everyday events since the accident)[/size1]

[size=26:d4a9810361]CD: Self-report of symptoms[/b:d4a9810361]

[size=13:d4a9810361] did not "trust" himself to remember activities[/size1]

[size=13:d4a9810361] limited daily routine ("game boy thumb")[/size1]

[size=13:d4a9810361] occasional visits to a local shop but will check and re-check the house [/size1]
before going[/size:d4a9810361]
– Cooker "off", back door & front door "locked" (up to 20 times)[/size:d4a9810361]
– tolerated  20 minute visit to a pub once  a week to socialise [/size:d4a9810361]
　　　　– embarrassed  "don't know if I lent John something, might ask Steve for it [/size:d4a9810361]
　　　　back…"[/size:d4a9810361]
　　　　– "checked himself" for personal possessions "constantly"[/size:d4a9810361]

[size=16:d4a9810361] Poor sleep, appetite down, pessimistic, suicidal thoughts[/size1]

[size=16:d4a9810361] Family very worried as CB getting ++ withdrawn & [/size1]
depressed[/size:d4a9810361]
[/list:d4a9810361]

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slide 8 a

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[list6]
[size=23:848e30c916]CB: emotional issues "underlying"[/b:848e30c916]
[size=23:848e30c916]obsessive behaviour[/b:848e30c916]

[size=16:848e30c916] Attention & Memory:[/size6]
– checking to "keep order" that he did what he thought he had[/size:848e30c916]
? compensatory behaviour for cognitive deficits[/size:848e30c916]

[size=16:848e30c916] Loss of self- control/ fear[/size6]
? checking a means of re-asserting sense of control[/size:848e30c916]

[size=16:848e30c916] Issues re: self-image[/size6]
– said he "looked a mess" after his accident. Friends had said that he [/size:848e30c916]
was good looking now, but he was "stuck" in a poor self image[/size:848e30c916]
? routines/checking "saves" from having to be with others[/size:848e30c916]
[/list:848e30c916]

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9[/size:fa48ddf34d]
[size=29:fa48ddf34d]CB: Interventions[/b:fa48ddf34d][listd]

[size=16:fa48ddf34d] Individual and Group therapy  (neuro and CBT)[/sized]

[size=13:fa48ddf34d] Palm-top organiser for long term & prospective (future) memory[/sized]
– E.g. to meet friends at pub[/size:fa48ddf34d]

[size=13:fa48ddf34d] Voice organiser for working memory[/sized]
– E.g. "Dave said to meet at gym tomorrow"[/size:fa48ddf34d][/list:fa48ddf34d][listd]

[size=13:fa48ddf34d] breathing/tense-relax  exercises for general anxiety[/sized]

[size=13:fa48ddf34d] Attention training & CBT for managing worries[/sized]

[size=13:fa48ddf34d] hierarchical goals for graded exposure to:[/sized]
– social activities[/size:fa48ddf34d]
– community mobility[/size:fa48ddf34d]
– physical activities[/size:fa48ddf34d]

[size=24:fa48ddf34d]CB: working through a hierarchy[/b:fa48ddf34d]

[size=12:fa48ddf34d]1 Making a call to a friend[list:fa48ddf34d]

[size=12:fa48ddf34d] friends  only  "putting  up" with [/sized]
me[/size:fa48ddf34d]

[size=12:fa48ddf34d] won't    remember  what  talked [/sized]
about[/size:fa48ddf34d][/list:fa48ddf34d][listd]
2 Meeting  friends in a pub[/size:fa48ddf34d]

[size=12:fa48ddf34d] leaving house [/sized]

[size=12:fa48ddf34d] Unable to keep track of [/sized]
belongings/conversation[/size:fa48ddf34d][/list:fa48ddf34d][listd]
3 Going to a club with friends[/size:fa48ddf34d]

[size=12:fa48ddf34d] too many people/pushing [/sized]

[size=12:fa48ddf34d] losing friends and not getting [/sized]
self home[/size:fa48ddf34d][/list:fa48ddf34d]

[size=13:fa48ddf34d] General Strategies:[/sized]
　　　Check evidence (negative "voice")[/size:fa48ddf34d]
　　　list chat items (check f-fax)[/size:fa48ddf34d]
　　　pad for notes [/size:fa48ddf34d]
　　　who-what-when-where[/size:fa48ddf34d]
　　　breathing exercises[/size:fa48ddf34d]
　　　listen to door "click"[/size:fa48ddf34d]
　　　visualise belongings at home[/size:fa48ddf34d]
　　　find quiet area[/size:fa48ddf34d]
　　　check breathing[/size:fa48ddf34d]
　　　visualise belongings at home[/size:fa48ddf34d]
　　　picture where things are [/size:fa48ddf34d]
　　　make "leaving" arrangements[/size:fa48ddf34d]
[/list:fa48ddf34d]

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slides 10

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slides 11 a

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[listb]
CB: Outcome[/size:b5e33d624b]

"I've had my life back…I spent all the time since the [/size:b5e33d624b]
accident at home watching TV..afraid that if I do [/size:b5e33d624b]
something I'd look foolish… [now] every weekend, [/sizeb]
[I'm with] friends…using [memory and anxiety [/sizeb]
management] strategies... that was confusing for a [/sizeb]
while but over time you get used to the new habits, [/size:b5e33d624b]
and what technique to use where and when, and you [/size:b5e33d624b]
get to trust [yourself]..and get confident..[but] you've [/sizeb]
got to watch for that vicious cycle of withdrawal.."[/size:b5e33d624b]
[/list:b5e33d624b]

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12[/size:9392bae462]
Main issues[/size:9392bae462]

[size=19:9392bae462] Assessment & Diagnosis is very important[/size2]
– could be combination of anxiety disorder and/or [/size:9392bae462]
depression and/or effects of neurological injury [/size:9392bae462]
(medical aspects)[/size:9392bae462]

[size=19:9392bae462] Must be able to "see the person" not the diagnostic [/size2]
label[/size:9392bae462]

[size=19:9392bae462] Treatment needs to be:[/size2]
– Evidence based [/size:9392bae462]
– monitored for effectiveness[/size:9392bae462]

Structure of Course[/size:9392bae462]

[size=16:9392bae462] Lectures[/size2]

[size=16:9392bae462] Historical background[/size2]
– Socio-cultural context of [/size:9392bae462]
mental health issues[/size:9392bae462]

[size=16:9392bae462] Mental Health Disorders[/size2]
– Mood disorders[/size:9392bae462][list2]

[size=12:9392bae462] Depression (I /II)[/size2]

[size=12:9392bae462] anxiety [/list:u:9392bae462]
– Main forms (I)[/size:9392bae462]
– PTSD (II)[/size:9392bae462]
– Psychosis[/size:9392bae462]
– Specialist services, e.g. [/size:9392bae462][list2]

[size=12:9392bae462] eating disorders[/size2]

[size=12:9392bae462] drug & alcohol[/list:u:9392bae462]

[size=19:9392bae462] Practicals[/size2]
– Weeks 3 & 7[/size:9392bae462]

[size=19:9392bae462] Tutorials[/size2]
– Weeks 4 & 8[/size:9392bae462]
[/list:9392bae462]