Exam

• PPSSFRC
• Problem chronicity/complexity
• Problem solving phase
• Social support
• Subjective Distress
• Functional impairment
• Resistance
• coping style

• High
• -high restrictiveness i.e. locked up for own safety
• Intensity, sicker people need higher intensity
• Medical vs psychotherapy
• Prognosis,
• Urgency

• Low
• -low restriction ie out patient
• low intensity e.g. a bit anxious
• No meds
• good pronosis
• not urgent

• CBT VS rels prog
• duration of treatment
• psychosocial vs meds
• possible group intervention

• the quality and quantity of support available.
• High = shorter therapy duration, therapy gains faster and maintained esp. those related to relationship skills
• low - CBT more effective, meds and longer treatment more likely, group therapy might be good

narrow symptom focus VS thematic unresolved issues

more likely to be identified by psychodynamic clinicans.

• High - free association
• 2 chair
• dream work
• carthartic discharge
• interpretation

• Low- behavioural intervention
• CBT
• self monitoring
• relaxation

phobia vs self fulfilling prophecy e.g. poor selction of partner.

behavioural vs insight oriented

• externaliser
• act out, blame others e.g. projection, extroversion, manipulation

DO better with behavioural  e.g. social skills contracts, questioning beliefs

• Internaliser
• intellectualise, deny, withdraw

do better with insight orientated e.g. blbliotherapy, dream interpreatation, interpretation, 2 chair.

directive vs non directive

• High resiatnce
• anxious, oppositional conflict, non compliant
• use non directive approach e.g. support and reassurance, prescribe no change

• Low resitance submissive, open
• direct approach
• CBT

increase/decrease arousal

• high distress -visible autonomic agitation
• reduce using PMR exercise CBT for physical agitation
• mental agitation, meditation, reassurance

• low distress low energy, absence of
• symptoms.
• role play, confrontation pratcie, interpretaion

stages of change