Cognitive behavioural approaches to mental health
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Transcript of Cognitive behavioural approaches to mental health
Cognitive Behavioural Approaches to Mental Health
Sophie Kennish –
MSc Occupational Therapy Student, UEA
Session outline
Icebreaker What does CBT mean? What are thoughts CBT triangle Actions / Behaviours The CBT process What CBT is (and isn’t!)
ACTIVITY!
Does CBT work? CBT in Norwich Bibliotherapy and CCBT Pros and Cons of CBT Some other alternatives Homework Discussion, role of
MHFA / Associate
ANYTHING ELSE YOU’D LIKE TO COVER?
Icebreaker
1. Your MIDDLE name (if you have one)
2. One thought you’ve had today (positive, negative or neutral)
3. One thing you’ve done this week to promote your positive mental wellbeing
4. Any experience / knowledge of CBT
The powerpoint isn’t going to work!
Cognitive Behavioural
Behavioural = ActingCognitive = Thinking
Example Thoughts
I’m uselessI’ll never achieve anything
I’ll never get betterIt’s all my fault
It’s going to go wrongThey hate me
Why does this always happen to me?
Thoughts about youThoughts about others
Questions
CBT Triangle
Some actions / behaviours
Self Harming Phoning a friend Going on a walk Going to work Drinking alcohol Hiding under the
duvet Taking/not taking
medication
What is the CBT process?
CBT involves three stages: Identifying / acknowledging and writing down
thoughts Classifying these thoughts Modifying these thoughts
Also involves some understanding of our ‘core beliefs’
What was I just thinking about which made me so depressed?
What CBT is…
Hard, and requires a lot of effort and time, including homework!
Something that’s ‘taught’ rather than ‘given’
Realistic thinking; NOT “positive thinking”Shorter term than traditional therapies
What CBT isn’t…
Let’s try out some CBT
Two groups Handout – thought identification Cards with example thoughts written on them
Match up the thought to the thought type using the worksheet – 15 minutes (don’t worry if you don’t manage them all)
If you find this easy (you won’t!), try thinking of alternative, more helpful thoughts to the ones on the cards
NB – Not all of them fit into neat little boxes!
Does CBT work? (Here’s the science…)
Yes! “Low-intensity psychosocial interventions” are effective for people with mild-moderate depression and anxiety
Recommended by NICE guidelines ‘Best Practice’ - Based on high quality data
As effective as Prozac? Group exercise
programmes are also effective!
CBT in Norwich
IAPT Service – “Improving Access to Psychological therapies” – Short term low level CBT for mild-moderate anxiety, depression Referral from GP or health professional [email protected], 01603 421 688
Local Counsellors may be trained in CBT approaches - BABCP (British Association of Behavioural and Cognitive Psychotherapy)
Private practices – Psychologists - £££! Long waiting lists! Group CBT
Bibliotherapy
CBT self help approaches Gilbert Overcoming Depression : a
Self-help Guide Using Cognitive Behavioural Techniques
Padesky & Greenberger Mind Over Mood: Change How You Feel By Changing the Way You Think
Books on prescription, available at the city libraries
CCBT- The future?
Some websites offer computerised CBT ‘courses’ http://www.beatingtheblues.co.uk/patients/ http://www.livinglifetothefull.com/ - This one is
free if you sign up! http://www.themindgym.com/ No human contact (if you don’t want any)
Pros and Cons of CBT
It’s quick, and doesn’t involve dredging up the past. This means it’s cheap (for the NHS) and (quite) easily accessible (for patients).
It can work really effectively if people are able to put the effort in
Effective with people with mild-moderate depression, also for use in anger management, relationships, other mental health problems
Some people need longer term therapies, but are given CBT as this is what the NHS can afford
It can be seen as a bit of a ‘cure-all’, without consideration to the complexity of people’s lives
It focuses so much on the thoughts rather than the ‘doing’
Alternatives to CBT
Other talking therapies such as counselling
Medication Graded exposure /
“flooding” Occupational Therapy –
‘doing’ rather than ‘thinking’.
Exercise Five Ways to Wellbeing A combination of different
interventions
Homework!
Try to become more aware of your thoughts by jotting them down, even if they sound ridiculous. Try to connect them with a certain situation, feeling or behaviour.
Try to rationalise thoughts by working out why they’re ‘faulty’ and providing alternative ‘helpful’ thoughts
Try some ‘thought experiments’; doing something that you’ve been dwelling on for a while. Is it as bad as you imagined?
Perhaps next time we can feedback on how we found this
Discussion
What do you think about CBT?As a MHFA, how would you use what
you’ve learnt today to support?Can this approach be applied to people
with other mental health problems (Bipolar Disorder, Schizophrenia)?
Thanks for listening!
Time for a tea break!
Please fill in the evaluation forms (be as nasty as you like, so I can improve!)