Psychology in Physical Healthcare
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Questions and Answers

What does Mindy and Body Dualism propose?

  • There is no relationship between mind and body.
  • Mind and body are separate entities. (correct)
  • Mind and body are interconnected.
  • Mind is a product of the body's physical state.

    • Which element is NOT part of the Biopsychosocial Model?

  • Biological factors
  • Dysfunctional behavior (correct)
  • Social factors
  • Psychological factors

    • Which psychological intervention has evidence supporting its effectiveness in improving quality of life?

  • Medication management
  • Cognitive Behavioral Therapy (correct)
  • Surgical interventions
  • Physical therapy

    • What does the role of Clinical Psychologists include?

    <p>Consultation and teaching</p> Signup and view all the answers

    Which of the following is an indirect cost associated with unnecessary medical investigations?

    <p>Reduced work productivity</p> Signup and view all the answers

    What is one of the third-wave approaches mentioned in psychological interventions?

    <p>Compassion Focused Therapy</p> Signup and view all the answers

    Which of the following is a suggested benefit of psychological interventions like self-help?

    <p>Improvement in mood for some patients</p> Signup and view all the answers

    Who is credited with establishing a framework for the Biopsychosocial Model?

    <p>Engel</p> Signup and view all the answers

    What assumption did the GP make about the male patient's condition?

    <p>The symptoms may be psychological in nature.</p> Signup and view all the answers

    How did the patient’s upbringing influence his coping strategies?

    <p>He struggles with emotional expression.</p> Signup and view all the answers

    What is the definition of chronic pain?

    <p>Pain that lasts more than 6 months</p> Signup and view all the answers

    What factor might be keeping the patient’s problem ongoing?

    <p>A lack of adequate coping strategies.</p> Signup and view all the answers

    What is a potential trigger for the patient's symptoms?

    <p>Feeling overwhelmed.</p> Signup and view all the answers

    What percentage of GP appointments are accounted for by physical health presentations?

    <p>50%</p> Signup and view all the answers

    How much of the NHS budget in England is spent on physical health presentations?

    <p>£8-13 billion</p> Signup and view all the answers

    How long after his symptoms began did the patient seek further support?

    <p>5 years.</p> Signup and view all the answers

    Which of the following statements about children and physical health difficulties is true?

    <p>10-30% of children are directly affected by physical health issues.</p> Signup and view all the answers

    What should be considered when assessing the patient’s condition?

    <p>Social support systems.</p> Signup and view all the answers

    What role might medical professionals or psychologists play in this case?

    <p>Identifying and addressing emotional factors.</p> Signup and view all the answers

    What is the impact of not receiving appropriate psychological support on service costs?

    <p>Increases costs by 45-75%</p> Signup and view all the answers

    What is a protective factor for the patient despite his challenges?

    <p>Rest and recovery when symptoms occur.</p> Signup and view all the answers

    What is the relationship between chronic conditions and psychological distress?

    <p>Those with one or more chronic conditions can be up to 7 times more likely to have mental health issues.</p> Signup and view all the answers

    How many children experience significant chronic illnesses that limit their daily life?

    <p>11%</p> Signup and view all the answers

    What are long-term health conditions generally characterized by?

    <p>Conditions that typically have no cure and require ongoing management</p> Signup and view all the answers

    What was the impact of psychological interventions on cardiac mortality for individuals with cardiac heart disorder?

    <p>They improved psychological symptoms and reduced cardiac mortality.</p> Signup and view all the answers

    Which psychological intervention was found effective in an 8-week RCT for patients with Irritable Bowel Disease?

    <p>Acceptance and Commitment Therapy (ACT)</p> Signup and view all the answers

    What has been reported about the use of CBT for migraine treatment?

    <p>It is effective in reducing migraine frequency and intensity.</p> Signup and view all the answers

    What is a challenge in providing psychological interventions in physical health care settings?

    <p>Exclusively focusing on the physiological impact.</p> Signup and view all the answers

    How should language be utilized in psychological interventions according to the content?

    <p>It should reflect an Acceptance-Based approach.</p> Signup and view all the answers

    Why is it important to consider cultural factors in psychological interventions?

    <p>Ignoring cultural factors can lead to misunderstandings.</p> Signup and view all the answers

    What influence do assumptions have in clinical health presentations?

    <p>They can create biases and influence perceptions.</p> Signup and view all the answers

    What are the reported benefits of integrated MDT care for Type 2 diabetes?

    <p>It improves quality of life and mood-related outcomes.</p> Signup and view all the answers

    What is the primary focus of the systematic review conducted by Matcham et al. (2014)?

    <p>Self-help interventions for symptoms of depression and anxiety.</p> Signup and view all the answers

    Which publication discusses the costs associated with depression in medically ill patients?

    <p>Healthcare costs associated with depression in medically ill fee-for-service Medicare participants.</p> Signup and view all the answers

    Which study highlights the impact of co-morbidities on mental health and long-term conditions?

    <p>Long-term conditions and mental health: The cost of co-morbidities.</p> Signup and view all the answers

    What aspect of healthcare is addressed in the paper by Suls and Rothman (2004)?

    <p>The biopsychosocial model in health psychology.</p> Signup and view all the answers

    Which study focuses on psychological interventions specifically for coronary heart disease?

    <p>Psychological interventions for coronary heart disease: Cochrane systematic review.</p> Signup and view all the answers

    What does the research by Sanjida et al. (2018) systematically investigate?

    <p>The effectiveness of psychological interventions on anxiety in cancer patients.</p> Signup and view all the answers

    Which factor did Ricou et al. (2019) identify as a predictor of success in psychological intervention?

    <p>Patient compliance and engagement.</p> Signup and view all the answers

    What main concept is critiqued by Mehta (2011) in relation to health?

    <p>Mind-body dualism.</p> Signup and view all the answers

    Study Notes

    Psychology in Physical Healthcare

    • Psychology plays a crucial role in physical healthcare settings.
    • 16.5 million people in England have long-term physical health conditions.
    • 4.5 million experience psychological distress related to these conditions.
    • People with long-term conditions are 2-3 times more likely to experience mental health difficulties compared to the general population.
    • This risk increases to 7 times for people with one or more conditions.
    • 10-30% of children are affected by physical health difficulties.
    • 11% of children experience significant chronic illnesses that limit daily life.
    • 10-37% experience a psychological difficulty.
    • This relationship between physical and psychological health accounts for £8-13 billion of the NHS budget in England.
    • 50% of GP appointments and 70% of bed days and acute/primary care budgets are related to this.

    Definitions

    • Acute illness/injury/pain: Pain lasting less than 6 months, a warning sign that something is wrong.
    • Chronic pain/condition: Pain lasting more than 6 months. Long-term health conditions that typically have no cure, and are managed using medications and interventions.

    What do I do?

    • Clinical Psychologist at Great Ormond Street Hospital NHS Foundation Trust.
    • Across Psychological and Mental Health Services Department in different medical teams.
    • Private practice.

    Today's Session Aims

    • Understand the background and context of psychology in physical healthcare settings.
    • Discuss the role of psychology.
    • Discuss models and evidence-base for psychology in physical health.
    • Identify the challenges of using psychology in physical healthcare.
    • Examine a clinical case study.

    What contributes to increased costs?

    • Inappropriate psychological support resulting in a 45-75% increase in service costs, regardless of medical condition.
    • Costs remain even after considering demographic and clinician factors.
    • Unnecessary medical investigations.
    • Frequent A&E visits and outpatient appointments.
    • Increased medication use and admissions.
    • Indirect costs such as missed work and reduced productivity.

    Mindy and Body Dualism

    • 17th Century philosophy (Descartes).
    • Mind and body are separate entities.
    • Underpins the medical model.

    Biopsychosocial Model

    • Biological, social and psychological factors all interact to influence health and well-being.
    • Developed by Engel (1977).

    Role of Clinical Psychologists

    • Clinical work (individual, families/couples, group).
    • Joint work with other professionals (multi-disciplinary teams).
    • Inpatient and outpatient work.
    • Consultation.
    • Teaching, education, and training.
    • Facilitating reflective practice for medical staff.
    • Supervision.
    • Research and audit.

    What models do we use in physical health?

    • Cognitive Behavioral Therapy (CBT)
    • Third-wave approaches.
    • Compassion-Focused Therapy.
    • Acceptance and Commitment Therapy (ACT).
    • 5 P's.
    • Solution-Focused Approaches.
    • Systemic approaches.

    Clinical effectiveness of psychological interventions

    • Evidence-based interventions (e.g., CBT, third-wave therapies) improve treatment adherence, adjustment to conditions, quality of life, and coping.
    • Self-help interventions sometimes improve mood in patients with physical health conditions.
    • Studies show psychological interventions improve psychological symptoms and reduce cardiac mortality.
    • Short, medium, and long-term psychological interventions improve quality of life in patients with long-term conditions.
    • ACT improved psychological stress and depression in patients with Irritable Bowel Disease.
    • CBT for migraine reduces frequency and intensity.
    • CBT is effective for chronic pain.
    • Integrated care models (MDT) improve quality of life and mood for conditions like Type 2 diabetes.
    • NICE guidelines recommend psychological approaches as part of interventions for certain physical conditions.

    Challenges

    • Failure to recognize psychological factors contributing to physical presentations.
    • Focusing solely on physiological aspects, ignoring individual factors.
    • Risk of pathologizing distress or normal coping responses to stress.
    • Using language that pathologizes.

    Assumptions

    • Assumptions influence perceptions, often unconsciously.

    Assumptions - Small Groups

    • Identify assumptions about medical conditions and presentations.
    • Assess how these influence perceptions.
    • Explore assumptions of medical professionals and psychologists.
    • Examine how these assumptions impact service users.

    Case Example

    • 40-year-old male with chronic headaches and fatigue.
    • Symptoms started 10 years ago and lost job around the same time.
    • Initial GP visit suggesting problem was in his head, leading to 5 years without seeking support.
    • Family background of not discussing emotions.
    • Triggered by feeling overwhelmed and experiencing light sensitivity.
    • Coping strategies focussed primarily on individual efforts without seeking support.

    Case Example - Questions

    • What information is needed to assess the patient?
    • What factors might influence the assessment?
    • How can the difficulty be understood?
    • What might be maintaining the problem?
    • What protective factors may exist?
    • What can be done to help?

    Further Suggested Reading

    • Books available for further information on psychology in physical health are Pain is Really Strange, The Body Keeps the Score, Promoting Psychological Well-Being and others.

    References

    • List of cited sources for the session. (Multiple authors' names with year).

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    Related Documents

    Psychology in Physical Health PDF

    Description

    Explore the significant impact of psychological health on patients with long-term physical conditions. This quiz delves into the statistics and relationships between physical health issues and mental health challenges, specifically in the context of the NHS budget and healthcare appointments in England.

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