NURS 3141 CBT for Mental Health Nurses 2024-25 PDF

NURS 3141- Introduction to CBT for Mental Health Nurses Dr. Tim Carter and Gary Payne Optional Module 2024-25 QR Code 2  Pause and reflect Kahoot Quiz! https://create....

NURS 3141- Introduction to CBT for Mental Health Nurses Dr. Tim Carter and Gary Payne Optional Module 2024-25 QR Code 2  Pause and reflect Kahoot Quiz! https://create.kahoot.it/share/cbt-for-mh-nurses/914 0d5b2-ec9b-458e-ab93-d7abd024ba68  Welcome and introductions Introductions Housekeeping What have I signed up for? Module overview You said, we did- more practical emphasis- self-directed study 4  Pause and reflect By the end of today…. - Outline of the module including ExamSys - Introduction to CBT and fundamentals of therapy - Links between thoughts, emotions and behaviours - Understanding of the CBT model - Opportunities to observe and practice using the CBT model  ExamSys- Multiple-Choice Questions  Formative and Summative assessments Formative Exam = TBC Summative Exam= 50 or more marks- combination of MCQs and short answer questions and drag and drop Date – TBC- early to mid-January Time – TBC Themes and expectations – based on the information of taught content, PowerPoint slides and reading/ resources on Moodle Additional reading! 6 What is CBT? 7  Pause and reflect What are the fundamentals of CBT? Small groups discussion: 5 mins Each group to feedback one point from the discussion  What is CBT? Fundamentals…?  Short-term therapy  Goal-focused  Evidence-based  Collaborative  ‘Here and now’  Works from a ‘bio-psycho-social’ perspective  Weekly sessions  Action orientated- Homework! 9  Fundamentals of therapy  Interpersonal skills  Empathy  Warmth  Non-judgement  Positive regard  Appropriate body language, tone, eye contact  Research suggests that these factors may account for 50% of any therapeutic outcome (Richards & Whyte, 2011)  Engagement or buy-in! 10  Formulation How can we make How is the How can we sense of the problem being intervene? problem? maintained? CBT underpinned by Evidence- Based models that help us Cognitive models Formulate a person’s experiences……. 11  Thoughts lead to feelings Take a moment to look at this picture What are your initial thoughts? What might be happening? How does this make you feel? Now take a second look and think of an alternative explanation for what is happening........? Has this caused a different emotion? 12 How I think effects how I feel Thoughts (they are kissing or she is consoling him) Feelings (anger or sadness) 13 Thinking errors or distortions 14  Emotions are very important! Emotions (or feelings) can drive how we think and what we do! What are considered the 5 primary emotions? Happiness, Sadness, Fear, Anger, Disgust What might be considered complex emotions? Anxiety, Guilt, Shame, Humiliation, 15 How I feel affects what I think Feeling (scared and anxious) Thinking (Something is wrong, I’m in danger) 16 How we think and feel affects how we behave 17 How we think, feel and behave are linked Thoughts Behaviour Feelings 18 General cross-sectional formulation AKA…. Maintenance formulation Hot-cross bun 5 Aspects CBT model 19  Pause and reflect Recap In small groups take a moment to summarise what you have learnt so far- 5 mins Each group to feedback one point from the discussion Separating thoughts, feelings and behaviours Anne has always been constantly worried about everything in her life and tends to experience a lot of anxiety and apprehension. She thinks she is going mad and that her life is unbearable. She tries to plan everything down to the smallest detail and ensures she does everything for herself, so she doesn’t have to rely on anyone else. Her sleep is very poor, and she finds herself pacing around the house at night, worrying about the next day. She avoids seeing people and tends to put things off until the last minute. She often feels low in mood and finds it hard to concentrate. Anne has recently started to experience severe heart palpitations and shortness of breath when she is on public transport so has started to avoid using it. As a consequence, she has stopped going to work. 21 Separating thoughts, feelings and behaviours Thoughts/thinking: I’m going mad/ My life is unbearable/ Worrying Feelings/ mood Anxious/ Apprehensive/ Low Physical feelings Tension, heart palpitations, breathless, poor sleep Behaviours Pacing at night/ Avoiding work and transport/ Over planning/ Procrastinating/ Worrying?/ Doing everything herself 22  Pause and reflect Role Play Gary and Tim will role play a CBT initial Assessment using the CBT model Your job: Identify the symptoms Categorise symptoms into the 5-aspect model Opportunity to pause assessment to ask questions Opportunity to identify next steps  Some ideas for questions  Tell me about the situation – what? Where? When? Who with?  What thoughts went through your mind, what were you thinking about  How did it feel in that moment? Can you put a word to that feeling?  How did it feel in your body in that moment? What did you notice?  What did you do? What happened? How did you cope? How did you manage? What did you to keep yourself safe?  What was it about that behaviour that helped? 25  The process  Ask about a recent specific example of presenting problem  Generally, start with situation – thoughts – feelings- behaviours  Try to link thoughts, feelings and behaviours- bi-directional  Identify opportunities to measure thoughts and emotions  Empathy and curiosity 26  CBT model  Recent, specific example of when that situation occurred  Thoughts: what was going through your mind at the time? how believable was that thought (0-100%)? were there any images? What did you think was happening?  Emotions: how did that make you feel? How intense was that emotion (0- 10)? Did you notice any other emotions?  Bodily sensations: did you notice any bodily or physical sensations?  Behaviours: how did you respond? What did you do? How did you cope? manage in that situation? Did that help? 27 Formulate your own recent experience when you felt anxious 28  Pause and reflect By the end of today…. - Outline of the module including ExamSys - Introduction to CBT and fundamentals of therapy - Links between thoughts, emotions and behaviours - Understanding of the CBT model - Opportunities to observe and practice using the CBT model Homework! Read Understanding the presentation and treatment of anxiety disorders in preparation for Friday’s lecture on CBT for Anxiety Overview of anxiety disorders Read the Core Module PowerPoint Slides for Day One on Moodle 30  Learning outcomes and session aims  Module aims:  To demonstrate an understanding of the process of CBT-informed assessment, formulation and interventions for common mental health problems  To demonstrate an understanding of different CBT-informed skills and techniques to individuals experiencing common mental health conditions  Session Learning Outcomes:  To have an understanding of the module and associated ExamSys examination  To have an understanding of CBT fundamentals  To have an understanding of the CBT model and its application 31  Further Reading & References  Beck, A.T. (1967). The Diagnosis and Management of Depression. USA: University of Pennsylvania Press  Ehlers A, Clark DM. Post-traumatic stress disorder: the development of effective psychological treatments. Nord J Psychiatry. 2008;62 Suppl 47(Suppl 47):11-18. doi:10.1080/08039480802315608  Layard (2006). The depression report: A new deal for depression and anxiety disorders. Centre for Economic Performance: London School of Economics  NICE (2011). Common mental health disorders: Identification and pathways to care.  Richards, D. (2008). Behavioural activation. In: Callaghan, et al (eds.), Mental Health nursing skills in practice. Oxford: Oxford University press. Chp 12  Richards, D. & Whyte, M. (2011). Reach out: National programme student materials to support the delivery of training for psychological wellbeing practitioners delivering low intensity interventions (3rd ed). UK: Rethink Mental Illness  Rogers, C.R. (1951). Client-centred Therapy. Boston: Houghton Miffin  Lindsley, O., Skinner, B.F. & Solomon, H.C. (1953). Studies in behavior therapy (Status Report I). USA: Metropolitan State Hospital  Veale, D. Behavioural activation for depression. Advances in Psychiatric Treatment (2008), vol. 14, 29–36 doi: 10.1192/apt.bp.107.004051  Williams, C. (2009) Noticing and changing extreme and unhelpful thinking. Overcoming Depression and Low Mood: A Five Areas Approach. Hodder & Arnold. 272-294 32