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cherry


Member

Posted Sun Apr 1st, 2007 1:02am Post subject: heloooo
hurrah - thanks atari - what a service!
TM - you are very imaginative, and has made me even more curious as to what you are really doing. i guess that serves me right for being nosey...
jvonearth - man sounds like a pain, offputting or what. i can't stand being watched while i'm doing something. maybe he thought he was being sociable?!

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JVONEARTH


Member

Posted Sun Apr 1st, 2007 1:05am Post subject: heloooo
it might have something to do with the date
Bloody hell in twelve days time i'll be a little bit older :'(
I wish he had made me a cup of tea if he wanted to be social X-D

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panda


Member

Posted Sun Apr 1st, 2007 1:08am Post subject: heloooo
yeah, guess some people have no idea how to be civilised...
hmm, so birthdays - you gonna do anything nice for it?

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JVONEARTH


Member

Posted Sun Apr 1st, 2007 1:10am Post subject: heloooo
Don't know yet might just go somewhere for the day or do nothing at all and just doss about

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Anonymous


Unregistered

Posted Sun Apr 1st, 2007 10:08am Post subject: heloooo
Cor, wish I hadn't been asllep from 5 yesterday afternoon ti an hour ago apart from surfacing at 11 last night to feed my insistant cats. Never sleep like that so must be recovering or getting moere ill, ooh er Mrs Jones.

Most impressed with the space stuff, one small step for....

C

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panda


Member

Posted Sun Apr 1st, 2007 10:16am Post subject: heloooo
hiya chris
wish i had slept like that!! sorry to hear you aren't well though.

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Anonymous


Unregistered

Posted Sun Apr 1st, 2007 10:45am Post subject: heloooo
Hi Panda, no actually I was just being a drama queen, thinking such unusual sleeping must indicate change - for the better or for the worse... thats the drama bit... i mean why be normal when you can be Dramatic !!%**$$$.... actually I'm fine...last day of term tomorrow, so guess what, spending the whole day writing stuff up....
Inventories + Working with maintaining factors + Is Cognitive Behavioural Therapy always applicable as a therapeutic response to serious mental anxiety or distress? + If someone is late how long do you wait?

I love it though....

Chris

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Anonymous


Unregistered

Posted Sun Apr 1st, 2007 10:48am Post subject: heloooo
Ps. JVONEARTH congratulations on being a 'little' older on April 12th? but of course congratulations on indeed being a little bit older today too

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panda


Member

Posted Sun Apr 1st, 2007 11:02am Post subject: heloooo
oh i see what you mean. yeah, i think i do that too (watch my sleeping). sounds v interesting - hope you will tell us what maintaining factors are, and obviously the answer to the question about cognitive therapy (is it always the best thing - though not sure i can handle the answer to this one yet!)

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JVONEARTH


Member

Posted Sun Apr 1st, 2007 12:00pm Post subject: heloooo
Thanks Chris this getting older thing isn't very nice

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Anonymous


Unregistered

Posted Sun Apr 1st, 2007 3:32pm Post subject: heloooo
Hi

Yes, to answer about 'Maintaining Factors'.

I must emphasise that this is about symptoms in general and is in no way about Bipolar Disorder specifically.

Having said this I've been really interested reading this forum about the views about Bipolar. There seem to be two points of view - that it is so 'biological' that people just have to accept their situation, and those who believe that the outcomes of Bipolar can be ameliorated by choices the individual can make in how they manage their lives and how they regard what happens to them in their daily lives.

Cos, I don't want to breeze in with my naive theories and learning (but see my signature below) and tell you all how it is. But I am struck by how much of what is written on the forum does tie directly in to the cognitive-behavioural model of health. Those doubting this just consider how much you affect others/the world when you are asleep! Not very much - and what is missing when you are asleep... er conscious thought.

So this is the bit about maintaining factors and also inventories - all my own words, not blagged off the net.....


Maintaining factors

‘Maintaining factors’ is the description in CBT given to the mechanisms that keep people in the situation of distress they are experiencing.

A common maintaining factor is an individual’s thought patterns. For example, negative automatic thoughts sustain depression - ‘I can’t face today so I’ll stay in bed, but staying in bed leaves me feeling useless (automatic thought = ‘I can’t even get out of bed so I must be really useless!’). So I really can’t face the day because I’m so useless and I will stay in bed.

Maintaining factors can provide a main starting point for therapeutic work. Making sense of the mechanisms of the client’s symptom maintenance can be seen as part of the collaborative educative process - the process of curiosity - of CBT, and understanding maintaining factors gives the client some choices in making changes. This empowerment is itself therapeutic.

Working with maintaining factors gives an opportunity to increase trust and rapport between therapist and client because the client feels their problems are being understood.

Addressing maintaining factors allows symptom reduction to occur, which allows the client to be more psychologically and physically available to work on issues they are concerned about.


An example of working with maintaining factors

A depressed client might give responses such as the following–

Thoughts: I’m useless, what’s the point in doing things, the phone call will be bad news. These are all ‘automatic thoughts’.

Feelings: I am tired of what’s happening (angry/frustrated), sad, lonely. These are all emotions.

Behaviours: I don’t get out of bed, I don’t answer the phone, I carry out acts that isolate me. These are all behavioural responses to emotions.

The therapist’s intervention is to draw these comments out in the form of a thoughts/feelings/behaviours triangle, and to deconstruct this picture the client portrays, for example, by asking the question:

‘As a client what do you get from the behaviour, for example, of not getting out of bed on the day?’

The client might reply:

’I don’t have to face up to things I can’t handle, but also I don’t think I feel any better for this, in fact I feel worse.’


The treatment protocol could make a switch at this point from a focus on affect to considering the behavioural aspect of the client’s situation, the ‘staying in bed’. The therapist might propose a ‘behavioural experiment’ that the client undertakes in the following week, before the next session:

‘What might be the effect of getting out of bed when you feel ‘depressed’?’

‘I wouldn’t feel so bad about myself – so useless – and it might not be as bad as I thought it was going to be.’


Although this example is given in a very simplistic form, it demonstrates the principle that understanding maintaining factors sustaining the client’s symptoms, i.e. feelings and behaviours, gives an effective entry point for the therapist to create choices for and relieve symptoms of the client.

It remains central to all forms of working in the CBT model that the process stays user-centred, and follows the client’s aims and goals rather than the therapist’s agenda in the situation.

Inventories

Inventories are questionnaires that enable clients to give graded responses to specific questions about the symptoms they may be suffering, for example, depression or anxiety. This enables the client and therapist together to assess the severity of individual aspects of the client’s concerns, and to establish a benchmark for how much their issues are affecting them.

Inventories are helpful because they highlight the more important issues in a person’s symptoms and they also act as a measure of their change across sessions of treatment. Inventories also play an important role in research into mental health problems by giving ‘hard’ i.e. objective, information in controlled circumstances.

There are many specialised psychological/psychiatric inventories, amongst them the following commonly used examples:

Beck Depression Inventory

Beck Anxiety Inventory

HADS Inventory – Hospital Anxiety and Depression Scale. This is frequently used in NHS hospital admissions as a quick initial assessment tool.

DASS Inventory – Depression Anxiety Stress Scale. This is useful because it gives a measure of the stress the client/patient feels themselves to be under.

CORE IMS The CORE System (Clinical Outcomes for Routine Evaluation) has been designed in the UK for use in psychotherapy, counselling and other psychological therapies to measure outcome and provide for service audit, evaluation and performance management (to quote from the website homepage).
http://www.coreims.co.uk/


That's all folks! Back to my cave.

Chris

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JVONEARTH


Member

Posted Mon Apr 2nd, 2007 1:29am Post subject: heloooo
Looks like there will be some tired people when the alarms go off X-D

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panda


Member

Posted Mon Apr 2nd, 2007 11:58am Post subject: heloooo
yeah, you were right!

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