Key points
- Treatment in psychiatry is more than medicine: psychological and non-pharmacological interventions are part of the MKU Year 4 curriculum (MBPS 4537).
- CBT restructures maladaptive thoughts and behaviours; IPT works on grief, role disputes and interpersonal deficits; behaviour therapy uses exposure and desensitisation.
- Psychoeducation for patients and families improves understanding, treatment adherence and relapse prevention.
- Family therapy and group therapy use relationships and peer support; motivational interviewing builds the person's own motivation to change, especially in substance use.
- Community-based care, and culturally sensitive work with religious or traditional leaders where appropriate, are part of the plan.
Built from the Psychological Therapies and Non-Pharmacological Interventions topic of the MKU Psychiatry and Mental Health MBChB curriculum (Year 4, MBPS 4537).
The interventions at a glance
| Intervention | What it does | Used for |
|---|---|---|
| Supportive psychotherapy | Reassurance, guidance and coping skills during crises | Crises |
| Psychoeducation | Helps patients and families understand the illness, keep to treatment and prevent relapse | Patients and families |
| Cognitive behavioural therapy (CBT) | Identifies and restructures maladaptive thoughts and behaviours | Depression, anxiety, OCD, psychosis |
| Behaviour therapy | Systematic desensitisation, exposure and token economy | Phobias, OCD, behavioural problems |
| Interpersonal therapy (IPT) | Addresses grief, role disputes and interpersonal deficits | Especially depressive disorders |
| Psychodynamic therapy | Explores unconscious conflicts and past experiences for insight and resolution | Personality and neurotic disorders |
| Family therapy | Improves communication, reduces relapse and strengthens family dynamics | Schizophrenia, substance use disorders |
| Group therapy | Peer support, social learning and coping | Addiction, chronic illness |
| Motivational interviewing | Builds intrinsic motivation for behaviour change | Especially substance use |
| Mindfulness-based therapies (MBSR, MBCT) | Stress management and relapse prevention | Stress, anxiety, depression relapse prevention |
| Relaxation techniques | Deep breathing, guided imagery, progressive muscle relaxation | Calming, with breathing, imagery and muscle relaxation |
| Occupational and recreational therapy | Restores function, promotes socialisation, improves quality of life | Function, socialisation and quality of life |
| Community-based interventions | Integrate mental health into primary care, with home visits and community health workers | Primary care and the community |
| Spiritual and cultural therapies | Culturally sensitive approaches, working with religious or traditional leaders where appropriate | Culturally sensitive care |
Exam tip: for each therapy, learn what it targets and one condition it suits. That is the shape of most exam questions.
Therapies that work on thoughts and behaviour
Cognitive behavioural therapy (CBT)
- Aims to identify and restructure maladaptive thoughts and behaviours.
- Useful in depression, anxiety, OCD and psychosis.
Behaviour therapy
- Includes systematic desensitisation, exposure and token economy.
- Used for phobias, OCD and behavioural problems.
Therapies that work on relationships
- Interpersonal therapy (IPT): grief, role disputes and interpersonal deficits, especially in depressive disorders.
- Family therapy: better communication, fewer relapses and stronger family dynamics, in schizophrenia and substance use disorders.
- Group therapy: peer support, social learning and coping among people with similar challenges such as addiction or chronic illness.
- Psychodynamic therapy: unconscious conflicts and past experiences, for insight and resolution, particularly in personality and neurotic disorders.
Supporting recovery
- Supportive psychotherapy gives reassurance, guidance and coping skills during crises.
- Psychoeducation for patients and families supports understanding, adherence and relapse prevention.
- Motivational interviewing builds the person's own motivation for change, especially in substance use.
- Mindfulness and relaxation help with stress, anxiety and depression relapse prevention.
- Occupational and recreational therapy restore function and quality of life.
- Community-based care brings mental health into primary care, with home visits and community health workers.
- Spiritual and cultural approaches work with religious or traditional leaders where appropriate.
Practice questions
1. Which therapy identifies and restructures maladaptive thoughts and behaviours? Cognitive behavioural therapy (CBT). It is useful in depression, anxiety, OCD and psychosis.
2. What does interpersonal therapy (IPT) address? Grief, role disputes and interpersonal deficits, especially in depressive disorders.
3. Name three techniques used in behaviour therapy. Systematic desensitisation, exposure and token economy, used for phobias, OCD and behavioural problems.
4. Why give psychoeducation to patients and families? It improves understanding of the illness, treatment adherence and relapse prevention.
5. Which therapy is aimed at building a person's own motivation to change? Motivational interviewing, especially in substance use.
6. When is family therapy used? To improve communication, reduce relapse and strengthen family dynamics, in schizophrenia and substance use disorders.
7. What does psychodynamic therapy explore? Unconscious conflicts and past experiences, for insight and resolution, particularly in personality and neurotic disorders.
8. What do mindfulness-based therapies (MBSR, MBCT) help with? Stress management, anxiety, and relapse prevention in depression.
Exam-style MCQs with answers and explanations
Try each question before you open the answer.
1. A therapist helps a patient with OCD identify and change distorted thoughts and behaviours. Which therapy is this?
A. Psychodynamic therapy
B. Cognitive behavioural therapy
C. Group therapy
D. Occupational therapy
Answer: B. CBT identifies and restructures maladaptive thoughts and behaviours and is useful in OCD.
2. A woman with depression after the death of her mother needs help with her grief and relationships. Which therapy is aimed at this?
A. Interpersonal therapy
B. Token economy
C. Systematic desensitisation
D. Relaxation training
Answer: A. IPT addresses grief, role disputes and interpersonal deficits, especially in depressive disorders.
3. A technique that uses graded exposure to treat a phobia is part of:
A. Psychodynamic therapy
B. Family therapy
C. Behaviour therapy
D. Supportive psychotherapy
Answer: C. Behaviour therapy includes systematic desensitisation, exposure and token economy.
4. Which approach is aimed at increasing intrinsic motivation for behaviour change in a person with alcohol use disorder?
A. Motivational interviewing
B. Psychodynamic therapy
C. Occupational therapy
D. Mindfulness-based stress reduction
Answer: A. Motivational interviewing enhances intrinsic motivation for change, especially in substance use.
5. Which intervention helps relatives understand an illness and prevent relapse?
A. Token economy
B. Psychoeducation
C. Exposure therapy
D. Relaxation techniques
Answer: B. Psychoeducation for patients and families improves understanding, treatment adherence and relapse prevention.
References
- Mount Kenya University, School of Medicine. Psychiatry and Mental Health MBChB Curriculum, Year 4, unit MBPS 4537 (Junior Clerkship in Psychiatry and Mental Health I).