U4 AOS2 psychology - sac checklist

Define mental wellbeing as a continuum

Mental wellbeing exists on a continuum with no fixed points or clear-cut boundaries. It is dynamic and can change over time depending on internal and external factors. Higher levels are associated with optimal functioning, while lower levels are associated with increased distress, dysfunction and difficulty coping.

Define resilience

Resilience is the ability to manage change and uncertainty and regain normal or positive functioning when faced with adversity. Resilience is supported by factors such as social support, self-efficacy, problem-solving skills and the ability to make and carry out plans.

High vs low functioning

High functioning involves adaptive behaviour, appropriate emotional responses, positive relationships, effective coping and the ability to perform everyday activities independently. Low functioning involves maladaptive or dysfunctional behaviour, greater distress, reduced coping ability and disruption to everyday activities, relationships or roles.

Define stress

Stress is a psychobiological response to internal or external stressors that are perceived to challenge or exceed a person's ability to cope. It is subjective and can be acute (short-term) or chronic (long-term).

Define anxiety

Anxiety is a state of psychological and physiological arousal involving feelings of worry, apprehension and unease that something is wrong or something unpleasant may happen. It can be adaptive when short-lived and related to potential threats, but excessive or persistent anxiety can impair functioning.

Define specific phobia

Specific phobia is an excessive, distressing, irrational and persistent fear or anxiety in response to a specific stimulus, often leading to avoidance behaviour. It significantly disrupts daily functioning and is a type of anxiety disorder.

How can stress influence mental wellbeing?

Normal levels of stress can be adaptive and help motivate a person to respond to challenges. However, intense, frequent or prolonged stress can increase distress, reduce coping ability and interfere with everyday functioning, potentially lowering mental wellbeing.

How can anxiety influence mental wellbeing?

Normal, short-lived anxiety can be adaptive and help a person prepare or respond to potential threats. Excessive, persistent anxiety can produce intense psychological and physiological arousal and interfere with daily functioning, reducing mental wellbeing.

How can a specific phobia influence mental wellbeing?

A specific phobia can cause excessive fear and anxiety when the person encounters or anticipates the phobic stimulus. Avoidance can restrict activities and relationships, while the ongoing fear and disruption to functioning can lower mental wellbeing.

Define Social and Emotional Wellbeing (SEWB)

SEWB is a holistic and multidimensional framework for wellbeing for Aboriginal and Torres Strait Islander peoples that considers all elements of being. It recognises connections between body, mind and emotions, family and kinship, community, culture, Country, and spirituality and ancestors.

Why is SEWB holistic, multidimensional and interconnected?

SEWB is holistic because it considers the whole person rather than only mental or physical health. It is multidimensional because it includes seven interconnected domains: body; mind and emotions; family and kinship; community; culture; Country; and spirituality and ancestors. These domains interact and influence wellbeing concurrently and cumulatively.

Define the biopsychosocial approach

The biopsychosocial approach is a holistic, interdisciplinary framework for understanding human health, behaviour and wellbeing through the interaction of biological, psychological and social factors. It recognises that wellbeing is shaped by a combination of influences rather than one factor alone.

What are the biological factors in the biopsychosocial approach?

Biological factors are internal, genetic and/or physiological influences involving processes and structures within the brain and body. They can be innate, such as genetic predispositions, or develop later, such as through medication or other physiological changes.

What are the psychological factors in the biopsychosocial approach?

Psychological factors are internal influences relating to mental processes, including cognition, thoughts, beliefs, attitudes, emotions, affect and behaviours.

What are the social factors in the biopsychosocial approach?

Social factors are external influences involving a person's relationships, interactions and environment. They include family, friends, social support, employment, education, community and experiences within wider society.

Define GABA dysfunction

GABA dysfunction is insufficient inhibitory neural transmission of GABA. It may involve low GABA levels or problems with the reception or transmission of GABA across the synapse, resulting in greater nervous system activity and an increased likelihood of the stress or anxiety response being activated.

Define Long-Term Potentiation (LTP)

LTP is a form of neural plasticity involving the long-lasting strengthening of synaptic connections between neurons following repeated co-activation and intense stimulation. In specific phobia, LTP can strengthen the association between neural signals involved in perceiving a phobic stimulus and those involved in the fear or anxiety response.

Define precipitation

Precipitation refers to factors that increase susceptibility to and contribute to the occurrence or development of a specific phobia. In the behavioural model, classical conditioning can precipitate a specific phobia.

Define perpetuation

Perpetuation refers to factors that inhibit recovery from a specific phobia and maintain the phobic response. In the behavioural model, operant conditioning can perpetuate a specific phobia through negative reinforcement of avoidance behaviours.

Define cognitive bias

A cognitive bias is a predisposition to think in a way that involves errors of judgement or faulty decision-making. In specific phobia, cognitive biases such as memory bias and catastrophic thinking can contribute to the development and maintenance of fear.

Define catastrophic thinking

Catastrophic thinking is a thinking style involving overestimating, exaggerating or magnifying a stimulus or situation and predicting the worst possible outcome. It can make a phobic stimulus appear extremely dangerous and increase fear and anxiety.

Define environmental triggers

Specific environmental triggers are negative or traumatic experiences in a person's environment that can prompt an extreme stress response and contribute to the development or maintenance of a specific phobia. A sufficiently traumatic experience may sometimes produce a phobia after only one encounter.

Define stigma

Stigma refers to negative attitudes, beliefs and stereotypes held by society about particular conditions or behaviours. It can result in shame, discrimination, social isolation and reluctance to seek treatment.

What is an evidence-based intervention and why is it used for specific phobia?

An evidence-based intervention is a treatment supported by scientific research and evidence demonstrating its effectiveness. Evidence-based interventions are used for specific phobia because they provide scientifically supported approaches for reducing phobic symptoms and improving functioning, with different interventions targeting biological, psychological or social contributing factors.

Define GABA agonists

A GABA agonist is a substance that binds to GABA receptors and mimics or amplifies the effects of GABA. This increases inhibitory activity in the nervous system and reduces excessive neuronal firing. Benzodiazepines are an example of GABA agonists.

How do GABA agonists treat specific phobia?

GABA agonists such as benzodiazepines amplify the inhibitory effects of GABA at the synapse. This helps counter excessive neural activity associated with the phobic fear response, reducing physiological arousal and feelings of anxiety. They primarily manage phobic anxiety rather than addressing the underlying cause of the phobia.

What are the benefits and limitations of GABA agonists for specific phobia?

GABA agonists can provide short-term relief from phobic anxiety by increasing inhibitory neural transmission. However, prolonged use can result in physical or psychological dependence and withdrawal symptoms, and symptoms may return when medication is stopped. They also do not provide coping skills or address the underlying cause of the phobia, so psychotherapy may be used alongside them.

Define breathing retraining

Breathing retraining is a technique that teaches an individual to control their breathing to reduce physiological arousal. It aims to counter fast, shallow breathing associated with anxiety and help the person regain a calmer physiological state.

How does breathing retraining treat specific phobia?

When encountering a phobic stimulus, a person may breathe rapidly and shallowly, contributing to hyperventilation and increased physiological arousal. Breathing retraining teaches controlled breathing, which can reduce physiological arousal and help manage feelings of phobic anxiety.

How effective is breathing retraining for specific phobia?

Breathing retraining can help reduce physiological arousal and manage anxiety symptoms when encountering a phobic stimulus. However, it primarily manages the physiological symptoms of anxiety rather than directly addressing the underlying learned fear association, so it can be used alongside other interventions.

Define CBT (Cognitive Behavioural Therapy)

CBT is a type of psychotherapy that encourages individuals to replace dysfunctional cognitions and behaviours with more adaptive ones. It is based on the idea that thoughts, feelings and behaviours are interconnected and influence one another.

How does CBT treat specific phobia?

CBT identifies and challenges dysfunctional thoughts and behaviours that contribute to or maintain a phobia. The individual learns to recognise unrealistic or anxious thoughts, develop more realistic thoughts and replace maladaptive behaviours such as avoidance and safety behaviours with more adaptive behaviours.

How does CBT challenge unrealistic or anxious thoughts?

CBT identifies dysfunctional thoughts and examines them as hypotheses rather than automatically accepting them as true. The person considers evidence for and against the thought and develops a more realistic alternative. For example, a person who believes a feared event will definitely occur can examine evidence showing that the feared outcome is unlikely.

What are avoidance behaviours?

Avoidance behaviours involve actively averting contact, exposure or engagement with a phobic stimulus. They temporarily reduce fear and anxiety but maintain the phobia through negative reinforcement because the person learns that avoiding the stimulus removes the unpleasant emotional response.

What are safety behaviours?

Safety behaviours involve not completely avoiding a phobic stimulus but using a measure intended to ensure safety when encountering it. They can maintain a phobia because the individual may continue to believe the stimulus is dangerous and that the safety behaviour prevented harm.

Define systematic desensitisation

Systematic desensitisation is a behavioural therapy that aims to replace an anxiety or fear response with a relaxation response when a person anticipates or encounters a phobic stimulus. It involves gradual exposure to the phobic stimulus while using relaxation techniques.

How does systematic desensitisation treat specific phobia?

Systematic desensitisation gradually exposes an individual to the phobic stimulus while they use relaxation techniques. Through classical conditioning, relaxation becomes associated with the phobic stimulus, helping replace the learned anxiety response with a relaxation response.

What are the steps of systematic desensitisation?

First, the individual learns appropriate relaxation techniques. Second, a fear hierarchy is constructed, ranking feared stimuli from least to most fear-producing. Third, the individual gradually faces each item while remaining relaxed, progressing only when they can successfully manage the current level of fear. Eventually, they work towards calmly encountering the phobic stimulus.

What is a fear hierarchy?

A fear hierarchy is a list of feared stimuli or situations ranked from the least fear-producing to the most fear-producing. It is used in systematic desensitisation to guide gradual exposure to the phobic stimulus.

How does relaxation work in systematic desensitisation?

Relaxation techniques are taught before exposure and then paired with items in the fear hierarchy. The individual learns to remain relaxed while gradually encountering increasingly fear-producing stimuli, helping associate the phobic stimulus with relaxation rather than anxiety.

How can psychoeducation for families help treat specific phobia?

Psychoeducation teaches families and supporters about the nature of specific phobia and how to support treatment. Families are taught to challenge unrealistic or anxious thoughts in a supportive, non-judgemental way and avoid encouraging avoidance behaviours.

Define psychoeducation

Psychoeducation involves teaching individuals, families and supporters about a mental health disorder so they can better understand, manage and support treatment. For specific phobia, it includes education about phobia and teaching families to challenge unrealistic thoughts and not encourage avoidance.

How can families challenge unrealistic thoughts about the phobic stimulus?

Families can supportively and non-judgementally question unrealistic or anxious thoughts by encouraging the person to consider evidence and more realistic alternatives. This can help challenge catastrophic thinking and other unhealthy cognitions contributing to the phobia.

Why should families discourage avoidance behaviours?

Avoidance provides temporary relief from fear but does not provide a long-term solution. It maintains the phobia through negative reinforcement by strengthening the likelihood that avoidance will be repeated. Families should therefore avoid encouraging avoidance and instead support appropriate contact with the phobic stimulus as part of treatment.

What evidence-based interventions target each contributing factor of specific phobia?

Biological factors: GABA agonists and breathing retraining. Psychological factors: CBT and systematic desensitisation. Social factors: psychoeducation for families and supporters, challenging unrealistic or anxious thoughts, and discouraging avoidance behaviours.

What are the three types of factors that maintain and protect mental wellbeing?

The three types are biological, psychological and social factors. These factors interact and influence one another and can work together to maintain and protect high levels of mental wellbeing.

What biological factors can maintain and protect mental wellbeing?

Adequate nutritional intake and hydration and adequate sleep are biological protective factors. Adequate nutrition and hydration support energy, mood, sleep and physical health, while adequate sleep supports physical repair, replenishment, hormone release, information processing and memory consolidation.

What psychological factors can maintain and protect mental wellbeing?

Cognitive behavioural strategies and mindfulness meditation are psychological protective factors. They can promote realistic and positive thinking, challenge maladaptive thoughts, reduce stress and rumination, improve focus and cognitive flexibility, and support effective coping and resilience.

What social factors can maintain and protect mental wellbeing?

Authentic and energising social support from family, friends and community can maintain and protect mental wellbeing. Support can provide belonging, emotional support, practical assistance, connection, purpose and opportunities for positive relationships.

How do biological, psychological and social factors interrelate to maintain and protect mental wellbeing?

Biological, psychological and social protective factors interact and influence one another. For example, adequate sleep can improve mood and cognitive functioning, which can support positive relationships and coping, while supportive relationships can help a person manage stress and maintain healthy behaviours. A holistic and combined biopsychosocial approach is therefore most effective.

How could you apply the biopsychosocial approach to a person experiencing stress?

Biologically, consider factors such as adequate sleep, nutrition and hydration. Psychologically, use cognitive behavioural strategies to identify and challenge unhelpful thoughts and use mindfulness to reduce stress. Socially, seek authentic and energising support from family, friends or community. These factors should be considered together because they interact.

How do you explain a factor that maintains and protects mental wellbeing?

Identify the factor, explain how it influences mental wellbeing, and link it to maintaining or increasing functioning and resilience. For example, adequate sleep supports cognitive, behavioural and emotional functioning, which helps a person cope with everyday challenges and maintain higher mental wellbeing.

Define cultural continuity

Cultural continuity involves the preservation of Aboriginal and Torres Strait Islander culture over time and the sense of history, identity and belonging this provides. It includes the intergenerational maintenance and transmission of cultural knowledge and practices such as language, connections to Country, family and kinship, community, spirituality and ancestors.

What is a holistic, multidimensional framework for wellbeing?

A holistic, multidimensional framework considers the whole person and recognises that wellbeing consists of multiple interconnected dimensions rather than one aspect alone. In the Aboriginal and Torres Strait Islander SEWB framework, these include body, mind and emotions, family and kinship, community, culture, Country, and spirituality and ancestors.

Why is a holistic, multidimensional approach important for wellbeing?

It recognises that different aspects of wellbeing are interconnected and influence one another. For Aboriginal and Torres Strait Islander peoples, wellbeing is not understood solely through individual mental health but through connections with family, community, culture, Country, spirituality and ancestors as well as body, mind and emotions.

What is cultural continuity?

Cultural continuity is the preservation and continuation of Aboriginal and Torres Strait Islander cultural knowledge, practices, identity and connections across generations. It provides a sense of history, identity, belonging and cultural connection.

How does cultural continuity impact wellbeing?

Cultural continuity strengthens cultural identity and connection and can enhance resilience and healing. Maintaining cultural knowledge and practices supports social and emotional wellbeing by providing a sense of history, identity, belonging and connection to culture, Country, family, kinship and community.

How could cultural continuity protect wellbeing?

Cultural continuity can protect wellbeing by strengthening cultural identity, maintaining connections and belonging, supporting resilience and promoting healing from past trauma. Passing cultural knowledge and practices between generations helps maintain strong cultural and social connections.

What is self-determination?

Self-determination is the right of Aboriginal and Torres Strait Islander peoples to make decisions about matters that affect their lives and communities. It involves Aboriginal and Torres Strait Islander people having ownership, control and responsibility for decisions, policies and services that affect them.

How does self-determination contribute to wellbeing?

Self-determination contributes to wellbeing by giving Aboriginal and Torres Strait Islander peoples greater control over decisions affecting their lives and communities. Community control allows mental health services and policies to reflect local priorities, goals, cultural needs and appropriate solutions.

How can self-determination protect wellbeing?

Self-determination can protect wellbeing by empowering communities, supporting cultural safety, addressing racism and trauma, prioritising culture, and transferring power and resources to communities. Greater control and culturally appropriate services can strengthen identity, connection and wellbeing.

What are the seven domains of the SEWB framework?

The seven overlapping domains are body; mind and emotions; family and kinship; community; culture; Country; and spirituality and ancestors. Together they represent interconnected sources of wellbeing and connection that support a strong and positive identity.

How do social, historical and political determinants influence SEWB?

Social determinants include socioeconomic status, poverty, unemployment, housing, education, racism, violence, trauma and access to community resources. Historical determinants include the effects of past government policies, oppression and cultural displacement. Political determinants include unresolved issues of land, control of resources, cultural security, self-determination and sovereignty. These determinants can affect SEWB concurrently and cumulatively.

What is the relationship between SEWB and mental wellbeing?

SEWB and mental wellbeing have an interactive relationship. A person can experience relatively good SEWB while still experiencing mental health problems, or experience mental health without having poor SEWB. SEWB recognises that mental wellbeing is connected to cultural, social, physical, spiritual and community factors.

What are protective factors?

Protective factors are influences that enable an individual to improve and maintain high levels of mental wellbeing. They strengthen mental wellbeing and improve the ability to cope with difficult circumstances by reducing the risk of low mental wellbeing or mental health disorders and increasing the likelihood of high mental wellbeing.

Why is a combined biopsychosocial approach important for maintaining mental wellbeing?

High levels of mental wellbeing are best maintained through a holistic and combined biopsychosocial approach because biological, psychological and social protective factors are interrelated and interactive. Increasing protective factors, minimising risk factors and reducing barriers to seeking help can support mental wellbeing.

What is adequate nutritional intake and hydration?

Adequate nutritional intake and hydration occurs when the type and amount of food and drink consumed meet a person's physical needs. It includes sufficient water and nutrients such as carbohydrates, protein, fats, vitamins and minerals.

How does adequate nutrition and hydration protect mental wellbeing?

Adequate nutrition and hydration support physical health, energy levels, mood and sleep. Meeting the body's nutritional and hydration needs can contribute to an overall sense of mental wellbeing and reduce the risk of physical health problems.

What is adequate sleep?

Adequate sleep involves obtaining the right amount of good-quality sleep needed to wake feeling rested, refreshed and ready for the day. During sleep, the body repairs tissues, replenishes resources, releases hormones, processes information and consolidates learning.

How does adequate sleep protect mental wellbeing?

Adequate sleep supports emotional, behavioural and cognitive functioning. It helps with mood regulation, concentration, alertness, memory, clear thinking and decision-making, supporting effective everyday functioning and mental wellbeing.

How can poor sleep lower mental wellbeing?

Inadequate or poor-quality sleep can impair affective, behavioural and cognitive functioning. It can increase irritability and emotional reactivity, reduce alertness and concentration, slow reaction time, impair memory and judgement, and negatively affect relationships and overall wellbeing.

What are cognitive behavioural strategies as a protective factor?

Cognitive behavioural strategies are techniques based on CBT that identify, assess and correct faulty patterns of thinking and problem behaviours that may threaten mental wellbeing. They can promote more helpful thinking and behaviour and increase resilience by improving coping with challenging situations.

What is cognitive restructuring?

Cognitive restructuring is the process of identifying, challenging and replacing negative, irrational or distorted thoughts with more reasonable and helpful ways of thinking. This can reduce maladaptive feelings and behaviours influenced by those thoughts.

How can cognitive behavioural strategies increase resilience?

Cognitive behavioural strategies teach individuals to identify and challenge unhelpful thinking and develop more adaptive ways of responding to challenges. These skills can improve coping and problem-solving, increasing the person's ability to manage difficult situations and recover from adversity.

Define mindfulness meditation

Mindfulness meditation is a practice involving moment-to-moment awareness of one's experiences without judgement. It involves observing thoughts, feelings, behaviours and sensations in the present moment rather than becoming caught up in negative thoughts or worries about the future.

How does mindfulness meditation protect mental wellbeing?

Mindfulness meditation can reduce rumination and stress, improve working memory and focus, increase cognitive flexibility and reduce emotional reactivity. It helps people observe thoughts and emotions without automatically reacting to them.

What is social support?

Social support refers to assistance, care or comfort provided by other people to help an individual cope with a stressor or mental health difficulty. It can be practical, tangible or emotional and is more likely to benefit wellbeing when it is authentic and energising.

How can family support protect mental wellbeing?

Family can provide a sense of belonging to a familiar group, support during difficult times and unconditional love. These forms of support can help an individual cope with stressors and maintain positive mental wellbeing.

How can friends protect mental wellbeing?

Friends can contribute to happiness, provide an outlet for sharing experiences and create a sense of like-minded belonging. Positive friendships can provide emotional support and help protect mental wellbeing.

How can community protect mental wellbeing?

Community can provide opportunities for interaction and relationship development, challenging experiences that promote personal growth and learning, and a sense of purpose and collective achievement.

What does authentic and energising social support mean?

Authentic and energising social support is support that is genuine, positive and uplifting rather than harmful or draining. It can help an individual feel valued, accepted, understood and connected to others.

How should you apply the biological protective factors to a scenario?

Identify adequate nutrition/hydration and/or adequate sleep as relevant factors, then explain how they support physical health, energy, mood, cognition, emotional regulation or functioning, leading to improved or maintained mental wellbeing.

How should you apply the psychological protective factors to a scenario?

Identify cognitive behavioural strategies and/or mindfulness meditation, then explain how they improve thinking, coping, emotional regulation, stress management, focus or resilience, thereby maintaining or improving mental wellbeing.

How should you apply the social protective factors to a scenario?

Identify authentic and energising support from family, friends and/or community, then explain how it provides belonging, emotional or practical support, connection, purpose or opportunities for relationships, helping the person cope and maintain mental wellbeing.

How do classical and operant conditioning contribute to specific phobia?

Classical conditioning can precipitate a specific phobia by creating an association between a previously neutral stimulus and an aversive stimulus, causing the neutral stimulus to eventually trigger a fear response. Operant conditioning can perpetuate the phobia because avoiding the stimulus removes fear and is negatively reinforced, making avoidance more likely.

How does classical conditioning precipitate a specific phobia?

A neutral stimulus can become associated with an aversive or traumatic event through repeated pairing. Eventually, the previously neutral stimulus becomes a conditioned stimulus that triggers a conditioned fear response, contributing to the development of a specific phobia.

How does operant conditioning perpetuate a specific phobia?

A person may avoid the phobic stimulus, which removes the unpleasant fear response. This relief acts as negative reinforcement, increasing the likelihood of future avoidance and maintaining the phobia.

How does memory bias contribute to specific phobia?

Memory bias is a tendency for recall of a phobic stimulus or experience to focus on negative or threatening information rather than positive or neutral information. This can make a past event seem more threatening than it was and help maintain the person's fear.

How does LTP contribute to the development and maintenance of specific phobia?

Repeated co-activation of neural pathways involved in perceiving a phobic stimulus and activating the fear response strengthens their synaptic connections through LTP. This makes the phobic stimulus more readily activate the fear response. Recalling or imagining the phobic stimulus can also reactivate and strengthen these pathways.

How does GABA dysfunction contribute to specific phobia?

GABA is the primary inhibitory neurotransmitter in the central nervous system and helps regulate neural activity associated with anxiety and the fight-flight-freeze response. GABA dysfunction means insufficient inhibitory transmission, which can make the stress response easier to activate and harder to calm, contributing to phobic anxiety.

How do social factors contribute to specific phobia?

Environmental triggers such as traumatic experiences can contribute to the development or maintenance of a phobia. Stigma can also prevent people from seeking treatment because negative attitudes and stereotypes may produce shame, social disapproval or fear of judgement.

What are the three categories of interventions for specific phobia?

Biological interventions act on physiological elements and include GABA agonists and breathing retraining. Psychological interventions address cognitive and mental processes and include CBT and systematic desensitisation. Social interventions address social and interactional factors and include psychoeducation for families and supporters.

What is the difference between an adaptive and maladaptive response?

Adaptive behaviour enables an individual to adjust to their environment appropriately and effectively and fulfil everyday roles. Maladaptive behaviour is detrimental or counterproductive and interferes with the individual's ability to adjust to the environment and fulfil typical roles.

What is the relationship between functioning and mental wellbeing?

Higher mental wellbeing is generally associated with optimal or high functioning, including effective coping, positive relationships and appropriate emotional responses. As mental wellbeing decreases, functioning can become disrupted, with greater distress, reduced coping ability and difficulty completing everyday activities.

How are stress and anxiety different?

Stress is a psychobiological response to stressors perceived to challenge or exceed a person's ability to cope and can involve both positive and negative experiences. Anxiety is psychological and physiological arousal involving worry, apprehension and unease about something potentially unpleasant and is typically experienced as negative.

How is fear different from anxiety?

Fear is an adaptive response to a clearly identifiable and specific threat and is usually short-lived. Anxiety involves worry, apprehension and unease about something potentially unpleasant or wrong, which may not involve an immediate identifiable threat.

What makes a fear a specific phobia rather than a normal fear?

A specific phobia involves fear or anxiety that is excessive, distressing, irrational and persistent in response to a specific stimulus. It leads to significant disruption to daily functioning and is often accompanied by avoidance behaviour.

Why can a person with a mental health disorder still have high mental wellbeing?

Mental wellbeing is dynamic and exists on a continuum. A person with a diagnosed mental health disorder may experience periods of low wellbeing but, if their condition is well managed and they have adequate support, they may experience higher levels of wellbeing and functioning at other times.