module 8 - alternative therapies and self help groups

chapters 10 and 19

What are therapeutic factors of self help groups?

• instillation of hope

• universality (knowing you are not alone)

• imparting of information

• altruism (patients experience being useful to others)

• corrective recapitulation of primary family group

• development of socialization techniques

• imitative behavior

• catharsis

• existential factors

• cohesiveness

• interpersonal feelings

What are types of groups that patients may join?

• psychoeducational

  • teach variety of content and skills, such as medications, problem solving

• maintenance

  • provides support, respond to needs, reinforce strengths, reality orientation

• activity

  • facilitates interaction, self expression and increase self esteem, recreation, or exercise

• self help and special problems

  • members share a common problem

What type of patient in a group monopolizes the entire group session?

dominant patient

What techniques should be used to manage a dominant patient in a group?

use gate keeping to offer all patients the opportunity to contribute to the group

What type of patient in a group is not interesting in what is going on and does not participate?

uninvolved

What techniques can be used to manage an uninvolved patient in a group?

support the patient by relating that each individual is important and capable of helping others

What are techniques to manage a hostile patient in a group?

use support to attempt to help the patient deal with feelings of fear, self anger, or unresolved anger towards others

What techniques are used to manage a distracting patient in a group?

use empathy, focus on the underlying need and present reality, refocus the group

What drugs interact with MAOIs and stimulants?

phenylephrine and pseudoephedrine

What drugs increase the clearance of many psychotics?

nicotine and nicotine cessation products

What drug can cause elevated BP and HR?

caffeine

What drugs combined with SSRIs can increase the risk of gastric bleeding?

NSAIDs

What are some reasons that people choose herbal therapies?

• desire for empowerment

• belief in enhanced health with concomitant use

• desire to try a novel therapy

• belief that conventional medicine will not help

• on advice from a health care professional

• costs of conventional treatments

• assumption that natural implies better tolerated

What are common herbs used to treat psychiatric illness?

• angelica

• chamomile

• ginkgo

• kava

• melatonin

• St. John’s wort

• valerian

• SAM-e

• ashwagandha

What herbal therapy is used for depression and increases the risk for serotonin syndrome if used with SSRIs, also interferes with protease inhibitors?

St. Jonn’s wort

What herbal therapy can be used as an adjuvant only for depression and has a serotonin syndrome risk when given with MAOIs?

SAM-e

What herbal therapies are used to treat anxiety?

kava, valerian, chamomile, angelica, and ashwaganda

What herbal therapy for anxiety interacts with antiparkinsonian drugs, benzos, and other drugs that act on the CNS, is also hepatotoxic?

kava

What herbal therapy for anxiety and sleep disorders is effective when used with St. John’s wort but negates effects of MAOIs, warfarin, and phenytoin *** also has a potential for dependance?

valerian

What herbal therapy is used for sedation and anxiolysis, has a hypersensitivity risk, and interacts with anticoagulants and CNS drugs?

chamomile

What herbal therapy for anxiety has CV and CI effects and increased the PTT with anticoagulants?

angelica

What herbal therapy for anxiety must be used with caution with antihypertensives?

ashwagandha

What herbal therapy is used for memory and dementia but studies show is ineffective?

ginkgo

What herbal therapy is an effective antidote to erectile dysfunction caused by antidepressants (also increases effects of anticoagulants)?

ginkgo

What herbal therapy worsens mania, anxiety, and insomnia?

ginseng

What herbal therapy causes nervousness, irritability, and insomnia?

yohimbine

What mental health drugs are at high risk for interacting with herbals?

TCAs, valproic acid, and lithium

What vitamins are associated with reduced risks of cognitive decline?

vitamins C and E

What vitamin may alleviate symptoms of depression?

vitamin D

What vitamin increases the effectiveness of antidepressant drugs?

folate

What fat must com from diet and helps depression, schizophrenia, ADHD, autism, BPD, and substance use disorder?

omega 3