Psychotherapy and Psychological Interventions
This domain tests evidence-based psychological treatments, mechanisms, indications, boundaries, and common factors. Part I expects you to match therapy to formulation and risk, not just list modalities.
Core rules
- CBT targets maintaining cognitions and behaviors; exposure with response prevention is first-line for OCD.
- Psychodynamic therapy explores recurring patterns and relationships; supportive therapy stabilizes coping and alliance.
- DBT combines skills training, mindfulness, and validation for chronic self-harm and emotion dysregulation.
- Informed consent includes goals, expected duration, alternatives, confidentiality limits, and possible distress.
- Measurement-based care uses symptom and functioning measures to review progress; rupture repair matters.
Worked example
A patient with contamination OCD asks for relaxation to stop washing. Reasoning: relaxation may reduce anxiety but does not test the obsessional threat. ERP would build a hierarchy, expose the patient to feared triggers, and prevent washing rituals; the rationale and consent are explained before starting.
Traps
Do not use insight-oriented exploration as the sole treatment in acute psychosis or severe risk. Do not confuse supportive contact with a specific evidence-based protocol. Do not ignore trauma, safeguarding, or confidentiality limits.