Psychisch welzijn en gezondheidszorg GMW 2025-2026.pdf

# Case studies illustrating depressive and manic episodes ### Core idea * Psychological well-being extends beyond the absence of disorders to encompass optimal functioning and personal growth [7](#page=7). * It involves the ability to manage thoughts, feelings, and relationships, leading to satisfaction with one's existence [7](#page=7). * Mental health promotion is a crucial societal task, addressed at macro, meso, and micro levels [7](#page=7). * Interventions aim to strengthen protective factors and reduce risks for mental health issues [7](#page=7). ### Key facts * Happiness is multifaceted, involving aspects like being true to oneself, having strong social connections, and feeling good emotionally [5](#page=5). * Statistics highlight significant prevalence of anxiety disorders, depression, suicidal ideation, and psychoactive medication use in the population [8](#page=8). * Geestelijke gezondheidszorg (mental healthcare) is typically organized into three levels based on accessibility and specialization: first, second, and third line [8](#page=8). * A "zeroth line" includes self-care and informal care from one's immediate environment and community [8](#page=8). * The biopsychosocial model posits that psychological problems arise from a complex interplay of biological, psychological, and social factors [9](#page=9). * Maslow's hierarchy of needs describes a progression of human motivations from basic physiological needs to self-actualization [12](#page=12). * Later revisions to Maslow's model included cognitive and aesthetic needs [13](#page=13). * Carl Rogers proposed three core conditions for therapeutic relationships: empathy, unconditional positive regard, and authenticity [15](#page=15). * French and Raven identified five types of power in relationships: coercive, reward, legitimate, referent, and expert [16](#page=16) [17](#page=17). ### Key concepts * **Psychological well-being** encompasses emotional, personal, and social well-being [7](#page=7). * **Emotional well-being:** Life satisfaction and presence of positive over negative feelings [7](#page=7). * **Personal well-being:** Self-acceptance, autonomy, purpose, self-realization, and growth [7](#page=7). * **Social well-being:** Positive relationships, trust in societal progress, participation, and community acceptance [7](#page=7). * **Symptoms** are specific characteristics indicating a psychological problem [11](#page=11). * **Syndromes** are cohesive sets of symptoms with defined severity and duration [11](#page=11). * **DSM (Diagnostic and Statistical Manual)** is a guide for describing psychological disorders [11](#page=11). * **Well-being needs** are essential conditions for satisfying fundamental human needs [14](#page=14). * **Empathy** is the attempt to understand the client's feelings and experiences from their internal perspective [15](#page=15). * **Unconditional positive regard** is an open and accepting stance towards the client's feelings and thoughts [15](#page=15). * **Authenticity** means the helper is genuinely present and does not hide behind a professional facade [15](#page=15). * **Power** is the ability to influence the behavior, thoughts, and feelings of others [16](#page=16). ### Implications ### Common pitfalls --- ## Case studies illustrating depressive and manic episodes ### Behavioral approach * Behavioral approach distinguishes between classical and operant conditioning, both involving learned associations through experience [18](#page=18). * Classical conditioning: Learning meanings/associations between events for predictability (e.g., dark clouds and rain) [18](#page=18). * Pavlov's dogs: Bell predicts food [18](#page=18). * Watson's "Little Albert" experiment: Paired white rat with loud noise, leading to fear generalization [18](#page=18). * Phobias can also be learned through "model-learning" (observing others) [18](#page=18). * Operant conditioning: Learning the link between voluntary behavior and subsequent environmental events [19](#page=19). * Reinforcement (rewarding desired behavior) is more effective than punishment (discouraging undesired behavior) [19](#page=19). * Punishment can lead to resentment, fear, and negative self-image [19](#page=19). * **S-R-C Model for Behavioral Analysis**: * S: Stimulus (specific preceding circumstances) [20](#page=20). * R: Response (concrete behavior) [20](#page=20). * C: Consequence (learned link between behavior and outcomes) [20](#page=20). * Example: A child's whining (R) in a store (S) leads to getting desired candy (C) [20](#page=20). * Example: Alcohol use (R) to alleviate hardship (S) leads to reduced psychological distress (C) [20](#page=20). * **Types of Consequences**: * Positive reinforcement: Offering an pleasant consequence [20](#page=20). * Negative reinforcement: Ending or avoiding an unpleasant situation [20](#page=20). * Positive punishment: Administering an unpleasant stimulus [20](#page=20). * Negative punishment: Removing a pleasant circumstance [20](#page=20). * **Behavior Change Techniques**: * Encouraging desired behavior via positive reinforcement (social, material, or activity rewards) [22](#page=22). * Prohibiting undesired behavior with clear "no" and alternatives [22](#page=22). * Distraction (especially for young children) [22](#page=22). * Ignoring attention-seeking, non-harmful behavior [22](#page=22). * Time-out: Temporarily separating a child to calm down [22](#page=22). ### Cognitive approach --- ## Motivation and cognitive approaches in practice * The document discusses various cognitive and motivational approaches used in client counseling and behavior change interventions. * Key theories include Weiner's attribution theory, Rotter's locus of control, and Self-Determination Theory (SDT). * Practical techniques like the stop-think-do method, psycho-education, and motivation-supportive counseling are detailed. * Cognitive therapy's effectiveness with young children (5-8 years) is less researched and shows smaller effects than with older age groups [32](#page=32). * Weiner's attribution theory extends Rotter's locus of control, adding dimensions of stability and controllability [32](#page=32). * Common cognitive biases include the self-serving bias and the fundamental attribution error [33](#page=33). * The "stop-think-do" method is a strategy for problem-solving and inhibiting impulsive behavior [33](#page=33). * Psycho-education involves informing clients and their environment about psychological issues, often supported by visual aids [34](#page=34). * Self-Determination Theory (SDT) emphasizes autonomous motivation, driven by intrinsic interest, perceived usefulness, or value integration [35](#page=35) [36](#page=36). * Controlled motivation stems from internal or external pressure ("MOETivation") and is less sustainable [37](#page=37). * Amotivation is characterized by a lack of motivation, belief in effectiveness, or perceived ability [37](#page=37). * SDT posits three universal psychological needs: autonomy, connectedness, and competence (the "abc" of motivation) [35](#page=35) [38](#page=38). * Fulfilling these needs fosters autonomous motivation, leading to greater energy, satisfaction, and sustained behavior change [38](#page=38). * Undermining these needs leads to negative emotions, avoidance of desired behavior, and a return to unhealthy habits [38](#page=38). * Motivation levels fluctuate over time, influenced by the satisfaction of the abc needs [39](#page=39). * Counseling methods aim to be autonomy-supportive, relationally supportive, and competence-supportive [39](#page=39). * Autonomy support involves not pressuring clients and aligning goals with their values [39](#page=39). * Relational support focuses on the client's social environment and building trust [40](#page=40). * Competence support involves setting achievable goals and providing clear feedback [40](#page=40). * General counseling principles include confidentiality, non-judgment, respect, and viewing the client as the expert in their life [41](#page=41). * Effective counseling skills include open questioning, active listening, paraphrasing, and summarizing [41](#page=41). * Case study examples illustrate inappropriate counseling responses, identifiable attitudes, and situations requiring intervention [41](#page=41) [42](#page=42) [43](#page=43). * Specific examples of power dynamics (e.g., in a CAW setting) and group work challenges are presented [42](#page=42) [43](#page=43). * Behavioral analysis (ABC schema) and behavior change techniques (e.g., for teeth brushing, homework) are discussed [43](#page=43). * **Attributional dimensions:** Internality/externality, stability/instability, controllability/uncontrollability of causes [32](#page=32). --- ## Depressive and manic episodes - Depressive and manic episodes are characterized by significant mood dysregulation. - Depressive disorders and bipolar disorders are distinguished by the presence of depressive episodes and, in bipolar disorders, manic episodes as well. - A depressive episode requires five or more specific symptoms within a two-week period, including either a depressed mood or diminished interest/pleasure [48](#page=48). - Symptoms of a depressive episode include changes in sleep, appetite, energy, concentration, and feelings of worthlessness or guilt [48](#page=48). - Recurrent thoughts of death or suicide are also characteristic of a depressive episode [48](#page=48). - A manic episode is defined by a distinct period of abnormally elevated, expansive, or irritable mood and increased activity/energy lasting at least one week [50](#page=50). - Symptoms of a manic episode include grandiosity, reduced need for sleep, pressured speech, flight of ideas, distractibility, increased goal-directed activity, and excessive engagement in risky behaviors [50](#page=50). - Bipolar disorder requires at least one manic episode alongside depressive episodes [47](#page=47). - Depressive episodes must last at least two weeks, while manic episodes must last at least one week [50](#page=50). - **Depressive episode criteria (DSM-5)**: Five or more symptoms, including depressed mood or loss of interest/pleasure, present for at least two weeks, causing significant distress or impairment [48](#page=48). - **Manic episode criteria (DSM-5)**: Distinct period of elevated/irritable mood and increased energy/activity for at least one week, with three or more additional symptoms (four if mood is only irritable) causing - **Bipolar disorder**: Characterized by recurrent depressive and manic episodes [47](#page=47). - **Dysthymia**: A persistent depressive disorder requiring a depressed mood for at least two years, with potential for superimposed depressive episodes [51](#page=51). - **Cyclothymic disorder**: Characterized by at least two years of alternating periods with mild manic and mild depressive symptoms, with no more than two months symptom-free [51](#page=51). - **Age-dependent manifestations**: Depression presents differently across age groups, from protest in babies to irritability in toddlers, and somberness or emptiness in adults [52](#page=52). - **Psychological factors**: Dysfunctional thoughts, negative life experiences, and prior depressive episodes contribute to depressive disorders [54](#page=54). - **Social factors**: Family climate and parental psychopathology are significant contributors to childhood depression [54](#page=54). - **Biological factors**: Genetics, neurotransmitter imbalances (serotonin, noradrenaline), and physical health conditions play a role [53](#page=53). - The distinction between normal sadness and a clinical depressive disorder lies in the persistent nature and impact on daily functioning [47](#page=47). - Differentiating bipolar disorder in children and adolescents can be challenging due to rapid mood swings rather than distinct episodes [47](#page=47). - Psychotic features can occur in both severe depressive and manic episodes, involving delusions related to self-worth or other themes [51](#page=51). - Co-occurring disorders like anxiety, ADHD, or substance use can prolong depressive episodes and increase suicide risk [51](#page=51). ### Treatment approaches - Treatment for depressive disorders may include medication (antidepressants for moderate to severe cases) and psychotherapy, such as cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT) [55](#page=55). - For bipolar disorder, biological therapies like lithium or other mood stabilizers are primary, often lifelong, treatments, supplemented by psychosocial support [56](#page=56). - Psychoeducation is a crucial first step in managing depression, providing information about the disorder and coping strategies [55](#page=55). --- ### Illustrative examples of depressive and manic episodes * **Example 1: Music student (19 years old)** * Followed a depressive period with six months of increased energy and cheerfulness [63](#page=63). * Exhibited excessive talking, constant criticism, and defiance towards his teacher [63](#page=63). * Continued to experience auditory hallucinations, seeing Beethoven who praised his genius [63](#page=63). * Believed himself to be the Messiah, preached against prostitution, and composed a "Great Song of Love" [63](#page=63). * Felt persecuted by doctors he perceived as hypnotists experimenting on him [63](#page=63). * Experienced nighttime visitations from Christ or his father's spirit [63](#page=63). * Speech was characterized by rapid shifts in topic and unexpected humorous questions [63](#page=63). * Displayed arrogance, conceit, irritation, and a condescending demeanor [63](#page=63). * Talked excessively, often aloud to himself, and paced noisily on the ward [63](#page=63). * Interfered with other patients, attempting to uplift and influence them [63](#page=63). * Worked late into the night on letters and compositions, producing rushed, sloppy work [63](#page=63). * Described as an example of what Kraepelin termed "manic-depressive insanity," now known as bipolar disorder [63](#page=63). * **Example 2: Mr. Pieters (47 years old)** * Previously experienced months of somberness and lack of energy, attributed to overwork [63](#page=63). * Suddenly felt much better and initiated a major home renovation [63](#page=63). * Purchased expensive materials, acting uncharacteristically [63](#page=63). * Worked day and night on renovations, neglecting sleep and food [63](#page=63). * His wife became alarmed due to his extreme behavior and potential for exhaustion or heart attack [63](#page=63). * He claimed a "mental invention" eliminated the need for sleep [63](#page=63). * Refused help, stating he was "hyper-healthy" [63](#page=63). * His wife, with family and friends' help, managed the situation but he eventually collapsed from exhaustion [63](#page=63). * Diagnosed by a psychiatrist with a manic episode, preceded by a depressive period [63](#page=63). * **Example 3: Jimmy (10 years old)** * Exhibited frequent temper tantrums and irritability at home and school [64](#page=64). ### Guidelines for managing depressive symptoms ### Cognitive restructuring example ### Suicide risk assessment --- ## Trauma and post-traumatic stress disorder * Psychological trauma involves deeply disturbing, emotionally overwhelming experiences [74](#page=74). * Trauma is categorized into single, acute events (Type 1) and prolonged, repeated events (Type 2) [74](#page=74). * Post-traumatic stress disorder (PTSS) is a potential response to experiencing or witnessing traumatic events [74](#page=74). * Acute stress disorder occurs within days of trauma and resolves within four weeks; PTSS is diagnosed if symptoms persist beyond four weeks or appear later [75](#page=75). * PTSS symptoms can manifest months or even years after the initial trauma [75](#page=75). * DSM-5 criteria for PTSS include exposure to trauma, intrusive symptoms, persistent avoidance, negative alterations in cognitions/mood, and changes in arousal/reactivity [75](#page=75) [76](#page=76) [77](#page=77). * Criterion A4 for PTSS excludes exposure to media unless it is work-related [75](#page=75). * Intrusive symptoms can include flashbacks, distressing dreams, and repetitive play in children expressing trauma themes [75](#page=75). * Avoidance of trauma-related stimuli includes memories, thoughts, feelings, people, places, and activities [76](#page=76). * Negative alterations in cognitions and mood may involve memory gaps, negative beliefs about self/world, and persistent negative emotions like fear and shame [76](#page=76). * Changes in arousal and reactivity can present as irritability, recklessness, hypervigilance, exaggerated startle responses, concentration, and sleep disturbances [77](#page=77). * The duration of PTSS symptoms must be longer than one month, causing significant distress or functional impairment [77](#page=77). * **Traumatic experiences** evoke strong emotions like fear, horror, and helplessness [74](#page=74). * **Intrusive symptoms** are recurring, involuntary, and distressing memories or dreams related to the trauma [75](#page=75). * **Dissociative reactions**, such as flashbacks, involve feeling as if the traumatic event is happening again [75](#page=75). * **Avoidance behaviors** aim to prevent distressing memories, thoughts, or feelings associated with the trauma [76](#page=76). * **Negative cognitions and mood** involve distorted beliefs about oneself, others, or the world, and persistent negative emotions [76](#page=76). * **Changes in arousal and reactivity** include increased vigilance, exaggerated startle responses, and sleep disturbances [77](#page=77). * **Distorted time perception** is common after trauma, leading to a fragmented recollection of events [78](#page=78). * **Attributional processes** influence the persistence of PTSS symptoms; internal, controllable attributions can lead to guilt and shame [78](#page=78). * Traumatic events can disrupt basic assumptions about safety, predictability, and self-worth [78](#page=78). * Difficulty processing trauma can lead to persistent symptoms, including depression and re-experiencing [79](#page=79). * Young children may exhibit attachment issues, nightmares, and behavioral problems following trauma [77](#page=77). * Adolescents and adults are at risk for identity disorders, depression, and behavioral problems such as aggression and substance abuse [78](#page=78). * Social support plays a critical role in trauma processing and resilience [79](#page=79). ### Treatment and guidance --- ### Case illustrations of trauma types and PTSD symptoms - **Romario (8 years old):** Experienced a house fire, witnessed mother's burns, and sister's death. Displays inattention, fatigue, jumpiness, and poor sleep. Likely Type 1 trauma due to a single, overwhelming - **Marcia (6 years old):** Subjected to a four-month kidnapping by her father, witnessing domestic violence and enduring abuse. Displays hyperactivity, jumpiness, irritability, engrossment in play, and poor eating/sleeping habits. Likely - **Amin (42 years old, Syrian refugee):** Experiences isolation, indifference towards family, and extreme irritability after fleeing war. Suffers from traumatic war memories, leading to nightly pacing and family fear. Shows - **Celia Vega (21 years old):** History of childhood sexual abuse by an uncle. Experiences episodes of chest pain, aggression (biting, kicking), and hallucinations (seeing a man's face). Reports this recurring ### Lifespan psychology overview * **Developmental psychology:** Studies the normal human lifespan from conception to death, focusing on typical developmental aspects [86](#page=86). * **Phases of life:** The lifespan is divided into phases, each with characteristic behaviors, possibilities, and risks [86](#page=86). * **Individual pace:** Development is not linear and occurs at an individual pace; phase divisions are general guidelines, not strict norms [86](#page=86). ### Erikson's psychosocial stages * **Eight stages:** Erikson's model proposes eight universal stages, each with a developmental crisis or challenge [87](#page=87). * **Crisis resolution:** Successful resolution leads to ego strength and learned life skills; failure results in ego weakness [87](#page=87). * **Key stages and conflicts:** * Trust vs. Mistrust (0-1.5 years): Foundation for future relationships [87](#page=87). * Autonomy vs. Shame (1.5-3 years): Developing self-control and independence [87](#page=87). * Initiative vs. Guilt (3-6 years): Learning to initiate and pursue goals [87](#page=87). * Competence vs. Inferiority (6-12 years): Acquiring skills for societal success [87](#page=87). * Identity vs. Role Confusion (Adolescence): Establishing a sense of self [87](#page=87). * Intimacy vs. Isolation (Young Adulthood): Forming close relationships [87](#page=87). * Generativity vs. Stagnation (Middle Age): Contributing to others and society [87](#page=87). * Integrity vs. Despair (Late Adulthood): Reflecting on life with satisfaction [87](#page=87). ### Attachment styles (based on Ainsworth's "strange situation") * **Secure attachment (60-70%):** Parents are accessible; child feels safe, explores, and is easily soothed. Leads to stress resilience and stable relationships [89](#page=89). * **Insecure-avoidant attachment (25%):** Child appears indifferent to parent and situation, minimizes attachment needs due to fear of rejection [89](#page=89). * **Insecure-ambivalent attachment (10%):** Child is anxious, distressed by separation, seeks but resists comfort upon reunion [90](#page=90). * **Disorganized attachment (~15%):** Child exhibits erratic behavior, confusion, and fear; often seen in neglect/abuse cases where caregivers are both a source of safety and fear [90](#page=90). * **Promoting secure attachment:** Requires parental sensitivity and responsiveness to child's cues [91](#page=91). ### Havinghurst's developmental tasks * **Tasks:** Identifies specific tasks for each life period, arising from social expectations. Success leads to happiness and self-confidence [91](#page=91). - **Examples:** Learning to walk and talk (early childhood); developing social skills and basic literacy (childhood); forming peer relationships and independence (adolescence); selecting a partner and starting a family (early adulthood) ### Grief and loss --- ### Erikson's developmental crises in case studies * A high school senior seeking guidance on future educational paths struggles with career choice and identifying true interests, indicating a conflict within **identity vs. role confusion** [96](#page=96). - An elderly man in a care facility expresses deep regret over past missed opportunities and feels it's too late for change, representing the **despair vs. integrity** crisis, leaning towards despair * A single father balancing childcare, work, and personal interests (like judo) highlights the challenge of **generativity vs. stagnation**, with potential for stagnation due to lack of personal time [96](#page=96). * A man experiencing difficulty forming colleague relationships and friendships, leading to loneliness, points to **intimacy vs. isolation**, struggling to achieve intimacy [96](#page=96). - A nine-month-old infant experiencing distress, crying, feeding difficulties, and aversion to caregivers due to the mother's substance abuse and depression may be in a critical stage related to **trust vs. ### Complicated grief illustrated * Nele, 32, exhibits prolonged and intense grief seven months after her mother's death, maintaining an "altar" and reacting negatively to others suggesting she move on [97](#page=97). * Nele's grief is complicated by difficulty accepting her stepfather's new relationship and her own daily functioning being significantly impaired, with feelings of restlessness, sadness, and meaninglessness [97](#page=97). * Despite meeting criteria for complicated grief, Nele expresses no desire for help with loss processing, instead seeking support for increased alcohol consumption causing marital and work conflicts [97](#page=97). ### Sources * APA. DSM-5: Handboek voor de classificatie van psychische stoornissen [98](#page=98). * De Bil, M., & De Bil, P.. Praktijkgerichte ontwikkelingspsychologie [98](#page=98). * Bögels, M., & Van Oppen, P.. Cognitieve therapie [98](#page=98). * Cladder, J., Nijhoff-Huijsse, M., & Mulder, G.. Gedragstherapie met kinderen en jeugdigen [98](#page=98). * Van Deth, R.. Psychiatrie: Van diagnose tot behandeling [98](#page=98). * De Bruyckere, P., Kirschner, P., & Hulshof, C.. Jongens zijn slimmer dan meisjes [98](#page=98). * Güldner, M.. Selectief mutisme bij kinderen [98](#page=98). * Grietens, H., et al. (Eds.). Handboek orthopedagogische hulpverlening [98](#page=98). * Jenner, J. A.. Directieve interventies in de acute en sociale psychiatrie [98](#page=98). * Van Lieshout, T.. Pedagogische adviezen voor speciale kinderen [98](#page=98). * De Mönnink, H.. De gereedschapskist van de sociaal werker [98](#page=98). * Rigter, J.. Psychologie voor de praktijk [98](#page=98). * Rigter, J.. Het Palet van de psychologie [98](#page=98). * Vandereycken, W., Hoogduin, C. A. L., & Emmelkamp, P. M. G. (Eds.). Handboek psychopathologie, deel 1 [98](#page=98). * Vandereycken, W., Hoogduin, C. A. L., & Emmelkamp, P. M. G. (Eds.). Handboek psychopathologie, deel 2 [99](#page=99). * Verhulst, J.. RET-jezelf [99](#page=99). * Weerman, A.. Zes psychologische stromingen en één cliënt [99](#page=99). --- # Therapeutic relationship and the role of power dynamics ### Core idea * The therapeutic relationship is central to the well-being and progress of a client within the healthcare system [12](#page=12). * Understanding power dynamics is crucial as they inherently exist in all human interactions, including therapeutic ones [16](#page=16). ### Key facts * Mental health services are typically organized into three (sometimes four) levels based on accessibility and specialization [8](#page=8). * The biopsychosocial model posits that psychological problems arise from a complex interplay of biological, psychological, and social factors [9](#page=9). * Symptoms are indicators of a psychological problem, while a syndrome is a coherent set of symptoms [11](#page=11). * Abraham Maslow's hierarchy of needs suggests humans are motivated by fulfilling successive levels of needs, from physiological to self-actualization [12](#page=12). * Carl Rogers proposed three core conditions for effective counseling: empathy, unconditional positive regard, and genuineness [15](#page=15). * Power is defined as influencing another's behavior, thoughts, or feelings [16](#page=16). * John French and Bertram Raven identified five types of power: coercive, reward, legitimate, referent, and expert [16](#page=16) [17](#page=17). * Behavioral approaches distinguish between classical and operant conditioning, both involving learning through association or consequences [18](#page=18) [19](#page=19). * The S-R-C model (Situation-Response-Consequence) is used for behavioral analysis [20](#page=20). ### Key concepts * **Maslow's Hierarchy of Needs:** While a widely used model, its strict hierarchical ordering and universality are debated; needs can be dynamic and culture-dependent [13](#page=13) [14](#page=14). * **Rogers' Counseling Conditions:** * **Empathy:** Deeply understanding the client's internal experience without emotional identification [15](#page=15). * **Acceptance (Unconditional Positive Regard):** Being open and non-judgmental towards the client's feelings and thoughts, fostering a safe environment for growth [15](#page=15). * **Genuineness (Authenticity):** The therapist being their authentic self, not hiding behind a professional facade [15](#page=15). * **Types of Power:** * **Coercive:** Based on threats of punishment or sanctions [16](#page=16). * **Reward:** Based on the ability to offer rewards [16](#page=16). * **Legitimate:** Derived from a social role or position [17](#page=17). * **Referent:** Based on charisma and personal appeal [17](#page=17). * **Expert:** Based on specialized knowledge or skills [17](#page=17). * **Classical Conditioning:** Learning associations between events, making the environment predictable (e.g., Pavlov's dogs, fear acquisition) [18](#page=18). * **Operant Conditioning:** Learning through the consequences of voluntary behavior (reinforcement and punishment) [19](#page=19). * **Behavioral Analysis (S-R-C Model):** Analyzing behavior by identifying the antecedent situation (S), the response (R), and the consequences (C) [20](#page=20). ### Implications --- ## Therapeutic relationship and the role of power dynamics ### Cognitive restructuring * Cognitive therapy focuses on altering interpretations of events, not events themselves [24](#page=24). * Developed by Aaron Beck for depression, it targets dysfunctional thought patterns [24](#page=24). * Albert Ellis's Rational-Emotive Therapy (RET) emphasizes rational thinking to reduce negative emotions [24](#page=24). * Irrational thoughts are often exaggerated, unrealistic, and disregard facts [24](#page=24). ### Common irrational thought patterns * **Selective abstraction:** Minor negatives overshadow positives [25](#page=25). * **Overgeneralization:** One incident leads to broad conclusions [25](#page=25). * **Mind reading:** Assuming knowledge of others' thoughts [25](#page=25). * **Personalization:** Taking responsibility for unrelated events [25](#page=25). * **All-or-nothing thinking:** Anything less than perfect is failure [25](#page=25). * **Magnification/Minimization:** Exaggerating negatives, downplaying positives [25](#page=25). * **Catastrophizing:** Assuming the worst possible outcome [25](#page=25). * **Emotional reasoning:** Equating feelings with reality [25](#page=25). ### Cognitive restructuring techniques * **ABC schema:** * A: Activating event/situation [25](#page=25). * B: Belief/automatic thought [25](#page=25). * C: Consequences (feelings and behavior) [25](#page=25). * **Socratic dialogue:** Helper asks questions to guide client to identify irrational thoughts [26](#page=26). * **Critical questions:** "Is this true?", "What's the evidence?", "Are there other viewpoints?" [26](#page=26). * **D (Discussion):** Critical questioning of automatic thoughts [26](#page=26). * **E (Effect):** Leads to helpful thoughts and behavioral change [26](#page=26). * **Challenging irrational beliefs:** Converting thoughts like "Everyone must like me" to "I can respect myself" [27](#page=27). * **4G schema:** Differentiates between event, thought, feelings, and behavior [29](#page=29). * **5G schema:** Includes further consequences in the analysis [29](#page=29). * **Psycho-education:** Providing information on psychological issues to clients and their environment [34](#page=34). ### Attribution theory and locus of control * **Attribution theory (Weiner):** Explains how people attribute causes to situations [32](#page=32). ### Problem-solving skills ### Motivation --- ## Autonomy and controlled motivation in therapeutic relationships ### Autonomy * **Interest-driven autonomous motivation**: Engaging in behavior because it is intrinsically interesting or enjoyable [36](#page=36). * **Use-driven autonomous motivation**: Performing behavior due to perceived usefulness or personal meaning [36](#page=36). * **Value-driven autonomous motivation**: Integrating behavioral change into one's lifestyle, aligning with personal values [36](#page=36). * Autonomous motivation leads to perseverance, satisfaction, and quality work [36](#page=36). * It improves the success and sustainability of lifestyle changes [36](#page=36). * Health interventions benefit from fostering autonomous motivation [36](#page=36). * Many health behaviors are driven by perceived meaningfulness or importance, leading to autonomous motivation [36](#page=36). * Over time, healthy behaviors can become enjoyable, shifting towards interest-driven motivation [37](#page=37). ### Controlled motivation * Driven by pressure or coercion ("HAVE-motivation") [37](#page=37). * **Internal pressure**: Self-imposed expectations or obligations, e.g., shame for not dieting [37](#page=37). * **External pressure**: Environmental demands, e.g., a partner wanting you to quit smoking [37](#page=37). * Leads to tension, guilt, low self-worth, and less emotional engagement [37](#page=37). * Results in less favorable outcomes and lower chances of lasting behavioral change [37](#page=37). * Requires significant energy and is harder to sustain long-term [37](#page=37). * Can be a starting point for change, e.g., using reward systems [37](#page=37). * Some internal or external pressure is often unavoidable [37](#page=37). * Autonomous motivation can emerge from controlled motivation by addressing basic needs [37](#page=37). ### Amotivation * Absence or lack of motivation [37](#page=37). * Often due to a deficiency in necessary health skills [37](#page=37). * Characterized by disbelief in effectiveness, lack of willingness to exert effort, or feelings of incompetence [37](#page=37). * Associated with uncertainty, indifference, and fear of failure [37](#page=37). * Leads to resistance towards recommended activities [37](#page=37). * Can stem from a lack of basic material needs (food, housing) or social factors (lack of support) [37](#page=37). * Individuals with amotivation are less open to behavioral change [37](#page=37). * This group is the most challenging for health promoters or social workers [37](#page=37). --- # Self-determination theory and motivation ### Core idea - Motivation is the internal energy or force driving behavior towards a goal [35](#page=35). - Self-determination theory (SDT) explains how to achieve high-quality, autonomous motivation by supporting basic psychological needs [35](#page=35). - The quality of motivation, not just quantity, is crucial for sustained behavior change [35](#page=35). ### Key facts - SDT identifies three universal psychological needs: autonomy, relatedness, and competence (the "abc" of motivation) [35](#page=35). - Autonomy is the feeling of choice and freedom in one's actions, thoughts, and feelings [35](#page=35). - Relatedness is the sense of connection with others and feeling valued [35](#page=35). - Competence is the feeling of being capable of achieving desired goals [35](#page=35). - When these needs are met, motivation is more autonomous and leads to better outcomes [38](#page=38). - Conversely, unmet needs lead to pressure, failure, and negative emotions, hindering change [38](#page=38). - Motivation is not fixed and can vary over time and situations [39](#page=39). ### Key concepts - **Autonomous Motivation:** Doing something because you genuinely want to ('goesting', 'zin') [36](#page=36). - **Interest-driven (intrinsic):** Motivated by inherent enjoyment or interest [36](#page=36). - **Meaning-driven (extrinsically autonomous):** Motivated by perceived usefulness or personal significance [36](#page=36). - **Value-driven (extrinsically autonomous):** Motivated by the activity integrating with one's lifestyle and values [36](#page=36). - **Controlled Motivation:** Doing something due to pressure or coercion ('MOETivatie') [37](#page=37). - **Internal pressure:** Self-imposed expectations or obligations (e.g., shame, pride) [37](#page=37). - **External pressure:** Pressure from others or societal expectations [37](#page=37). - **Amotivation:** The absence or lack of motivation, often due to perceived lack of skills or effectiveness [37](#page=37). ### Implications - Supporting the abc needs fosters autonomous motivation, leading to better adherence and satisfaction in lifestyle changes [36](#page=36) [38](#page=38). - Health interventions should focus on promoting autonomous motivation through need-supportive approaches [39](#page=39). - A need-supportive approach involves being autonomy-supportive, relationally supportive, and competence-supportive [39](#page=39). - Autonomy-supportive approaches involve not pressuring individuals and focusing on personally meaningful goals [39](#page=39). - Relationally supportive approaches focus on the social environment and fostering connection and value [40](#page=40). - Competence-supportive approaches involve setting challenging yet achievable goals and providing clear feedback [40](#page=40). - > **Tip:** While controlled motivation can be a starting point, focus on transitioning it to autonomous motivation by addressing basic needs [37](#page=37) --- # Counseling methods and techniques ### Core idea - Counseling aims to support individuals in behavioral change through goal setting, feedback, and social environment mobilization [41](#page=41). - Key principles include confidentiality, non-judgment, respect, dedicated time, and fostering an equal relationship [41](#page=41). - Effective counseling employs active listening, open questions, non-verbal cues, and paraphrasing [41](#page=41). ### Key facts - Small successes should be celebrated to support competence needs [41](#page=41). - Relevant and clear feedback structures the change process and builds confidence [41](#page=41). - The counselor acts as a professional expert, but the client remains the expert in their own life [41](#page=41). - Self-determination theory is supported by specific communication skills [41](#page=41). - Examples demonstrate common counseling pitfalls such as dismissive or unhelpful advice [41](#page=41). - Identifying the client's perspective and validating their feelings are crucial [42](#page=42). - Exploring discrepancies between stated feelings and observed behavior can be insightful [42](#page=42). - Power dynamics in helping relationships can be identified and understood [42](#page=42). - Techniques for behavioral change include addressing specific behaviors with concrete strategies [43](#page=43). - The ABC framework (Activating event, Beliefs, Consequences) is used for cognitive analysis [43](#page=43). - The ABCDE schema expands on this to include Discussion and Encouragement [43](#page=43). - Autonomous motivation stems from interest, utility, or value [45](#page=45). - Controlled motivation arises from external pressures or internal obligation [46](#page=46). ### Key concepts - The importance of creating a safe and trusting environment for the client [41](#page=41). - The counselor's attitude should be empathetic, non-judgmental, and collaborative [41](#page=41). - Casuistry involves analyzing practical situations to apply counseling methods correctly [41](#page=41). - Identifying different types of power in the client-helper relationship is important [42](#page=42). - Behavioral analysis breaks down problem behaviors into observable components [43](#page=43). - Cognitive techniques like the ABCDE model help in restructuring negative thought patterns [43](#page=43). - Distinguishing between autonomous and controlled motivation is key to understanding client engagement [45](#page=45). - Autonomous motivation is linked to intrinsic satisfaction and personal values [45](#page=45). ### Implications - Counselors must be mindful of their language and avoid invalidating client experiences [41](#page=41). --- # Stemmingsstoornissen ### Core idea * Mood disorders involve a sustained disruption of mood, impacting emotional, cognitive, physical, and behavioral functioning [47](#page=47). * Distinguishing between normal mood fluctuations and clinical mood disorders is crucial [47](#page=47). ### Key facts * A depressive episode requires at least two weeks of depressed mood or loss of interest, with at least five additional symptoms [48](#page=48). * A manic episode requires at least one week of elevated, expansive, or irritable mood with increased energy/activity, plus at least three additional symptoms [50](#page=50). * Depressive disorders and bipolar disorders are classified based on the presence of depressive and/or manic episodes [50](#page=50). * Dysthymia involves a persistent depressed mood for at least two years [51](#page=51). * Cyclothymic disorder involves alternating periods of mild manic and mild depressive symptoms for at least two years [51](#page=51). * Depressive disorders are most often diagnosed around age thirty, affecting about 20% of the population [47](#page=47). * In adolescence, the prevalence of depression is higher in girls than boys (2:1 ratio) [47](#page=47). * Bipolar disorder in children and adolescents often presents as rapid mood swings rather than distinct episodes [47](#page=47). * The diagnosis of bipolar disorder can be delayed, often occurring in early adulthood [47](#page=47). ### Key concepts * **Mood vs. Emotion:** Mood is a long-lasting feeling (weeks), independent of specific events; emotions are short-lived and triggered by specific events [47](#page=47). * **Depressive Mood:** Characterized by abnormal sadness, apathy, and anhedonia (inability to experience pleasure) [47](#page=47). * **Manic Mood:** Characterized by excessive cheerfulness, inflated self-confidence, grandiosity, and irritability [47](#page=47). * **DSM-5 Criteria for Depressive Episode:** Includes criteria A (symptoms), B (functional impairment), and C (not due to substance/medical condition) [48](#page=48). * **DSM-5 Criteria for Manic Episode:** Includes criteria A (duration and mood/energy), B (symptoms), C (severity/impairment), and D (not due to substance/medical condition) [50](#page=50). * **Age-dependent expressions of depression:** Manifestations differ across age groups, from protest in infants to irritability in toddlers/school children, to sadness and irritability in adolescents, and apathy in adults [52](#page=52). * **Cognitive factors in depression:** Dysfunctional thoughts, negative self-appraisals, negative interpretation of events, and high self-expectations are common [54](#page=54). * **Psychosocial factors in depression:** Family climate, parental psychopathology, and negative life experiences (neglect, abuse, loss) contribute [54](#page=54). * **Biological factors in depression:** Neurotransmitter imbalances (serotonin, noradrenaline), genetic predisposition, and hormonal changes (puberty in females) play a role [53](#page=53). ### Implications * The presentation of depression varies significantly with age, impacting how it is recognized and diagnosed [52](#page=52). * Distinguishing mood disorders from ADHD in children requires careful assessment of symptom persistence and mood regulation [48](#page=48). * Co-occurring disorders (anxiety, ADHD, substance use) can prolong depressive episodes and increase suicide risk [51](#page=51). * Childhood and adolescent depression can manifest through behavioral challenges, masking the underlying mood disturbance [52](#page=52). ### Treatment overview * **Medication:** Antidepressants are effective for moderate to severe adult depression, but less conclusive in children/adolescents; lithium and mood stabilizers are used for bipolar disorder [55](#page=55) [56](#page=56). --- ## Suggestions for dealing with mood disorders * Provide appreciation and positive attention to individuals with depressive complaints [57](#page=57). * Foster a sense of competence by expressing positive expectations [57](#page=57). * Encourage a regular life rhythm with relaxation and sufficient exercise [57](#page=57). * Offer a safe, predictable, and supportive environment [57](#page=57). * Stimulate and enthuse individuals to undertake activities [57](#page=57). * Address potential suicide thoughts and discuss them if indicated [57](#page=57). * Do not get entangled in confidentiality agreements [57](#page=57). * Refer to expert help for severe, persistent mood complaints [57](#page=57). * Provide explanation and support to significant others (partner, parents) [57](#page=57). * **Cognitive restructuring:** Changing negative, self-defeating thoughts into positive, self-building ones [57](#page=57). * **Problem-solving:** Viewing mood as a signal of a problem and analyzing situations for solutions [59](#page=59). * **Activity scheduling:** Daily engagement in tasks and planning for weekend work [59](#page=59). * **Challenging thoughts:** Questioning the evidence and feasibility of negative beliefs [59](#page=59). * **Alternative generation:** Encouraging and practicing the creation of new solutions [59](#page=59). * Individuals learn to analyze their feelings and connect them to specific problems [59](#page=59). * Problem-solving skills are developed, leading to more adaptive coping [59](#page=59). * The focus shifts from rumination to taking action and making plans [59](#page=59). * Self-rewarding mechanisms can be implemented upon task completion [59](#page=59). * Challenging the belief that one must always make a good impression on everyone [59](#page=59). - > **Example:** A 14-year-old named Wouter learns to identify negative thoughts during a family party, such as "I don't belong here" and "Does my family like me - " - He then practices generating alternative thoughts like "I don't need to get along with everyone" and "It's okay to be myself" [57](#page=57) [58](#page=58) - > **Example:** Wouter learns to challenge the thought that his teachers dislike him - He questions the evidence for this belief, realizing it's mostly based on feelings or isolated incidents, and concludes that making a good impression on everyone is not feasible [59](#page=59) --- # Etiology of mood disorders: biological, psychological, and social factors ### Core idea * Mood disorders arise from a complex interplay of biological, psychological, and social factors [52](#page=52). * Understanding these factors is crucial for diagnosis and treatment across different age groups [52](#page=52). ### Key facts * Depressive disorders and bipolar disorders are classified separately in the DSM [50](#page=50). * A depressive episode requires at least two weeks of symptoms, while a manic episode requires at least one week [50](#page=50). * Depression is diagnosed when at least five specific symptoms are present for two weeks, including a depressed mood or loss of interest [48](#page=48). * Mania is characterized by elevated mood, increased energy, and at least three other symptoms for at least one week [50](#page=50). * Prevalence of depression is higher in adult females than males from puberty onwards [53](#page=53). * Children and adolescents may exhibit different symptoms of depression compared to adults [52](#page=52). * Bipolar disorder onset in children is often rapid mood swings, not distinct episodes [47](#page=47). ### Key concepts * **Mood vs. Emotion:** Mood is long-lasting (weeks), situation-independent; emotion is short-lived, situation-specific [47](#page=47). * **Depressive mood:** Characterized by abnormal sadness, apathy, and/or anhedonia (inability to feel pleasure) [47](#page=47). * **Manic mood:** Characterized by excessive cheerfulness, inflated self-confidence, and irritability [47](#page=47). * **Dysthymia:** A persistent depressive disorder lasting at least two years [51](#page=51). * **Cyclothymic disorder:** Characterized by at least two years of alternating mild manic and mild depressive symptoms [51](#page=51). * **Psychotic features:** Can occur in severe mood disorders, involving delusions of worthlessness or grandiosity [51](#page=51). ### Biological factors * Genetic predisposition plays a role, especially in recurrent depression and bipolar disorder [53](#page=53). * Neurotransmitter imbalances, particularly serotonin and noradrenaline, are implicated in depression and bipolar disorder [53](#page=53). * Manic episodes may involve low serotonin and high noradrenaline activity [53](#page=53). * Individuals with intellectual/physical disabilities or chronic illnesses may be more susceptible to depression [53](#page=53). * Biological changes during puberty may contribute to higher depression rates in adolescent girls [53](#page=53). ### Psychological factors * Dysfunctional thought patterns, such as negative self-appraisals and cognitive distortions, are common in depression [54](#page=54). * Negative life experiences (e.g., neglect, abuse, loss) can trigger or contribute to depression [54](#page=54). * Previous depressive episodes can increase sensitivity to stress and risk of relapse (sensitization) [54](#page=54). ### Social factors * Family climate, including parental criticism or disinterest, can increase a child's vulnerability to depression [54](#page=54). * Having parents with other psychological disorders (e.g., depression, addiction, personality disorders) elevates a child's risk [54](#page=54). ### Implications --- # Cognitive restructuring and problem-solving techniques in therapy ### Core idea - Cognitive restructuring involves changing negative, self-defeating thoughts into positive, self-building ones [57](#page=57). - Problem-solving techniques help analyze situations and develop strategies for managing feelings and tasks [59](#page=59). - These techniques are crucial for addressing issues like depression and anxiety disorders [57](#page=57) [59](#page=59). ### Key facts - Patients learn to identify thoughts linked to their mood [57](#page=57). - A worksheet can be used to list negative thoughts and brainstorm alternatives [57](#page=57). - Feelings can be signals of underlying problems that can be addressed through problem-solving [59](#page=59). - Encouraging alternative solutions and practicing them is a key aspect [59](#page=59). - Establishing a reward system for completing tasks can be beneficial [59](#page=59). - Challenging thoughts involves questioning their origin and evidence [59](#page=59). - Cognitive restructuring helps assess the feasibility of beliefs, like needing everyone's approval [59](#page=59). - Therapy aims to help individuals manage situations where they feel they need constant approval [59](#page=59). ### Key concepts - **Cognitive restructuring:** Identifying and modifying maladaptive thought patterns [57](#page=57). - **Problem-solving:** A structured approach to resolving issues, including planning and seeking help [59](#page=59). - **Self-efficacy:** Building competence by expressing positive expectations [57](#page=57). - **Emotional signal:** Recognizing negative emotions as indicators of problems needing solutions [59](#page=59). - **Challenging thoughts:** Questioning the validity and basis of negative automatic thoughts [59](#page=59). - **Attributional style:** How individuals explain successes and failures, impacting anxiety [69](#page=69). - **Threat overestimation:** A cognitive pattern in anxious individuals where danger is magnified [69](#page=69). - **Underestimation of coping abilities:** Anxious individuals may not recognize their capacity to handle challenges [69](#page=69). ### Implications - Fostering a sense of competence can improve mood and self-esteem [57](#page=57). - Problem-solving skills can reduce rumination and promote action [59](#page=59). - Challenging ingrained negative beliefs can reduce distress and improve self-perception [59](#page=59). - A safe and predictable environment supports the therapeutic process [57](#page=57). - Encouraging activities and a regular life rhythm are supportive strategies [57](#page=57). - Alertness to suicidal thoughts and open discussion are critical in therapy [57](#page=57). ### Common pitfalls --- # Explanation of anxiety disorders from a biopsychosocial perspective ### Core idea * Anxiety disorders arise from an interplay of biological, psychological, and social factors [69](#page=69). * Understanding these interconnected influences is key to explaining the development and maintenance of anxiety [69](#page=69). ### Key facts * Genetic factors contribute to anxiety disorders, with family history and twin studies suggesting a genetic component [69](#page=69). * Temperament differences present at birth, like easy, difficult, or slow-to-start temperaments, are linked to anxiety risk [69](#page=69). * Neurotransmitters, specifically serotonin and noradrenaline, play a role in regulating emotions like anxiety [69](#page=69). * Cognitive factors, such as threat detection, overestimation of danger, and underestimation of coping abilities, maintain anxiety [69](#page=69). * Negative experiences, like those in classical conditioning experiments, can lead to learned fears [70](#page=70). * Social factors, particularly parental modeling and overprotection, can influence children's anxiety development [70](#page=70). ### Key concepts * **Biological factors:** * Genetic predisposition and temperament (slow-to-start children at higher risk) [69](#page=69). * Neurotransmitter dysfunction (serotonin, noradrenaline) affecting emotional regulation [69](#page=69). * **Psychological factors:** * Cognitive biases: heightened threat perception, overestimation of danger, underestimation of coping skills [69](#page=69). * Attentional bias towards threats [69](#page=69). * Attentional bias towards self-blame for failures [69](#page=69). * Learned responses through conditioning (e.g., Watson's Little Albert) [70](#page=70). * **Social factors:** * Parental modeling of anxious behaviors [70](#page=70). * Overprotective parenting, leading to overestimation of threats and feelings of helplessness [70](#page=70). ### Implications * Treatment should address multiple levels: biological, psychological, and social [70](#page=70). * Psycho-education is crucial, highlighting genetic predisposition and critical evaluation of negative thoughts [70](#page=70). * Cognitive Behavioral Therapy (CBT) is highly effective, focusing on cognitive restructuring and behavioral experiments [71](#page=71). * Family involvement, especially in treating children, can significantly improve outcomes [71](#page=71). * Strategies for parents include modeling coping, discussing fears, encouraging independence, and validating efforts [71](#page=71). ### Common pitfalls * Relying solely on medication, especially for children, without considering other interventions [70](#page=70). --- # Symptoms and manifestations of trauma ### Core idea - A psychical trauma is a highly impactful, emotionally disruptive experience [74](#page=74). - Trauma can be a single acute event (Type 1) or prolonged/repeated (Type 2) [74](#page=74). - Symptoms include intrusive memories, avoidance, negative mood changes, and altered arousal [74](#page=74). ### Key facts - Acute stress disorder occurs within days of trauma and resolves within four weeks [75](#page=75). - Post-traumatic stress disorder (PTSD) is diagnosed if symptoms last over four weeks or appear later [75](#page=75). - Trauma exposure can involve direct experience, witnessing, learning about a loved one, or repeated exposure to disturbing details [75](#page=75). - Exposure via electronic media is excluded unless work-related [75](#page=75). - Intrusive symptoms include painful memories, nightmares, and dissociative reactions like flashbacks [75](#page=75). - Physiological reactions to trauma reminders can be intense [76](#page=76). - Avoidance of trauma-related stimuli is a key characteristic [76](#page=76). - Negative changes in cognition and mood include amnesia, negative beliefs, guilt, shame, and loss of interest [76](#page=76). - Altered arousal and reactivity can manifest as irritability, aggression, recklessness, hypervigilance, and sleep disturbances [76](#page=76). ### Key concepts - **Type 1 Trauma:** Single, acute, shocking experiences like disasters or accidents [74](#page=74). - **Type 2 Trauma:** Prolonged or repeated distressing events such as abuse or neglect [74](#page=74). - **Intrusive Symptoms:** Unwanted, distressing recollections or re-experiencing of the trauma [75](#page=75). - **Dissociative Reactions:** Feeling like the event is happening again, with varying degrees of detachment from reality [75](#page=75). - **Avoidance:** Deliberately steering clear of thoughts, feelings, or external reminders associated with the trauma [76](#page=76). - **Negative Cognitions/Mood:** Persistent negative beliefs about self/others, distorted views, and emotional numbing [76](#page=76). - **Altered Arousal/Reactivity:** Changes in the body's stress response system [76](#page=76). ### Implications - Untreated trauma can lead to Post-Traumatic Stress Disorder (PTSD) [74](#page=74). - Processing trauma can take three to six months; longer duration may require intensive therapy [74](#page=74). - Suppressing traumatic events can lead to uncontrolled re-experiencing and PTSD [74](#page=74). - Support, comfort, and non-judgmental listening are crucial after trauma [74](#page=74). - Distorted memories can sometimes serve a protective function by reducing perceived threat [77](#page=77). - Young children may exhibit clinginess, separation anxiety, and nightmares [77](#page=77). ### Common pitfalls --- # Traumaopvangmethode and coping suggestions ### Core idea * Suggestions and methods exist to support individuals who have experienced traumatic events. * These approaches aim to provide safety, validation, and a structured path towards processing and integrating traumatic experiences. * The trauma recovery method is a specific toolkit for social workers to assist clients with recent or past traumatic events. ### Key facts * Provide ample rest, safety, and validation of feelings [82](#page=82). * Ensure professional trauma team involvement or maintain contact with them [82](#page=82). * Be patient, as trauma processing can take a long time [82](#page=82). * Allow for measured expression of confusing feelings to initiate processing [82](#page=82). * Repeatedly speaking openly about the trauma is crucial for processing [82](#page=82). * Reintroducing the trauma and related stimuli should occur in a supportive, therapeutic setting [82](#page=82). * Cognitive restructuring can help develop a different perspective on the trauma [82](#page=82). * Provide information about stress reactions and stress processing to regain control [82](#page=82). * Normalize stress reactions to prevent clients from being alarmed by their own responses [82](#page=82). * Mobilize social support from the client's environment [82](#page=82). * Encourage the client to retell their story to foster understanding and distance [82](#page=82). * Create space for expressing emotions and discharging tension related to the event [82](#page=82). * Refer clients for professional help if complaints remain overwhelming after three months [82](#page=82). * The trauma recovery method is not suitable for clients with physical/psychological inability, insufficient/disinhibited behavior, type 2 traumatization, PTSD, or refusal of help [82](#page=82). ### Key concepts * **Stabilization technique:** Finding a safe, undisturbed space, assessing the client's needs, informing relevant third parties, and establishing ground rules like confidentiality and equal participation [83](#page=83). - **Regisseur technique:** Focusing on client needs and wishes, emphasizing that the client has control over the process ("not pulling, but checking") and determines the pace and method of working through * **Reconstruction technique:** * **Fact level:** Creating a factual reconstruction of events, including what happened before, during, and after the incident, to provide cognitive control and order [83](#page=83). * **Experience level:** Reconstructing the client's subjective experience of the incident, allowing for emotional release and leading to order and awareness [83](#page=83). * **Follow-up technique:** Proposing a follow-up appointment to check on the client's well-being, providing a safety net and acknowledging their victimhood [83](#page=83). * **"Niet trekken, maar checken":** A principle emphasizing checking in with the client's needs rather than forcing them to confront their trauma [83](#page=83). ### Implications * The goal of these methods is to achieve greater mental and physical rest for the client. --- # Developmental tasks across the lifespan according to Havighurst ### Core idea - Havighurst identified developmental tasks as tasks individuals confront throughout their lives due to social and environmental expectations [91](#page=91). - Successful completion leads to happiness and facilitates tasks in later stages, fostering hope and self-confidence [91](#page=91). - Failure results in unhappiness and difficulties in future tasks due to anxieties and tensions [91](#page=91). ### Key facts - **Early childhood (0-6 years):** Learning to walk, use solid food, talk, become toilet trained, understand sex differences, use language for reality description, and be ready for reading [92](#page=92). - **Childhood (6-12 years):** Developing physical skills for games, building self-attitude, learning to play with peers, adopting gender roles, mastering basic literacy and numeracy, developing everyday concepts, and acquiring conscience and - **Adolescence (12-18 years):** Establishing mature peer relationships, accepting one's physique, preparing for marriage and career, developing an ideology, and learning socially responsible behavior [92](#page=92). - **Early adulthood (18-40 years):** Selecting a partner, adapting to married life, starting a family, raising children, managing a household, pursuing a career, taking on civic responsibility, and finding a social - **Adulthood (40-65 years):** Guiding adolescents, acquiring adult responsibilities, building a satisfactory career, developing leisure activities, adapting to aging parents, and adjusting to physical changes [93](#page=93). - **Late adulthood (65+ years):** Adapting to reduced physical strength, retirement, and income reduction; coping with the death of a spouse; adjusting to changing social roles; and building affinity with peers ### Implications - Havighurst's model provides a concrete framework for understanding life's challenges [91](#page=91). - It highlights the continuous nature of development beyond childhood [91](#page=91). - Social expectations are a key driver of these developmental tasks [91](#page=91). --- ## Common mistakes to avoid - Review all topics thoroughly before exams - Pay attention to formulas and key definitions - Practice with examples provided in each section - Don't memorize without understanding the underlying concepts

| Term | Definition | |------|------------| | Competence Need | The psychological need to feel effective and capable in one's actions and interactions with the environment, supported by recognizing small successes and receiving relevant feedback. | | Self-Determination Theory | A macro theory of human motivation and personality that concerns people's innate growth tendencies and their integration into personality, emphasizing the importance of autonomy, competence, and relatedness. | | Open Questions | Questions designed to encourage detailed responses and exploration, rather than simple yes/no answers, facilitating deeper communication in counseling. | | Active Listening | A communication technique where the listener fully concentrates, understands, responds, and remembers what is being said, demonstrating engagement and empathy. | | Non-Verbal Following | Paying attention to and mirroring a client's body language, posture, and gestures to convey understanding and build rapport. | | Paraphrasing | Restating a client's message in your own words to ensure understanding and to show the client that they have been heard accurately. | | Summarizing | Briefly condensing the main points of a client's communication to reinforce understanding and provide a concise overview of the discussion. | | Behavioral Analysis | A systematic examination of the antecedents, behaviors, and consequences of a specific problem behavior to understand its function and develop intervention strategies. | | Behavior Change Techniques | Specific methods and strategies employed to modify an individual's behavior, often based on principles of learning and motivation. | | ABC Schema (Cognitive Approach) | A model used in cognitive therapy to understand the relationship between an activating event (A), beliefs (B), and the consequences (C) of those beliefs, including emotional and behavioral outcomes. | | ABCDE Schema | An expanded version of the ABC model that includes disputing irrational beliefs (D) and developing effective new beliefs (E), commonly used in cognitive behavioral therapy. | | Autonomous Motivation | Motivation that stems from intrinsic interest, enjoyment, or personal values, leading to a sense of volition and self-endorsement of actions. | | Cognitive Restructuring | A therapeutic technique aimed at identifying and challenging negative or unhelpful thought patterns, and replacing them with more balanced and constructive ones to improve emotional well-being. | | Problem-Solving Techniques | A systematic approach used in therapy to help individuals identify problems, brainstorm potential solutions, evaluate these solutions, and implement the most effective ones to overcome challenges. | | Negative Self-Talk | Internal dialogue characterized by critical, self-defeating thoughts that can contribute to low mood and reduced self-esteem, often targeted for modification in cognitive therapy. | | Competence Feeling | A sense of self-efficacy and capability, which can be enhanced in therapy by expressing positive expectations and encouraging the individual to engage in activities that build confidence. | | Supportive Environment | A safe, predictable, and encouraging setting provided by a therapist or support system that fosters trust and facilitates the therapeutic process, particularly for individuals experiencing distress. | | Activity Engagement | The process of encouraging and motivating individuals to participate in activities, which can help counteract withdrawal and improve mood, often a focus in therapeutic interventions for depression. | | Problem Identification | The initial step in problem-solving where an individual clearly defines the specific issue or challenge that needs to be addressed, often facilitated by therapeutic questioning. | | Solution Generation | The phase in problem-solving where various potential strategies or actions are brainstormed to address the identified problem, encouraging creativity and diverse perspectives. | | Solution Evaluation | The process of assessing the potential effectiveness, feasibility, and consequences of each generated solution before selecting one or more to implement. | | Reward System | A strategy used in therapy where a self-administered reward is planned upon successful completion of therapeutic tasks or goals, serving as positive reinforcement. | | Challenging Thoughts | A cognitive technique where individuals are guided to question the validity and evidence supporting their negative or distorted thoughts, often by asking critical questions. | | Attributiion Style | The way individuals explain the causes of events, particularly successes and failures; in the context of anxiety, a tendency to attribute failures to internal factors and successes to external ones can be maladaptive. | | Biopsychosocial Perspective | A theoretical framework that explains psychological disorders by considering the interplay of biological, psychological, and social factors. | | Genetic Factors | Inherited predispositions that can influence an individual's temperament and increase their risk for developing anxiety disorders. This includes variations in temperament from birth, such as easy, difficult, or slow-to-warm-up. | | Neurotransmitters | Chemical messengers in the brain that play a role in regulating emotions like anxiety and sadness. Imbalances or dysfunctions in neurotransmitters such as serotonin and noradrenaline are associated with anxiety disorders. | | Cognitive Factors | Mental processes, including thinking styles and beliefs, that can contribute to the development and maintenance of anxiety. This involves a heightened focus on threats, overestimation of danger, and underestimation of coping abilities. | | Attentional Bias | The tendency to focus more on threatening stimuli or potential dangers in the environment, which is characteristic of an anxious cognitive style. | | Attributional Style | The way individuals explain the causes of events. In anxiety, this often involves attributing successes to external factors and failures to personal shortcomings. | | Conditioning | A learning process where a neutral stimulus becomes associated with a naturally aversive stimulus, leading to a learned fear response. This can occur through direct negative experiences. | | Social Factors | Environmental and interpersonal influences that can impact the development of anxiety disorders. This includes parental modeling of anxious behavior, overprotective parenting, and peer interactions. | | Psychoeducation | An educational component of treatment that informs individuals about their condition, including the role of predisposition, coping strategies, and critical evaluation of negative thoughts. | | Behavioral Experiments | A therapeutic method used in cognitive behavioral therapy where individuals confront feared situations or test anxious predictions to gather evidence that challenges their beliefs. | | Family Guidance | A therapeutic approach that involves parents as co-therapists, providing them with insights and techniques from behavioral therapy to help manage their child's anxiety. | | Acute Stress Disorder | A rapid and intense reaction to trauma that occurs within days of the event and typically resolves within four weeks. It shares characteristics with PTSD but is shorter in duration. | | Arousal | An increased state of physiological excitement or tension related to trauma, manifesting as exaggerated startle responses, heightened vigilance, and difficulty concentrating or sleeping. | | Dissociative Reactions | Symptoms where an individual feels or acts as if the traumatic event is happening again, such as flashbacks. In extreme cases, this can involve a complete lack of awareness of the current environment. | | Flashbacks | A type of dissociative reaction where the individual experiences the traumatic event as if it were occurring in the present moment, often accompanied by intense emotional and physiological responses. | | Hypervigilance | An exaggerated state of watchfulness and alertness for potential threats, often seen as a symptom of trauma-related arousal. | | Intrusive Symptoms | Unwanted and distressing memories, dreams, or flashbacks related to a traumatic event that intrude into conscious awareness, causing significant emotional pain. | | Post-Traumatic Stress Disorder (PTSD) | A mental health condition that can develop after experiencing or witnessing a traumatic event. Symptoms include intrusive memories, avoidance, negative changes in mood and cognition, and altered arousal and reactivity. | | Psychotraumatic Event | A deeply distressing and emotionally overwhelming experience that can lead to trauma. Examples include disasters, accidents, abuse, or witnessing violence. | | Reactivity | A reduced ability to respond appropriately to the environment, often seen in individuals who have experienced trauma. This can manifest as emotional numbing or detachment. | | Type 1 Trauma | Refers to single, acute, and shocking traumatic experiences, such as natural disasters or traffic accidents. | | Type 2 Trauma | Refers to traumatic events that are prolonged or repeated, such as ongoing abuse or neglect. | | Avoidance | A behavioral response to trauma characterized by the persistent avoidance of stimuli (thoughts, feelings, people, places, activities) that are associated with the traumatic event. | | Traumaopvangmethode | A method, part of a social worker's toolkit, designed for clients who have experienced recent or past traumatic events. It is not suitable for clients with physical or psychological incapacity, insufficient or disinhibited behavior, Type 2 traumatization, PTSD, or those who refuse support. | | Stabilisatietechniek | A technique within trauma support that involves finding a calm, undisturbed space where the client feels safe. The social worker assesses the client's needs, determines if third parties need to be informed, and establishes ground rules for trauma support (confidentiality, informality, equal participation) to ensure safety and provide structure. | | Regisseurstechniek | A technique where the social worker prioritizes the client's needs and wishes, asking what they require after an incident. It emphasizes client control, stating that the client is in charge of the pace and manner in which they process the event, allowing for a controlled working-through process. The client directs the support sessions, with the social worker providing final oversight. | | Reconstructietechniek | A technique that begins with organizing facts and then proceeds to organize experiences, unless the client's needs dictate otherwise. This involves creating a factual reconstruction of events and a reconstruction of the client's subjective experience, aiming to provide cognitive control, order out of chaos, and emotional processing. | | Follow-uptechniek | A technique where the social worker proposes a follow-up appointment at the end of treatment to check on the client's well-being at a later time. This aims to provide a safety net and acknowledges the client's victimhood. If the offer is refused, a telephone check-in can be proposed. | | Cognitieve herstructurering | A therapeutic approach that helps individuals develop a different perspective on traumatic experiences, thereby facilitating processing and recovery. | | Stressreacties | The physiological and psychological responses that occur when an individual encounters a stressful or traumatic event. Understanding these reactions can help individuals regain control of their lives. | | Sociale steun | The mobilization of support from an individual's personal network, which is crucial for coping with traumatic experiences and promoting recovery. | | PTSS (Post-Traumatische Stressstoornis) | Post-Traumatic Stress Disorder, a mental health condition that can develop after a person experiences or witnesses a terrifying event. Symptoms include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. | | Mood Disorder | A mental health condition characterized by significant disturbances in mood, affecting emotional state and behavior, and impacting daily functioning. | | Depression | A mood disorder characterized by persistent sadness, loss of interest or pleasure, and a range of emotional, cognitive, physical, and behavioral symptoms that impair daily life. | | Depressive Episode | A period of at least two weeks during which a person experiences a depressed mood or loss of interest or pleasure, along with other symptoms like changes in appetite, sleep, energy, concentration, and feelings of worthlessness. | | Anhedonia | The inability to experience pleasure from activities that are normally found enjoyable, often a core symptom of depressive disorders. | | Manic Episode | A distinct period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased activity or energy, lasting at least one week and causing significant impairment. | | Bipolar Disorder | A mood disorder characterized by alternating episodes of depression and mania (or hypomania), involving significant shifts in mood, energy, activity levels, and the ability to carry out daily tasks. | | Dysthymia | A chronic form of depression, also known as persistent depressive disorder, characterized by a depressed mood that lasts for at least two years (one year for children and adolescents), with fewer or less severe symptoms than a major depressive episode. | | Cyclothymic Disorder | A milder form of bipolar disorder characterized by at least two years (one year for children and adolescents) of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet the full criteria for a hypomanic or major depressive episode. | | Serotonin | A neurotransmitter that plays a significant role in regulating mood, sleep, appetite, and other functions. Low levels are often associated with depression. | | Noradrenaline | A neurotransmitter and hormone that plays a role in alertness, arousal, and the "fight or flight" response. Dysregulation of noradrenaline is linked to mood disorders, with different patterns observed in depression and mania. | | Psychomotor Agitation | A state of increased motor activity and restlessness, often observed in individuals experiencing manic episodes or severe agitation during depression. | | Rational Emotive Behavior Therapy (REBT) | A form of psychotherapy developed by Albert Ellis, which focuses on the idea that psychological problems stem from irrational beliefs and thinking patterns. REBT aims to help individuals identify and dispute these irrational beliefs to promote more rational thinking and emotional well-being. | | Classical Conditioning | A learning process where a neutral stimulus becomes associated with a naturally occurring stimulus, leading to a learned response. For example, Pavlov's dogs learned to associate a bell with food, eventually salivating at the sound of the bell alone. | | Operant Conditioning | A learning process where behavior is strengthened or weakened by its consequences, such as rewards or punishments. Behaviors followed by positive outcomes are more likely to be repeated, while those followed by negative outcomes are less likely. | | S-R-C Model | A model used in behavioral analysis that breaks down behavior into three components: Situation (S), the antecedent or trigger; Response (R), the behavior itself; and Consequences (C), the outcomes that follow the behavior. This model helps understand the factors maintaining a particular behavior. | | Positive Reinforcement | The process of strengthening a behavior by presenting a desirable stimulus or reward after the behavior occurs. This increases the likelihood that the behavior will be repeated in the future. | | Negative Reinforcement | The process of strengthening a behavior by removing an aversive stimulus or unpleasant situation after the behavior occurs. This also increases the likelihood that the behavior will be repeated. | | Positive Punishment | The process of weakening a behavior by presenting an aversive stimulus or unpleasant consequence after the behavior occurs. This decreases the likelihood that the behavior will be repeated. | | Negative Punishment | The process of weakening a behavior by removing a desirable stimulus or pleasant situation after the behavior occurs. This also decreases the likelihood that the behavior will be repeated. | | Irrational Thoughts | Beliefs or ideas that are illogical, unrealistic, and often exaggerated, leading to emotional distress and maladaptive behavior. These thoughts are typically not based on facts or evidence. | | Cognitive Distortions | Systematic errors in thinking that occur when processing information. Examples include selective abstraction, overgeneralization, personalization, and all-or-nothing thinking, which contribute to irrational beliefs. | | ABC Schema | A foundational model in cognitive and REBT, where A represents the Activating event or situation, B represents the Belief or thought process about the event, and C represents the Consequences, which include emotions and behaviors resulting from the belief. | | Developmental Task | A task that arises at a particular stage of life, the successful accomplishment of which leads to happiness and success with later tasks, while failure leads to unhappiness, disapproval, and difficulty with later tasks. These tasks are influenced by social and societal expectations. | | Early Childhood (0-6 years) | This developmental stage includes tasks such as learning to walk, using solid food, learning to talk, becoming toilet trained, understanding sex differences and sexual modesty, learning to use concepts and language to describe reality, and achieving readiness for reading. | | Childhood (6-12 years) | Key developmental tasks in this period include learning physical skills for games, developing attitudes toward oneself as a growing organism, learning to play with peers, learning to use appropriate masculine or feminine gender roles, developing basic skills in reading, writing, and arithmetic, acquiring concepts for everyday life, and developing a conscience, morality, norms, values, and attitudes toward social groups and institutions. | | Adolescence (12-18 years) | This stage involves acquiring new and more mature relationships with peers of both sexes, learning a masculine or feminine role, achieving emotional independence from parents and other adults, accepting one's own physical appearance and learning to use the body effectively, preparing for marriage, family life, and an economic career, developing an ideology (a system of norms, values, and ethics), and desiring and acquiring socially responsible behavior. | | Early Adulthood (18-40 years) | Developmental tasks include selecting a partner, learning to live with a spouse, starting a family, raising children, managing a household, pursuing an occupation, assuming civic responsibilities, and finding a congenial social group. | | Adulthood (40-65 years) | This period involves assisting teenage children to become responsible and happy adults, acquiring adult social and civic responsibilities, building a satisfying career, developing leisure activities, adjusting to aging parents, and accepting and adapting to physical changes. | | Late Adulthood (65+ years) | Developmental tasks include adapting to a decrease in physical strength, adjusting to retirement and reduced income, coping with and adapting to the death of a spouse, adjusting to changed social roles, developing explicit affinity with age peers, and establishing satisfactory physical living conditions. | | Motivation | That which moves us into action; a mental energy or internal force directed towards a specific goal, encompassing drives and reasons that guide choices and behavior. | | Autonomy | The feeling of choice and freedom in acting, thinking, and feeling, allowing individuals to feel in control of their own lives. | | Relatedness | The feeling of connection with others and being valued by them. | | Competence | The feeling of being capable of achieving desired goals. | | ABC of Self-determination Theory | The acronym representing the three core psychological needs: Autonomy, Relatedness, and Competence, which are fundamental to self-determination theory. | | Intrinsically Driven Autonomous Motivation | Motivation stemming from genuine interest or enjoyment in an activity itself. | | Extrinsically Driven Autonomous Motivation (by Usefulness) | Motivation arising from recognizing or experiencing the personal utility or meaningfulness of an activity. | | Extrinsically Driven Autonomous Motivation (by Value) | Motivation where an activity becomes integrated into one's lifestyle and aligns with deeply held personal values. | | Controlled Motivation | Motivation driven by a sense of pressure or obligation, often referred to as "MUST-ivation," arising from internal or external pressure. | | Internal Pressure | Pressure originating from self-imposed expectations or obligations. | | Trauma | A highly impactful, emotionally distressing experience. Traumas can vary greatly in nature, such as being bitten by a dog, experiencing an earthquake, or being a victim of burglary, robbery, or kidnapping, witnessing or experiencing acts of war, domestic violence, or psychological, physical, or sexual abuse. | | Post-Traumatic Stress Disorder (PTSS) | A condition that can occur when a child or adult has been a victim or witness to a traumatic experience. The characteristics can vary depending on the trauma, the individual, and the social support provided after the trauma. | | Cognitive Schemas | Underlying mental frameworks that guide thinking, feeling, and acting. In the context of trauma, these schemas can become dysfunctional, leading to distorted, one-sided negative interpretations of events. | | Attributions | Explanations or interpretations for events. Problematic attributions, such as blaming oneself for the trauma or believing it was uncontrollable, can contribute to the persistence of PTSS symptoms. | | Critical Incident Stress Debriefing (CISD) | A professional support process offered after a traumatic experience. It involves discussing what happened, allowing for emotional expression, assessing stress symptoms, explaining stress reactions, providing coping strategies, and offering guidance on social support and aftercare. | | Mood Disorders | Conditions characterized by significant disturbances in emotional state, affecting mood regulation and leading to problems in daily functioning. These disorders span the spectrum from depression to mania. | | Depressive Mood | An abnormal state of profound sadness, characterized by a lack of motivation and interest, and an inability to experience pleasure (anhedonia). This is distinct from normal sadness experienced in response to life events. | | Manic Mood | A state of abnormally elevated, expansive, or irritable mood, accompanied by increased self-confidence and overconfidence. Individuals in this state are often easily irritated and may exhibit impulsivity. | | Depressive Disorder | A mental health condition characterized by one or more depressive episodes, which are periods of at least two weeks of persistent low mood, loss of interest, and other symptoms that impair functioning. | | Psychotic Features | In the context of mood disorders, these are symptoms that involve a loss of contact with reality, such as delusions (e.g., believing one is a prince, or has ruined their family) or hallucinations. These can occur in both depressive and manic episodes. | | First Line | Refers to healthcare services with high accessibility and low specialization, such as general practitioners, youth information centers (JAC), and social welfare centers (CAW). These services are easily accessible, have short waiting times, and handle a broad range of issues in a familiar environment. | | Second Line | Encompasses healthcare services that are less freely accessible and have a more specific specialization, including general mental health centers (CGGZ) and psychiatric departments of general hospitals (PAAZ). Access often requires an appointment, may involve waiting lists, and typically follows a referral from the first line. The services offered are more specialized for a narrower range of problems, usually on an outpatient basis. | | Third Line | Consists of highly specialized services accessible only through referral, such as psychiatric hospitals and therapeutic communities. These facilities have a high threshold for entry, requiring mandatory referrals and strict admission procedures, and almost always involve inpatient care. | | Zero Line | Includes self-care and informal care provided by the individual's immediate environment (family, friends, neighbors) and self-help groups. It also involves professionals in key positions like teachers and youth workers who offer informal, accessible support and can refer individuals to professional healthcare when needed. | | Biopsychosocial Model | A perspective that views psychological problems as arising from a complex interplay of biological, psychological, and social factors. It emphasizes that understanding an individual's mental health requires considering all these dimensions, as they influence each other. | | Biological Explanations | Factors related to physical health that contribute to psychological dysfunction, including genetic predisposition and brain function disturbances. This encompasses inherited tendencies for disorders and imbalances in neurotransmitters crucial for brain activity. | | Psychological Explanations | Focuses on how an individual's personality and mental health influence psychological complaints. Negative life experiences can shape thinking styles, attitudes, and behaviors that perpetuate problems, leading to developmental stagnation and distress. | | Social Explanations | Examines causes rooted in the client's current life circumstances. This includes family conflicts, societal issues like poverty and discrimination, and social isolation, all of which can significantly impact mental well-being. | | Symptom | An indication of a psychological problem, characterized by specific features that manifest with a disorder. The severity and duration of symptoms are important factors in determining the appropriate treatment. | | Syndrome | A coherent set of symptoms, with explanations regarding their severity and duration. Identifying specific disorders involves observing which symptoms co-occur and assessing their intensity and persistence. | | DSM (Diagnostic and Statistical Manual) | A manual used for diagnosing mental disorders, providing concrete descriptions of various psychological disorders and syndromes. The DSM-5 is the most recent version. | | Maslow's Hierarchy of Needs | A theory proposing that human behavior is driven by a need to fulfill five sequential levels of needs: physiological, safety and security, social contact and belonging, esteem and recognition, and self-actualization. Later additions included cognitive and aesthetic needs. | | Psychisch Welzijn (Mental Well-being) | This refers to a state of psychological health characterized by the ability to develop one's talents, cope with daily stresses, work productively, and contribute to the community. It encompasses managing thoughts, feelings, and relationships, leading to satisfaction with one's existence. | | Emotioneel Welbevinden (Emotional Well-being) | This aspect of mental well-being relates to life satisfaction, characterized by the presence of positive feelings and the absence of negative ones. Higher emotional well-being is linked to a healthier and longer life, as well as faster recovery from physical ailments. | | Persoonlijk Welbevinden (Personal Well-being) | This dimension of mental well-being involves self-acceptance, autonomy, having a purpose in life, self-actualization, and personal growth. The perception that one's existence is meaningful has a significant impact on overall psychological well-being. | | Sociaal Welbevinden (Social Well-being) | This component of mental well-being assumes positive relationships, a favorable view of others, trust in societal progress, understanding, participation in society, and feeling accepted within the community. | | Geestelijke Gezondheidszorg (Mental Healthcare) | This encompasses the range of services and facilities available for individuals seeking help with psychological problems. It is a broad sector aimed at promoting mental health and treating mental disorders. | | Eerste Lijn (First Line) | This refers to the most accessible level of mental healthcare, characterized by low specialization. Examples include general practitioners, youth advice centers (JAC), and community welfare centers (CAW). These services are easy to access with minimal waiting times or complex procedures. | | Tweede Lijn (Second Line) | This level of mental healthcare is less freely accessible and involves more specific specialization. Examples include specialized mental health centers (CGGZ) and psychiatric wards in general hospitals (PAAZ). Access often requires a referral from the first line and may involve waiting lists. | | Derde Lijn (Third Line) | This is the most specialized level of mental healthcare, accessible only through referral. It includes psychiatric hospitals and therapeutic communities, offering highly specialized treatment, typically involving inpatient care. | | Nulde Lijn (Zeroth Line) | This level refers to self-care and informal care provided by the immediate environment of the individual, such as family, friends, and self-help groups, as well as professionally trained individuals in key roles like teachers or youth workers. | | Biopsychosociaal Model (Biopsychosocial Model) | This model posits that psychological problems arise from a complex interplay of biological, psychological, and social factors. It emphasizes that understanding mental health requires considering all these interconnected dimensions. | | Biologische Verklaringen (Biological Explanations) | These explanations for psychological functioning focus on physical factors such as genetic predisposition and brain function. They include hereditary tendencies towards disorders and disruptions in neurotransmitter systems. | | Psychologische Verklaringen (Psychological Explanations) | These explanations for psychological problems examine the influence of personality and life experiences on mental health. Negative experiences can lead to maladaptive thinking styles, attitudes, or behaviors that perpetuate problems. |