Monday 18 March 2013

A (sort of) review of MoodGYM-Cognitive Therapy Programme (Part 1)

I've been having a look at online counselling/therapy programmes for a few reasons. Firstly, because of my interest in therapy generally. Secondly, because I want to assess my own mental health. Thirdly, because I want to improve my mental health in order to help deal with my physical health. Finally, I want to see how effective online therapy actually is. I came across MoodGYM, a programme based loosely upon Cognitive Behavioural Therapy. The following is a guide/review of the programme as I try it on myself. It is in 2 parts due to how long it is.

Review of MOODGYM (Cognitive Therapy Program)
  • The start page gives an overview of the program and the modules you face, what to expect etc
  • Press YES to get to the moodgym start
  • An introduction follows (very positive psychology based) about depression, anxiety, taking control
  • Click on “Want to know more?”
  • The aims of the program are displayed, click next to proceed.
  •  More of an explanation is given next, click next to proceed.
  • The next page explains what moodgym hopes ‘the client’ will achieve from the program, click next to proceed.
  • An explanation of what you ‘won’t learn’ from moodgym follows, click YES to proceed.
  • This links to a page which lays out ‘terms of use’ – this clearly explains that the programme should not be used to treat clinical levels of depression, anxiety etc and is “ intended for information and skill development purposes only.” – click I AGREE
  • A form follows asking for some personal details (not home address) and asking about reasons for wanting to participate, have you felt symptoms of depression, how did you come across this etc. – Click add user to proceed.
  • The welcome page then appears and I’m able to start the program straightaway.

Once you actually start the program you will be introduced to a few ‘characters’. These are basic examples of people in certain situations (good or bad), shows how they appear on the outside and how they feel on the inside e.g. someone who is generally content with life, someone who has everything going for them (looks, relationships, talent, work etc) but feels as if they will be exposed as a ‘fraud’ and someone who had a bad childhood which affects the relationships they have with family, friends etc. I think this is just something to think about and to show that sometimes, we can all feel like each of these characters. There may be ones that you can relate to more than others in some ways. They each have a name as such but these aren’t exactly memorable. That may not be important though. I think it is useful to go into this program with an open mind.

Next comes a Depression Quiz. Fill this in and click ‘submit answers’ to access the results section. My results come up as “middle to high” which suggests that I may have more symptoms of depression than the average person my age. A brief description of what this means is given. I actually find my results quite surprising as I thought mine would be middle to low. Nevertheless, I can relate to the description given. I can overreact to situations, I cry when I’m stressed and angry as well as upset. Something I’d quite like to change!

Next comes an Anxiety Quiz. Fill this in and click ‘submit responses’ to access the results section. Again my results come up as “middle to high” Hmm, now I’m not so sure about this. The questions make sense but I think some background medical questions should have been asked prior to the mental health questions so things such as physical conditions are taken into consideration. I find myself answering ‘yes’ to the aching and dizziness questions which raise my score considerably. Now, as you know, I am going through the process of actively seeing doctors and may possibly be receiving a diagnosis of Fibromyalgia. The aches, pains and dizziness associated with this condition are not necessarily indicative of depression or anxiety (although a sufferer may experience either or both of these conditions as a secondary illness to fibro).

Next comes a Warpy Thoughts test. Fun name huh? This is a few pages long and goes through factors such as need for approval, perceptions of love and how important it is to feel it, the need to succeed, perfection,  influencing someone etc. Once all these forms are submitted you come to a results page with your results shown in a bar chart. My results are as below:

·         Need for approval from others = 9.7%
·         Need to be loved = 14.5%
·         Need to succeed = 22.6%
·         Need to be perfect = 9.7%
·         Sense of being able to influence other’s emotional reactions = 12.9%
·         Happiness is contingent upon external things = 11.3%
·         The sense of feeling deserving = 19.4%

To be honest, these results definitely make sense to me. The ‘deserving’ one seems a little high but the ‘succeed’ one I can definitely relate to. I’ve always wanted to be successful in life and my way of measuring my success is through achievements. These could be: doing well in school, making true friends, falling in love, maintaining a healthy relationship, getting a good job, getting married, having a family and living in a nice house/area. My ultimate relationship goals are to be happily married with children and my ultimate career goal is to become a Clinical Psychologist. I guess at the moment I don’t feel as successful as I should do especially as I compare my success to others and find that there are a lot of people, around my age, who are happily married and/or have lovely children and/or have great jobs that pay well. Maybe I should stay away from facebook?

Ok, we then return to the characters and are asked to click on each to see how they would score on the above tests. Mine actually seem to be a much higher version of NoProblemo’s results. Maybe I place more importance on certain factors than I should? Maybe I expect too much of myself, I don’t know yet.
We next move to the Feelings module. Once we have entered this module we are presented with a brief of the reasons CBT believes we may feel negative or positive. These reasons are very basic but there’s obviously bound to be other complications which contribute to a person’s emotions. I find the biopsychosocial model is relevant here. We need to look at health, environment, relationships, working life, lots and lots of reasons.

A question is presented which focuses on relationships with people. The program compares a happy person’s response and an unhappy person’s response. I think, even if we don’t think it of ourselves, we can all think of at least one person in our lives who would say something very similar to each of these characters. As we move on a couple of pages, these characters are presented with more hypothetical questions.
The next exercise involves implying what we have learnt to hypothetical situations. So we look at a few character responses and try to establish how their views are negative.
Once our responses are submitted, we move to a page which gives a more in depth insight into how negative views, interpretations and expectations actually affect how our life goes. However, we are not necessarily to blame for how we are feeling. I believe depression and anxiety is learnt through the way we interpret situations and how successfully we protect ourselves from how these situations make us feel. We can easily learn to expect the bad situations to carry on or even get worse, and it takes a lot of hard work to have the faith that our lives will improve as well as being able to positively deal with what we are facing presently. A particular sentence in the program to take note of is this: “People in similar situations can respond very differently”.
Next we go to a module entitled “The Thinker”. A negative and a positive interpretation of the same event is presented and a description of how each ‘thinker’ came to this thought. The concept, again, makes sense but I think it needs to be explained with some more examples to make the interpretations more relatable to someone. This will increase faith in the program as a whole.
On the next page, another example of an event is given and we are asked to click on each of the characters to see their response to this. We find the event could possibly be overcome by anyone in the situation dependent upon their thoughts, feelings and behaviours. The event has turned out more positively for NoProblemos because he has interpreted it in the correct way. He’s clearly annoyed it happened but he is grateful the situation wasn’t worse, knows he can choose to have a good day anyway and ends up having a good day because of what he’s done. He has, in fact, taken control of the situation rather than letting it take control of him.

We then have to apply what we've learnt to an exercise, to assess how we would respond to a few examples of events.  Once we have scrolled through the list of thoughts and the progression from there to our potential behaviours, we go to a page which explains the most appropriate ways to think. What I like here is that chronic conditions are mentioned as something to think about.
This leads on to an Auto Talk Quiz. These consist of a list of warped thoughts/negative thoughts and we are asked to tick Yes to the ones we find we think of ourselves or No to the ones we don’t relate to. These are only for thoughts we've had in the last two weeks however. Now these do seem a bit extreme and I think examples within a greyer area need to be shown. I find I only answered yes to two of these; with them only applying on my worst days and not thoughts I have constantly. Your results are given on the next page.

The next exercise is called “Bad Hair Day” and we are asked to think about the last time we felt upset and the last time we felt angry. We have to write down the event and then write down our thoughts about it. The next page explains how different events result in different thoughts and a feeling of upset is usually attributed to internal things, whilst anger is attributed to external things.
The next page explains the final exercise of the module; “Three Encounters of an Emotional Kind” where you will identify three events in your daily life that are associated with strong feelings (can be positive or negative). You then have to identify the thoughts that led to these feelings. I think the concept of Mindfulness comes into play here in order to identify the source of positivity as well as negative. Like learning when to change our negativity and when we can turn something into a positive (or not so negative/easy to deal with?) situation.
Well now I have my three events written down; with the thoughts, feelings and behaviours added to the table. I typed these into the table provided on the programme and clicked ‘submit answers’. I have now completed the ‘Feelings’ module. I think this exercise was just to practice skills, such as mindfulness, however I do not feel that I have begun to reorder  my thoughts in a calmer and more logical way. I may just know a bit more about the way I think. An actual person to respond to the homework may be useful here for more information and support.
Next we come to a summary of the module and progress so far. The summary is sub-headed by sections such as “What have I achieved this module?”, “ What have I found out about myself this module?” and “What would I like to do about learning how I think and what effect this has on me”. This particular heading allows you to fill in a short list of goals you want to achieve by the next module. These are my two goals:
  1. I'd like to learn how to change my perception of certain negative events.
  2.   I'd like to learn how to be less anxious and cynical about certain things.

(    (Go to Part 2 to read on)

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