Treatments/ Therapies From Each Of The Five

Psychological Approaches

• Cognitive• Social• Psychodynamic• Biological • Learning

The Cognitive Approach

Strengths Weaknesses

Chadwick(2000) studied 22 schizophrenics who herd voices. After 8 hours of CBT they all had decreased negative beliefs about how powerful and controlling the voices were. This study supports CBT because all of the patients benefited from the therapy.

This method of therapy does not take into account the affect of biological factors in the disorder being treated.

Studies also suggest that CBT is effective on patients who do not respond to drugs and has the benefit of not producing any side effects.

This method does not work for all individuals and the therapy can be time consuming and expensive.

One Therapy from the Cognitive Approach is Cognitive Behavioural Therapy.

CBT is a therapy which is based on the idea that most unwanted thinking patterns, and emotional and behavioural reactions are learnt over a long period of time.

The four main aims of CBT are to Challenge and modify the patients delusory beliefs, Help the patient to identify delusions, Challenge those delusion by looking at evidence and to help the patient to test the reality of the evidence.

Evidence which would support Cognitive Behavioural Therapy is the case study by Bradshaw of a Schizophrenic women named Carol. Carol underwent a 3 year supportive CBT programme where it was found that after the therapy she had significant improvements in psychological functioning and the reduction of symptoms and hospitalization was maintained at a 1 year follow up. This would suggest that CBT produces long term effects.

CBT can be seen as unethical because it is trying to make the individual believe that their own thoughts and beliefs are wrong in order to obtain social control by normalizing socially deviant behaviour.

The Social Approach One Treatment from the Social Approach is Family Based Treatment

This treatment can help individuals suffering form eating disorders such as anorexia. It is also known as the Maudsley Approach. The treatment uses the parents of the suffer as a resource because with the help of a therapist parents take charge of refeeding by being persistent and consistent in order for the individual to return to a healthier weight. Siblings also help by offering support at meal times so that the ill sibling is distracted from the pressures of eating. Once there is less resistance at meal times the individual will then become responsible for their own eating.

The three phases of treatment are – Weight restoration, Return to independent eating and finally healthy adolescent development.

A case study which would support the effectiveness of this method of treatment would be Sarah, an anorexia suffer who along with her parents followed a family based treatment programme and have returned to a healthier weight and overcome anorexia .

This treatment is ethical and is not used as a way of social control because even though the behaviours of eating disorders do deviate from the social norm the treatments main concern is to help the individual return to a healthier state because eating disorders have a high mortality rate. Strengths Weaknesses

The treatment ensures that the individual is not blamed for the illness instead there is a separation of illness and adolescent, this is also known as externalizing the illness.

It can be difficult for some parents to maintain the persistence and consistency needed during the treatment which can make it ineffective.

This treatment allows for the individual to overcome the disorder in their natural environment as opposed to being hospitalized or institutionalized for a long period of time.

This treatment does not help to resolve the issue which may have manifested into the eating disorder as it only focuses on changing the individuals eating habits.

The Psychodynamic ApproachOne therapy from the Psychodynamic Approach is Dream Analysis.

This therapy works under the assumption that mental disorders come from the unconscious mind and therefore for the mental illness to be treated the unconscious mind of the individual must be assed through dream analysis in order for the root issues causing the disturbance to be identified and overcome. When we sleep material which usually stays in our unconscious mind enters our conscious in the form of a dream.

To avoid anxiety the material is not displayed in our conscious in its actual form but instead symbolised or disguised to allow us to sleep peacefully. The content of the dream that we remember is called the manifest content and the actual meaning of the dream is called the latent content. In this therapy it is the analyst's job to analyse the manifest content to determine the latent content.

This method could be seen as a way of social control and slightly unethical because it is making the individuals think that what they thought their own personal thoughts and ideas where are actually not true or that they means something else based on the analysts own opinions.

Strengths Weaknesses There are no side effects from this method of therapy therefore the individual is not being subjected to any more psychological or physical harm than that of their daily life.

Dream analysis is subjective because different analysts may have different interpretations of the same dream making it invalid.

It is a unique method as is needed to uncover the un-measurable unconscious as there is nothing physical to measure or analyse.

The client may not tell the analyst the whole dream as they may have forgotten bits or have left information out to avoid discomfort. Therefore the interpretation will not reflect what is actually in the unconscious.

The Biological Approach

Strengths Weaknesses Drugs allow the patient to live in society instead of being institutionalised in long term stay in hospitals.

The drugs being taken as chemotherapy may have unpleasant side effects.

The use of drugs has cured some disorders and dramatically prolonged and improved the quality of life for other suffers.

The individual may build up a tolerance for the drug and therefore become ineffective. Also not all individuals are effected by the drugs therefore making it unnecessary.

One Treatment from the Biological Approach is the uses of drugs (chemotherapy)

It is suggested that some disorders for example Schizophrenia are caused by a biological abnormality. Therefore drugs have been produced to reduce the intensity and frequency of psychotic symptoms.

Drugs such as amphetamines are given to people suffering from schizophrenia because it is thought that schizophrenia is caused by high dopamine activity in the brain therefore the amphetamines work by reducing dopamine activity which results in a reduction of schizophrenic symptoms.

Pickar et al.(1992) compared the effectiveness of the antipsychotic drug Clozapine with other narcoleptics and a placebo, which showed that Clozapine was the most effective in reducing symptoms and that the placebo was the least effective. This study suggests that the use of drugs to treat psychotic disorders can be effective

This method of treatment can be seen as ethical because it allows for psychotic symptoms to be reduced in intensity and frequency and therefore allow for the individuals to continue with daily life without the need for long term hospitalization. However this could be seen as social control to reduce the level of abnormal behaviour in society.

The Learning Approach

Strengths Weaknesses

It is a method used in many institution and everyday life as a way of getting the desired behaviour. For example rewarding a child with sweet if they behave. This therefore suggests that this method is ecologically valid.

Patients would have to be kept in an unnatural, controlled environment thorough out the token economy programme so that their behaviour can be closely monitored in order for tokens to be given effectively.

This methods can be applied to many different situation from changing the behaviours of criminal offenders to the behaviour of those in a psychiatric institution and even daily life such as disciplining a child.

Tokens may be given for behaviours to help achieve social control in the institution environment, rather than rewarding for behaviours which would benefit the patient in real life.

Token Economy is usually used in institutions to encourage desired behaviours. It is based on the principle of operant conditioning by BF Skinner who suggested that welearn through consequence. It has also been suggested that some disorders such as anorexia nervosa are learnt through rewards from the external environment which reinforce the abnormal behaviour.

Each time the desired behaviour is carried out by the individual for example the anorexia suffer eating food without resistance, they will be rewarded with a token these tokens then add up to the individual receiving a desired reward. The resultant reward has to be desired by the individual in order for token economy to work effectively.

Hobbs and Holt (1976) investigated the effectiveness of a token economy programme with 125 boys , detained in a correctional institution. They compared boys living in different accommodation units (cottages) three of the cottages participated in the token economy programme and the fourth cottage did not. They found that the system improved the targeted behaviours in the three participating cottages and there was no change in the boy in the non participating cottages behaviour. This suggests that his method is effective if used appropriately

However it can be unethical and used as social control if it is abused by institution staff members by rewarding individuals for behaviour which would make their jobs easier rather than behaviours which would benefit the individual themselves.

One treatment from the Learning Approach is Token Economy