Therapies

Therapies

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  • Created by: Elisa
  • Created on: 11-05-09 14:16

Biological!

Biological/medical model proposes that the causes of mental disorders
resemble those of physical illnesses.
- Infection, genetics, biochemistry, neuroanatomy etc.
- Because it's physical causes- treatment should also be physical (direct manipulation of the body)- drugs, ect and psychosurgery.


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PSYCHOSURGERY 1

- Old methods- e.g. the use of brain surgery to reduce psychological or
behavioural disorders. 
PREFRONTAL LEBOTOMY where fibres running from the frontal lobes of the
rain to other parts of the brain were cut (for example in ONE FLEW OVER THE CUKOO'S NEXT0 reduces character's rebellion against prison authorities). Between 1935 and 1955 70,000 were carried out. VERY
IMPRECISE!
SIDE EFFECTS OF PREFRONTAL LABOTOMY = apathy, diminished intellectual powers, imparied judgements, coma's and even death. SO.. reduced. NOW, PREFRONTAL LEUKOTOMY (more refined techniques)- involves drilling 2 holes into the side of the skull and inserting needles to sever specific
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PSYCHOSURGERY 2

nerve fibres (makes some areas of the brain unfuctional so same as
removing them).
EFFECTIVENESS
- During the 1950's and 60's many psycho-surgery procedures were carried out on criminals in america. these operations were usually a success and made criminals less agressive. However, side effects= lack of motivation, confusion, and unable to work (Eysenck & Eysenck 1989) so
hardly carried out anymore. -SO, is possible that psychosurgery can be effective if precisly and on
right patients. BUT, major ethical issues. In the UK, the MENTAL HEALTH



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PSYCHOSURGERY 3

ACT requires a patients consent for psychosurgery and an opinion from a
2nd doctor.
ETHICAL ISSUES = Just to get rid of psycho symptoms- Irreversible
alteration of persons thought process, damage to cognitive capactities
(e.g. memory and reasoning) and an interference with an inviduals
excisercise of free will.

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ELECTRO-COMPULSIVE THERAPY 1

- Origins= observations that epileptics rarely suffered from
schitzophrenia. It was thought that by giving patients the seizures
associated with epilepsy schitzophrenia would be prevented.
- ECT= strong electric current passed between 2 electrodes on either
side of forehead. The current caused almost immediate loss of
consciousness and caused a seizure. (now only between 70 and 130 vaults
passed through only the non-dominant brain hemisphere so less spasms).
- Typically a patient would recieve between 6 and 9 treatments over the
period of a month.

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ELECTRO-COMPULSIVE THERAPY 2

EFFECTIVENESS= now rarely used for schitzophrenics HOWEVER seems to be
successful for cases of severe depression.
+ FINK concluded 60% less people committed suicide when had ECT than
not.
- SACKHEIM found high relapse rate within a year so only a temporary solution.
+ Janicak said it was successfull with patients who had not responded to drugs (80% respont as only 64% with drugs respond).

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ELECTRO-COMPULSIVE THERAPY 3

APPROPRIATENESS= 
- We have little idea HOW it works so how can it be used as a therapy?
Either works as a punishment so people unlearn depressiveness, works by restructuring disordered thinking OR it changes around levels of
hormones in the body.
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DRUG THERAPY 1

DEPRESSION
- MONOAMINE OXIDASE INHIBITORS (MAOIs)- change levels of
neurotransmitters such as nor-adreniline)- range of side effects
- TRICYCLIS- Same as MAOIs- dizziness, blurred vision, dry mouth
-SSRIs E.G. PROZAC- As MAOIs but mainly affect levels of seratonin.-
preoccupation with suicide/violence
ANXIETY DISORDERS
- BARBITURATES- treat symptoms of anxiety e.g. shortness of breath,
nausea and dizziness etc- problems of concentration, slurred speech etc.


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DRUG THERAPY 2

SKITZOPHRENIA
-NEUROLEPTIC drugs- Reduce delusions, hallucinations etc. Some patients report grogginess, dry mouth, blurred vision etc. THERE IS A PROVEN LINK BETWEEN NEUROLEPTIC DRUGS AND PARKINSONS DISEASE (very much an ethical issue)!

EVALUATION OF DRUG-THERAPY

-Tends to take responsibility away from the patient and give it to the therapist

- Patients often dislike taking the drugs when they have serious side-effects etc, and it's hard for therapists to make sure they're being taken as/when they should be.

- Drugs can treat symptoms not causes, as a result when drugs are stopped.. symptoms re-appear.
- Drugs are not effective with all patients (raises questions about their usefullness).

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DRUG THERAPY 3

- Patients can become dependant on drugs and become addicted.

- The use of drugs/chemotherapy has allowed many mentally ill to live normal lives despite disorders.

- It is unethical to compare the effects of a given form of therapy with those who have been denied treatment.

- Many patients e.g. young children or schitzophrenics are not able to give informed consent. Also, it may be difficult to gain full informed consent because side-effects vary from patient to patient (you can't tell a patient which side effects they may have).

- Drugs are useful because may stop distress, there has also been proof that drugs have reduced the liklihood of someone commiting suicide.

-REDUCTIONIST and inappropriate for disorders that are clearly not based on biochemical abnormalities e.g. cultural values and expectations play a kep role in producing eating disorders and so biological therapies are unlikely to be of any help.

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Behavioural Therapies

- Most forms of mental illness occur through maladaptive learning, and the best treatment
is to re-learn/re-educate
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