Biological Therapies - Drugs
Widely used for all biological and psychological therapies. For some disorders, schizophrenia, drugs as the only generally available treatment.
- Antipsychotics. Reduce the activity in the brain neurotransmitter dopamine.
- Supports the hypothesis that it is caused by overactivity of dopamine pathways in the brain
- Can be highly effective
- Antidepressants - Prozac - increase the activity of serotonin.
- Supports the idea that depression is linked with low levels of serotonin.
Evaluation of Drugs
- Widely avaliable
- Cheap compared to psychological therapies
- Extremely effective for schizophrenia.
- Can suppress symptoms
- Do not work well for phobias or eating disorders
- Do not cure the disorder as they don't targer underlining problems.
- All drugs have physiological and psychological side effects
- Can lead to physical dependence
- Ignores cognitive, emotional or envrionment influences
- Ethical issue of people with severe depression may not be capable of giving informed constent
Electroconvulsive therapy (ECT)
- Small electric current passed through the brain, producing an electric convulsion similar to epilepsy
- Behavioural signs are controlled by the use of anticonvulsant drugs
- Electircal discharge in the brain is thought to alter levels of brain neurotransmitters
- Historically used for a wide range of conditions, like schizophrenia, but doubts about its effectiveness mean that in the UK it is only precribed for severe depression that has not responded to drugs.
- Has been shown to be effective in a number of patients with severe depression
- Seen as barbaric assault on the brain that is out of place in modern society
- Do not know how it works
- To be effective a series of ECT treatments is given over a period of weeks, there is some evidence that this can lead to long - term memory problems in some patients.
- Ethically it is doubtful if people with severe depression are capable of giving fully informed consent to this stressful an dviolent procedure.
Psychological Therapies - Psychoanalysis
Repression and the unconscious mind.
- Individuals are unaware of the many factors that cause their behaviour, emotions and general mental health.
- Operate at an unconscious level and are the result of repressed memories or unresolved conflicts from childhood
- Belief that i fa personal can gain an insight into what has happened in the past, they will be able to deal with their curent problems
- Therapist attempts to trace thesse unconscious factors to their origins and then help the individual deal with them.
- Therapist uses a variety of different techniques to uncover repressed material and help the client deal with it.
- Patient expresses thought exactly as their occur, even if they seem unimportant.
- Free association lies in the fact that these associations are determined by unconscious factors which pyschoanalysis tries to uncover.
- Reveals ares of conflict and brings them to the conscious.
- Therapist helps to interpret these for the patient, who can correct or reject and add.
- Listen carefully to their patients talk, looking for clues and drawing conclusions abot possible cause(s) of the problem.
- Patient may initally offer resistance to the therapist's interpretations, or may even display transference where they recreate feelings and conflicts and transfer these onto the therapist
- Psychoanalysis is not a brief from of therapy
- Patients tend to meet up with the therapist four or five times a week
- Examine the same issues over and over again, can be for a period of years, in attempt to gain greater clarity concerning the cuases of thier neurotic behaviour
- Allows the patient to understand the influence of the past on their current condition and gives them the chance to use this insight to make positive changes in their life
- Working thorugh the past helps the patient to gain a measure of control over their inner conflicts, to minimise their influecne over their current behaviour
Effectiveness: Bergin (1971) estimated that out of 10,000 patients 80% benefited from psychoanalysis compared to 65% from other therapies. Length and intensity of treatement was a cirtical factor in recovery rather than the type of treatment. The longer and more intense the treatment the better the results.
Length of treatment: The importance of the length of treament in recovery was supported by Tshuchke et al (2007)who carried out one of the largest long-term psychodynamic treatment. More than 60 patients included in the study which showed the longer the treament the better the outcome.
Theoretical limitations: Based on Freud's theory of personality: if that is flawed then the explanations of mental illness and the therapy must be flawed.
There may be wrongly implanted repressed memories from this therapy, it is expensive and takes a long time.
This is where an individual is gradually introduced to a phobia or an event that they feel anxious about. Then through various stages, a hierarchy agreed upon by the patient and the therapist, is worked through with a relaxation method brought in after each stage.
How it works:
- Step 1: Patient is taught how to relax their muscles completely. (Relaxed state is incompatible with anxiety)
- Step 2: Therapist and patient together construct a de-sensitisation hierarchy - a series of imagined scenes, each one causing a little more anxiety than the previous one.
- Step 3: Patient gradually works his/her way through de-sensitisation hierarchy, visualising each anxiety-evoking event while engaging in the competing relaxation response
- Step 4: Once the patient had mastered one step in the hierarchy they are able to move on to the next
- Step 5: Patient eventually masters the feared situation that caused them to seek help in the first place.
Evaluation of Systematic De-Sensitisation
- Quick and require less effort on the patient's part, so successful outcomes are reached quickly.
- This treatment may be the only one that works for people with learning difficulties.
- This treatment can also be self-administered over the computer.
- Research has shown that SD is successful for a wide range of anxiety disorders.
- They have lower levels of anxiety than people using other treatments.
- SD may appear to resolve a problem but simply eliminating or suppressing symptoms may result in other symptoms appearing.
- May not be effective in reating anxieties that have evolutionary survival components. As these fears have helped humans to survive for years and are harder to shift.
Cognitive Behavioural Therapy (CBT)
Assumes that psycholgoical disorders are caused by maladaptive or irrational perceptions and thoughts.
Beck's cognitive Therapy: Believes that depression is caused by egative schemata maintained by cognitive biases and pessimitstic thoughts about the self.
How it works:
- Therapist helps the cilent to indentify key nagative thoughts. Diary keeping is an important part of this stage.
- Using this material the therapist challenges these negative thoughts oby indentifying examples, that cotradtict the client's own pessimistic views. Form of reality testing, key component.
- Behavioural techniques are used to encourage more positive behaviour. Small goals set a day. Minor achievements help a depressed person to develop a sense fo personal effectiveness.
Evaluation of CBT
- Shown to be as effective as drug therapy for treating depression and anxiety
- Improvement may last longer
- Assumes that the cause of depression, for example, lies in maladaptive thoughts so it targets the causes of abnormality and not just the symptoms.
- CBT avoids the in-depth probing associated with psychoanalysis
- CBT is less effective for phobias than SD and severe disorders like schizophrenia is not suited for CBT
- Ignores gentic and biological factors in abnormality
- Some people might find the diary keeping and self-monitoring assocaited with the therapy stressful