Treating Abnormality

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Biological Therapies - Drugs

Widely used for all biological and psychological therapies. For some disorders, schizophrenia, drugs as the only generally available treatment.

Schizophrenia:

  • Antipsychotics. Reduce the activity in the brain neurotransmitter dopamine.
  • Supports the hypothesis that it is caused by overactivity of dopamine pathways in the brain

Depression:

  • Can be highly effective
  • Antidepressants - Prozac - increase the activity of serotonin.
  • Supports the idea that depression is linked with low levels of serotonin.
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Evaluation of Drugs

Pros:

  • Widely avaliable
  • Cheap compared to psychological therapies
  • Extremely effective for schizophrenia.
  • Can suppress symptoms

Cons:

  • 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
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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.
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ECT Evaluation

Pros:

  • Has been shown to be effective in a number of patients with severe depression

Cons:

  • 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.
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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.

Free Association

  • 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.
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Psychoanalysis continued

Therapist interpretation:

  • 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

Working through:

  • 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
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Psychoanalysis evaluation

Pros:

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.

Cons:

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.

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Systematic De-Sensitiastaion

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.
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Evaluation of Systematic De-Sensitisation

Pros:

  • 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.

Cons:

  • 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.
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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.
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Evaluation of CBT

Pros:

  • 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

Cons:

  • 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
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