5.3 abnormal psychology: implementing treatment
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5.3 Abnormal psychology: implementing treatment. Introduction - History. “madness” was attributed to the supernatural forces, or possession of evil spirits Treatment was drilling holes in the skull to release the evil spirit, this is known as trepanation. - PowerPoint PPT PresentationTRANSCRIPT
5.3 Abnormal psychology:
implementing treatment
“madness” was attributed to the supernatural
forces, or possession of evil spirits Treatment was drilling holes in the skull to
release the evil spirit, this is known as trepanation.
Diagnosis was occurring and treatment was being sought.
Introduction - History
Possible relationship between etiology and
treatmentPages 166 - 169
Biomedical Individual or group therapy Biopsychosocial approach: Multifaceted
approach is know considered to be the most efficient. Includes drug therapy cognitive therapy (individual) or family therapy (group therapy) Stress related environmental management
‘Client’ has replaced the term ‘patient’
Contemporary approach to treatment
Not all people will respond to drug therapy the
same Side effects may occur Dosage levels take time to assess No conclusive data to pinpoint specific
biophysiology to behavior, but rather a general knowledge that neurotransmitters and hormones may contribute.
Drug Therapy
Therapist work one-on –one with the client Most therapy involves some form of cognitive
Works to change negative thought pattern Highly effective Personalized/individualized to the client.
Individual therapy
A group if clients with similar issues meet with one or two
therapist. Women who have experiences sexual abuse Abusive family Depression
Group therapy allows individuals to openly discuss shared experiences in a safe environment; It provides group support (collectivism), Cost effective for client Therapist can work with multiple clients at once The group setting diminishes the role of the therapist and thus
buts the client on the path to self management. Many disorders are caused or promote poor social skills – group
works allows individuals to interact in a safe environment.
Group Therapy
Some individuals may not want to express
themselves Confidentiality Group dynamics
Disadvantages of Group
Culture Considerations in
treatmentPages 168-169
Not all cultures respond to all treatments the
same. Mutlaq and Chaleby (1995) – problems with
group therapy with Arab culture Gender roles Deference to members in the group based on
age or tribal status Misperception that this is simply a social activity
Culture and treatment
Indigenous healing practices – a combination of western
psychotherapy and therapeutic beliefs and practices that are rooted within a given culture.
Commonalities in nonwestern countries of indigenous practices include: Heavy reliance on family and community networks. Incorporation of traditional, spiritual and religious beliefs
Malaysia, religion has been incorporated into psychotherapy Chinese Taoist cognitive psychotherapy – verses from the
Taoist writings that highlight main principles, such as restricting selfish desires, learning how to be content, and learning to let go, are read and reflected. This was found to be more effective in the long term reduction of
anxiety disorders than drug therapy
Indigenous healing practices
Analyze psychological health from a community level. Ecological model – Miller (2000), looks at the
relationship between people and the settings they live in Identifies naturally occurring resource within the
community that can promote healing/healthy adaptations
Enhancement of coping strategies/response to stress Development of collaborative, culturally grounded
community interventions that actively involve community members in the process of solving their own problems.
Community Psychologist
Eclectic approach to therapy – an approach that
incorporates principles or techniques from various systems and theories.
Eclectic approach allows for an individualistic approach to each client’s needs. Cognitive therapy may not be ideal based on the age of the
individual or the current state of mind of the individual. Group therapy is appropriate in all cases – the level of
development of the client must be considered. Drug therapy alone is not significant for long term success. Rush et al ( 1977) high relapse rate for patients only
treated with drug therapy (i.e. no cognitive therapy).
The use of eclectic approaches
Cognitive therapies are more effective than
drug treatment alone at preventing relapse or reoccurrence, except when drug treatment is long term (Hollon and Beck 1994)
A combination of drug and psychotherapy appears to be moderately more successful than either therapy alone (Klerman et al., 1994)
Eysenck (1961) proposed the idea of spontaneous
remission, recovery that came about due to no treatment other than time.
How does one assess is a treatment works? How long must an individual be symptom free for
treatment to be successful? Should the total absence of symptoms be the only
criteria? Should only observable behavior be the measuring stick? Can you gather both quantitative and qualitative data
when measuring the disorder? Who decides is the therapy is successful?
Measuring the effectiveness of
Therapy
Outcome Studies: focus on the results – did the
patient show improvements or not? Not all studies are equal - much depends upon the
interpretation and style of the therapist, and the compliance of the patient.
Most treatments have positive effect (Smith et al., 1980) – meta analysis of 475 studies
Some approaches work better for some disorders while other approaches are best for others.
Thus eclectic styles of treatment are often applied.
Determining Effectiveness