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Treatments – Most mental disorders can be treated effectively with some kind of treatment.
Biological therapies – used to treat the way body functions.
Chemotherapy
A quarter of all medication prescribed in Britain consists of drugs that modify the workings of the brain and behaviour.
- Antipsychotic drugs – treating the most disturbing forms of psychotic illness including schizophrenia and manic depression. Increases subjective feelings of well being and happiness.
- Antidepressants – relieve symptoms of depression. Treat moderate to severe mental illnesses – helps with anxiety, panic attacks and obsession problems.
- Used for at least 4 – 6 months. E.g. Prozac
- Antixiolytic – used for anxiety to bring symptoms under control. Immediate symptom relief.
- Stimulants – to treat attention deficit disorder. Stimulates CNS to increase attention and ability to focus.
Appropriateness
- + Drug therapies use knowledge about physiological mechanisms.
- + Many patient prefer drugs as they require little effort and a quick response.
- + Drugs may also be use to psychological methods of treatment.
- - Many side effects including headaches, nausea, vomiting, sleep disturbance.
- - Addiction is possible
- - Drugs treat the symptoms not the causes.
Effectiveness
- NHS cites 50-60 % success rate for antidepressants
- New drugs are more effective as we now have better understanding.
Electroconvulsive therapy (ECT)
ECT is generally used for those suffering from depression, also those with schizophrenia.
ECT used suicide level is high.
- Patient is given muscle relaxant and anaesthetic.
- Low voltage shock applied to both side of the brain – inducing an epileptic fit, reduced by the muscle relaxant.
- Treatment given twice or three times weekly. 6 – 12 treatments.
- Treatment for depression needs to continue to maintain recovery.
- ECT may restore abnormal neurotransmitter levels in individuals. Or memory loss may allow for restructure of thinking.
Side effects
- 1/3 patients complain of persistent memory loss after ECT
- Impaired memory
- Cardiovascular changes
- Headaches
Appropriateness
- + ECT works more quickly and effectively than antidepressants in short term treatment of depression.
- - Slight risk from use of anaesthetic.
- Should only be used if other methods prove unsuccessful.
Effectiveness
- Sackeim et al found that out of 300 patients, 60% responded to treatment.
- High relapse rate, around 60%. Temporary relief and not a cure.
- Lose dose bilateral therapy ECT more effective than high dose.
Psychosurgery
- Very controversial.
- Surgical intervention that aims to treat behaviour with no obvious cause.
- Pre-frontal lobotomy – surgical destruction at nerve fibres in pre frontal lobe of brain to alleviate severe symptoms.
- Drill hole either side of head – something pushed through to destroy nerves.
- Stereotatic – new method to treat what other methods may not.
- Computer based imagery to remove large sections and burn tissue.
Side effects
- Patient may appear calmer
- Paralysis
- Reduced functioning
- Loss of memory
- Loss of emotion and personality.
Effectiveness
- Moniz claimed a 70 % success rate with schizophrenia, and anxiety.
- Bridges et al described psychosurgery as a last resort if other treatments don’t work.
Appropriateness
- + effective treatment as a last resort
- - Patient undergoes irreversible operation with many side effects
- - Strong rehab because recovery is slow.
Behavioural therapies
- Deliberately short term, only require a few sessions
- Targets symptoms rather than underlying problems
Classical conditioning
Classical conditioning involves learning through association.
Aversion therapy
Psychotherapy designed to reduce undesirable behaviour by associating it with an undesirable stimulus. Leads to suppression of undesirable behaviour.
Can be used for alcoholism, drug abuse, and more controversially homosexuality and aggression.
Appropriateness
- high numbers of patient drop out. Up to 50 % may refuse aversion therapy.
- Ethics – Can result in long term psychological effects – despair and depression. But benefits may outweigh the cost.
Effectiveness
- Therapy may appear successful in short term and also when learning took place, but effects may be reduced when the patient knows sickness or shocks will follow.
- Smith et al found 79 % abstinence rates after 12 months in alcoholics when combined with counselling, rather than just counselling alone. Multi modal programmes might be much more effective.
Systematic desensitization
Used to treat phobias and OCD. Phobia is introduced gradually. Counter conditioning occurs.
First taught relaxation then construct hierarchy of fears. Work through gradually until patient is relaxed at each stage before moving on. If one stage too stressful move back to last one.
Appropriateness
- Success may not be due to classical conditioning. May be that patient overcomes phobia simply though exposure.
- Can be slow therapy
Effectiveness
- Wolpe reported 90% success rate for phobias, but more likely 75 %.
- 60-90% success rate for OCD’s.
- SD may be more effective when drugs are taken to reduce anxiety.
Flooding/Implosion
Used in treatment of phobias.
Patient is given maximum exposure to phobia which continues until the body goes into relaxed/exhausted state.
In flooding, a bird phobic for example would be put in a room with hundreds of bird flying around.
Implosion therapy the patient would imagine the worst possible situation.
Appropriateness
- Flooding shows the patient that there is no objective basis to their fear.
- Virtual reality techniques may be more useful.
- Ethics – very stressful situation for patient. Will produce a lot of stress and anxiety.
Effectiveness
- Flooding tends to be more effective than implosion.
Psychodynamic therapies
Treats the underlying causes of a problem rather than targeting symptoms or behaviour.
Psychoanalysis
Freud developed Psychoanalysis.
The analytic theory is based on assumption that we are unaware of conflicts that influence our current self.
Psychoanalysis brings the conflicts into the conscious mind so the can be dealt with.
More useful for neuroses problems rather than psychoses.
Repression – Major defence mechanism that pushes memories that cause pain and anxiety into the unconscious mind. Repressed memories continue to influence a person’s behaviour in “disguised form” for example through dreams.
- Free association – Patient expresses thoughts and feelings as they occur, however irrelevant. Designed to bring in areas of conflict into conscious mind. Therapist interprets; patient then accepts or rejects idea.
Therapist interpretation – Therapist listen carefully as the patient talks to look for any clues.
- Dream interpretation – Dreams seen as the key to repressed memories in unconscious mind. Looks beyond the manifest content of the dreams to find the real, latent meaning. For example, dreaming about adoption – Being adopted in dream signifies acceptance. Being put up for adoption signifies rejection.
In psychoanalysis patient and therapist tend to meet up 4-5 times a week and repeatedly examine the same issues.
Appropriateness
- Based on theory of personality. If this theory is flawed, the explanations of mental illness and therapies must be flawed.
Effectiveness
- Freud developed his techniques when working with his patients. Successful outcomes are proof that techniques work. Anna O was one of the earliest of Freud’s success stories, but she did not fully recover and spent time in institutions.
- Eysenck argued that therapy actually delayed recovery for many individuals.
- Only effective for certain illnesses and certain groups of people (ie, those that have the time and money for such lengthy treatments.)
- Smith conducted meta analysis, showed that psychoanalysis was effective but not as effective as cognitive – behavioural therapies. May not be reliable as they clump together studies that may not use the same method.
Play therapy
Children can recreate problematic experiences using play.
Mainly aimed at 3 – 11 year olds with a range of problems. (In UK most play therapy involves issues of abuse, disability, loss and trauma.
Non directive play therapy
Children use toys to recreate things that cause emotional conflict.
The therapist will watch the children play, listen to what is said and note any symbolic actions.
Directive play therapy
The therapist takes a more active role in the session with the child. The therapist may ask the child to draw pictures of different situations or play a game.
Play therapy is conducted once or twice a week. 6 months – 4 years depending on state of child.
Appropriateness
- Only one of a few methods that are suitable for use with children.
Effectiveness
Non-Directive play –
- Shown to be effective with a wide range of problems.
- Kot et al found that children who have witnessed domestic violence given play therapy showed reduced problem behaviours and better self control.
- Mostly or completely successful with 80% of children
Directive play –
- Used to collect court evidence from children.
- May not be reliable. Fantasy rather than truth?
- May be more useful to use with non-directive play therapy.
Also See
Comments
- Suitable for: A2 Psychology
- Written by: 8owman
- From this thread.
