Treatments from the 5 Psychological approaches

1. Treatments from the 5 Psychological approaches

2. The Social Approach Care in the Community • This approach is based upon the assumption that mental disorders are triggered by environmental factors. • The social approach states that long stays in Psychiatric hospitals for people who suffer with a mental disorder, can result in institutionalisation. This is a state in which the person who suffers with a mental disorder becomes dependant on the Psychiatric doctors and nurses to care for them. • During the 1970-80’s things changed... • People began to create community care groups, which consisted of various agencies which worked together in the community to rehabilitate somebody. • What does care in the community provide? • Sheltered accommodation • 24 hour care to help people deal with their disorder • Staff who support patients as well as oversee day-to-day living by encouraging independence of the patients. • Long term support that care in the community offers includes specialist mental health teams.

3. Evaluation of Care in the Community as a Psychological treatment Better than hospitalisation TRAUER ET AL. (2001) Studied patients one year following release from a Psychiatric hospital. Despite improvements in quality of life, symptoms showed no improvements. More severe cases chose hospitalization LORA ET AL. (2001) Those who had severe symptoms and were a serious burden on their family, tended to be admitted to hospitals rather than chose care in the community. Symptoms less severe LEFF (1997) Found patients with Schizophrenia displayed less severe symptoms in community accommodation than those who were staying in hospital. Patients well being- ETHICS If the funding and staff were not available, the risk of patients illnesses worsening increases.

4. Ethics and Social Control- Care in the Community • Ethics By Being encouraged to be as independent as possible, the patient may harm themselves as well as others in doing so. Alongside this, there are ethical issues in observing the quality of care an individual receives. For example Kuno Et Al. (2005) studied America and found that white affluent areas received a higher quality of Care than those living in low-income African American areas. • Social Control This treatment is used as a form of social control in the fact that it uses the community in order to help people who may not be able to receive a place in a Psychiatric hospital. This forces the individual to be independent, despite the fact that they may not be in the psychological state to be.

5. The Learning Approach Token Economy Programmes • -The Learning approach assumes that all behaviour is learnt via processes including things such as Positive reinforcement, Operant conditioning, Negative reinforcements and Vicarious reinforcement. • What are they ? • Token Economy Programmes are based upon the idea of Positive reinforcement. This is the idea that good behaviour will be reinforced with rewards ( tokens). • Where are they used ? • Token economy programmes are often used within institutional settings such as prisons, as a form of social control and obedience. • The tokens are known as the secondary reinforcers and the things in which can be bought using the tokens are known as the primary reinforcerse.g sweets.

6. Evaluation of Token Economy Programmes as a Psychological treatment Is the a Genetic Cause? If behaviours seem to have been inherited via genetics, it is difficult to use Token Economy to treat an illness such as Schizophrenia, as Token Economy isn't a cure. Significant Difference Duker and Seys (2000) said that Token Economy Programmes used by SINDELAR (2007) have made a significant improvement to the lives of individuals. Can you apply it to real world settings ? Due to that fact that Token Economy Programmes are used within institutional settings, it is very difficult to apply them to the real word. Very Effective PERRY ET AL (2006) Reward of entries to a prize draw as tokens for alcoholics was seen as very effective.

7. Ethics and Social Control- Token Economy • Ethics • Deception There can be ethical issues involved with Token Economy Programmes if the people using them aren't aware of the strict behaviours they must abide to in order to receive a token. • Psychological Harm If a person is denied a token and already shows signs of withdrawal or anxiety, these could worsen as they aren't being positively reinforced to improve their behaviour. • Physical harm In terms of physical harm, this type of programme is preferred to things such as aversion therapy as it is safe and causes no physical suffering. Social Control - This type of treatment is viewed as a form of social control as people are asked to behave in a certain way and follow guidelines, in which they may not agree with, but rather favour and benefit the institutional setting.

8. The Cognitive Approach • The Cognitive Approach • The Cognitive approach believes that how we view ourselves, is a strong reflection of how the world views us. This approach focuses on how cognitive processes effect our perception of the world, and how these views can be demonstrated in the behaviours that people display. • What are the aims of CBT? • CBT focuses on both the cognitive and behavioural perspectives. • This type of treatment aims to deal with current behaviours and symptoms rather than discovering why the appeared. • The aim is to help the patient come to terms with their illness and help them gain a better understanding of their perceptions of the world, for example via Psycho education. • What occurs during CBT? • - CBT is a treatment which is viewed as short-term and involves session with a therapist, whose aim it is to empathise with the patient. • The patient will often learn various things including treatment and begin to understand reality, rather than what their view of reality is. • It has been known to help people with various mental illnesses including Schizophrenia and Anorexia. Cognitive Behavioural Therapy (CBT)

9. Evaluation of CognitiveBehavioural Therapy as a Psychological treatment It isn't effective for people who suffer from Schizophrenia, or is it? CHADWICK (2000)- Found that after having 8 hours of CBT each, 22 Schizophrenia sufferers who had previously heard voices, had decreased negative beliefs which allowed them to cope with their voices better. Long term process CBT sessions require dedication by the patient, because unlike other treatments such as chemo, CBT isn't an immediate solution. Low drop out rates GOULD ET AL. (2001)- Found that people who had stopped taking antipsychotics but had CBT alongside side this, had a lower drop out rate than those who didn't have CBT – 12%. Does not cure CBT is not a cure, but rather it helps somebody cope with their illness

10. Ethics and Social Control- Cognitive Behavioural Therapy • Ethics • Deception There is a risk that the patient may be deceived into thinking that the therapist will be responsible for their improvement, evidence has suggested that this can be a negative thing. DELSIGNORE ET AL. (2008)- Found that a study he carried out on 49 people suffering from social anxiety behaviour, showed that after a three month follow-up, people who felt they were responsible for their improvement were more likely to feel the long term benefits. • Psychological Harm For this to be completely effective, the patient is required to attempt to remember early experiences. For some people, this may be what triggered the disorder/illness in the first place, which may be emotionally hard to deal with. • Social Control This is a form of social control as it forces someone to accept the behaviours they display aren't rational and do not fit in with the norms and values of a culture.

11. The Psychodynamic Approach Psychoanalysis The Psychodynamic approach This approach is based upon the famous Psychiatrist ; Sigmund Freud, who focuses upon the unconscious mind. He stated that we are all born with the ID. This is the part of our personality which is entirely unconscious and involves our instinct behaviours. The ego then develops and helps us to cope with reality, and alongside this then comes the superego which is the component of our personality which develops as a result of learning what right and wrong is. What is Psychoanalysis ? This treatment is based upon the idea that all behaviour is influenced by the unconscious mind. This treatment uses a technique called free association, which allows the patient say whatever comes to mind, and the therapist analysing what is said and makes links between past experience and current problems. This type of treatment treats psychological illnesses. How often do the sessions take place? Psychoanalysis takes place 4-5 times a week, for several years.

12. Evaluation of Psychoanalysis as a Psychological treatment Long term visits The practicalities of this treatment are doubtful due to the fact that it is so time consuming and therefore expensive. This means it requires a lot of dedication and commitment from the patient. BACKRACH ET AL (1991) Looked at current studies, including a sample of 1700 patients and 450 analysts. It was found that 60-90% of patients improved significantly during psychoanalysis. Concepts involved Concepts involved in relation to the unconscious mind, are measured unscientifically via interpretation. This means that questions are asked regarding its validity. Whole life experiences Unlike many other treatments, this treatment aims to delve into the patients whole life experiences, in order to get a more in-depth picture.

13. Ethics and Social Control- Psychoanalysis • Ethics Psychological Harm by allowing free association, it allows the patient to delve into their past experiences which could psychologically traumatise them further if they had been repressed. • Social Control This is a form of social control as it helps society to maintain mental health. This forces people who are mentally ill to accept that they should change their way of thinking to fit with the culture.

14. The Biological Approach Chemotherapy • The Biological Approach • The biological approach states that all psychological disorders are treated by imbalances within the brain and can be treated the same as a physical illness. • What is Chemotherapy? • Chemotherapy studies the uses of antipsychotics to control the symptoms of a psychotic disorder. These drugs are also known as neuroleptics and were first discovered in the 1950’s. They are used as a way of decreasing the amount of dopamine in the synapse, and are especially useful in treating people who suffer from Schizophrenia. • What are the effects of the drugs? • Despite many of the drugs treating both negative and positive symptoms, such as Clozapine which treats negative symptoms, they produce unpleasant side effects. • Examples ; • Tightening of the muscles • dry mouth • constipation and weight gain • decrease in emotion and motivation

15. Evaluation of Psychoanalysis as a Psychological treatment Complying with therapy ROSA ET AL – Found that only 50% of patients comply with drug therapies. Living in society Drug treatment allows people to live in society, which avoids institutionalisation. This allows for other therapies to be accessed in order to benefit them further. Effectiveness of Clozapine PICKAR ET AL (1992)- Found that in comparison with other antipsychotics and found that Clozapine was most effective. Not a cure Drug treatment cant be viewed as a cure, due to the fact that patients have to be kept on maintenance doses of the drug to maintain the therapeutic effect.

16. Ethics and Social Control- Chemotherapy • Ethics Physical harm Physical harm is at risk as patients may experience side effects which are unpleasant, including things such as a dry mouth. Consent Despite the fact that patients have to consent in order to have drug therapy, there is question over whether they are in a fir state to consent to the therapy. • Social Control This like many other treatments is used as social control, by providing this treatment it decreases the amount of people that have to be sent to an institution and increases mental well being.