Psychological Treatments

1. From the 5 different approaches Psychological Treatments

2. THE SOCIAL APPROACHFamily Therapy Family therapy involves the family as much as possible for a teenagers recovery. Instead of blaming the parents for a child’s disorder it believes that they and the siblings hold the answer to the individuals recovery. In terms of anorexia the treatment has three stages: • Weight restoration • Returning control over eating to the adolescent • Establishing healthy adolescent identity The therapist works with the family at each stage and stresses the importance of siblings presence to act as a fun distraction from the harrowing task ahead.

3. Family TherapyEvaluation • Conflicting evidence – In Maudsley Study, 80% patients achieved a positive outcome which means 20% found treatment ineffective. • Application – excellent mundane realism as a family meal is a normal everyday thing meaning easy application once treatment has stopped. • Supporting evidence - In Maudsley Study, 80% patients achieved a positive outcome both with eradication of bulimia and normal weight gain. • Testable – Yes, current case studies are being undertaken. • Limited – Does not work for everyone. • Ethics – No deception, family has right to withdraw, consent is given from parents at least, therapy itself is protecting the individual from harm and therapy is confidential apart from with family. A competent therapist should always be used. • Socially sensitive– yes, involving family shouldn't offend people

4. THE COGNITIVE APPROACHRational Emotive Therapy Focuses on resolving emotional and behavioural problems by the ‘ABC’ model proposed by Ellis (1959). A The client identifies the Activating event. B The client tells the therapist their Beliefs about the event. C The client identifies the emotional and behavioural Consequences that occurred because of those beliefs. The client is then taught to rationalise events by weighing them up and taught appropriate responses which are positive beliefs about themselves and the others around them.

5. Rational Emotive Therapy Evaluation • Conflicting evidence – • Application – Gives the individual the responsibility to change their own cognitions with the help of a therapist. • Supporting evidence • Testable – Yes, it is a very popular model • Limited – Unscientific as thoughts cant be objectively measured. It also ignores the nurture side of the nature nurture debate and is therefore reductionist. • Ethics – No deception, client has right to withdraw, consent is given for treatment, therapy itself is protecting the individual from harm and therapy should confidential. A competent therapist should always be used. • Socially sensitive– yes, individuals choice to reprogram thought processes shouldnt offend people.

6. THE PSYCHODYNAMIC APPROACHFree Association Free association is a talking therapy. The client lies on a chez long away from therapist who comes up with a list of words for which the client talks about what they think of in response to those words. If they were off guard and relaxed, they would talk freely of things they otherwise wouldn’t have, revealing thoughts and conflicts from their unconscious which need to be resolved.

7. Free AssociationEvaluation • Conflicting evidence – Some people have found it to reinforce thoughts which are already obsessive. • Application – Takes all experiences into account so fairly holistic. • Supporting evidence – Case of Anna O with Freud. • Testable – No, is very subjective. Open to interpretation by therapist. • Limited – Doesn’t explain why people feel this way to begin with. No real link to cause. • Ethics – Client has right to leave and withdraw, consent is given for treatment, therapy itself is protecting the individual from harm, although could be open to psychological abuse and therapy should confidential. A competent therapist should always be used. • Socially sensitive– yes, not offensive in anyway.

8. THE BIOLOGICAL APPROACHChemotherapy (Drug Therapy) Drugs have been developed to work in the synapse to help sedate a person, and reduce the intensity and frequency of behaviours such as delusions and hallucinations. An example of this is IDOPA for those suffering with schizophrenia which works by blocking the receptor cells to prevent the dopamine being picked up. A careful balance of drugs has to be developed for each individual as everyone reacts differently to chemotherapy.

9. ChemotherapyEvaluation • Conflicting evidence – Side effects are often found to outweigh benefits. • Application – Allows people with mental disorders to live in society and avoid institutionalisation. • Supporting evidence - • Testable – It is often difficult to get people to comply to the drug therapy responsibly. • Limited – Patients mostly become dependant on the drugs and it is therefore not a cure. • Ethics – Client has right to leave and withdraw, consent is given for treatment, therapy itself is protecting the individual from harm, although could be open to psychological abuse and therapy should confidential. A competent therapist should always be used. • Socially sensitive– yes, not offensive as people take drugs for all sorts of things all the time.

10. THE LEARNING APPROACHToken Economy Token economy is based on the principles of operant conditioning and works by giving secondary rewards (such as tokens or points) for desired behaviour, which can be saved and exchanged for a primary reinforcer. In the case of anorexia this could mean sitting and eating a meal with the family, or weight gain would gain an individual a token. Once saved the teenager could then go and see a friend, watch TV or have some make up.

11. ChemotherapyEvaluation • Conflicting evidence – It has been found that if the focus is on weight gain too early on, it can be unsuccessful due to to much pressure. • Application – Difficult to implement outside an institution; however can be used with other treatments. • Supporting evidence - • Testable – It is being used in many institutions today. • Limited – Only deals with the physical issue of weight, not the emotional problem. • Ethics – No deception, but would not have right to leave if detained under mental health act in an institution, which also means consent may not be given. Therapy itself is protecting the individual from harm, although could be open to abuse. Therapy should confidential. A competent team should always be used in an institution. • Socially sensitive– could be seen as patronising adults.