Summary - Psychology chapter 16 (SLK110)

PSYCHOLOGY NOTES
chapter 16
Treatment: a psychological approach
 Significant differences between psychology and psychiatry
 Particularly in the formulation of mental disorders
 Psychological approach: additional emphasis placed on aetiology of disorder
 Must be especially mindful of psychological reasons for presentation and
aetiology of mental disorders to understand them and apply effective treatment
 Psychological intervention is substantiated through research
 Empirically supported treatment options developed to support this intervention
 Psychologists can adapt generic treatment protocols to the patient
 Treatment protocol: a specific approach to treating and managing a specific disorder
that has been developed, implemented and evaluated over a period of time
 Authenticated with reference to an appropriate patient population
 Allows clinician to identify, modify and implement empirically supported treatment
regiment
 Able to provide service within parameters of good ethical practice
1. Combined approach
 Biopsychosocial approach gained momentum since published introduction of its
clinical utility in 1980s
 George Engel introduction of the biopsychosocial model replaced purely
medical model of viewing health
 Promoted multifaceted integration of biological, social and psychological
influences on mental health
 Complexity of mental illness becomes evident
 Clinician able to explore illness through integration of components than in
isolation
 Includes biological composition of mental health
 Includes general medical conditions, genetic predispositions,
neurological, biological and cognitive impairments
 Model also considers the psychological predisposing risks factors that can
significantly impact the mental state of an individual
 Emotional turmoil, self-esteem, coping skills, external locus of control and
traumatic events
 Social influences: individuals family, interpersonal relationships, poverty,
education and/or culture
 Important in development and sustainability of mental illness
 Model allows clinician to explore causality of health in parameters of
integrative theoretical understanding rather than hierarchy of primary
components
 Facilitates an integrative approach to aetiology of mental illnesses while
highlighting its complexity

,2. Elements of treatment process
 Around 1880, Josef Breuer began to treat young woman referred to as “Anna O”
 Real name: Bertha Pappenheim
 Exhibited a variety of physical maladies (headaches, coughing, loss of feeling
and movement in right arm)
 Physical symptoms cleared when Breuer encouraged her to speak about
emotionally charged experiences from past
 This case inspired Freud, Josef was one of his colleagues
 Freud wondered in Anna O speaking through things enabled her to release the
bottled-up emotions that caused her symptoms
 Breuer was uncomfortable with intense emotional exchange and did not
follow through on his discovery
 Freud applied Breuer’s insight to other patients
 Developed a systematic treatment procedure = psychoanalysis
 Today, psychotherapy is not always curative and many modern treatments
place little emphasis on talking
 Psychoanalysis produced many other treatment approaches as his followers
developed their own systems of treatment
 Approaches today are more diverse and more effective, with a wide range
of therapies
3. Types of treatment
 “treatment” can be understood in parameters of a medical definition
 Individual presents with area of concern, aka “presenting problem” or “chief
complaint”
 Problem: manifestation of the pathology
 Complaint: persons account of the experiences
 Depending on severity of symptoms, those closest to the individual become
aware of the change in their mental state
 Clinician must gather as much info as possible about individual or families
concerned
 So to gain a clear understanding of the aetiology of the individuals current
level of functioning (biological, psychological and psychosocial
functioning)
 Clinician then able to use info to provide “working diagnosis”
 Empowers clinician to determine the most beneficial approach to treating
the individual
 May make use of diagnostic tools to support their understanding and
treatment recommendations
 Clinician remains actively involved in treatment process of individual
 Mental health professionals may use many treatment methods
 Including discussion, facilitation, emotional support, persuasion, conditioning
procedures, relaxation training, role-playing, drug therapy, biofeedback and
group therapy
 Estimated over 400 approaches to treatment

,  Classified into 3 major categories
 3 major categories of approaches to treatment:
 Insight therapies
 Clients engage in complex verbal interactions with therapist
 Goal: pursue increased insight regarding the nature of the clients
difficulties and to sort through possible solutions
 Behaviour therapies
 Based on principles of learning
 Therapists make direct efforts to alter problematic responses and
maladaptive habits
 Goal: changing clients overt behaviours
 Psychopharmacology
 Intervention on a person’s biological functioning
 Recently, drug therapy become dominant mode of treatment for
psychiatric disorders
 Treatment usually provided by physicians with a medical degree
4. Role of mental health professional
 Role of psychologist: be a part of the treating team of professionals responsible
for the mental well-being of an individual
 Not uncommon for them to be part of a multidisciplinary team (MDT)
 A group of professionals, from a variety of disciplines, working together
to manage, improve and maintain and individuals mental well-being
 Approach facilitates an empathetic stance to treatment of an individuals
from multiple perspectives
 Adopting a holistic approach to treatment becomes plausible and imperative
 Allows for multiple interventions to occur simultaneously, regardless that
their practical and theoretical approaches may differ significantly
 Psychology and psychiatry are principle professions involved in providing
psychotherapy
 Supportive therapies may be provided by other types of mental health care
professionals
 Various mental health care professionals
 Psychiatric nurses
 Additional qualification of Advanced Psychiatric Nursing (honours) within
clinical field of Mental Health Nursing Science
 Large role in hospital inpatient treatment
 Required to register with the SA Nursing Council (SANC) and the Health
Professions Council of SA (HPCSA)
 HPCSA: legal and independent entity, governed by legislation that acts as
in intermediary between professionals and public
 Counsellors
 Work in schools, colleges and human service agencies
 Have a BPsych degree