Mental Health Treatment Quiz

Lecture Overview

• The lecture focuses on basic theoretical models of human functioning used in clinical psychology.
• The overview centers around integrating clinical models.

Comparing the Models

• Models consider biological, psychodynamic, behavioral, cognitive, humanistic, existential, family, and multicultural factors involved in cases of dysfunction.
• Biological models focus on biological malfunction, psychodynamic on underlying conflicts, behavioral on maladaptive learning, cognitive on maladaptive thinking, humanistic on self-deficit, existential on avoidance of responsibility, social on family/social stress, and multicultural on external pressures or cultural conflicts.
• Research support levels and consumer designations vary across models.
• Therapist roles (e.g., doctor, interpreter, teacher, persuader, observer) and techniques (e.g., free association, conditioning, reasoning, reflection) differ.
• Therapy goals (e.g., biological repair, broader psychological change) vary depending on the model.

Towards the Integration of Clinical Models

• Clinicians often use an eclectic approach, meaning they use elements from different models.
• The biopsychosocial model is frequently used, which considers the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences in abnormality.
• Every perspective provides value in understanding abnormal behavior.

Integration of Clinical Models

• The integration movement in psychotherapy suggests focusing on assimilating existing therapy constructs and techniques into existing therapies instead of forcing a choice between treatments.
• Numerous therapeutic techniques exist.
• Examples of specific numbers of techniques are 400 from Ross & Fonegy (1996) and 600 from Norcross (2011).
• Resources such as the websites talkspace.com and div12.org offer more information on this topic.
• The integration of models is influenced by author culture.
• No single model can encompass all aspects of abnormality.
• Different perspectives are useful for different conditions.
• An integrated approach provides a framework for thinking about abnormal behavior and factors relevant to specific disorders.

Integrative or Eclectic?

• Integration is a combined theoretical approach with an intention to create a whole new perspective.
• Eclecticism is a practice of drawing from several approaches, selecting approaches based on the particular case.
• Integrative practitioners are not bound by any specific therapy approach.

Multiple Pathways to Achieve Integration in Therapy

• Common factors, which are core components of all therapy, are looked into across various theoretical approaches to find common healing elements.
• Common factors are fundamental, not techniques.
• Examples of common factors include therapeutic relationship/alliance, instillation of hope, attention, corrective experience, practicing new behaviors and opportunity for catharsis.

Cathartic Technique in Psychological Practice

• Catharsis involves releasing emotions and venting anger.
• Cultural norms often value containing emotions, but doing so can be harmful.
• Catharsis is recognized as a healing technique in many cultural practices.
• Methods such as debriefing, psychodynamic psychotherapy, primal therapy, psychodrama, and emotion-focused therapy use cathartic techniques.
• Many professionals regard cathartic techniques as vital for achieving positive therapeutic change.

Research on Cathartic Techniques

• Research spanning back to the 1950s on the effectiveness of cathartic techniques yielded ambiguous results.
• Intensified expression of negative emotions may paradoxically cause further intensification of those feelings.

Limitations of Cathartic Technique

• People with personality dispositions to experience negative emotions may not benefit.
• Expressing anger can be problematic for some situations.
• Bereavement (grief) cases do not always improve through these techniques.
• Debriefing after traumatic events can be harmful if done immediately after the event.
• Evoking trauma-related emotions without proper reevaluation of the situation can be detrimental.
• Effectiveness depends on the specific situation and when applied.
• Patients with cancer may fare better with denial rather than expressing negative emotions during a difficult period.
• Grieving and sexual violence cases show no positive effects with cathartic techniques.

Which Model is Best?

• Counseling and Psychotherapy are usually more effective than medication for relieving anxiety and depression, but only certain kinds, like Cognitive Behavioral Therapy (CBT), have been proven effective through controlled trials.
• A British study comparing CBT, person-centered, and psychodynamic therapy in cases of mental disorders found no distinct advantage for any one approach.
• Many approaches have seen good improvements in patients treated with these approaches.
• Various resources offer information on effective treatments for psychological diagnoses.

What Works in Therapy

• Major reviews identify factors affecting therapy outcomes.
• General effects (common factors) are responsible for about 70% of positive outcomes.
• Specific effects linked to a particular model make 8% of the total positive outcome.
• 22% of the positive outcomes are unexplained and are likely related to client differences.

So What Works?

• The relationship factor is the most important factor, according to research.

New Science of Mental Disorders

• Success rates for mental disorder interventions are modest, particularly with adults and adolescents, across various diagnoses.
• Many patients do not benefit from treatment or relapse afterwards.
• Short-term improvements do not guarantee sustained positive outcomes.
• Many patients do not get treatment at all, and approximately 60% of those treated do not respond to treatment or relapse after a year.

Rates and Determinants of Use of Pharmacotherapy and Psychotherapy by Patients With Major Depressive Disorder (MDD)

• Treatment guidelines are not always followed.
• Individuals frequently use one type of therapy (either medication or psychotherapy) in the first year.
• Few continue treatment past 5 months for most patients.
• Shorter time from diagnosis to treatment and lower patient-paid treatment costs are factors that relate to increased antidepressant use and intensive psychotherapy.

Assessing Motivation for Change: Stages of Change

• Stages of change in therapy include precontemplation, contemplation, preparation, action, maintenance, relapse, and recycling.
• Precontemplation is a denial stage where individuals reject the need for change.
• Contemplation includes ambivalence about making changes.
• In preparation, individuals acknowledge a need for change.
• Action involves implementing changes.
• During maintenance, one maintains these positive changes.
• Relapse represents setbacks, but patients can recycle.

Mental Disorder Diagnosis

• A significant portion (approximately 70%) of mental health disorders are diagnosed before age 25.
• These conditions form the most significant burden on mental health during the 20-24 age range.