alternatives to the medical model Flashcards
what ways can behaviour be modelled?
learning behaviours; thinking processes; emotional processes; biological processes
what does the behavioural model assume?
abnormal behaviour is the consequence of abnormal learning from the environment. there is no qualitative difference between normal and abnormal behaviour as they are all learned in the same way
how does the behavioural model believe behaviour is learned?
classical conditioning, operant conditioning, social learning theory- what is learned can be unlearned
what is learning by assosciation?
when two environmental changes occur together, we learn to associate them- and the response from one may transfer to another
how does learning by association affect mental illness?
reactions such as phobias can be learned, e.g., being startled when someone screams at a spider, and we then learn to associate spiders with that fear.
what is learning by consequence?
the likelihood of individuals repeating behaviour depends on its consequence
how does learning by consequence affect mental illness?
e.g., we feel anxious about an action, so we avoid it. this removes the anxiety and negatively reinforces the behaviour.
what is learning by observation?
people observe the behaviour of those around them, and may imitate this behaviour depending on the observed consequences
how does learning by observation affect mental illness?
if someone grows up around people with mental illnesses, they may learn to imitate this behaviour
what are some behavioural treatments?
systematic desensitisation; aversion therapy; flooding
what is systematic desensitisation?
based on classical conditioning, where patients learn to relax and are taken through a hierarchy of increasingly frightening stimuli whilst relaxing.
- mcgrath (1990) found this worked with a ten-year-old girl who had a fear of loud noises and assosciated objects such as balloons and party poppers.
what is aversion therapy?
where patients learn to link negative associations to objects
what is flooding?
unlearning associations all at once by being exposed to the stimulus
benefits of the behavioural explanation
provides a simple, testable explanation that is supported by experimental evidence; hopeful, as it predicts that people can change their behaviour
- shown to be effective with reducing symptoms of schizophrenia. paul and lentz (1977) gave schizoprhenic patients therapy based on social learning theory and operant conditioning -> became twice as likely to be discharged from hospital
limitations of the behavioural explanation
criticised as being dehumanising and mechanistic by reducing people to programmed stimulus-response units; cannot explain all psychological disorders; cannot cure conditions such as schizophrenia
what does the cognitive model assume?
dysfunctional behaviour is caused by faulty or irrational thoughts, and we interact with the world through our mental representation of it- so inaccurate representations may cause behaviour to become distorted
what are irrational beliefs?
where people suffering from anxiety or depression believe they are unloved and nothing good will ever happen
what does beck believe?
depressed people have acquired negative schemas in childhood that are activated around new experiences- leads to the expectation of failure
what percent of people benefited from beck’s cognitive therapy?
80%; more effective than drug treatment
what do cognitive treatments aim to do?
change the faulty cognitions and help the client see how their irrational beliefs are contributing to their illness
benefits of the cognitive explanation
focuses on how the individual experiences the world and their feelings and beliefs, rather than other people’s interpretations; hopeful as it assumes that people have the power to change their behaviour
limitations of the cognitive explanation
encourages the idea that people are responsible for their own psychological problems- could lead to people being blamed for their own abnormalities; reductionist as it ignores biological causes of abnormality; cause or effect?
what does the psychodynamic model assume?
psychological disorders are caused by emotional problems in the unconscious mind, and these can be traced back to early childhood. parent-child relationships are crucial towards mental health
what are latent motives?
unconscious forces that drive our behaviour
what are manifest motives?
lies to protect us from the truth, as ego defence mechanisms turn latent motives into manifest ones
what are the ego defence mechanisms?
reaction formation, displacement, and sublimation
what does the psychodynamic model assume psychological disorders are?
defence mechanisms against repressed emotional problems and impulses, and that symptoms have a hidden meaning that can be decoded
what do psychodynamic treatments believe?
you have to access unconscious thoughts through free association and dream analysis, which gains access to the latent content
benefits of the psychodynamic explanation
apter (1997) assessed suicidal adolescent patients for ego defence mechanisms and found they scored higher on regression and other ego defences, which suggests that regression is involved in psychological abnormality
limitations of the psychodynamic explanation
if freud is correct, then psychoanalysis should be an effective treatment, however it was discovered it can negatively impact recovery from OCD by thinking more about intrusive thoughts and obsessions; subjective, qualitative, difficult to replicate, self report, bias; based on case studies so unscientific; not falsifiable
what does szasz (2011) believe mental illness is?
a myth, rather than a disease that is scientifically proven
what does szasz (2011) see the medical model as?
the only way of dealing with people who behave differently. he looks at a more holistic view of mental illness through understanding society and the process of labelling
what does szasz (2011) say about government and mental illness?
that government decides what illnesses exist as they control all regulation and funding
how does szasz (2011) feel about mental hospitals?
that they are more like prisons to control people’s behaviour
what economic issues does szasz (2011) talk about?
big businesses in pharmaceuticals and treatments for the mentally ill
what does szasz (2011) argue that people are deprived of?
the freedom to behave in the way they choose on grounds of having a disease, which has implications for ‘insanity’ as a defence
he believes that people’s actions need to be understood and offered help, rather than being diagnosed under a loose fitting definition.
why does szasz (2011) believe the medical model is unacceptable?
there is no identifiable cause of mental illness; denies people freedom through being forced into treatment; subjectivity of diagnosis; dehumanising aspect of the medical model which ignores personal suffering
what ethics does szasz’s work cover?
it is socially sensitive and highly controversial, as people could be distressed to hear their illness described as a ‘myth’ if medicine has worked for them; he overstates the case against the medical model and risks a dispute between psychiatry and psychology
how useful is szasz’s work?
had a huge impact on psychiatry and psychology, and is influential in movements to empower users of mental health services; his criticism allows us to question the effectiveness, appropriateness and morality of invasive trreatments
is szasz’s work unscientific?
yes- he explicity rejects science as an appropriate method for studying and treating mental illness
what is cognitive behavioural therapy?
talking therapy combines the strategies of cognitive and behavioural explanations.
- focuses on changing thinking pattern and behaviour.
szasz- ethical issues
- free of ethical issues as it does not collect participant data
- views are socially sensitive and highly controversial. distressing for those who have mental health difficulties.
- overstates the case against the medical model. brings the professions of psychiatry and psychology into disrepute
szasz- usefulness of research
- had a huge impact on world of psychiatry and psychology
- important that it is well-known, as it makes us question the effectiveness, appropriateness and morality of invasive treatments and consent of those with mental health issues
szasz- nature vs nurture/individual vs situational
- rejects hereditary casues, argues mental illness is a social construct/environmental explanation
- mental illness is a product of psychiatrists’ particular views on mental health
szasz- reductionism vs holism/psychology as a science
- offers a more holistic view of mental illness
- states that the medical model oversimplifies the human experience.
- unscientific as he rejects science as an appropriate method for studying mental illness
