Mental Health - Alternatives to the Medical Model Flashcards
Behaviourist explanation
mental disorders are assumed to be learned in the same way as any other types of behaviour are learned
Classical Conditioning
learning through association
- when an emotional response, such as fear, anxiety, sadness etc., becomes associated with a particular neutral stimulus
- if a person is regularly exposed to a particular stimulus together with an unpleasant experience, then the stimulus will come to elicit a fearful/disgusted response
Pavlov (1903)
in his study he teachers dogs to salivate when they heard a bell (sounded at the presentation of food)
Watson + Rayner (1920)
Little Albert
- conditioned to have a phobia of white rats due to that being associated with the UCS of a loud metal bang (fear becoming the CR to the white rat)
- this fear was then generalised to white fluffy objects in general e.g. Santa mask, rabbits etc.
Operant Conditioning
learning through consequence (reinforcement/punishment)
- consequences of different behaviours shape behaviour
- negative reinforcement for example will maintain a phobia due to the pleasant feeling you get after the fearful stimulus is removed
- a schedule of reinforcement can be seen as the cause of addictive behaviours as the person will feel a compulsive need to keep repeating their behaviour
Vicarious Reinforcement
learning through observation of the consequences of actions for other people
- comes under SLT: learning through role models
Bandura, Ross + Ross (1963)
children watched a film of an adult punching and shouting at a Bobo doll
- 3 conditions
- both boys and girls produced more aggressive acts after watching the film where the model was rewarded for their aggression
Cognitive Explanation
- Focus on thinking, perception and attention
- Believe that the thinking of a person with a mental illness is faulty
- Thinking becomes irrational or maldaptive in people who have a mental illness
Cognitive distortions
Thinking errors in those with mental health disorders
Cognitive Distortions - Overgeneralisation
Viewing one unfortunate event as part of a neverending defeat/struggle
Cognitive Distortions - Filtering
Giving greater consideration and focus to negative aspects, while ignoring or downplaying positive ones
Cognitive Distortions - Catastrophization
Feeling that a situation/outcome is or will be far worse than it actually is/turns out to be
Cognitive Distortions - Dichotomous reasoning
All-or-nothing thinking; the world is viewed as black and white
Beck’s Negative Triad
- Negative views about the world
- Negative views about oneself
- Negative views about the future
Beck - Childhood schemas
- Believes that faulty thinking is acquired in childhood
- Difficult early experiences and dysfunctional beliefs lead to the development of the negative triad
- However, to acquire a mental disorder trauma or a serious life incident is also required
Psychodynamic explanation
Freud
- When the ID, ego and/or superego are in imbalance, there is an unconscious conflict
- This unconscious conflict leads to the build up of psychic energy, which triggers your brain’s defence mechanism
- This manifests physically as a mental illness
Psychosexual stages
- Freud believes that we all go through the psychosexual stages of development
- Not being properly guided through the stages could lead to mental illness and faults in our development due to these unconscious conflicts
Cognitive Behavioural Therapy (CBT) (Application)
- Usually takes place once a week/fortnight for between 5 and 20 sessions
- Can be administered in form of self-help books, leaflets and CDs
- Involves helping patients identify irrational and unhelpful thoughts and trying to challenge them by showing links between their thinking and behaviour
- Therapy is collaborative - patient will share what they are feeling and therapist will directly treat that irrational thought first
- E.g. depressed patient may believe there is no point in going out as they won’t enjoy it and therapist responds by vigorous argument of why the patient may actually enjoy going out
- Homeworks can be given to patients e.g. positive affirmations, keeping a mood diary
Strengths of CBT (Application)
- Effective in all forms: Hollon and Beck (1994) saw increased mood scores in depression patients after completion of CBT and Liu et al (2021) saw same trends in online administration of CBT during COVID
- Model focused on human thought and many people with psychological disorders have been found to display maladaptive assumptions and thoughts
Weaknesses of CBT (Application)
- Ethical issues: some forms of CBT such as Rational Emotive Behavioural Therapy (REBT) can be quite forceful and considered unethical
- Time consuming and costly - could have to attend sessions for up to/over 5 months to be properly treated
- Does not work for everyone - challenging cognitive beliefs may result in greater harm to a patient than good
Szasz - Overview
- Essay reflecting upon his initial article in the 1960s and reconsider how his points may/may not be valid
- Szasz suggested that mental diseases were actually behaviours that made people feel uncomfortable and were thought by society to need treating to make others feel better
- Believed this was done instead of trying to help the person displaying these behaviours
- Believed that people w mental illnesses should not be treated in the medical sense
Szasz - 1960s
- Health care for mental health consisted of mental hospitals and private professionals
- Mental patients are treated no better than prisoners
- Mental illness is not the same as physical illness
- Mental illness doesn’t exist, so it is foolish to look for causes or cures
Szasz - 2010s
- All mental health care provided by the NHS is to prevent danger to patients and others
- A false belief that is apparent in research is that mental illness can be diagnosed accurately and treated successfullly
- Mental illness is seen as being a disorder of the brain, despite there being no scientific evidence that mental illness is caused solely by the brain
- Mental disorders are labels given to people with undesirable behaviours
- Doctors don’t see people as inherently bad, but if they perform negative behaviours, it is a result of their mental illness
- Consent for treating mental illness does not happen
- Medical treatments should not be used to treat mental illness but instead people need to be helped to overcome obstacles and treated with respect
- Medical treatments have become politicised greatly and are used to promote other things and contribute to the capitalist society
Szasz - reasons to support
- Gives free will back to the ‘patients’ - don’t have to act performatively/in a way that reflects mental health disorders and they can choose to have talking therapies
- Believes we should respect people more and treat people more humanely
- Erases what Rosenhan found to be the ‘stickiness of labels’; less stigma towards groups who had previously been regarded to have mental disorders
Szasz - reasons to not support
- Medical treatments have been proven to work (i.e. SSRIS)
- Socially sensitive - those who suffer from a mental illness may find his views extremely distressing and demeaning; invalidates their symptoms and feelings
- Destructive theories about the medical model (capitalist, don’t really care about patients) may make people lose faith in the professionals in psychiatry
