P3 - M.H. - Alternatives to the Medical Model Flashcards
Behaviourist Explanation of M.H.
- The behaviourist perspective is based on the assumption that all behaviour is learned from the environment.
- It can be argued that theories like classical conditioning, operant conditioning & social learning theory can explain & suggest treatment for some mental illnesses.
BEHAVIOURIST EXP - Classical Conditioning (WATSON & RAYNER)
Classical conditioning can explain how phobias develop.
* Watson & Rayner (1920) investigated whether it was possible to create a phobia in a baby boy (Little Albert).
* Watson & Rayner induced a phobia of a white rat (Little Albert wasn’t naturally afraid of) by making a loud noise (something that upset Little Albert) repeatedly every time he saw the rat.
* Albert eventually formed an association; got upset at the sight of the rat even when the noise was not presented.
This could explain how phobias develop, though there are limits:
* Little Albert’s fear lessened over time, but could be brought back with further conditioning
* Little Albert’s mother withdrew him from the experiment once it was done, but before Watson & Rayner could attempt to decondition/desensitise him
* No Informed Consent: his Mother was unaware of the stress & other details of the experiment
* Harm & Distress - short or long term - caused to Little Albert
BEHAVIOURIST EXP - Operant Conditioning
Some people argue that mental illness can be explained in terms of the rewards.
* Negative reinforcement could explain why some phobias remain over time.
* Negative reinforcement is the removal of something unpleasant.
For example, if an Arachnophobe gets another person to remove spiders they see, they are rewarded as the fear is lifted.
* However, this negative reinforcement could actually ensure the phobia persists in the long term.
BEHAVIOURIST EXP - Social Learning Theory
Social learning theory is based on the assumption that people will imitate what they observe.
* Vicarious Reinforcement
* Some argue that behaviours shown in depression (withdrawal, mood swings) can be transmitted to others.
* In particular, children (very susceptable to S.L.T.) who see role models reacting to challenges in unhealthy ways will learn to also respond to situations in the same way.
* Phobias can be learnt from adults
* Operant conditioning can make it more or less likely for the child to develop the adult’s behaviour; through adult &/or vicariously *
* Positive Reinforcement: more attention from adults (who are helping the person in distress), the adult gets support/treatment for their phobia
* Negative Reinforcement: If phobic stimulus is removed & the adult shows a better mood
Vicarious Reinforcement: conditioned through others’ actions *
BEHAVIOURIST EXP - Systematic Desensitisation Treatments
Classical conditioning can be used to treat phobias as well as create them. If someone can associate their phobia with feelings of calmness then this could remove the phobia.
* Systematic desensitisation involves a person being taught relaxation techniques and then pairing these techniques with their phobia.
* In order not to make the therapy too intense they are systematically introduced to their phobia (e.g. seeing a drawing of their phobia first, then a photo, etc.).
* McGrath (1990) - a 10-year-old girl called Lucy had her fear of loud noises (caused by party poppers and balloons) reduced by systematically desensitising her to them. Her self-rating of fear of party poppers began at 9/10 and reduced to 3/10 after the therapy was completed.
BEHAVIOURIST EXP - Aversion Technique Therapy
- Aversion therapy also works on the principles of classical conditioning.
- It can reduce drug and alcohol addiction by adding substances to them that create nausea.
- The person will then associate drugs or alcohol with feeling sick and this will stop their addiction.
BEHAVIOURIST EXP - Flooding Technique Therapy
- Involves immediately putting someone into contact with their phobia.
- Although they will panic at first, their body cannot sustain the fear response for a long period and after the person cannot physically be afraid they will associate their phobia with calmness.
BEHAVIOURIST EXP - Operant Conditioning
Lewinsohn
* Using operant conditioning, this study asked parents to only reinforce non-depressed behaviours of teenagers who met the DSM criteria for depression.
* When this technique was used, rates of depression dropped to 52% – demonstrating the effectiveness of reinforcing desired behaviour.
* could use self report,observer &/or heart-rate monitor to measure effectiveness with Phobias
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Paul and Lentz
* Found patients w/ Schz. who were given therapy based on social learning theory were:
* 2x as likely to be discharged from hospital
* 10x more likely to be living independently
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compared to patients who had drug treatments.
BEHAVIOURIST EXP - Comparisons
COGNITIVE EXP - Irrational thoughts
- One of the main assumptions of the cognitive area is that behaviour is due to mental processes and thoughts.
- Mental illnesses could then be explained throughout faulty thought processes.
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Beck suggests that there are three main dysfunctional beliefs that people with depression have: ‘I am worthless’, ‘Everything I do will fail’, ‘The future is hopeless’.
___ - This negative cognitive triad will result in behavioural consequences, for example believing that it is not worth revising for an exam because of a belief that everything is hopeless.
- Beck stated that depressed people only concentrate on information that confirms their negative thoughts, ignoring other positive factors that are present.
COGNITIVE EXP - Rational Emotive Behavioural Therapy
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Ellis was another cognitive theorist who also claimed that irrational thoughts could cause mental disorders.
- Overly high expectations for themselves such as ’the world should give me happiness or I will die’ lead to mental illness.
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- Overly high expectations for themselves such as ’the world should give me happiness or I will die’ lead to mental illness.
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Rational Emotive Behavioural Therapy (REBT) involved the therapist challenging a patient’s irrational beliefs.
- A ‘talking therapy’ where the therapist calmly but firmly identifies what irrational thoughts the patient is having, then encourages them to think more rationally about their life.
- This modification of distorted thinking can also involve teaching the patient cognitive and emotional regulation skills so the patient will eventually learn to look after themselves independently.
COGNITIVE EXP - Cognitive Behavioural Therapy
- CBT combines strategies from both Cognitive & Behavioural.
- CBT is another ‘talking therapy’ where a wide range of disorders such as Depression, PTSD and OCD can be treated.
- Cognitive techniques address thought patterns while Behavioural techniques help change behaviours.
- CBT can be done individually or in groups. It focuses on the ‘here and now’ rather than past experiences like other therapies do.
COGNITIVE EXP - Morrison (CBT)
- Morrison compared patients w/ Schz. & found that CBT in combination w/ social support & contact w/ health professionals was more effective than the latter two alone.
- This reduction of psychotic symptoms suggests that CBT can also help people with schizophrenia.
CONGITIVE EXP - Treatments overview
- CBT & REBT
- 1/5 ppl have at least one mental health crisis such as depression &/or anxiety (the most common)
- Phobias - systematic, flooding
- Depression - Person centered therapy
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Process of CBT
1. Identify negative thoughts - e.g. in a diary - and will name them, e.g. catastrophising
2. Challenge the thoughts
3. Practice new thoughts, rephrasing thoughts, role play
4. Try new things in real life
5. Report back to therapist
6. Repeat over several months
HUMANISTIC EXP - the assumption
- The basic assumption of the Humanistic area is that all people are born with the ability to be mentally healthy. Every person is born w/ the innate desire to self-actualise.
- Anyone can achieve self-actualisation through freewill, & the basis of this success comes from self-esteem & self-worth.
- Anything that prevents a person from growing & self-actualising is what can cause social or mental problems.
HUMANISTIC EXP - Conditions of Worth
- Rogers was a humanist who believed someone’s self-esteem is based on how much their actual self matches their ideal self.
- What affects our image of our actual self are Conditions of Worth; parents often place these conditions on children, e.g. ‘I won’t speak to you unless you calm down’ or ‘If you can’t pass this exam then I will be ashamed of you’.
- Rogers claimed that these conditions will cause people to lower their self-esteem – which in turn affects their mental health.
___ - E.g. people w/ Schz. may have low self-esteem because society’s condition of ‘being normal’ is not being met, which makes them feel rejected – causing even more suffering.
- Rogers claimed that imposing these conditions are wrong and all people should be shown Unconditional Positive Regard (the knowledge that we are loved no matter what we do).
HUMANISTIC EXP - Client-centred Therapy
Humanistic Treatments focus of raising self esteem through Client-Centred Therapy.
* A therapist gives a client unconditional positive regard; being genuine and empathetic.
* This will make the client feel valued & will help them match their ideal self w/ their actual self.
* Part of the therapy could involve removing conditions of worth that have been established from others.
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* As one assumption of the humanistic area is that people are free willed and have an innate desire to self-actualise, the therapist does not tell the client what to do but gives them time to make their own choices.
CONGITIVE EXP - Comparisons
HUMANIST EXP - Comparisons
HUMANIST EXP -
COGNITIVE EXP - Summary
- Schemas - patterns of thought
- Maladaptive -
- Beck’s model; Triad
- negative views about the world, the future, and oneself
- Ellis’ ABC Model - healthy/depressed
- Activating event - external/internal
- Beliefs about event - rational/irrational
- Consequences - positive/negative
- e.g. your left on read, fear of break up,
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