Lecture 20 Notes Mental illness diagnosis can have more to do with the person making the diagnosis than with the person who has the illness Consequences diagnostic psychology has a history of fad diagnoses such as ADHD is controversial because there are no agreed physical correlates of ADHD diagnosis diagnosis of ADHD is based on evaluations of mental behavior the rate of ADHD diagnosis is 10x greater in the USA than in other countries Treatment Methods Outline Types of therapy Repressed memory of sexual abuse Bipolar Mood Disorder Split personality o Treat the body drug therapies o Treat the mind Insight therapies Cognitive therapies Humanistic therapies o Treat the behavior behavior therapies Evaluation o Clinical Outcome Studies o General Results o Specific Therapies o Common Factors Based on the fundamental idea that mental illness has a physical basis Uses drugs Drugs don t cure the problem they stop the symptoms Drug companies have corrupted this treatment This was developed by behaviorists stimuli and responses They claim that Problems are caused by past learning history and patterns of reinforcement Solution institute a new pattern of reinforcement conditioning Treat the body Treat the behavior Treat the mind Insight therapies improvement from mental illness will occur when the patient understands why they are behaving in the way that they are behaving This type of therapy is used by Freudian psychoanalysts Solution since people have unconscious motives and desires if the patient understands these motives and desires they can overcome their issues because the issues stem from the motives and desires This type of therapy is associated with lying on a couch and talking about how you feel Cognitive therapy mental illness stems from patient s beliefs about themselves and the world around them Solution get people to accept that they hold irrational beliefs and then get people to change those beliefs Humanistic therapy mental illness stems from a person not realizing their full potential Solution Self actualization to get better the person needs to realize Evaluation Results their full potential THIS THERAPY IS POPULAR NOT SCIENTIFIC Patient needs to get in touch with their real self This therapy developed as a reaction to the behaviorists and Freudianism Do these therapies work Case studies careful examination of an individual case CASE STUDIES ARE NOT VERY GOOD EVIDENCE 1 A case study is a sample of 1 which is statistically worthless You can overcome this issue slightly by gathering case studies together this is meta analysis 2 There is extensive interaction between the patient and the practitioner Thus the practitioner has a vested interest in the case because they believe that their approach is correct and is curing the person what is reported in the case is chosen by the practitioner and can be based on interpreted in the light of theoretical bias Therapist may not intend to influence patient but they may reward with a smile etc a patient when they say something the supports the psychologist s belief does the patient get better because of the positive reinforcement or because the therapy works Clinical Outcome studies an alternative to case studies gather a group of people with the same illness Different subsets of these people get different therapies and you see who gets better Clinical Outcome studies can be difficult to do because of inaccurate diagnosis because people have a mixture of symptoms In the studies treatment methods are carefully monitored and there are control groups that receive no therapy but interact with therapists to eliminate the possibility that people got better just because they talked to someone they knew was a therapist 1 Most people who undergo therapy get better and the improvement lasts over time THERAPY WORKS A small number of people get worse A small number of people get better without therapy 2 Which therapies work ALL THERAPIES ARE EQUALLY EFFECTIVE This is a a No therapy has a sound understanding of mental illness b Something in common must be producing the improvement Common factors problem are i For social and cultural reasons patients believe that the therapist will make them better and people believe in the efficacy of the program ii Therapists engage in non judgmental acceptance of secrets that the patient may be guilty about or embraced of iii The patient is dealing with someone who cares about them without any baggage of prior relationships iv Patients learn a different way to think about themselves they find different ways to make attributions about their behavior patterns
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