SLO #8: Evaluate the use of biomedical, individual and group approaches to treatment of one disorder

Quick Review List the approaches to treatment of psychological disorders What are the key assumptions for each Which approach do you think would be the most effective treatment for an individual with depression? Explain why?

What exactly are we doing? S.L.O – 8: Evaluate the use of biomedical, individual and group approaches to the treatment of one disorder Command Term: Evaluate requires you to make an appraisal by weighing up the strengths and limitations. So you are: 1) Critically look at the strengths and limitations of each approach to treating depression 2) Make a judgement of the effectiveness each of the three approaches to the treatment of depression.

Biomedical Approach to Treatment Drug Treatment: Used to increase/decrease the levels of available NT’s in synaptic gap. Have calming/energizing effects on behaviour depending on NT drug is targeting. Antidepressant drugs are used to elevate the mood of people suffering from depression. Selective Serotonin Re-uptake Inhibitors (SSRIs): Increase the level of available serotonin by preventing its re-uptake in the synapse Ex. Prozac

Biomedical Approach to Treatment ECT – Electroconvulsive therapy Small circuit passed through brain 1sec Activates the brain & induces convulsive seizure 30- 60 secs For optimal effectiveness requires 3-15 treatments Bilateral treatments more effective but more side effects than unilateral treatments Only appropriate for individuals where other forms of treatment have failed. Controversial therapy

Biomedical Approach to Treatment of Depression Advantages – Drug Therapy: Effective way to treat depression in short term, significantly helping 60-80% of people according to some reports Reducing the number of hospital inpatients who are being treated for psychological disorders (but….what else might cause reduction in numbers?) May help to prevent suicide in depressed patients.

Biomedical Approach to Depression Disadvantages: Side effects: ST soreness, vomiting, nausea,insomnia, sexual dysfunction, or headaches. Does not constitute a cure as shown by high relapse rate Not equally effective in all cases. ECT can cause brain damage, memory loss and reduced cognitive function Can be used as a means of social control over uncooperative patients. Study: Kirsch and Spirstein (1998) –analyzed results of 19 studies and found antidepressants only 25% more effective than placebos and no more effective than other kinds of drugs, like tranquilizers There is an enormous market for antidepressant drugs.(Money to be made)

Disadvantages of drug therapy cont. Kirsch et al. (2008) – reviewed 47 clinical trials published by US FDA on effectiveness of antidepressants. Medical treatment was not more effective than a placebo. Kirsch: medication only prescribed to most depressed patients or if alternates fail Leuchter and Witte (2002) support Kirsch. - brain scans NIMH study (Elkin et al. 1989)– one of the best controlled outcome studies in depression. No difference in effectiveness of CBT, IPT and drug treatment

Biomedical Approach to Treatment Appraisal: So what is the overall judgment that can be made about the biomedical approach to treating depression? This is a good method of treating only the most severe cases of depression and other approaches to the treatment of this disorder should be administered first.

Group Approach to Treatment of Depression Marital therapies - Strong link between depression and marital problems Focus on teaching couples to communicate and problem-solve more effectively, while increasing positive, pleasurable interactions Effective for treating symptoms of depression esp. in women Traditional Group Therapy – Patients talk about and listen to others experiences about depression. Individuals are encouraged and feel that they are not alone in their battle with depression

Group Approach to Treatment 4 Factors to consider in group therapy: 1) Group Cohesion: No one person seen as different from the rest. A sense of belonging is fostered 2) Exclusion: It is important to consider if there are any characteristics that should be excluded from the group. For ex. Current substance abusers, married men or people with certain health concern 3) Confidentiality: It is important to create an environment were people trust that they can speak feely in the group. 4) Relationship with therapist: It is essential that therapist show empathy for the members of the group and attempt to understand their reality.

Group Approach to Treating Depression In groups of 3-4 evaluate and appraise the group approaches to the treatment of depression. Make sure that evaluations are written down for future use – search for studies in OneNote document or texts which help in your evaluation

Group Approach to Treatment See general evaluation of it from last class Particularly related to Depression: Toseland and Siporin (1986) – reviewed 74 studies comparing individual and group treatment. McDermut et al. (2001) – meta-analytic review of the effectiveness of group psychotherapy in treatment of depression But there was a difference found between these two meta- analyses….what was it? Why? So many more variables to consider in group therapy

Individual Approach to Treatment Cognitive Behavioral Therapy (CBT): Helps client to change faulty thinking patterns and underlying schemas. Beck - 6 patterns of faulty thinking which lead one to dysfunctional behaviour. Arbitrary inference: Drawing wrong conclusions about oneself by making invalid connections. (Ex. When it rains – only I have bad luck the world is against me) Selective abstraction: Focusing on a single part of a whole (Ex. I have large thighs therefore I am fat) Exaggeration: overestimating significance of negative events (Ex. shortness of breath after exercising think it is a sign of imminent death ) Cognitive Symptom - of depression is distorted cognitions

Individual Approach to Treatment Cognitive Behavioral Therapy (CBT) Personalization: Assuming others behaviour is done with intention of hurting you. Dichotomous thinking: An all or nothing approach to viewing the world. Ex. If you don’t get an A on a test you have failed 2) Helps client to develop coping strategies, problem solving skills, and to engage in behavioural activation. Behavioural symptom of Depression: lack of initiative. Depressed patients stop doing potentially enjoyable activities because they don’t’ think it’s worth doing them.

Individual Approach to Treatment IPT – Interpersonal Therapy Therapist helps patient explore how relationships and social roles may be contributing to depression. Helps client develop and use positive social support networks they have in their life. Therapist seeks to address deficient social and interpersonal skills that may have lead to depression.

Individual Approach to Treatment Evaluation Activity: In new groups, maximum 3 people, discuss how effective cognitive therapy is in treating depression. Use the OneNote document as well as your texts to guide you. Make sure that evaluations are written down for future use. - Indicate the studies you think would be best to use for this

Closing Activity: Facebook Page Create a Facebook company page through word or on A4 paper that includes the following: Background picture and profile picture Name and type of company Two general wall posts that relate to your company. (Ex’s: memes facts, or events) Two specific wall posts that must incorporate evaluations of individual therapy as well as ability of this therapy to effectively treat Depression. (Ex’s Mission statement, company description etc.) Designer – Compiles all information onto one word document in the form of a Facebook page Make sure to divide the tasks equally among group members.

Homework: Homework: Create an IB LAQ (essay) outline answering the following question. Evaluate the use of biomedical, individual and group approaches to the treatment of one disorder. Some Empirical Evidence: Leuchter and Witte (2002) (Biomedical) CC P.173 Elkin et al. (1989) (Biomedical) CC P.173 Riggs (CBT) CC. P.176 Toseland and Siporin (1986) (Group) CC P. 177