Describe one major therapeutic approach in clinical psychology and using appropriate evidence, evaluate its efficacy.
The definition of ‘therapeutic’ is a way of treating disease and relieving pain, therefore a therapeutic approach in a clinical environment uses a number of techniques to restore patients to health. Therapeutic approaches usually involve one to one sessions with a trained therapist or psychiatrist, where patients are able to freely talk about their problems instead of using pharmacotherapy which involves the use of drug treatments prescribed by the patient’s doctor. In some instances depending on the individual, it can be found that a combination of a therapeutic approach and pharmacotherapy is more effective than using one individual treatment alone. One therapeutic intervention that is commonly used in clinical psychology is cognitive behavioural therapy otherwise known as CBT.
Cognitive behavioural therapy was developed by Albert Ellis and it is based on the theory that it is how we think about an event that affects us not the event itself. CBT can be used in order to help patients alter their way of thinking and patterns of behaviour, it is a therapy that focuses on the present and how to improve the way of life for the patient rather than using other therapies such as psychodynamic therapy which has an emphasises on the past and how past experiences of the client can affect their conscious and unconscious thoughts and behaviour.
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Cognitive behavioural therapy works on the basis that positive change can only occur when the client changes their way of thinking about various situations. The therapy usually takes a similar course with all patients. The therapist and patient will look at individual problems and break them up into separate parts; once any negative thought processes or behaviour has been identified the patient is then able to work through these issues. However with CBT the therapist can only do so much, there is a large amount of individual work that the patient will have to go through, for example they may be asked to keep a diary to note down when a negative thought enters their head and what situation they were in to cause this thought process. After two weeks the therapist and patient would look at the diary and a pattern may be identified. The therapist can then work with the patient to replace negative thoughts with more positive ones; the diary can also be used as an important technique to highlight any repetitive thought processes, these can then be altered overtime using various practises such as exposure therapy where the patient would confront a feared situation in a controlled environment. Using techniques such as this when practising CBT can further improve the mental health of the patient.
This therapy can be used for many personality and clinical disorders such as depression and generalised anxiety disorder (GAD) it can also be used for behavioural problems.
CBT is used in different ways depending on the individual problem of the patient, although the therapy takes a similar course with all patients, different aspects may be focused on according to the type of mental disorder. For example someone suffering with depression will focus on changing their thinking patterns and the way they view the world by altering their negative schemas which they would have learned in childhood and adolescence. However someone diagnosed with GAD will use techniques that help them to overcome the situation or object they are fearful of. For example a person with a phobia of spiders will have this phobia reinforced every time they avoid a situation where they would be around spiders, Mowrer’s (1960) two factor model suggests that if you expose a person to their fear this conditioning can be unlearned.
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“Jesus Christ, what in the fuck did you do to my face? Where the fuck is my face” (Identity) the main actor in the movie Identity by Columbia Pictures presenting a Konrad Pictures production a film by James Mangold. and shows his discomfort and his misunderstanding of what is going in his life when he is face to face with many lawyers and a judge; along with the Doctors trying to ...
Research is continually conducted to look at the efficacy of CBT for these disorders. Hollon et al (2005) conducted a study to look at the effects of pharmacotherapy with various psychotherapies in adults and geriatrics and found CBT to be as effective as medication and reduces risk of reoccurrence after treatment has finished. It has also shown to have similar efficacy with those suffering from GAD (Linden et al, 2005).
When a review study was carried out by Hay and Bacaltchuk (2003) on those suffering from bulimia nervosa and similar syndromes they found that there was some improvement, however the researchers stated that psychotherapy alone would have little effect on changing the body weight of the participants. Other studies examining the efficacy of the therapeutic approach when working with those suffering from bulimia nervosa found that when cognitive behaviour therapy was combined with pharmacotherapy it had a greater improvement on the health of the participants (Agras et al, 1992).
Similar results have been found when conducting research into the efficacy of using combined treatment with patients suffering from depression. It was found that a combined approach is more likely to work than using either treatment in isolation, results also suggested that patients were less likely to drop out of combined therapy and more likely to recover (Jonghe et al, 1999).
Research shows CBT to be an extremely successful approach for dealing with a number of mental disorders (Butler et al, 2004).
It is now being used as an effective treatment for children and adolescents who have suffered from post traumatic stress disorder, anxiety and mental disorders. A study conducted by Clarke et al (1999) found that repeated exposure to CBT can be used as an effective intervention for adolescents suffering from depression and dysthymia. CBT has shown to be effective when treating children even when it has been modified to individual needs, a case study by Suveg et al (2006) of an 8 year old girl who was suffering from GAD and social phobia, after 20 sessions she no longer met the criteria for her symptoms at follow up appointments.
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This disorder is characterized by the presence of non-bizarre delusions, which have persisted for a least one-month. Non-bizarre delusions typically are beliefs of something occurring in a persons life, which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a ...
As CBT is a very popular form of therapy, it has accumulated many criticisms. The most prominent of these is that CBT is a ‘quick fix’ therapy. The standard course of treatment is 10 sessions over a 6 month period after these have been completed the patient reports that their overall mood has improved as they experience fewer symptoms of their disorder. Yet a study by Durham et al (2005) which looked at the long term effects of cognitive behavioural therapy found that there was no evidence that it had positive lasting effects. They also found that after the initial therapy 19% of the participants received almost constant interim treatment. CBT is also heavily criticised as it doesn’t look for the route of the patient’s disorder and find ways for them to overcome past issues, it only helps with current problems the patient may be experiencing.
Another problem with CBT is the availability of it to the general public however this can also be generalised to most forms of clinical therapy. Those waiting for treatment from the NHS are often not seen for months after they’ve been diagnosed with a mental health problem as so many hospitals are understaffed. Lengthy waiting lists can lead to serious repercussions for patients awaiting treatment, for example those suffering with severe depression may attempt or succeed in committing suicide as they were not able to receive the help they needed in time. Similar problems can arise with those suffering from other mental disorders. As the NHS are only able to provide the patient with a certain number of sessions, it may not be enough and the patient will either have to apply for another set of sessions or pay for private ones and this can be expensive.
Whilst cognitive behavioural therapy as an approach seems extremely effective when used with some patients and mental illnesses, there is also an equal amount of data and research that shows CBT to be nothing more than positive thinking and that more often than not it does little to improve the symptoms the patient is suffering from. When researching CBT, it may be more prudent to look at many different approaches such as psychoanalytic therapy or psychodynamic therapy rather than focusing on just one or two.
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Cognitive Behavioral Therapy or CBT is used to teach autistic children or adults with asperger’s syndrome how to manage their emotions. CBT teaches coping skills and deals with mental well being issues such as depression, repetitive thoughts and anxiety. Many people who suffer from autistic spectrum disorder fear working with a psychotherapist. It is difficult for them to even think about ...
By doing this researchers would then be able to see which form of psychotherapy is the more effective approach and has the highest likelihood of helping the patient to recover depending on the mental disorder. Researchers would then be able to see which form of therapy would be most beneficial to the individual; admittedly this would be very expensive and time consuming. Although there is a growing movement to combine various therapeutic approaches together along with the use of pharmacotherapy it is still shown that particularly with patients suffering from depression, many do not fully recover and only a third will go into remission (Hollon et al, 2002).
Many of those suffering from mental disorders are seen to need continual treatment to ensure that their symptoms won’t return.
The research suggests that CBT is a valid and effective alternative to pharmacotherapy, though due to the nature of CBT as a structured, adaptable and highly applicable psychotherapy it is able to be used in conjunction with other treatments to produce more effective results. As more research is conducted to analyse its effectiveness a large amount of evidence has been accumulated which suggests that it has positive effects when used to treat a wide range of psychiatric disorders.
