clinical psychology 18 essays on extended response questions
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Course
Unit 5 - Clinical psychology
Institution
PEARSON (PEARSON)
18 essays on 8 and 20 markers focusing on most topics in clinical psychology, such as reliability and validity of diagnosis, schizophrenia and depression explanations and treatments, key studies and key question, use of interviews.
Clinical psych essays
Evaluate 1 psych treatment for SZ (20)
One weakness of family therapy is that it is often carried out with drug therapy.
The family is educated on the causes of the patient’s mental illness to break down
concerns about blame for the development of psychosis in schizophrenia, so that they
have a better understanding of the behaviours shown by the patient. In this way, they
can learn that the symptoms of schizophrenia can’t be controlled by the patient during
an episode of psychosis. It may be argued that the patient’s improvement in symptoms
may only result from the medication they’re taking throughout family therapy. This is
because medication for schizophrenia such as clozapine, has been demonstrated to be
effective in many studies even without family therapy. This is a weakness as it implies
that the patient only needs medication to manage their symptoms of schizophrenia, and
involving their family might be pointless and time-consuming. However, family therapy
alone is not designed to relieve symptoms but to reduce the amount of expressed
emotion and prevent relapse through medication compliance and support. This may be
true since through the support of their family, a patient may be more likely to continue
with their medication and experience an improvement in their symptoms.
One strength of family therapy is that it helps families of patients with a mental
health disorder cope with their condition. Family therapy offers an opportunity for the
family members of someone with a mental health condition to air their concerns in a
supported environment and work together to find solutions or develop understanding
that reduces negative emotions. This can help the patient feel more supported, which
has a positive impact on the chances of successful treatment. This helps to create a
more manageable family environment, which may encourage medication compliance by
the patient as they are more likely to be offered support from their family. This is a
strength as it helps to reduce relapse in the patient and contributing at the same time to
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their mental health condition if they have a healthy relationship with their family. On the
other hand, not all families are able to commit to this therapy due to work or living far
apart from the patient. This means that family therapy may not be suitable for every
family, but only for those that have free time with the patient and are willing to help
them cope with the disorder.
One weakness of family therapy is that it suffers from treatment bias. Family
members are encouraged to talk openly about the symptoms experienced by the
patient, and are made aware of the psychotic symptoms and diagnosis of the patient.
The family then learns more constructive ways of communicating and are told that it’s
normal to feel angry and impatient, but they need to find ways of coping with these
feelings without resorting back to high expressed emotional patterns of behaviour.
Many studies aren’t able to randomly allocate participants to a treatment or control
group as participation in treatment programmes is often decided by clinicians. This
means that patients regarded as best suited to family therapy are put on the
programme, accounting for their improvement. This is a weakness because this is more
likely to result in results not representative of the whole target population with a certain
type of schizophrenia, as the results only apply to people who are regarded as most
likely to benefit from the programme. This might suggest that family therapy may not be
effective in the treatment of schizophrenia and might only be beneficial to certain
groups of people. However, living with someone with a serious mental health problem
such as schizophrenia comes up with high demands as the challenging behaviour
caused by symptoms of schizophrenia, such as hallucinations and delusions, are
emotionally draining. Therefore, developing better ways to cope with the patient’s
mental disorder might help the family to understand the patient’s presentation of
symptoms and cope with them better, without resorting to negative feelings of
frustration and anger. This may not only help improve the patient’s mental disorder, but
also their mental wellbeing overall.
One strength of family therapy is that it is shown to be effective. Family therapy
lasts 3-12 months with sessions every 2-4 weeks at home. 2 therapists work with the
family to develop a support network and build up a collaborative relationship between
the family and the professional. The therapists will educate the family on how
medication for the patient’s mental health disorder works and what are the expected
side effects. Pilling et al. (2002) in his meta analysis that compared the effectiveness of
family therapy with CBT as a treatment for schizophrenia, found that family therapy was
more effective in reducing relapse rates for episodes of psychosis and improving
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compliance with the medication prescribed. This means that patients undergoing family
therapy are more likely to benefit from it by being supported by their family and being
encouraged to continue with their medication. This is a strength because the
medication will likely help relieve the patient’s symptoms, which in turn might help
improve their relationship with the family since the symptoms may get milder. However,
family therapy is not widely available on the NHS, which means that people who could
benefit from it may not have access to it. This may lead them to their symptoms
potentially getting worse over time, especially if their mental health condition may
deteriorate their relationship with their family.
One weakness of family therapy is that it may not be effective. 2 therapists work
with the family to develop strategies for the patient to cope better with their symptoms
of schizophrenia. This can create a supportive atmosphere, which helps patients to
make better progress and relatives to feel more positive about their supportive roles. It
is hard to accurately assess the effectiveness of family therapy alone as researchers
cannot be certain whether the decrease in relapse rates are solely due to the
effectiveness of family therapy or due to the mode of action of antipsychotics. This
means that it is not scientifically proven that family therapy reduces relapse rates in
patients with schizophrenia as this could well be due to the effectiveness of
antipsychotics as they have been shown to be effective even without family therapy.
This is a weakness as patients undergoing family therapy may not experience any relief
from their mental health condition until they take antipsychotics for weeks. This might
make the concept of family therapy pointless and time-consuming. On the other hand,
Goldstein and Miklowitz (1995) found that family intervention combined with
medications were more effective in reducing relapse rates compared to taking
medication alone. This suggests that the family does have a role in helping the patient
to manage their symptoms of schizophrenia, therefore taking antipsychotics alone may
bring less relief compared to when experiencing support from their family to take the
medication.
In conclusion, family therapy aims to develop a supporting atmosphere in the
patient’s family environment, giving an opportunity for the family to gather together to
discuss potential solutions in managing the patient’s mental health disorder, which is
more likely to improve the patient’s symptoms. However, not all families will be
committed to this kind of therapy as they may not even be willing to be open and honest
with 2 therapists, therefore the patient may have to rely on only their medication, which
may be the only reason for the reduction in relapse rates. This suggests that more
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controlled research is needed to compare family therapy with standardised medication
therapy since it is certain which component of family therapy is most significant in
helping to reduce relapse rates.
Evaluate 1 non-bio explanation of SZ (8)
One strength of attention deficit theory is that it has supporting evidence. Frith
(1979) proposed that schizophrenia results from increased self-awareness and an
inability to filter out unnecessary cognitive noise created by internal information
processing.The patient can’t make sense of this, which results in further delusions and
worsened symptoms. Frith (1992) found that cognitive deficits are linked to
abnormalities in the brain areas that use dopamine. In patients with schizophrenia, there
was reduced blood flow to the pre-frontal cortex (which is involved with attention and
self-monitoring) during certain cognitive tasks. This suggests that the underlying cause
of cognitive processing deficits are attributable to biological factors. This is a strength
as it provides scientifically credible evidence for attention deficit theory, suggesting that
it may be a valid explanation for schizophrenia. On the other hand, this explanation does
not account for the negative symptoms of schizophrenia. This means that attention
deficit theory is not a complete explanation of schizophrenia as some individuals
display only negative symptoms and schizophrenia does not necessarily manifest
through positive symptoms.
One weakness of attention deficit theory is that there is contradicting evidence.
Patients suffering from schizophrenia might have a faulty attention system, where
preconscious thought is not filtered as irrelevant. Therefore, irrelevant information
might be noticed and treated more significantly than it really is. This may lead to the
positive symptoms such as hallucinations, delusions and disorganised speech. Brain
damaged patients have problems with attention and memory as well, but they don’t
display symptoms of schizophrenia. This suggests that problems with attention and
memory in experienced by patients with schizophrenia may not be caused by the same
factor as problems with attention and memory experienced by brain damaged people.
This points out that multiple brain regions are involved in attention and memory, and
that Frith’s explanation may not necessarily apply to patients with schizophrenia, as
different brain areas might be affected across individuals with different types of
schizophrenia. This is a weakness as the attention deficit theory may not be a valid and
reliable explanation for the positive symptoms of schizophrenia. However, Beck et al.
(2009) investigated the effect of dopamine reduction on cognitive loading, and found
that the brain struggles more in processing information, therefore it experiences
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