Treatment+of+one+disorder


 * Evaluate the use of biomedical, individual and group approaches to the treatment of one disorder. **

toc //**Evaluate- Strengths and limitations**// There are key statements under each of the 3 topics. Each of these statements can act as a topic sentence These are from the packet you were given in class.


 * Below you will find a general overview and then a student essay outline of an evaluation of the individual approach**


 * The disorder that we have focused on is DEPRESSION**

=Overview of strengths and limitations=

Strengths
 * Biomedical Approach**
 * antidepressant drugs can alleviate symptoms of depression and provide effective long-term control for mood disorders

Limitations
 * Side-effects can be a major drawback (support with evidence of side effects)
 * drugs may reduce the symptoms of a psychological disorder but they do not constitute a cure
 * There is a huge market for anti-depressant drugs and drug companies may not be making all data from efficacy trials available to physicians and the public
 * Drugs are not effective in all cases (support with studies that demonstrate this)
 * Symptoms of depression can also be alleviated by other means (evidence of CBT success rate)

Strengths
 * Individual Approach**


 * CBT is just as effective as drugs as a treatment for patients with depression
 * CBT is also effective when combined with drugs

Limitations (discuss these in general, no specific evidence for these)
 * CBT can focus on symptoms rather than causes
 * Therapist has control over what constitutes acceptable thinking patterns; such subjectivity can lead to ethical concerns. The relationship with the therapist is vital.
 * Depression is increasing – why is this so when so much treatment is available? (support with stats from WHO)
 * One complication in the study of any treatment is that there are no studies that compare all available treatments – this is not practical. We don’t have all the information that we need.

Strength
 * Group Approach**
 * A therapy group is beneficial for the individual
 * Group therapy is more cost-effective

Limitation
 * many more variables are involved in group therapy than in individual therapy because of group dynamics Thus the reliability of the data decreases (Evidence: Yalom)
 * one complication in the study of any treatment is that there are no studies that compare all available treatments – this is not practical. We don’t have all the information that we need.

= Evaluate the use of an individual approach to the treatment of one disorder. = (an essay question may ask you to evaluate one OR two OR all three of the approaches)


 * STUDENT EXAMPLE OF AN OUTLINE for an __evaluation of the Individual Approach__ - ** ** Connie/Grace/Karen/Ragna **

**Statements:** **Statement 1: CBT as an individual approach, has been proven to be very effective for patients with depression.** Elkin et al. (1989): included 28 clinicians who worked with 28- patients diagnosed as having major depression. 1. Randomly assigned patients an antidepressant drug, interpersonal therapy (IPT), or cognitive-behavioral therapy (CBT). 2. And a control group was given a placebo pill with weekly therapy. a. Double blind experiment, neither patient nor doctors know which was which. 3. Patients assessed at the start, after 16 weeks, and after 18 months. 4. Found that over 50% of patients recovered in each of the CBT, IPT, and drug group. a. Only 29% recovered in placebo group. - therapy is more effective than placebo group, but less effective than drug use

**Statement 2: CBT is effective but CBT with a combination of biomedical drugs is proven to be most effective in cases of chronic depression.** Riggs et al (2007): effectiveness of CBT in combination with a placebo or an SSRI. 1. Randomized double-blind with 126 adolescents (13-19 yrs) who suffered from depression. a. 20 were not able to be followed up or participated. 2. Participants were rated afterwards by a physician who found that 67% of patients in the CBT + placebo group and 76% of patients in the CBT + drug group were classified as “very much or much improved.” 3. Conclude that the treatment with CBT and rugs is effective but with placebo and CBT is almost just as effective.

**Statement 3: Other limitations** **Individual treatment has been proven to less cost effective than other treatments**
 * Cognitive therapies are cost-effective because they do not usually involve prolonged treatment. They have also been found to be quite effective, especially for milder depressions. No negative effects have been found.
 * Nemeroff et al. (2003) found the CBT (cognitive behavioural therapy) in combination with the biomedical approach (drugs) was the most effective in cases of chronic depression, from people suffering from traumatic childhood experiences.
 * (Above, disproves the fact that some may say it’s less cost-effective. However, Nemeroff discusses a eclectic approach.)
 * Siporin (1986) viewed 74 studies comparing individual and group treatment. Group treatment was more cost-effective than individual therapy in 31 per cent of the studies

Personal bias coming from individual therapists or psychologists.Evidence? **Psychologist have to take into consideration the specific cultural background of their client, because this treatment may be less effective for certain cultures.**Evidence?
 * Cognitive therapies have been criticized to focus on symptoms rather than the causes. **