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Sarah Schwab posted Nov 25, 2018 5:43 PM
There are six types of methodologies used to assess the effectiveness of psychological treatments.
Type 1: randomized clinical trials. These trials have objective and random comparison groups, assessments, large sample sizes, and very clear statistical methods.
Type 2: clinical trials similar to type 1, with some requirements missing.
Type 3: trials aimed to collect primary data, indicating if a treatment method is worth using.
Type 4: reviews with secondary data analysis
Type 5: reviews with no secondary analysis
Type 6: case studies, essays, opinion papers
(Nathan & Gorman, 1998).
Bulimia nervosa (BN) is an eating disorder. Affecting males and females of all ages, it is a common disorder that, untreated, can lead to severe health issues, irreversible physiological and mental problems, and death. In order to be diagnosed as bulimia nervosa, the subject must have symptoms that align with the ICD required symptoms. The subject must consistently show the following symptoms:
Recurrent binge-eating, often triggered by an emotional or stressful situation
Preoccupation or compulsion to eat large amounts of food
Behavior to avoid weight gain after binge episode including- vomiting, starvation, laxative use.
Obsessive concern with weight gain
Poor body image
The causes of bulimia nervosa can be related to environmental and natural factors in the subject’s life. Personality, heredity and family history, and sociocultural factors all play a part in the development of BN (Osińska, A., Mozol-Jursza, M., Tyszkiewicz-Nwafor, M., Słopień, A., Paszyńska, E., 2016).
Nathan, Skinstad, and Dolan state the most successful treatment method for bulimia nervosa is cognitive behavior therapy (CBT) (2018). They find the types of treatments most successful for BN are “designed to instill healthy eating habits and resolve associated interpersonal problems.”
This may be why the CBT is so successful, as it uses both Type 1 and 2 trials to treat the disorder, and both are very thorough in encompassing mental and physical triggers and behaviors. Most treatment plans for BN are based on the work of Christopher Fairburn. He discovered the key relationship of physiological factors to the physical symptoms of BN (Nathan, Skinstad, and Dolan). While anti-depressants are also used to treat BN, but seem to be most successful when accompanying CBT.
Nathan, P., Skinstad, A., & Dolan, S. (2018). Clinical Psychological Treatments: Research and Practice. The International Handbook of Psychology. http://dx.doi.org.ezproxy.umuc.edu/10.4135/9781848…
(Please respond with 100 words)
In the international handbook of psychology, “Nathan, Skinstad, & Dolan” (2000) describe three of the most influential methodologies used to assess treatment effectiveness. First, The Agency for Health Care Policy and Research (AHCPR) Depression in Primary Care Guidelines uses “empirical data on best practices for depression in primary care settings” to assess the efficacy of treatment methods and diagnosis of depression (p. 5). Second, The American Psychiatric Association publishes practice guidelines for the treatment of 5 major disorders based on empirical data from treatment results; the disorders include major depressive disorder in adults, bipolar disorder, alcohol, cocaine, and opioid abuse and dependence, nicotine dependence, and schizophrenia (Nathan, Skinstad, & Dolan 2000). Furthermore, methodological adequacy on the literature cited is also rated in three categories, these are based on research design and methodology representing levels of clinical confidence such as; level I, indicates recommended with substantial clinical confidence; level II, indicates recommended with moderate clinical confidence; and level III, indicates options that may be recommended on the basis of individual circumstances (Nathan, Skinstad, & Dolan 2000). Finally, the last methodology used to assess treatment effectiveness used reports produced by the Division of Clinical Psychology Task Force. The report identified 22 well-established treatments from 21 syndromes based on empirically validated behavioral and cognitive-behavioral treatments (Nathan, Skinstad, & Dolan 2000).
The diagnosis I selected is Posttraumatic Stress Disorder (PTSD) which occurs when a person is exposed to a traumatic event such as a when a soldier experiences combat or a when a person survives a natural disaster. PTSD is defined as “a chronic and debilitating mental health disorder characterized by symptoms of re-experiencing, avoidance, negative cognitions and mood, and arousal, all of which result from exposure to a traumatic event” (“Monson, Lonergan, Caron, & Brunet” 2016) (p. 1001). In order to reduce PTSD symptoms, I would recommend for patients to actively participate in cognitive and behavioral therapy. Empirically supported treatment for PTSD includes exposure therapy and anxiety management, furthermore, when combined with anti-depressants these treatments have been proven to reduce anxiety, depression, and also increase social functioning (Nathan, Skinstad, & Dolan 2000). The criteria used was based on empirically supported treatments from “A Guide to Treatments that Work” (Nathan, Skinstad, & Dolan 2000). In addition, “Ursano et al.” (2010) state that the goals of treatment for those who suffer from PTSD symptoms include “preventing or treating trauma-related comorbid conditions that may be present or emerge, improving adaptive functioning and restoring a psychological sense of safety and trust, limiting the generalization of the danger experienced as a result of the traumatic situations, and protecting against relapse” (p. 12).
Monson, E., Lonergan, M., Caron, J., & Brunet, A. (2016). Assessing trauma and posttraumatic stress disorder: Single, open-ended question versus list-based inventory. Psychological Assessment, 28(8), 1001–1008. Retrieved from https://doi-org.ezproxy.umuc.edu/10.1037/pas000022…
Nathan, P., Skinstad, A. & Dolan, S. (2000). Chapter 22: clinical psychology II: psychological treatments: research and practice. The international handbook of psychology, 429-451. Retrieved from http://sk.sagepub.com.ezproxy.umuc.edu/reference/h…
Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., Pynoos, R. S., Zatzick, D. F., & Benedeck, D. M. (2010). Practical guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. American Psychiatric Association. APA. Retrieved from https://psychiatryonline.org/pb/assets/raw/sitewid…
Osińska, A., Mozol-Jursza, M., Tyszkiewicz-Nwafor, M., Słopień, A., Paszyńska, E., (2016). Bulimia nervosa – its prevalence, symptoms and treatment with special attention to oral health. Family Medicine, 12 (3), 276–284. DOI: 10.15557/PiMR.2016.0028
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Jennifer Young posted Nov 25, 2018 12:19 PM
Cognitive behavioral therapy (CBT) focuses to correct psychological symptoms by changing and understanding their underlying cognitions and behaviors. (Boettcher, Hofmann, & Wu, 2015) CBT is typically a brief intervention that takes place over 12-16 months, and often involves between-session assignments for the patient. CBT addresses thoughts, behaviors, and emotions that interact and contribute to psychopathology. (Boettcher, Hofmann, & Wu, 2015) There are many techniques within the CBT approach, one being exposure therapy. (Boettcher, Hofmann, & Wu, 2015) Exposure therapy has patients confront their issues, and has them work out their issue, rather than avoiding the situation. The goal is for the patient to understand and become less fearful of the situation they are working through. (Boettcher, Hofmann, & Wu, 2015) CBT is an intuitive approach to therapy, and there is a large pool of research that has supported CBT and its effectiveness. (Boettcher, Hofmann, & Wu, 2015)
CBT is a good first approach to helping a patient overcome some of their psychological symptoms of mental illness. (Boettcher, Hofmann, & Wu, 2015) CBT is typically brief, and lasts between 12-16 sessions, which makes this therapy cost effective. CBT is also easily adapted, which makes therapy customizable for each patient and their specific needs. (Boettcher, Hofmann, & Wu, 2015) These are reasons that support the belief that CBT best describes abnormal behavior in today’s world. There are many approaches to therapy but starting with a therapy that aims to understand the emotion and behavior of a patient is the first step to helping them overcome their mental illness and symptoms. This also supports the idea that psychopathy is linked to our thoughts, behavior, and cognition due to the effectiveness of this treatment. (Boettcher, Hofmann, & Wu, 2015)
Boettcher, H., Hofmann, S. G., & Wu, Q. J. (2015). Therapeutic Orientations. Retrieved from UMUC.edu: https://learn.umuc.edu/d2l/le/content/332220/viewC…
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Bridgette Roa posted Nov 25, 2018 11:31 AM
Choose the one therapeutic orientation which you think best explains abnormal behavior in TODAY’S world. Second, define the theoretical orientation. Third, justify your choice.
After reading all of the types of therapeutic orientations, in my opinion, Cognitive Behavioral Therapy (CBT) describes abnormal behaviors of today the best. CBT seeks to uncover the thoughts, behaviors, and emotions that contribute to abnormal behavior (Boettcher, Hofmann & Wu, 2015). In the 20th century, psychologist Albert Ellis and psychiatrist Dr. Aaron T. Beck developed the idea from their clinical work (Boettcher, Hofmann & Wu, 2015). Beck believed patients’ “automatic thoughts” derived from “three belief systems or schemas: beliefs about the self, beliefs about the world, and beliefs about the future” (Boettcher, Hofmann & Wu, 2015).
This therapeutic orientation best explains abnormal behaviors of today as many manifests based on one’s emotions and beliefs and then turn into psychological behaviors. CBT has interesting treatment techniques to help people recover or become better functioning with their disorder. For example, with CBT, the psychologist will try to help the patient discover what is the underlying reason he or she may be having these feelings or thoughts and then the patient will be assisted in changing their negative thoughts to more productive ones (Boettcher, Hofmann & Wu, 2015). Additionally, psychologists use exposure therapy, where the patient must confront what has been affecting them in order to move past it.
Boettcher, H., Hofmann, S. G. & Wu, Q. J. (2015). Therapeutic orientations. Retrieved from https://content.umuc.edu/file/e8b627a2-948a-4e5f-8…