Explorations Approaches in Practice

Contemporary psychological perspectives can be divided into two areas:

1. biological approaches look at physiological factors

2. psychological approaches look at mental, behavioral, and social factors

Biological Approaches target the “hardware,” the body’s mechanisms that control the central nervous system, endocrine system, and metabolism. Biological approaches assume that many psychological disorders stem from underlying biological causes, such as structural abnormalities in the brain, biochemical processes, and genetics.

Biological Treatments attempt to alter brain functioning with chemical or physical interventions, including drugs that act directly on the brain and body, surgery, and electroconvulsive therapy. Conducted by psychiatrists, physicians, and surgeons, biological treatments, also known as biomedical therapies, include the following practices.

Psychopharmacology:

• Therapy that incorporates drugs and chemicals; includes three major types of drugs: anti-psychotic, anti-depressant, and anti-anxiety

Biomedical Psychosurgery:

• Surgical procedures on brain tissue to alleviate psychological disorders

Electroconvulsive Therapy (ECT):

• A brief electrical current applied to a patient’s temples to alter the brain’s chemical and electrical activity

Psychological Approaches target the “software,” learned faulty behaviors and habits, along with damaging words, thoughts, interpretations, and feedback that direct strategies for daily living. Psychological approaches assume that many disorders result from mental, behavioral, and social factors, such as personal experiences, traumas, conflicts, and environmental conditions.

Psychological Treatments attempt to change behaviors, thoughts, and thought processes that impair daily living, thereby improving functioning. Practiced by clinical psychologists, psychiatrists, social workers and counselors, psychological treatments include four types of psychotherapy.

Psychodynamic Therapy

• View: Problems are symptoms of unresolved traumas and conflicts

• Focus: Inner, often unconscious motivations as well as attempts to resolve conflicts between personal needs and social requirements

• Approach: By understanding and making more conscious the relationships between overt problems and the unresolved, internal conflicts that caused them, people can work through problems to reach an effective solution

Behavioral Therapy

• View: Problems are the result of learned, self-defeating behaviors

• Focus: Observable behavior and conditions that sustain unhealthy behavior

• Approach: By applying the principles of conditioning and reinforcement, people can learn healthy behaviors

Cognitive Therapy

•View: Problems are the result of what we think (cognitive content) and how we think (cognitive process), including distorted view of situations and self, faulty reasoning, and poor problem solving

• Focus: Thoughts and thought processes that cause problematic emotions and behaviors

• Approach: By reconfiguring damaging thinking patterns, people can learn healthy, realistic ways of thinking about life experiences

Existential/Humanistic Therapy

• View: Problems are the result of issues related to difficulties in daily life, especially a lack of both meaningful relationships and significant goals

• Focus: Ways to unite mind and body, that is, the whole person, and thus release the potential for greater levels of performance and greater richness of experience

• Approach: By examining experiences in current life situations, people can develop their individuality and learn how to realize their full potential

Now that you’ve learned about the different approaches and associated therapies, it’s time to put them into practice with a patient.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Now you’ll be asked five series of questions about A’s alcoholism. For each series, you will take a different psychological approach as you consider A’s illness.

To begin, take a biological approach.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Question 1: What might be a potential cause of A’s alcoholism?

Answer: a. A biological approach views family history of alcoholism and genetic predisposition as potential causes of alcoholism.

Question 2: What might you examine to better understand A’s alcoholism?

Answer: d. A biological approach might examine parts of A’s brain involved in addiction.

Question 3: Which treatment would you prescribe for A?

Answer: c. A biological treatment approach might include psychotropic medications that help curb cravings.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Take a psychodynamic approach:

Question 1: What might be a potential cause of A’s alcoholism?

a. faulty neurotransmitters in A’s brain

b. unconscious conflicts that are manifested in drinking behaviors

c. thoughts and feelings of being a failure

d. heartbreak from a relationship that recently ended

Question 2: What might you examine to better understand A’s alcoholism?

a. if drinking keeps difficult feelings out of A’s awareness

b. if A’s drinking only becomes a problem after a certain number of drinks

c. if A drinks alone or with others

d. if drinking hinders A’s long-term memory

Question 3: Which treatment might you prescribe for A?

a. subliminal suggestion into A’s psyche of new, unpleasant associations with drinking

b. art therapy that encourages creative expressions of interpersonal conflicts

c. therapy to help A gain insight into difficult feelings and memories that fuel drinking behaviors

d. surgery on the part of A’s brain that oversees repression

Next, take a behavioral approach.

Question 1: What might be a potential cause of A’s alcoholism?

Answer: b. A psychodynamic approach might view unconscious conflicts that are manifested in drinking behaviors as a potential cause of alcoholism.

Question 2: What might you examine to better understand A’s alcoholism?

Answer: a. A psychodynamic approach might examine how drinking keeps difficult feelings out of A’s awareness.

Question 3: Which treatment might you prescribe for A?

Answer: c. A psychodynamic treatment approach might include therapy to help A gain insight into difficult feelings and memories that fuel drinking behaviors.

Next, take a behavioral approach.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Take a behavioral approach:

Question 1: What might be a potential cause of A’s alcoholism?

a. metabolic problems related to the absorption of alcohol

b.learned behaviors around drinking

c. an inability to think through the consequences of drinking

d. a distorted attitude about the impact of drinking behavior

Question 2: What might you examine to better understand A’s alcoholism?

a. A’s dreams

b. A’s irrational beliefs that fuel drinking behaviors

c. A’s drinking behaviors that have been reinforced over time

a. A’s cultural background and its views on drinking

Question 3: Which treatment might you prescribe for A?

a. strategies to increase A’s healthy behaviors while decreasing unhealthy drinking behaviors

b. a journal in which A tracks feelings for the therapist that develop over the course of treatment

c. long-term therapy to help A release difficult feelings and thoughts

d. medication to decrease anxiety and its resultant drinking behaviors

Next, take a cognitive approach.

Question 1: What might be a potential cause of A’s alcoholism?

Answer: b. A behavioral approach views learned behaviors around drinking as the cause of alcoholism.

Question 2: What might you examine to better understand A’s alcoholism?

Answer: c. A behavioral approach might examine how A’s drinking behaviors have been reinforced over time.

Question 3: Which treatment might you prescribe for A?

Answer: a. A behavioral treatment approach might include strategies to increase healthy behaviors while decreasing unhealthy behaviors.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Question 1: What might be a potential cause of A’s alcoholism?

Answer: a. A cognitive approach views a lack in problem-solving skills and an inability to think through consequences of drinking as a potential cause of alcoholism.

Question 2: What might you examine to better understand A’s alcoholism?

Answer: c. A cognitive approach might examine A’s thoughts and thoughts processes that lead to drinking behaviors.

Question 3: Which treatment might you prescribe for A?

Answer: a. A cognitive treatment approach might include changing A’s negative self-statements into constructive coping mechanisms.

Patient A has been diagnosed with alcohol dependence or alcoholism. Alcoholism may be treated as a substance dependence disorder characterized by behavior patterns resulting from uncontrolled use of alcohol and continued, or even increased, use, often despite awareness that the substance is disrupting one’s life.

Take an existential/humanistic approach:

Question 1: What might be a potential cause of A’s alcoholism?

a. inability to resist peer pressure to drink

b. lack of healthy personal relationships

c. addictive personality

d. poor diet that increases alcohol cravings

Question 2: What might you examine to better understand A’s alcoholism?

a. A’s childhood traumas

b. the onset of A’s drinking

c. environmental influences that might lead A to drink

d. A’s unexpressed feelings that interfere with psychological well-being

Question 3: Which treatment might you prescribe for A?

a. electroconvulsive therapy that stimulates the parts of A’s brain involved in addiction

b. therapy that involves listening, reflecting, and sometimes restating A’s evaluative statements and feelings

c. therapy that requires A to end relationships that interfere with her or his well-being

d. behavioral goals for A to achieve over the course of treatment

Well done. To learn more on topics, explore Program 21: Psychopathology and Program 22: Psychotherapy.

Question 1: What might be a potential cause of A’s alcoholism?

Answer: b. An existential/humanistic approach might view A’s lack of healthy personal relationships as a potential cause of alcoholism.

Question 2: What might you examine to better understand A’s alcoholism?

Answer: d. An existential/humanistic approach might examine A’s unexpressed feelings that interfere with psychological well-being.

Question 3: Which treatment might you prescribe for A?

Answer: b. An existential/humanistic treatment approach might include listening, reflecting and sometimes restating A’s evaluative statements and feelings.