Treatments for mental disorder vary depending on the theory behind the mental disorder research of various therapies and the efficacy (success) of the treatments against the disorder. The biological approach to mental disorders is often associated with the medical model which includes the use of medications to treat and/or manage the symptoms related to a particular mental disorder. Genetic factors have been a significant part of diagnosing disorders related to developmental disabilities such as Downs syndrome. However as the understanding of genetics and their interactions with environmental catalysts grows a greater understanding of the onset of mental disorders is also growing.
Describe how genetic and environmental factors may influence the onset of a mental disorder.
Explain why some individuals may have a higher risk of acquiring a particular disorder than others especially if has been present in family members.
Describe the main types of psychotherapies; for each type explain how it may be more effective for a particular set of disorders.
Describe the major types of drug classes that are used to treat mental disorders. Briefly explain how they work based on their neurochemistry.
Reading Material For Assignment
Mental-Health Treatments
Early in the course you learned about the dominant theories of abnormality. Each of these theories has given rise to a form of interpersonal therapy. Interpersonal therapy is one way to treat mental-health issues. Other treatment methods include medication management behavioral training and electroconvulsive therapy (ECT) as well as eye movement desensitization and reprocessing (EMDR). However most individuals with a mental-health issue typically seek out therapy or medication first.
The textbook discusses several individual theoretical approaches to counseling; however in reality most therapists take an eclectic or integrational approach to treat their clients. Very few therapists operate from a single theoretical orientation. Most therapists integrate various approaches to individualize treatment for their clients.
Transtheoretical Model
Many models exist for a systematic way of treatment. One such model is the transtheoretical model of change by Prochaska and Norcross. This model suggests individuals go through distinct stages when they are approaching any type of change from a simple habit to a pattern of mental illness. Lets have a look at the stages of mental-health treatment as per the transtheoretical model of change.
According to the transtheoretical model of change individuals do not progress through the stages in a straight line. Rather they might move back and forth between stages. For example clients who might be in the contemplation stage questioning whether or not they have problems might move forward to the preparation stage. However they might also be unready to face the idea of their behavior being a problem and therefore they could move back to the precontemplation stage.
Most clients come for counseling in the contemplation preparation or action stages. Depending on the stage the model suggests different theoretical strategies for treating clients. If a client comes for counseling in the contemplation stage insight-oriented (humanistic) approaches would be suggested. However if the client comes for counseling during the action phase active approaches (behavioral or feminist strategies) would be more appropriate. The value of this model is it allows therapists to accentuate the positive aspects of various theoretical approaches in a clinically responsible manner.
Psychology and Law
Since its inception as a science psychology has had a confusing and often conflicting relationship with law. When you first began this course you read about much of that historymental-health disorders being interpreted as demon possession as justification for institutionalization as proof of criminality or as a sign of inferiority. Even as we entered the twenty-first century psychology was still fighting for full acknowledgement from lawmakers and other entities. For example managed care has acknowledged mental health and covered its treatment under health insurance policies only within the last couple of decades. As research has improved and psychologys professional organizations have become more outspoken in their lobbying efforts individuals with mental-health issues have become less stigmatized and have gained more legal rights.
Perhaps one conflict between psychology and the legal system has been the often discrepant goals harbored by the psychology profession as dictated in its codes of ethics and the legal system as dictated by state and federal laws. Psychologists and mental-health professionals are held to a very strict code of what is and what is not acceptable. Since professionals are involved in their practices it is not uncommon for this code to come in conflict with laws. For example a psychologist is ethically bound by confidentiality. This means the psychologist does not release any information even to acknowledge a person is a client without the clients written permission. Yet many times when clients are involved in legal disputes such as custody hearings and criminal trials attorneys and judges subpoena the clients mental-health records.
This type of situation puts the psychologist in a terrible situation. If psychologists release the records they have violated the professional code of conduct and can be held accountable by the licensing boards. However if psychologists do not release the records they can be held in contempt of court and go to jail.
Thanks to the work of lobbyists for organizations such as the American Psychological Association (APA) and the American Counseling Association (ACA) some states have rectified this conflict of allegiances and have granted licensed mental-health professionals a privileged communication.
Privileged Communication
Privileged communication means psychologists cannot by law reveal any information obtained about or by clients without the clients permission. Having legal privilege takes the concept of confidentiality a step further; it protects the clients right to confidentiality by law and aligns the psychologists obligation to their profession and to the legal system. This protection has long been accorded to attorneys (attorney-client privilege) and to some clergy (Catholic priests and the sacrament of confession); yet many states have denied psychologists this privilege. In such states if psychologists receive a subpoena they have an ethical obligation to do everything they can to protect the records from being released.
A step psychologists can take to protect the records is to attempt to quash the subpoena. Through this procedure the psychologist communicates a willingness to fight to keep from having to release the records. However a judge can overrule a motion to quash. In that case the psychologist would eventually have to release the records of the individual. If a psychologist is practicing in a state without privileged communication for mental-health providers the psychologist must inform the client of such during the initial session.
Other exceptions to confidentiality exist and many differ from state to state. For example ethically psychologists have an obligation to break confidentiality only if by doing so they will be able to prevent harm to an identifiable other person. One of the reasons few states offer psychologists licensure reciprocity is because laws can change dramatically from one state to the next and psychologists must always be aware of the laws of the state in which they practice. There are other issues impacting psychologists which often differ between states; for example there are differences in the age of consent for treatment and the period of time for which records must be kept.
Mental Health Parity Bill
Psychology has made great strides legislatively. Perhaps one of the most momentous advances made was the recently passed Mental Health Parity Bill.
Health insurance companies began to cover mental-health treatment only fairly recently. However if you have ever tried to use your health insurance for such treatment you know the co-payments for mental-health treatments are typically much higher than those for seeing a physician. In addition there is typically a limit on the number of sessions you can have whereas visits to physicians are unlimited.
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