Behavioural, pharmacological, nondirective, and family therapies came into view as new methods of treatment of patients who have mental health problems in the 1950s and 1960s. Rather than being guided by a traditional theory, these therapies were generated largely as specific techniques. Despite the efforts of Dollard, Miller, and others to develop ideas of learning theory and psychoanalysis, most behaviour therapies of the late 1950s and 1960s developed against psychoanalysis.
For instance, in Psychotherapy by Reciprocal Inhibition, which announced the renewal of behaviour therapies, Joseph Wolpe (1958) wrote that he originally was “a staunch follower of Freud. ” But Wolpe became sceptical of the universality of the Oedipus complex and the effectiveness of psychoanalysis. Identifying concepts from Pavlov and Hull, Wolpe defined neurotic behaviour as “… any persistent habit of unadaptive behaviour acquired by learning in a physiologically normal organism. Anxiety is usually the central constituent of this behaviour, being invariably present in the causal situation….
By anxiety is meant the autonomic response pattern or patterns that are characteristically part of the organism’s response to noxious stimulation” (1958, 32-34). Wolpe trained more favourable responses that would “reciprocally inhibit” anxiety responses to specific stimuli. In Wolpe’s major method, called systematic desensitization, patients who have mental health problems build anxiety hierarchies beginning from the things that make them most anxious down to the things that make them minimally anxious.
The patient is then instructed in relaxation responses that Wolpe considers are inimical to anxiety. Thereafter, the patient must imagine the anxiety stimuli one after another, beginning with the least harmful in the hierarchy. As each stimulus is imagined, the patient will treat anxiety with the help of relaxation responses. Although young children may not be able to accomplish everything needed for this procedure, the same principles can be used while the child is engaged in enjoyable activities (cf., Lazarus, Davison, & Polefka, 1965).
Other behavioural methods are obtained from Skinner’s operant-conditioning paradigm. Instead of attempting to remove anxiety by pairing threatening stimuli with nonfearful responses, operant methods alter the reinforcement contingencies of the target behaviour. For instance, positive- strengthening consequences are made possible on responses that are to be made stronger, whereas negative consequences are made possible on responses that are to be made weaker.
At first, behaviour therapists suggested that their techniques were strictly derived from “modern learning theory” (Neugebauer 482). However, paradoxes emerged from the apparent success of methods that were theoretically opposite. A method called implosive therapy or flooding, for instance, is entirely opposite to Wolpe’s systematic desensitization: It presents massive doses of the feared stimuli under the assumption that anxiety responses will quickly extinguish when no harm results from facing the feared stimuli.
And there is evidence that implosive therapy can work with very fearful children (e. g. , Ollendick & Gruen, 1972). Many other behavioural techniques similarly have ambiguous ties to traditional learning theories. During the 1950s, it was found that some drugs first developed for other purposes seemed to reduce psychotic symptoms in maladjusted adults. Further improvement of these drugs led to a revolution in the care of people who had mental health problems. Main tranquilizers—such as chlorpromazine (Thorazine)—made it probable to weaken physical restraints.
It helped to release violent and excited patients from hospitals. Antidepressants—such as imipramine (Tofranil)— encouraged severely depressed patients. Although the biological functioning was not well understood, the evident benefits of pharmacotherapy turned psychiatry toward psychopharmacology and away from psychoanalysis (Neugebauer 483). New approaches With the developments in recent years, there is a growing potential for new ways to investigate, intervene in and understand the psychological consequences of mental health problems.
Health psychology can be described as:the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, and related dysfunctions, and to the analysis and improvement of the health care system and health policy formation (Sheppard 89). All treatments are different and it is of great significance that interventions are matched to the individual’s symptoms. Treatments also need to take into account all factors that might be contributing to the problem.
A combination of methods is commonly the most effective and brief outpatient treatment (Maheu et al. , 96). From their review of treatments for phobia, Moore and Carr concluded, for instance, that a six-session family-based behaviour therapy programme was the treatment of choice for phobia. On the other hand, for severe anxiety problems a programme of twenty-four sessions of combined individual and family-based cognitive behaviour therapy is the treatment of choice (Kent and Hersen 18). Treatment producing favourable outcomes must be guided by a thorough assessment. It is generally recognised that a single method is not efficient.
Treatment plans need consider individual needs. Assessment should comprise observations of patients in a variety of settings, including school, work and interviews with co-workers, relatives, parents, teachers and children. Early intervention is necessary to prevent secondary problems (Kent and Hersen 120). Kent and Hersen (2000) concluded that a variety of psychological interventions have positive outcomes. These include self-centred approaches, such as social skills and self-instruction training, behavioural training and family therapy, as well as combinations of these approaches (Kent and Hersen 124).