Criado por vesara
mais de 8 anos atrás
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Drug therapies for phobias;
Ao1-
Benzodiazepines (Bz's) such as Valium and Librium are minor tranquilizers designed to reduce levels of anxiety by inhibiting the nervous system causing muscle relaxation and an overall calming effect. As anxiety's a core symptom of phobia, BZ's are often used. They enhance the action of GABA which acts to balm brain activity in response to arousal (during panic attacks or normal anxiety). They have been used in the treatment of social phobia and agoraphobia but only for short-term help wait a patient waits for another treatment for the LT. They may also be prescribed to help reduce the symptoms of panic associated with specific phobias.
Ao1-
Antidepressants such as Prozac have been used to treat people with phobic disorders possibly because these patients often have high levels of depression as well as high anxiety. They affect the availability of serotonin and noradrenaline thus reducing panic and other depressive symptoms. There are several types which have been used to treat phobias particularly social phobia and agoraphobia. MAOIs work by blocking the action of an enzyme that breaks down mono-amines therefore increasing their levels in the nervous system. SSRI's work by increasing the availability of serotonin in the brain-these have been effective in reducing panic in people with agoraphobia and social phobia by aiming to improve our moods with the boost in serotonin levels.
Ao2- Appropriate?!
While drug therapies are seen as effective during treatment, there are only ST benefits and those are lost very quickly afterwards which leads patients to relapse. Liebowitz et al carried out a follow up study of patients who had received either drug therapy or CBT. 6 months later 0 receiving CBT suffered a relapse during that period compared to 33% of those who had received drug therapy. This shows that drugs treat the symptoms not the cause, psychologists argue that biochemical imbalance is the result not the case for anxiety. Also, each anxiety disorder has its own specific underlying mechanisms yet the same antianxiety and antidepressant drugs are prescribed to patients regardless of their specific anxiety drugs. Such approach is not likely to cure the underlying problems beyond symptoms. It can be concluded that drug therapy for phobias is palliative rather than curative as it only treats the symptoms without curing thus dealing with the cause of the phobia.
Psychological therapies for phobias
Ao1- systematic desensitization
This method developed by Wolpe was designed specifically to counter-condition phobias and anxiety. It's based on the classical conditioning and assumption that phobic disorder is caused by a negative association between two stimuli. Therefore, it follows that treatment will involve breaking this faulty association. Clients must learn to associate the feared stimulus with a pleasant experience rather than traumatic one-SD involves client confronting the feared object or situation in a peaceful, relaxing, non-threatening environment until the phobia disappears due to new association. Covert or in-vivo.
1) Relaxation
2) Hierarchy
3) Visualising
4)Working up
5) Phobia is unlearnt.
Ao2- Effective?!
Research also suggests that SD may not be effective treatment for all types of phobia. Ohman et al suggest that SD may not be as effective in treating phobias that have an underlying evolutionary survival component (e.g. fear of heights or fear of snakes) than phobias which have been acquired due ot personal experience (e.g. fear of clowns or fear of dogs). These phobias may be more resistant to treatments as evolutionary theory proposes that phobias are innate and help for survival purposes and are more deeply engrained in a person's memory. As such, SD isn't an effective therapy for all phobias.
Ao2- appropriate?!
It could be argued that SD is not an appropriate therapy as it appears to resolve a problem but only eliminates symptoms which can cause symptom substitution. Langevin however claims that there is no evidence to support this objection.n Similarly, it is suggested that the success of SD is more to do with exposure than relaxation it may be that the expectation of being able to cope with feared stimulus is most important. As such, SD's not an appropriate theory as it is not curative.
CBT ao1-
CBT began in the 60s and there are now several types. Beck developed a cognitive therapy and Ellis founded REBT. The aim of REBT is to help the client identify irrational, negative thoughts about the phobic object or situation and place with rational realistic and more positive ones.
Ellis claimed that a specific event (A) activates irrational thoughts and beliefs (B) which in turn lead to negative emotions and undesirable behaviour (C). People maintain negative and self-defeating beliefs by constantly telling themselves how inadequate they are and constantly looking for confirming evidence that they are inadequate. So REBT works by;
A) identifying the activating event
B) recognising the belief is irrational
C) the consequences that the irrational beliefs produce.
D) disputing/challenging beliefs
E) effect
F) new Feelings.
Ao2- effective
Research suggests that combing therapies from different approaches does not always bring more improvements than apllying one particular therapy alone. Burke et al conducted a studyw tih agorphobucs to wther SD alone was more or less effective than CBT and SD. They found that CBT and SD did not prove to be more of an effective treatment then SD lone. Furthermore, Beurs et al conducted a similar study and found that CBT combined with SD wasn't better than SD lone. This suggests that combining approaches in the treatment of phobias isnt always the most effective way of treating phobias.
Ao2- appropriate?!
Some beliefs are not cognitive biases but simply real-life rational and accurate thoughts and it may be inappropriate to use REBT to challenge and change those beliefs. One problem with REBT is that it fails to appreciate the fact that some negative thoughts are based on a rational and accurate perception of reality. e.g. some social phobics have poor social skills and are away thus other therapies e.g. social skill training may offer more appropriate forms of treatment than REBT. In addition, Alloy and Abrahmson found that depressed people gave more accurate estimates of the likelihood of a disaster than normal people. In conclusion some so called irrational and negative beliefs may just be realistic thus REBT wouldn't be an appropriate theory.
Ao1-psychodynamic therapy
The psychodynamic approach claims that phobias are only a symptom and occur as a result of protecting the individual from repressed conflicts that are too painful to confront. In dream analysis the client is asked to recount their dreams and the analyst helps them interpret the hidden meaning (latent by examining manifest). Free association is when the client is asked to free flow his/her feelings thoughts or images and then express them in words which reflects internal, unconscious conflicts that may be discussed with a client later on. Lastly, for projective tests the client is requires to impose their thoughts emotions anxieties on sme stimulus material once completed the content revealed by the client is analysed and interpreted.
Ao2- effective?
It has been claimed that there is no robust evidence that psychoanalytic therapy is effective for people with phobic disorders. Eysenck argues that empirical evidence is anecdotal and psychoanalysis simply doesn't work. He refers to a meta-analysis published in 91 . Researchers made an overview of 19 studies comparing psychoanalysis with no treatment no difference was found in outcome one year after the treatment. There's a lack of empirical evidence for the effectiveness in dealing with with phobias.
Ao2- appropriate?
Recent innovations in psychoanalysis has made it more appropriate treatment for some phobias. More modern, brief psychodynamic therapies have emerged where the focus has been much more on current. rather than past concerns. These brief therapies (dozen sessions) can produce quick improvements in patient functioning. This new type of psychotherapy has made psychoanalysis more practical and more affordable for the wider population. As such, modern psychoanalysis is able to meet the needs of people thus making it more of an appropriate therapy for treating phobias.