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GLT #9 Extended Response
GLT #9: Examine biomedical, individual and group approaches to treatment.
Treating psychological disorders can be divided in to three categories: biomedical,
individual and group. Biomedical treatment essentially means drug therapy; individual treatment
most commonly takes the form of Cognitive Behavioural Therapy, whereas group treatment can
take many forms, including family therapy or therapy with others suffering from the same
disorder. Research shows that these therapies are effective and moreover, are most effective
when used in conjunction with one another.
Biomedical therapy’s primary aim is to treat the disorder using drug therapy, most
commonly in the form of medication. Drug therapy relies on the assumption that the disorder is
caused by a chemical imbalance in the brain. That is to say, a disruption in neurotransmitter
levels is seen as the cause of the symptoms. Drugs aim to address this imbalance and restore the
neurotransmitter levels to their normal state. This however can cause some side-effects as some
drugs increase the levels of neurotransmitters across the whole brain, even if levels of
neurotransmitters are healthy in unaffected areas. This new imbalance is what can cause sideeffects.
One of the most common forms of drug therapy are selective serotonin reuptake
inhibitors (SSRIs). As their name suggests, SSRIs prevent the reuptake of serotonin, which
increase the level available in the synapse and consequently the level that will be transmitted to
the post-synaptic neuron. Serotonin is a neurotransmitter associated with mood regulation and so
with disorders such as depression, PTSD and even eating disorders, they can be effective to treat
the disorder. Bulimia for example, can have symptoms that are a consequence of low-self esteem
and depression. Some bulimia patients may turn to binge eating when they are feeling depressed.
SSRIs, such as Prozac, will have relatively immediate effects (drug therapy usually takes 7-14
days to take effect) which can relieve a bulimia patient’s depression symptoms and thus steer
them away from binge eating.
Another advantage of using drug therapy is that it is easy to study the effectiveness of the
treatment using treatment and control groups. One study conducted on 382 bulimia patients used
two groups: the treatment group received an SSRI (Prozac) and the control group received a
placebo. The results showed a 29% reduction in purging behaviours (i.e. vomiting) in those using
Prozac, compared with only 5% using the placebo. Furthermore, the results were replicated in a
later study when the medication was increased the reduction in binge eating was 67% and
purging over 50%.
While using drugs such as Prozac offers quick treatment of symptoms at a relatively low
cost (when compared with therapy sessions), there are some drawbacks. The drugs only target
the symptom, in the case of SSRIs they only target the low serotonin levels. They do not seek to
address what is causing those low levels in the first place. Furthermore, our brains are incredibly
adaptive and prolonged use of a drug will change the brain’s chemistry. In the case of SSRIs, this
could mean developing more reuptake receptors which will require a continued increase in the
dosage of the drug.
CBT on the other hand, seeks to address the causes of the symptoms, as well as
alleviating the symptoms themselves. CBT usually occurs on an individual basis with a trained
professional. In some cases, such as anorexia and bulimia, there may be more than one therapist
working with a client in the CBT process, such as a therapist, a dietician and a medical doctor.
CBT’s primary aim is to correct the distortion that has occurred between thoughts, behaviour and
emotion. It relies on this idea that these three elements are inextricably linked and a disruption in
one may cause disruptions in others. For instance, negative thoughts will influence someone’s
mood which will affect their behaviour.
CBT occurs in two major stages. Firstly, it seeks to identify the negative thought patterns
that a client has and to correct them. This would occur during 12-20 week sessions with
therapists and extensive interviews and therapy sessions would be help. An example would be
the distorted perception of a bulimia patient’s own body. The therapist would identify this
negative thought pattern and try to correct the client’s way of thinking about their own body. The
second stage for the client to participate and seek out enjoyable and positive activities. This is the
behavioural component of the therapy. Once the thought patterns have been corrected, the client
is then encouraged to seek enjoyable activities and participate in positive behaviours. The hope is
that the experience of enjoyable and positive behaviours will have a positive influence on their
thoughts and emotions.
Studies show that CBT is effective, but it is even more effective when combined with
drug therapy. However CBT is not 100% effective. One study conducted showed that 50% of
participants receiving CBT stopped binge eating and purging, although this still leaves the other
half who only received partial benefits or none at all.
The benefits of CBT include the fact that it often addresses the causes of the symptoms of
the disorder (i.e. negative thought patterns) and this can lead to longer lasting remission. By
working one-to-one with trained professionals, the therapy programme can also be tailored to
meet the needs of the individual client. On the other hand, this does make the therapy much more
expensive than drugs or group therapy.
Another approach to treatment is group therapy. Group therapy can either consist of
family members being part of an individual’s therapy (this is common with eating disorders), or
a group who have similar symptoms working through their therapy together (such as in AA).
Because the responsibility for treatment is shared among the group, a major advantage of group
therapy is that the pressure on the therapist is reduced. It also helps reduce the costs and so it’s a
cheaper form of therapy. However, when patients who have a similar disorder get together in a
group, there is a chance that they may learn negative behaviours or strategies from one another,
which is counter-productive to the therapy. For instance, an eating disorder client might find
ways of making it look like they’ve gained weight, or hiding food that they’ve been given to eat.
They may also find themselves in a group of other people behaving the same way, and decide
that their behaviour is normal.
In one study comparing CBT with family therapy for the treatment of bulimia in
adolescents, the results showed that both forms of therapy worked, but CBT was slightly better
because it alleviated symptoms quicker.
These three forms of therapy have their own advantages and disadvantages as can be
seen, which is why it’s generally accepted that an eclectic approach that combines elements of all
three is most preferred. (1,127 words)