Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.
Mental Health Treatment
Karen is depressed. She feels blue all the time, and she's lost interest in the people around her. She recently lost her job because she kept missing work when her depression kept her from getting out of bed. Sometimes, she just wants to die.
Imagine that you're a psychologist, and Karen comes to see you. What should you do? How should you treat Karen?
Abnormal psychology studies abnormal thoughts, behaviors, and feelings. More specifically, abnormal psychology looks at psychological disorders and how best to treat them. There are many ways to treat a disorder like depression, and the best treatment route often depends on a number of factors. Let's look closer at some of the things that can pose challenges in the treatment of psychological disorders.
So, Karen is depressed, and you have to figure out how to treat her. You decide that the best route is through talk therapy and settle in to hear Karen talk about her feelings and problems. But, when you ask her about how she's feeling and what she's thinking, Karen doesn't respond. What's going on?
There are many reasons why Karen might not feel comfortable talking to a therapist. One of the reasons some people struggle with psychological treatments involves culture or race. Cultural factors can play out in many ways. Some African-American patients find it difficult to speak with white therapists, some Asians feel uncomfortable talking about their emotions, and there are other culture-specific barriers to communication.
Speaking openly and understanding Karen's point of view can go a long way towards helping her overcome cultural factors that might make being open and honest difficult. But, what if the therapist isn't aware of the cultural factors that might be playing a role in their patients' views of therapy? Whether intentional or unintentional, some therapists are insensitive to cultural factors that might play a role in therapy. As a result, some patients might not receive the best care possible.
Another way that culture plays a role in treatment is in the concepts that underlie treatment. In most Western societies, mental health involves feeling autonomous and accomplished. Western patients find self-confidence in being able to control elements of the environment around them.
On the other hand, many Eastern cultures value feeling like part of a larger whole and contributing to success without seeking individual accomplishment. They might find self-confidence in interdependence on the people and environment around them. Sadly, most psychological treatment is skewed towards the Western view of things, which could pose problems when treating someone who has traditionally Eastern values.
Effectiveness & Validation
Culture is not the only challenge to psychological treatment. Let's go back to the first moment when Karen walks into your office. You have to decide what the best treatment for her is. But, how do you choose?
Centuries ago, Karen's depression might have been treated by drilling a hole in her head or chaining her up inside an insane asylum. As recently as the middle of the 20th century, she might have been committed to a psychiatric facility where she could have received devastating treatments, like electroshock therapy or surgery to remove parts of her brain. At the time that these methods were popular, they were thought to be the best treatments for mental illness. Nowadays, we know that there are dangerous side-effects to many of those treatments, and most psychologists use different treatments, like drugs and talk therapy.
But, how do we know that the treatments being used today are effective? In psychology, treatments are sometimes evaluated for effectiveness in scientific studies. Treatments that have gone through rigorous research are said to be empirically validated.
You might be thinking, 'Okay. No problem. Let's just get empirical validation for all the psychological treatments out there.' In a perfect world, that's exactly what would happen; every treatment for every disorder would go through a rigorous set of experiments that would show how effective it actually is.
Unfortunately, that's not practical for several reasons. Cost and the sheer number of treatments are two common barriers to empirical validation. In addition, some treatments are not easily tested. For example, many psychologists treat patients with a hybrid of several different types of treatments. They might use a little Freudian psychotherapy, a little behavioral therapy, and maybe also offer medication. These might work well together, but it's difficult to test hybrid treatments like that.
Abnormal psychology seeks to understand psychological disorders and the best way to treat them. There are some challenges that psychologists face when treating patients, though. One is cultural factors like an unwillingness to talk about one's feelings or a focus on non-Western values. Another is the difficulty of gaining empirical validation for the effectiveness of treatment.
Following this video lesson, you should be able to:
- Describe some examples of cultural differences that might create barriers to psychological treatment
- Explain why it is difficult to get empirical validation for psychological treatment
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