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Here is a compilation of essays on ‘Mental Disorder’ for class 9, 10, 11 and 12. Find paragraphs, long and short essays on ‘Mental Disorder’ especially written for school and college students.
Essay on Mental Disorder
Essay Contents:
- Essay on the Introduction to Mental Disorder
- Essay on the Models of Abnormality- Changing Conceptions of Mental Disorders
- Essay on Mental Health Challenges in the Indian Society- The Changing Scenario
- Essay on the Assessment and Diagnosis of Mental Disorders
- Essay on Treatment for Mental Disorders
- Essay on the Prevention of Mental Disorders
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Essay # 1. Introduction to Mental Disorder:
Some people over react to simple statements and situations. Some have difficulty in relating to other people, some often find fault with their colleagues and family members and feel threatened; others seem to experience hallucinations and delusions. Often we dismiss these people sometimes casually and sometimes with fear, as “mad” or “eccentric.” Morbidity on account of mental illness is set to overtake cardiovascular diseases as the single largest risk in India.
According to NIMHANS, there are over two crore people in India who are in need of treatment for serious mental disorders and about five crore people who are affected by common mental disorder. About 30 to 35 lakh people need hospitalization at any time for mental illness. As Mohandas (2009) has observed the situation is alarming.
He noted that “a meta-analysis of 13 epidemiological studies consisting of 33,572 persons reported a total morbidity of 58.2 per 1000. Another meta-analysis of 15 epidemiological studies reported a total morbidity of 73 per 1000. The saddest aspect is that the bulk of the affected falls in the 15 to 45 year age group. The existing facilities in the country fall short of the required norms, which makes the situation still worse. The number of psychiatric beds in the country is only about 0.2 per 1, 00,000 population and there are only two psychiatrists per 10 lakh population”.
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Math and Srinivasraju (2010) have estimated that about 20 percent of the adult population in the community is affected with one or the other psychiatric disorder. In particular female gender, children and adolescents, students, aged people, people suffering from chronic medical condition, disabled, disaster survivors, people in custodial care, marginalized persons, refuges and individuals with poor family, social and economic support are found at high risk of develop psychiatric disorders.
To a psychologist, the problems related to mental disorders are as fascinating as they are disturbing.
But what, precisely, are mental disorders? This question is much harder to answer than you might at first assume, because in fact there is no hard-and-fast dividing line between behavior that is normal and behavior that is somehow abnormal; rather, these are simply end points on an unbroken dimension.
That said, most psychologists do agree that mental disorders include the following features. First, they involve patterns of behavior or thought that are judged to be unusual or atypical in the society. People with these disorders don’t behave or think like most others, and these differences are often apparent to the people around them. Second, such disorders usually generate distress negative feelings and reactions in the persons who experience them. Third, mental disorders are maladaptive they interfere with individuals’ ability to function normally and meet the demands of daily life.
Combining these points, we can define mental disorders as disturbances of an individual’s behavioral or psychological functioning that are not culturally accepted and that lead to psychological distress, behavioral disability, and for impaired overall functioning.
Essay # 2.
Models of Abnormality- Changing Conceptions of Mental Disorders:
The pendulum of history swings, and like other pendulums, it does not move in only one direction. Over the course of the centuries and in different societies, mental disorders have been attributed to natural factors or forces for example, to imbalances within our bodies or, alternatively, to supernatural ones, such as possession by demons or gods. Let’s take a look at a few of these historical shifts, then turn to the modern view of mental disorders: models of abnormality that provide comprehensive accounts of how and why mental disorders develop and how they can best be treated.
From the Ancient World to the Age of Enlightenment:
The earliest views of abnormal behavior emphasized supernatural forces. In societies from China to ancient Babylon, unusual behavior was attributed to possession by evil spirits or other forces outside our everyday experience. Ancient Greece, however, provided an exception to this picture.
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Several centuries before the start of the Common Era, Hippocrates, a famous Greek physician, suggested that all forms of disease, including mental illness, had natural causes.
He attributed psychological disorders to physical factors such as brain damage, heredity, and the imbalance of humors within the body four essential fluids that, he believed, influenced our health and shaped our behavior. He even suggested treatments for these disorders that sound impressively modern: rest, solitude, and good food and drink.
The Romans generally accepted this view of psychological disorders, and because the Romans spread their beliefs all around what was then the known world, the idea of psychological disorders as the result of natural rather than supernatural causes enjoyed widespread acceptance, too. These views, of course, provided the foundations for what is known as the medical view of mental disorders the idea that such disturbances stem from natural biological causes and should be treated as forms of illness.
In the Indian context earliest reference to psychological disorders is found in the Atharava Veda, which is dated around second millennium BCE. It describes three metabolic processes or tridoshas as vata, pitta, and kaph and three gunas as sattva, rajas, and tamas. It is believed that a predominance of Tamas guna is manifested in mental disorders. Some of these are Unmad, Grahi (fit or seizure), Apasmar, Bhaya (fear), Manastap (anxiety), etc.
With the start of the Renaissance in the 1400s, however, the pendulum swung once again. The Swiss physician Paracelsus (1493-1541) suggested that abnormal behavior might stem, at least in part, from the influence of natural forces such as the moon, which, he believed, influenced the brain and induced madness or lunacy.
A few decades later, the physician John Weyer (1515-1588) emphasized the role of natural, physical causes in mental disorders and was, in a sense, the first psychiatrist (medical doctor specializing in the treatment of mental disorders). As the Renaissance continued, and as knowledge of anatomy and biology increased, Weyer’s view that abnormal behavior was a kind of illness gained acceptance. He also objected to the brutal way in which people with mental disorders were treated.
Change, however, was in the wind. During the 1700s reformers called attention to these problems, and in 1793 Philippe Pinel (1745-1826), a French physician in charge of a large mental hospital in Paris, unchained the patients, arguing that they would do much better if treated in a kinder fashion. These changes did produce beneficial effects, so Pinel’s ideas soon spread and did much to reduce the suffering of patients in such “hospitals.”
The result, ultimately, was the development of the moral treatment or mental hygiene movement, and during the nineteenth century reformers secured improved conditions for many persons experiencing mental disorders. However, the movement soon produced results its supporters did not foresee: It led to establishment of new state hospitals (mainly in the early decades of the twentieth century) that were so understaffed that they could offer only custodial care to the large number of patients they housed. However, these facilities did allow psychiatrists to study and compare the symptoms of many patients; this work led, ultimately, to the development of improved ways for describing and classifying mental disorders.
Modern Perspectives: Biological, Psychological, Sociocultural, and Diathesis-Stress Models:
So how are mental disorders viewed today? The answer involves several perspectives that should be viewed as complementary to one another. Together, these approaches provide a more accurate and complete picture of how such disorders arise and how they can be treated than any single perspective does alone.
One of these approaches, the biological model, emphasizes the role of the nervous system in mental disorders. This approach seeks to understand such disorders in terms of malfunctioning of portions of the brain, imbalances in various neurotransmitters and genetic factors.
For example, many mental disorders show a high degree of concordance among close relatives. If one family member develops a disorder, then others are at increased risk for developing it too.
It is clear, however, that biological factors are not the entire story where mental disorders are concerned. Often, such disorders occur without any apparent underlying biological cause. This suggests that psychological factors, too, can be important. The psychological perspective emphasizes the role of basic psychological processes in the occurrence of mental disorders.
For instance, many psychologists believe that learning plays a key role in many disorders. An example- phobias, or excessive fears of objects or situations. According to the psychological view, a boy who is humiliated in front of classmates by an insensitive teacher may acquire a fear of all social situations in which he is the center of attention, and may avoid them on future occasions. The psychological perspective also emphasizes the role of cognitive factors in mental disorders.
For example, individuals may attribute positive events and accomplishments to luck and other factors beyond their control, but negative outcomes to internal factors such as their own flaws or failings. Finally, the psychological perspective also takes account of unconscious forces and conflicts within individuals—the factors so vividly emphasized by Freud and his followers.
What about sociocultural factors do they too play a role in mental disorders? Psychologists and other mental health professionals believe that they do, and point to the important role of such social variables as poverty, unemployment, inferior education, and prejudice as potential causes of at least some mental disorders. In other words, the sociocultural perspective emphasizes the fact that external factors such as negative environments, a disadvantaged position in society, and cultural traditions can play a role in mental disorders.
A third modern perspective on mental disorders is the diathesis-stress model.
This view suggests that mental disorders result from the joint effects of two influences:
(1) A predisposition for a given disorder, termed a diathesis, and
(2) Stressors in an individual’s environment that tend to activate or stimulate the predisposition or vulnerability.
In other words, the diathesis-stress model suggests that for various reasons—genetic factors, early traumatic experiences, specific personality traits; individuals show varying degrees of vulnerability to specific mental disorders. Whether and to what extent an individual actually experiences such a disorder, however, depends on the environment in which the person lives.
If the environment is favorable, the vulnerability (diathesis) may never be activated, and the person may never experience a mental disorder. If environmental factors are unfavorable, the diathesis may be activated, and one or more mental disorders may result.
The diathesis-stress model has also played an important role in the emergence of a new perspective in the study of mental disorders, one that emphasizes the development of such disorders over time. This approach, often known as the developmental psychopathology perspective, emphasizes the fact that problems that first appear during childhood or adolescence often are linked to and serve as precursors for disorders that occur later in life.
In India, issues pertaining to mental health could not received due attention until recently. There is, however, increasing realization that conditions such as schizophrenia, mood disorders (bipolar, manic, depressive, and persistent mood disorders), and mental retardation can impose a marked disease burden on Indians. This was confirmed by a study conducted for the NCMH which stated that at least 6.5 percent of the Indian population had some form of serious mental disorder, with no discernible rural-urban differences; women had slightly higher rates of mental disorder than men.
If one were to include some other “common” mental disorders and alcohol and drug dependency, the estimates would be substantially higher. With the increasing size of the population, these numbers are expected to grow substantially by 2015; the population with serious disorders is expected to grow to more than eight crore in that year, and even higher if the category of “common mental disorders” in the population was included in the projections.
Reddy and Chandrashekar (1998) in a meta-analysis reported the total prevalence to be 58/1000 (confidence interval [CI] 55.7-60.7) with 48.9/1000 for the rural population, and 80.6/1000 for the urban population. Ganguli (2000), reviewing major Indian studies, computed the total rate to be 73/1000 (range: 18-207).
These studies utilized different inclusion and exclusion criteria and hence the number and type of studies included are not the same. The awareness and response of the people to mental health needs to be quite varied. The experiences of clinical psychologists as given in the Box indicate that much is still required to increase the awareness of the people.
Essay # 3.
Mental Health Challenges in the Indian Society- The Changing Scenario:
In 1960s no one ever realized that a psychologist was an essential part of life. Only if a child was grossly retarded, an IQ evaluation was required. People resented the concept of family counseling. I remember an elderly man saying about me: “Will this lady tell me how I must run my family? What nonsense”. Today, a large number of parents consult for their children’s aggressive nature, for their poor academic involvements besides issue like ADHD, autism, etc.
A large section of more boys but girls also come for counseling because of an Oppositional disorder. A XIIth class girl aged 17 and her brother aged 20 wanted to cook noodles and realized that the stock at home had finished. They sneaked the keys of the main door from under the pillow of their grandmother and left house at 2 a.m. to buy noodles. Some boys passing by caught the girl and raped her while the brother looked with hands and mouth tied.
When the boys left, the sister untied the brother. Out of anger, the brother beat up an elderly woman in rags passing by who had no connection with this episode. They came back home. The parents were up hearing some noise because when the children entered the house they slammed the door. The parents and the children shouted at each other in a heated argument and eventually the girl beat her mother and the brother beat up his father. Both the brother and sister have a very poor academic record.
These are very common cases coming up these days. Pubs leading to better drinking facilities add to the youth’s problems. So the family environments are deteriorating. The materialistic thrust within the parents reduces the Indian values within the Indian socio-cultural context. Thus the intergenerational conflicts are reportedly more in clinics. The urban problem worth reporting is of grave concern.
This is the problem of E Addiction. The adolescent and the early youth is addicted to the television, the laptop, the IPod and now the Ipad. There can be violence between the parent and the ward over these gadgets because the ward is unable to sleep or study. The face book is the main occupation of the youngsters. Try getting them away, there can be lethal war in the family which has also led to redefining the new Indian concept influenced by the West “It is my life and this is my space. You have nothing to do with it.”
So many issues arise like a disturbed sleep cycle, poor hygiene, poor academic health, poor social health and poor physical health due to lack of movement and exercise, junk food, etc. It also leads to poor concentration and poor attention processes. It leads to poor memory especially recall of a bulk material in the current examination system we have in schools.
Another set of cases that frequently visit the psychologist are the marriage counseling issues. Women with a logically developed educated mind find it difficult to withstand the illogically dominating nature of their husband get defiant and become extramarital.
Face back and online chats and the internet sex gives them enough opportunity to get romantically and sexually happy without the excess baggage of either the patriarch or the joint family hasseles. Very many times this is the outcome of a very throttling and a controlling husband who may be paranoid or obsessive in nature or it may be that the woman is a borderline bipolar depressive with also an overlay of obsessional disorder.
The awareness of psychological issues and the emerging role of the psychologist however still leave scope for the astrologer and the tantric. So the old and the new run together.
A very regular client of mine who had marital issues because the girl would not allow any sexual relations as she did not like her husband but was forced into marriage by her father (was suffering from childhood depression) always consulted her family Panditji. She would confide in her sessions that her Panditji said that if she had sexual relations with her husband, he would die of epilepsy. (The husband was epileptic).
This suited her so she would listen to his advice. If he really had given it, one does not know. So she would wear all kinds of stones in her rings on her fingers. The blend of such beliefs and newer psychological methods is more prevalent in the urban areas. There is still more work for the psychologists to show their relevance so that the stigma for counseling would go.
Essay # 4. Assessment and Diagnosis of Mental Disorders:
In order to assess and diagnose mental disorders, psychologists go through a set of steps when seeing a new patient for the first time. The psychologist would first gather information on the kind of problems the person is experiencing, inquire about conditions in her or his current life, examine the person’s responses to various psychological tests, and so on.
These information-gathering steps are known as assessment, and they are directed toward the goal of formulating an accurate diagnosis identification of the person’s problem(s).
Diagnosis is a crucial step, because identifying the problem often determines what the psychologist should do next how she or he can best help the individual. But how does the psychologist identify the specific disorder or disorders a given person is experiencing? To this end psychologists and other mental health professionals have an agreed-upon system for describing and classifying mental disorders.
Actually, several different systems for classifying mental disorders. However, the one that is the most widely used in the United States is the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), published by the American Psychiatric Association (1994).
Although this manual is published by the American Psychiatric Association, psychologists have long contributed to its development and increasingly so in recent years. Thus, the manual is designed to help all mental health practitioners correctly identify (diagnose) specific disorders. The DSM-IV (TR) has also been published in 2000 which includes certain modifications.
The manual describes hundreds of specific disorders many more than we’ll consider here. These descriptions focus on observable features and include diagnostic features symptoms that must be present before an individual is diagnosed as suffering from a particular problem.
In addition, the manual also provides much additional background information on each disorder; for instance, information about biological factors associated with the condition and about variations in each disorder that may be related to age, cultural background, or gender.
The DSM-IV classifies disorders along five axes rather than merely assigning them to a given category. This means that a person is described along several different dimensions (axes) rather than only one. Different axes relate to mental disorders, physical health, and social and occupational functioning.
For our purposes, two of these axes are most important- Axis I, which relates to major disorders themselves, and Axis II, which relates to mental retardation and to personality disorders—extreme and inflexible personality traits that are distressing to the person or that cause problems in school, work, or interpersonal relationships.
The third axis pertains to general medical conditions relevant to each disorder; the fourth axis considers psychosocial and environmental factors, including specific sources of stress. Finally, the fifth axis relates to a global assessment of current functioning. By providing a system for evaluating people along each of these various axes, the DSM-IV helps clinicians gain a fuller picture of each patient’s current state and psychological functioning.
Is the DSM-IV a useful tool for psychologists? In several ways, it is. It appears to be higher in reliability than earlier versions, and it rests more firmly on careful empirical research. However, it’s important to note that it is still largely descriptive in nature. It describes psychological disorders, but it makes no attempt to explain them. This is deliberate; the DSM-IV was specifically designed to assist in diagnosis.
It remains neutral with respect to various theories about the origins of psychological disorders. Because psychology as a science seeks explanation, not simply description, however, many psychologists view this aspect of the DSM-IV as a shortcoming that limits its value.
In addition, the DSM-IV attaches specific labels to people, and this may activate stereotypes about them. Once a person is labeled as showing a particular mental disorder, psychologists and mental health professionals may perceive the person largely in terms of that label; and this may lead them to overlook important information about the person.
A third criticism is that the DSM-IV may be gender-biased. Females are diagnosed as showing certain disorders much more frequently than males, and some critics suggest that this is due to the fact that the DSM—IV descriptions of these disorders seem to reflect society’s views about women (sex-role stereotypes).
Finally, the DSM-IV has been criticized because mental disorders occur on a continuum, not in discrete categories. People don’t necessarily simply have or not have a disorder; they may have the disorder to various degrees, and may show different aspects of it in varying proportions. For this reason, many psychologists prefer a dimensional approach, in which individuals are not simply assigned to specific categories but rather are rated on many different dimensions, each relevant to a specific mental disorder.
Still, although many psychologists might prefer a dimensional approach, and although they recognize the other potential problems with the DSM-IV already noted, they continue to use the manual because of the benefits of having a single widely used framework for describing and discussing mental disorders.
Essay # 5. Treatment for Mental Disorders:
Growing evidence suggests that individual psychotherapy works: Many of the kinds of therapy we have already considered are effective in alleviating mental disorders. But there are several factors that limit the usefulness or appropriateness of such procedures in some cases.
First, and perhaps most important, individual psychotherapy is not accessible to all persons who might benefit from it. It is often quite expensive skilled therapists often receive Rs.2000 or Rs. 3000 per hour! Obviously, many people can’t afford such costs.
But even if individual psychotherapy were free, cultural factors limit its accessibility for some groups of people. In many cultures, for example, it is considered unseemly to express one’s emotions openly or to discuss them with other persons—especially with total strangers (which is what therapists are, at least initially).
The result is that people from many non-Western cultures and persons from some ethnic groups (e.g., people of Hispanic or Native American descent in the United States) view individual psychotherapy as pointless or even shameful as a sign of weakness.
This situation is definitely not helped by what has been described as cultural insensitivity in the mental health field, at least in the past. Such insensitivity has resulted not from prejudice or other negative reactions on the part of therapists, but rather from an insistence on using standard procedures and assessment tools that may not be appropriate for various cultural groups.
Other factors limiting the usefulness of individual psychotherapy include its emphasis on individuals, a focus that overlooks the fact that social factors (e.g., conflicts and relationships with others) often play an important role in mental disorders, and its emphasis on treatment rather than on prevention. Preventing mental disorders has become an important theme in psychology, just as preventing physical illness has become an important aspect of modern medicine.
Largely in response to these and other limitations, alternative forms of treatment for mental disorders have been developed.
Several of these are described below:
1. Group Therapies- Working Together to Solve Personal Problems:
Group therapies involve procedures in which several people discuss their problems with one another under the guidance of a trained therapist. In some cases the procedures followed in group therapies are derived from specific forms of individual psychotherapy. For instance, techniques developed by Freud for individual therapy have also been modified for use in psychodrama a form of group therapy in which group member’s act out their problems in front of one another, often on an actual stage.
Psychodrama also involves such techniques as role reversal, in which group members switch parts, and mirroring, in which they portray one another on the stage. In each case the goal is to show clients how they actually behave and to help them understand why they behave that way—what hidden inner conflicts lie behind their overt actions.
In contrast, behavioral group therapies are derived from the basic principles of learning that underlie behavior therapies. Such therapy has been found to be especially useful in teaching people basic social skills, such as how to communicate their wishes to others and how to stand up for their rights without being aggressive. It has also proved helpful in teaching people self-control the ability to regulate their own behavior.
Psychologists who practice phenomenological/experiential therapies have perhaps been the most enthusiastic about adapting their techniques to group therapy. In fact, interest in group therapy first originated among humanistic therapists, who developed two forms of such therapy; encounter groups and sensitivity-training groups.
Both of these techniques focus on the goal of fostering personal growth through clients’ increased understanding of their own behavior and through increased honesty and openness in personal relations. In both kinds of groups, members are encouraged to talk about the problems they encounter in their lives. The reactions they receive from other group members then help them understand their own responses to these problems.
The major difference between encounter groups and sensitivity-training groups lies in the fact that encounter groups carry the goal of open exchange of views to a greater extreme. Members in these groups are encouraged to yell, cry, touch each other, and generally to act in a completely uninhibited manner. Sensitivity-training groups, in contrast, are somewhat more subdued.
In practice, most group therapy involves six to twelve persons, plus a therapist. Sessions last about two hours—twice as long as most sessions of individual psychotherapy. Yet costs can be relatively low, because group members, in essence, share the therapist’s fee. Do such groups really produce beneficial changes?
Growing evidence suggests that they can indeed be helpful, primarily because they provide the following benefits:
(1) People participating in these groups learn that their problems are not unique but that in fact they are shared by many other persons.
(2) Group therapy sessions encourage hope—when group members see others coping with their problems, they realize that they too can do the same.
(3) Persons in group therapy sessions share information with one another—suggestions on how to cope with specific problems and insights into these problems.
(4) Group therapy sessions give members a chance to practice altruism—to offer help to others; and this can boost their self-esteem.
(5) Group therapy sessions offer a supportive environment in which to practice basic social skills. When these potential benefits are combined, it is not surprising that group therapies can sometimes be very beneficial for the persons who participate in them.
Marital and Family Therapies: Therapies Focused on Interpersonal Relations:
Although group therapies take place in settings where several people are present, these therapeutic approaches often search for the roots of mental disorders in processes operating largely within individuals for instance, in inner conflicts, faulty habits, distorted self-concepts, faulty learning.
In contrast, two other kinds of therapy marital therapy and family therapy focus on the potential role of interpersonal relations in mental disorders and psychological problems. In other words, therapies in this category assume that individuals experience personal problems because their relations with important persons in their lives are ineffective, unsatisfying, or worse. Let’s now examine two important forms of therapy that adopt this interpersonal perspective.
2. Marital Therapy- Spouses as the Intimate Enemy:
In the United States and many other countries, more than 50 percent of all marriages now end in divorce. Moreover, the marriage rate has dropped sharply in recent years; it seems that young people may see these odds in increasingly unfavorable terms. Of course, keeping people in joyless marriages or mutually destructive relationships is definitely not a goal of therapy.
Rather, marital therapy (sometimes termed couples therapy) is designed to help couples who feel that their marriage is worth saving. In addition, marital problems are related to several mental disorders, including depression, anxiety, and drug dependency so marital therapy can be beneficial in helping people avoid these problems.
Before turning to the procedures used in such therapy, however, let’s first consider a very basic question- What, in your opinion, is the number one reason why couples seek professional help in the first place? If you guessed “sexual problems,” guess again; such difficulties are a distant second on the list. Problems relating to communication are far and away the number one cause of difficulties.
People entering marital therapy often state that their partner “never talks to them” or “never tells them what she/he is thinking.” Or they report that all their partner ever does is complain. “He/she never tells me that he/she loves me,” they remark. “All he/she does is tell me about my faults and what I’m doing wrong.” Given that couples begin their relationships with frequent statements of mutual esteem and love, the pain of such faulty communication patterns is doubled. Each person wonders what went wrong and then generally blames his or her partner!
Now, back to the specific goals and procedures of marital therapy. One type, behavioral marital therapy, focuses on the communication problems I have just emphasized. Therapists work to foster improved communication in many ways, including having each partner play the role of the other person so as to see their relationship as the other does. Other techniques involve having couples watch videotapes of their own interactions.
This procedure is often a real eye-opener- “Wow, I never realized that’s how I come across!” is a common reaction. As communication between members of a couple improves, many other beneficial changes occur; for instance, the partners stop criticizing each other in destructive ways, express positive sentiments toward each other more frequently, and stop assuming that everything the other person does that annoys or angers them is done on purpose.
Once good communication is established, couples may also find it easier to resolve other sources of friction in their relationships. The result may then be a happier and more stable relationship a relationship that increases, rather than reduces, the psychological well-being of both partners.
Other forms of marital therapy focus not on specific skills that can help people get along better but on gaining insight into the causes of couples’ problems. Such insight marital therapy and behavioral marital therapy have both been found to be helpful. Couples who undergo such therapy are more likely to stay together and report being happier than couples who do not.
3. Family Therapy- Changing Environments That Harm:
Let’s begin with a disturbing fact: when individuals who have been hospitalized for the treatment of serious mental disorders and who have shown improvements return home, they often experience a relapse. All the gains they have made through individual therapy vanish.
This fact points to an unsettling possibility: Perhaps the problems experienced by such persons stem, at least in part, from their families from disturbed patterns of interaction among family members. To the extent that this is true, attempting to help one member of a family is not sufficient; unless changes are made in the family environment, too, any benefits they have experienced may disappear once they return home.
Recognition of this important fact spurred the development of several types of family therapy; therapy designed to change the relationships among family members in constructive ways.
Such therapies differ in form, but most are based on the following concepts suggested by systems theory, an approach that views families as social systems:
(1) Circular causality—events within a family are interrelated and cause one another in reciprocal fashion;
(2) Ecology—families are integrated systems, so change in one member will affect all other members; and
(3) Subjectivity—each family member has her or his personal view of family events.
Together, these ideas emphasize the importance of working with all family members. Family members are in constant contact with one another and create an environment in which all exist.
What specific techniques does family therapy involve? Family systems therapy an approach closely linked to the concepts mentioned above assumes that relations among family members are more important in producing mental disorders than aspects of personality or other factors operating largely within individuals. This approach also assumes that all members of the family influence one another through the complex network of their relationships.
How does family systems therapy work? Here’s an example. Consider a highly aggressive boy who is getting into lots of trouble in school and elsewhere. A family systems approach would assume that this youngster’s difficulties stem, at least in part, from disturbed relationships between him and other family members.
Close observation of interactions among the family members might reveal that the parents are locked in bitter conflict, with each trying to recruit the boy to their side. The result, he experiences tremendous stress and anger and directs this outward toward schoolmates and others. Understanding the dynamics of this family, in short, can provide insights into the causes of the boy’s problem. Changing these dynamics, in turn, could help to reduce his difficulties.
In contrast, behavioral approaches (sometimes known as problem-solving therapy) emphasize teaching family members improved, non-coercive ways of communicating their needs and ways of acting that prevent or reduce conflicts.
Does family therapy work? Research findings indicate that in many cases it is quite successful. After undergoing such therapy, family members are rated by therapists, teachers, and other observers as showing more adaptive behavior and better relations with one another than was true before the therapy. And family therapy does seem to help reduce problems experienced by individual members. However, as has been the case with many forms of therapy involving several persons, most research on the effectiveness of family therapy has been somewhat informal in nature.
4. Self-Help Groups- When Misery Derives Comfort from Company:
When we are anxious, upset, or otherwise troubled, we often seek comfort and support from others. Long before there were psychologists and psychiatrists, people sought informal help with personal difficulties from family members, friends, or clergy. This tendency to seek help from people we know, even if they are not professionals, has taken a new form in self-help groups.
These are groups of persons who are experiencing the same kinds of problems and who meet regularly, without professionally trained leaders, to help one another in their efforts to cope with these difficulties. Self-help groups are a fact of life; indeed, it has been estimated that more than 5 percent of all adults in the United States are or have been involved in such groups. What kinds of problems do these groups address?
Almost everything you can imagine; in fact, several different types of groups, focusing on contrasting kinds of problems, exist. Habit disturbance self-help groups focus on specific behaviors (e.g., Alcoholics Anonymous, Gamblers Anonymous). General-purpose self-help groups address a wide range of difficulties (e.g., the death of a child or spouse, childhood sexual abuse, being a single parent, divorce, stuttering, and breast cancer).
Lifestyle organizations support individuals such as single parents or the elderly who feel that they are being treated unfairly by society (e.g., Parents without Partners, Gray Panthers). Physical handicap organizations offer support to people with heart disease and other medical conditions (e.g., Mended Hearts).
Significant-other organizations provide support and advocacy for relatives of disturbed persons (Gam-Anon for relatives of compulsive gamblers, Al-Anon for relatives of alcoholics). Finally, reflecting the tragic effects of AIDS, a growing number of self-help groups now focus on assisting persons who have been diagnosed with this illness as well as their friends, relatives, and significant others.
Do self-help groups succeed? Few scientific studies have been conducted on this question, partly because the groups themselves often strictly guard their privacy; but there is some indication that they can be beneficial. In any case, these groups do provide members with emotional support and help them make new friends. These outcomes alone may justify their existence.
5. Psychosocial Rehabilitation:
The development of effective drugs for treating serious mental disorders during the 1950s and 1960s resulted in the release of large numbers of persons from public mental hospitals. Many applauded the deinstitutionalization trend, the shifting of patients from public hospitals to the community. But positive reactions to this change were soon muted by the fact that many of these persons failed to receive regular treatment of any kind after their release. The result? Many were unable to deal with the problems of everyday life and drifted into unemployment and homelessness.
As recognition of these sad facts has grown, efforts by psychologists and other mental health professionals to reach such persons and to help them deal with their disorders increased.
Such efforts, known as psychosocial rehabilitation, center on teaching patients with serious mental disorders (schizophrenia, major mood disorders) to cope more effectively with their disorders and, especially, to avoid or lessen the crises that often stem from these disorders and make it virtually impossible for these patients to function in society.
Psychosocial rehabilitation, in short, does not attempt to cure serious mental disorders; rather, it seeks to help persons with such disorders live as close to a normal life in the community as possible. Efforts to assist patients through psychosocial rehabilitation focus on achieving several goals.
First, a key goal is to help such persons understand their disorders so that they can cope with them more effectively. For instance, patients may be taught to recognize early warning signs of deterioration and to avoid high-risk situations. Those with schizophrenia can be taught to recognize the hallucinations that often precede psychotic breaks and lead to arrest or hospitalization. Such steps can help individuals with serious mental disorders avoid serious trouble.
Second, psychosocial rehabilitation focuses on teaching patients the practical skills they need to live in the community how to use public transportation, shop for groceries, prepare meals, and interact with other persons.
Third, efforts are made to have a single professional coordinate effort to help the patient efforts with respect to employment, housing, nutrition, transportation, medical care, and finances. Such case management helps to ensure that patients get all the help available to them and do not “slip between the cracks.”
Growing evidence suggests that psychosocial rehabilitation works. It helps keep persons with serious mental disorders from having relapses or from experiencing serious problems with the law. However, such programs are most beneficial if they continue on a regular basis.
Essay # 6. Prevention of Mental Disorders:
The 1960s were a time of social turmoil in the United States and many other countries. Traditional ways of doing things were questioned and rejected in many spheres of life, ranging from education to styles of dress. The field of mental health was no exception to the currents of change that swept through U.S. society, and one of the key shifts to emerge was the development of what came to be known as the community mental health movement a new approach that focused on treating people with mental disorders in their local communities rather than in distant, huge, and often impersonal public mental hospitals. This movement was fueled, in part, by the passage of legislation that provided funds for the construction of community mental health centers throughout the United States.
While the community mental health movement produced many beneficial effects, it did not achieve all of the challenging goals it established for itself; and in some respects it was not fully in keeping with the scientific approach to mental disorders preferred by psychologists.
But the movement did lead, gradually, to the emergence of a new subfield of psychology known as community psychology; an approach that focuses on promoting mental health through positive change in the community. The field of community psychology is identified by several additional principles as well.
First, it adopts an ecological perspective, the view that the causes of mental disorders stem, at least in part, from the social, economic, and physical environments in which people live, factors such as poverty, disintegrating communities, and poor schools, to name just a few.
This perspective contrasted sharply with the traditional view that mental disorders stem entirely—or at least primarily—from factors within individuals. Because ecological factors often play a role, community psychologists argued, effective treatment of mental disorders should involve efforts to change the social systems in which people live, not just the people themselves.
Second, and perhaps most important of all, community psychology emphasizes prevention—interventions designed to prevent mental disorders from developing in the first place. Three distinct types of prevention became the focus of attention- primary prevention, secondary prevention, and tertiary prevention.
The term primary prevention refers to efforts to prevent new psychological problems from occurring. These efforts include programs aimed at both counteracting risk factors and strengthening protective factors—factors that prevent mental disorders.
Most programs of primary prevention emphasize the following goals- encouraging secure attachments and reducing family violence, secure attachments to parents or other caregivers appear to play a crucial role in children’s healthy development; teaching effective problem-solving skills—skills that help people get along with others and regulate their own behavior; changing environments—making environments more supportive in many different ways; enhancing stress-coping skills—skills that help people deal with the major stressors they encounter in their lives; and promoting empowerment—helping people who, because of old age, poverty, homelessness, minority status, or physical disability, feel that they have little or no control over their own lives.
Programs directed toward such goals must often involve an ecological approach that addresses the social and physical environments in which people live. For example, do we want to reduce the incidence of child abuse and the harmful effects it produces? Then we must, according to the ecological view, do more than simply provide counseling to parents; we must also try to counter the adverse effects of poverty so that parents have the resources to form warm, supportive bonds with their children and so that they experience less stress (e.g., stress generated by their inability to find decent affordable housing).
In contrast, secondary prevention focuses on groups of people who are at risk for developing a disorder and involves efforts to detect psychological problems early, before they have escalated in intensity. Diversion programs aimed at helping juvenile offenders in the criminal justice system, provide an example of secondary prevention.
It is a well-established fact that once young offenders are placed in prisons, they become more likely to continue their dangerous antisocial behaviors; such institutions are often more like training schools for criminal activities than anything else. In diversion programs, young offenders are steered away (diverted) from such institutions and given another chance to learn social skills and patterns of behavior that may help them lead happier and more productive lives.
A third type of prevention, tertiary prevention, involves efforts to minimize the long-term harm stemming from mental disorders. Such programs are especially helpful for persons who are released from state facilities after years of confinement. One such program, Training in Community Living, attempts to repair the damage done by long years of what may amount to custodial care by teaching former mental-hospital patients the skills they need to live out in the community.
The former patients are provided with living quarters and are visited every week by program staff. In other words, they are out in the community but are living in a protected environment, where they can learn the skills they need for an independent life.
In sum, efforts at preventing or minimizing the harm of mental disorders do often seem to be quite effective. Their goal—like that of all forms of therapy—is reducing human suffering; but by operating before serious disorders occur, such programs take full advantage of the wisdom in the old saying “An ounce of prevention is worth a pound of cure.”