Occupational therapy is incorporation of intervention strategies to counter the stigmas associated with disabilities via therapeutic deployment of dairy activities. It demands the requisite skills of occupational therapy assistants and or occupational therapists.
Occupational therapy (OT) helps people achieve independence in all activities that are normally performed by people without disabilities at ease. The intent of performing such involving tasks in the sense that it entails intensive training in the ways of doing things which seem impossible by some challenged persons especially children, is to make them live life to the fullest. OT helps to empower children to achieve exemplary results through improved cognitive abilities, self esteem, physical abilities and above all giving children a sense of accomplishment. According to the mission of the American occupational therapy association (AOTA), OT goes beyond addressing issues to do with individual physical challenges to embrace social, psychological and environmental factors. All the other factors, apart from the physical challenges facilitate functionality of such people in different ways and hence vital for incorporation in the health care of both kid and adults.
In an attempt to enable challenged people live their life to the fullest, AOTA, performs an evaluation at an individual level in which the AOTA staff determines the clients goals and aspirations in life and derive customized intervention strategies to arrive at the goals set out in the initial phase. Finally, they examine the results against the initially stipulated strategies. Where the anticipated results fails to merge the actual results, then the therapy crew make appropriate adjustments to the intervention plan. The prerogative of OT is to adapt the environment to adopt the client. Furthermore, the client forms an intrinsic element of the OT team.
Reflecting on Jacob’s physical situation: he was born with very short arms that rendered him comparable with a person with both hands amputated and deserved an artificial limb on one leg and a brace on the other leg, OT, interventions to make him live his life to the fullest , reminiscent to the chores of the AOTA, were amicably required. Urgent, change of conception of teachers that he really needed one on one assistant was crucial as it serves to inculcate a feeling of low self-esteem and therefore an enormous hindrance toward achieving personal independence. To participate in core activities just like other children, Jacob needed a universal cuff that would see him able to hold items such a paper and a pencil. He also deserved OT interventions to enable him ride on school bus just like other kids. This required his ability to fasten his seat belt fast enough as well as ‘unbelting’ it. Due to his condition, a customized and adapted chair was required to allow him adjust his body position both horizontally and vertically. On extracurricular such gym, media art and music additional specifics were required. For instance, his talent in painting had to be backed with appropriate interventional to enable him carry paints on a tray. The various successful therapeutic interventions changed Jacob from an ‘I cannot’ individual to an award-winning child. The various achievements obtained by Jacob not only brought fame and recognition on his part, but also on his occupational therapy assistant and his family. In a big way, the transformation of Jacob exemplifies the noble roles the organizations such AOTA play to help light up people’s lives irrespective of their challenges.
The discoveries in the research of stem cell properties have transformed approach to the treatment of multiple diseases. Nowadays, several types of stem cells are distinguished – totipotent, pluripotent, unipotent, etc. – and they all differ in their capacity to differentiation and proliferation. The investigation of adult stem cells and induced pluripotent stem cells is of increasing interest as these cells have the most potential for the restoration of myocardial infarction-induced tissue damages. The application of cell-based therapy in the treatment of cardiac disorders is underinvestigated, but the recent clinical research findings already reveal some promising results.
It is possible to define stem cells as the structures capable of transforming into functionally active cells. A stem cell can grow into a hepatocyte, a nephrocyte, a cardiomyocyte, etc. (Kin et al., 2013). By their nature, stem cells serve as reserve material needed for the formation of new cells replacing dead or damaged ones.
The main property of any stem cell is its potency which is defined by the level of its differentiation and proliferation (Kin et al., 2013). The potency is the strictly limited cell’s capability to be transformed into particular types of cells. The larger number of cell types can derive from a stem cell, the greater its potency.
For example, fibroblasts can transform into endothelial cells and adipocytes while mesenchymal stem cells can form cardiomyocytes, muscle fibers, etc. (Kin et al., 2013) It means that each stem cell can transform into a limited spectrum of cells which share a set of similar qualities and functions. Based on such limitations in potency, stem cells are divided into totipotent (transforming into all kinds of organ and tissue cells), pluripotent (transforming into several types of organ cells), and unipotent (transforming into cells of one particular organ).
Totipotent Stem Cells (TSCs)
Totipotency is the property of embryonic stem cells that comprise an organism up to the eight-cell stage of embryogenesis. It is impossible to obtain TSCs in the natural conditions and, nowadays, they are cultivated in vitro through artificial fertilization. TSCs are primarily used in animal experiments and organ engineering. Although the first embryonic mouse stem cell was isolated over twenty years ago, there is still no sufficient evidence that their implantation in a human body can be efficient in the treatment of chronic diseases (Krause, Schneider, Jaquet, & Kuck, 2010).
Pluripotent Stem Cells (PSCs)
Embryonic PSCs
PSCs develop at the late phase of embryogenesis when stem cells become “specialized to give rise to only a specific family of cells” (Sharma, Voelker, Sharma, & Reddy, 2012). At the later stages of embryo development, the segregation of primary organ structures and tissues commences. These elementary structures consequently become the basis for the development of all body organs, and evolvement of mesenchymal, neural, blood, and connective tissue PSCs.
Adult PSCs
Throughout the life span, cells of the human body go through life cycles of death and renewal. The restoration of lost cells is possible due to cambial elements – proliferating tissue-specific cell populations in the skin, intestine, muscles, red bone marrow, liver, and brain (Kin et al., 2013). Recently, researchers isolated adults’ cells which are capable of differentiating not only in tissue-specific directions but in the cells of other origins in multiple organs (Kin et al., 2013).
The discovery of adult stem cells helps to take a look at the issues of tissue renewal from a different perspective and change the conception of cellular and genetic therapy. The research of adult PSCs and their impact on recovery processes is one of the most topical tasks, and the significance of research studies in this area is emphasized by the opportunity to use stem cell technologies in the treatment of different cardiac diseases.
Mesenchymal stem cells (MSCs)
MSCs are regarded as the major elements of cell-based therapy. They are pluripotent and can be differentiated into bone, fat, muscle, neural, and other cells. The main source of MSCs is bone marrow but recently they were isolated from subcutaneous adipose tissue and cord blood. The advantage of MSCs’ use in treatment is the opportunity to implant the patient’s genetic material and avoid an adverse immune reaction and rejection of transplant (Sharma et al., 2012).
Cardiac stem cells (CSCs)
Myocardium-derived cellular elements can be differentiated into cardiomyocytes and vascular endothelium (Sharma et al., 2012). Transplantation of such cells in the area of myocardial infarction leads to the development of new cells in the damaged zone. As a result, the organ functions can be substantially restored. However, the methods of CSC isolation are very complex and are associated with the destruction of heart muscular tissue.
Induced PSCs (iPSCs)
Induced PCSs are cultivated from non-pluripotent cells through the process of enforced inducement which implies gene or protein transcription under the influence of particular induction factors and transition of genetic material via viral vectors (Kobayashi, Nagao, & Nakajim, 2013). It is considered that iPSCs are identical to natural PSCs. However, it is observed that the cells cultivated by viral transfection are prone to the occurrence of oncologic diseases (Kobayashi et al., 2013). Therefore, researchers make efforts to find other methods of gene transition needed for the development of healthy stem cells.
AMF triggers abrupt discontinuation of the coronary circulation. As a result, irreversible destruction of heart muscle cells occurs. The extent of cell death due to AMF is proportionally correlated with the diameter of an impaired blood vessel in which blood circulation stops. Present-day methods of treatment do not target the loss of tissue caused by AMI, and the researchers consider that bone marrow-derived stem cell treatment can significantly enhance the overall treatment outcomes – improve heart function and delay the progression of disorder (Clifford et al., 2012).
Another group of researchers investigated iPSC-derived cardiomyocytes AMI therapy. Santoso and Yang (2016) found that the iPSC therapy provokes such challenges as low cell survival rate, low level of cell engraftment, and “nonsustained contractility” as well as the difficulties in the monitoring of injected cells’ viability (p. 1).
The common cell delivery techniques are intracoronary stem cell injection and intramyocardial injection. The intracoronary method includes percutaneous transluminal coronary angioplasty and the use of an “over-the-wire balloon with central lumen placed at the desired position” (Sharma et al., 2012). Intracoronary injection of cells is administered up to six times and the surgeons artificially stop blood flow to increase cell retention. The intramyocardial injection is an invasive procedure. However, it is associated with a higher level of organ engraftment (Krause et al., 2010).
It is possible to say that bone marrow-derived stem cell (including MSCs) treatment can be regarded as a better option for AMI intervention because MSCs demonstrate a significant capacity of myocardial repair (Sharma et al., 2012). The meta-analysis of preclinical and clinical studies conducted by Clifford et al. (2012) makes it clear that along with moderate heart function improvement, it is associated with reduced safety concerns although “does not decrease mortality..significantly in the long-term follow-up” (p. 4).
The recent breakthroughs in stem cell research have a positive impact on the development of effective interventions for various diseases. However, despite the great potential of PCS-based therapy in the restoration of myocardium damages, the further investigation of best cell type and best delivery technique issues is needed.
References
Clifford, D. M., Fisher, S. A., Brunskill, S. J., Doree, C., Mathur, A., Clarke, M. J., &… Martin-Rendon, E. (2012). Long-Term effects of autologous bone marrow stem cell treatment in acute myocardial infarction: Factors that may influence outcomes. Plos ONE, 7(5), 1-9. Web.
Kobayashi, H., Nagao, K., & Nakajim, K. (2013). Human testis – derived pluripotent cells and induced pluripotent stem cells. Pluripotent Stem Cells. Web.
Krause, K., Schneider, C., Jaquet, K., & Kuck, K. (2010). Potential and clinical utility of stem cells in cardiovascular disease. Stem Cells and Cloning: Advances and Applications SCCAA, 49. Web.
Santoso, M. R., & Yang, P. C. (2016). Magnetic nanoparticles for targeting and imaging of stem cells in myocardial infarction. Stem Cells International, 1-9. Web.
Sharma, R., Voelker, D., Sharma, R., & Reddy, H. (2012). Understanding the application of stem cell therapy in cardiovascular diseases. Stem Cells and Cloning: Advances and Applications SCCAA, 29. Web.
Albinism is a rare and complex genetic disorder affecting the body’s melanin production. A lack of pigmentation in the skin, hair, and eyes typically characterizes it. Due to significant visible manifestations, albinism has many social implications, including the discrimination and stigma faced by those living with it. Apart from that, it can lead to various medical issues, including vision, hearing, and skin sensitivity to sunlight. Treatment options for albinism vary, including protective clothing and sunscreen, vision therapy, and surgeries. In recent years, various research has been conducted to understand the genetic basis of albinism better and to develop new treatments and therapies (Liu et al. 352). Hence, this essay will examine specific biological causes and symptoms of albinism, available treatments and therapies, and the latest research findings.
Genetics of Albinism
Albinism is an inherited condition that is caused by a mutation or deletion of the genes responsible for melanin synthesis. As a consequence of these genetic alternations, an affected individual lacks pigment in their skin, hair, and eyes (Oetting and Adams 1). Namely, it is caused by gene mutations that code for proteins involved in synthesizing the pigment melanin. Among the most frequent clinical manifestations of albinism belongs oculocutaneous albinism (OCA), which is caused by mutations in one of a group of genes known as the OCA genes. These genes code for proteins in synthesizing the pigment melanin, which is responsible for skin coloration, hair, and eyes (Ray et al. 352). Depending on the gene involved, OCA can be inherited in an autosomal dominant, recessive, or X-linked manner (Ray et al. 353). In autosomal recessive OCA, two copies of the mutated gene must be present for the condition to be expressed (Ray et al. 353). If only one of the parents is confirmed to have the mutated gene, their child will not necessarily have the condition.
People with the same mutated genes have a higher chance of contracting albinism to the child. When a female carries the mutated gene, there is a 50% chance that her sons will be born with OCA and a 50% chance that her daughters will be carriers of the condition (Kerr and Kromberg 240). Regardless of which type of OCA is present, the condition is caused by mutations in genes that code for proteins in synthesizing the pigment melanin. In some cases, these mutations can be inherited either from one or from both parents, while in other cases, they can occur spontaneously.
Inheritance of Albinism
Albinism is an inherent disorder that is inbred in an autosomal recessive pattern. This means that for a person to have albinism, they must inherit two mutated gene’s copies, one from each parent. If a person has only one mutated gene’s copy, they are said to be carriers and will not have any physical characteristics associated with albinism. When both parents are carriers of the mutated gene, there is a 25% chance with each pregnancy that the child will have albinism (Kerr and Kromberg 240). It is also possible for a person to have albinism even if neither of their parents is a carrier. This is because the mutated gene can spontaneously mutate in the egg or sperm that forms the embryo. Albinism is caused by mutations in the gene that produces an enzyme called tyrosinase. Tyrosinase produces melanin, the pigment that gives skin, hair, and eyes their color.
Mutations in this gene produce a non-functioning or reduced amount of tyrosinase, resulting in a lack of pigment, mostly in the skin, hair, and eyes. Albinism is not contagious or progressive and does not affect a person’s life expectancy. The disorder is present at birth and is lifelong, and it is also not linked to any other medical conditions. While there is no cure for albinism, it can be managed with proper sun protection and vision care. Albinism is a rare disorder, affecting only 1 in 17,000 people in the United States (Altınbay 150). However, it is much more frequent in certain ethnic groups, such as people of African or Asian descent. Hence, it is crucial to be aware of the inheritance pattern of albinism and the higher incidence of the disorder in certain ethnic groups.
Symptoms of Albinism
Albinism causes vision problems due to a lack of melanin or an insufficient amount of melanin in the eyes. As a result, albinism can cause vision problems such as reduced visual acuity, photophobia, and nystagmus (OECD 57). These vision problems can range from mild to severe and may be corrected with glasses or contact lenses. In some cases, vision problems associated with albinism may not be able to be corrected and may lead to permanent vision loss (Altınbay 154). The iris cannot contract and relax appropriately due to the lack of pigment, leading to increased sensitivity to light (Liu l5304). This problem is because of the lack of pigment in the eye, which affects the structure of the eye and how light enters and is processed by the eye (Altınbay 154). It can lead to decreased focus and reduced ability to distinguish between colors.
Moreover, albinism causes skin discolorations caused by reduced or absent melanin production. The most common skin discolorations associated with albinism are pinkish, yellowish, and greyish. People with albinism may also have white hair, which may be brittle and fragile (Nakkazi 553). Additionally, they may be susceptible to sunlight and be at risk for sunburn and skin cancer. People with albinism may have lighter-colored eyes than the general population. In some cases, the eyes may appear to be pink, blue, or even red. This is because the lack of melanin in the iris causes the underlying blood vessels to be visible. Hence, skin discolorations are one of the significantly visible symptoms of albinism.
Albinism can also cause hearing problems because it can affect the development of the middle ear and the bones that transmit sound to the inner ear. It can also affect the development of the auditory nerve carrying sound signals to the brain from the inner ear (Brody 93). Hearing loss can sometimes be helped with hearing aids or other devices. The inner ear comprises the semicircular canals and the vestibular system. The semicircular canals are responsible for maintaining balance and the vestibular system helps with head movements. The hair cells in the inner ear are sensitive to melanin because they contain tiny structures called melanosomes which help to absorb and transmit sound waves. When there is a decrease in melanin production, the melanosomes cannot absorb the sound waves effectively, resulting in hearing loss.
Furthermore, sunburn is another sign of albinism which results from ultraviolet rays (UV). People with albinism have very little protection from the sun’s ultraviolet rays, and as a result, they are more sensitive to the sun than people with normal pigmentation. This sensitivity can cause several health problems, including sunburns, skin cancer, and vision problems. The primary reason why people with albinism are so sensitive to the sun is that they lack the protective pigment melanin. Melanin absorbs UV light and helps protect skin from sun damage (Hartshorne and Manga 122). Without it, UV radiation can penetrate the skin more quickly, leading to sunburns, skin cancer, and other problems. Finally, people with albinism are more likely to display a deficiency of vitamin D, which puts them at an elevated risk for sunburn and skin cancer. When exposed to UV light, vitamin D is produced in the skin, and people with albinism may have difficulty producing enough vitamin D to protect against sun damage.
Treatment of Albinism
Surgery is one of the options available to treat individuals with albinism, and it can be used to correct various issues associated with the condition. One of the primary goals of surgery for albinism is to improve vision. This is often achieved through a procedure known as iris implantation. In this procedure, an artificial iris is implanted into the eye to enhance the patient’s vision, and it can also help to reduce the risk of photophobia (Liu et al. 375). Surgery can also be used to correct the cosmetic appearance of albinism. This is often done through skin grafting, where healthy skin is taken from another body area and transplanted onto the affected area. This can help to improve skin tone, reduce the appearance of pale spots, and create a more natural look.
Cosmetics can also be used to help people with albinism to achieve a more balanced skin tone. The first step in using cosmetics to treat albinism is identifying the right shade of foundation. Most people with albinism have very fair skin, so it is essential to choose a slightly darker foundation than the person’s natural skin tone. This allows the foundation to blend in more naturally and to provide even coverage. After the foundation has been applied, the next step is to use a concealer. Concealers are available in shades slightly darker than the foundation, specifically designed to cover up darker patches of skin. Using a concealer can help to reduce the appearance of any dark spots or patches on the skin, resulting in a more even complexion. The final step is to use a bronzer. Bronzers are available in various shades, from light to dark. Thus, applying a slightly darker bronzer than the foundation makes it possible to create a subtle sun-kissed effect that helps to even out the complexion.
Additionally, sun protection is an essential part of treating albinism. Sun protection helps to prevent photodermatitis and skin cancer, which are common in people with albinism. Sun protection also helps to reduce the risk of vision complications, such as photophobia and cataracts, which can be caused by prolonged exposure to ultraviolet (UV) radiation. The best way to protect people with albinism from it is to limit their exposure. It can be done in many ways, for instance, by wearing a wide-brimmed hat, long-sleeve shirts, and long pants. It is also essential to use SPF sunscreen and to apply it generously to all exposed skin. Sunscreen has to be reapplied every two or more hours if the person is sweating or swimming. It is also essential to avoid being outside when UV radiation is at its peak during the middle of the day. People with albinism should stay out of direct sunlight, and if they must be outside, they should remain in the shade most of the time.
Besides, special glasses or contact lenses can help treat albinism and some of its associated vision problems. Glasses or contact lenses can block out the glare caused by the sun, which can be incredibly bothersome to people with albinism. These lenses can also help to reduce the amount of light that enters the eyes, which can help to reduce eye strain. Special glasses and contact lenses protect the eyes from UV light, which can be damaging to people with albinism. By blocking out the UV light, these lenses aid in reducing the risk of developing certain eye diseases, such as cataracts, which can be more common for people with albinism. In summary, special glasses and contact lenses significantly improve the quality of life for those with albinism.
Latest Studies Concerning Albinism
Albinism is associated with many eye conditions that raise concerns about new treatments. The latest albinism research, titled “Stem cell model of albinism to study related eye conditions,” suggests that albinism is caused by a genetic mutation in a gene known as the CACNA1F gene (NIH). Albinism is associated with a lack of pigmentation in the skin and eyes and other eye conditions such as nystagmus, photophobia, and reduced visual acuity. To further understand the effects of this gene mutation, the researchers conducted experiments using human pluripotent stem cells (hPSC) derived from albinism patients (NIH). The stem cells were then differentiated into three-dimensional retinal tissue, which could provide a model to study the effects of albinism in the eye.
The experiment results showed that the retinal tissue from the albinism patients did not produce melanin, confirming that the mutation of the CACNA1F gene causes albinism (NIH). Additionally, the retinal tissue from the albinism patients had structural abnormalities in other eye conditions associated with albinism. This further confirmed that albinism is associated with these other eye conditions. The experiment results suggest that hPSCs could be used to model albinism and related eye conditions. This could lead to new treatments for albinism and related eye conditions, as well as a better understanding of the underlying causes of albinism.
OCA is another eye condition that draws scholarly attention. In its context, “In Vitro Disease Modeling” research focused on developing a model to further the condition understanding (George et al. 173). OCA is an inherited genetic disorder characterized by skin, hair, and eyes lacking pigment. While OCA has been studied for many years, there has been limited understanding of the pathology of the disease and the effects of treatments. George and his team developed a mouse model to study OCA. The researchers used gene-editing techniques to create mice with mutations in the TYR and OCA2 genes associated with OCA. These mice displayed reduced pigmentation in the skin, hair, and eyes and various eye defects. The researchers then conducted several experiments to study the effects of treatments on the OCA mice (George et al. 173). They tested various eye drops and topical medications to see if they could improve the symptoms of OCA. They also investigated the effects of dietary supplements and laser treatments.
The experiments showed that some treatments might effectively improve the signs and symptoms of OCA. The researchers found that eye drops containing melatonin and topical medications containing vitamin D improved the pigmentation of the skin, hair, and eyes. They also found that dietary supplementation with vitamin A and lutein, as well as laser treatments, improved the eye defects in the OCA mice. Overall, the research provides new insights into the pathology of OCA and suggests potential treatments for the condition. The results suggest that various eye drops, topical medications, dietary supplements, and laser treatments may effectively improve the signs and symptoms of OCA.
Social Implications of Albinism
Albinism results in social stigma, which causes loneliness and stress among its victims. People with albinism are often treated differently from those without the condition and may be excluded from social activities or even, in some cases, be subject to discrimination and prejudice. This stigma is often based on the misconception that albinism is contagious or a sign of bad luck. People with albinism can also be victims of physical and verbal abuse, including bullying. Albinism can be a complex condition to live with and causes significant stress and anxiety for those affected (OECD 57). People with albinism need support from family, friends, and medical professionals to help them cope with the physical and emotional effects of the condition. Additionally, it is essential to spread awareness and understanding of albinism to reduce the social stigma associated with it.
Social isolation is another common experience among people with albinism. People with albinism often experience a lack of acceptance and belonging in their communities due to physical differences. These disparities can lead to social exclusion, teasing, and bullying. Furthermore, the lack of pigment in the skin and eyes can result in vision problems such as decreased vision, nystagmus, and photophobia. This effect can further lead to social isolation as people with albinism may feel unable to participate in activities or feel uncomfortable in social situations. Individuals with albinism may be discriminated against due to their physical appearance (Clarke and Beale 263). This can lead to further social isolation as people with albinism may feel uncomfortable or unwelcome in specific social settings. People with albinism often face low self-esteem, affecting their social ability and leading to social isolation. Therefore, creating and maintaining an environment of acceptance and understanding is essential to help people with albinism feel included and valued in their communities.
Additionally, bullying and teasing at school can begin with general prejudices and misconceptions about albinism. People with albinism may be seen as different, and students can make fun of their physical features or make negative comments about their appearance. Students may make jokes or comments about the medical aspects of albinism, such as vision problems, which can further lead to teasing and bullying. People with albinism may also experience bullying because of their physical differences, as other students may feel uncomfortable about their skin or eye color (Clarke and Beale 261). Thus, bullying and teasing of people with albinism at school can arise from various factors, from general prejudices and misconceptions to a lack of understanding about the condition. Schools and teachers need to recognize the potential for bullying and take steps to prevent it.
Albinism also comes with invisibility in mainstream media among their victims. It is often portrayed as a mysterious, magical condition, and albino characters are often described as having the power of invisibility in the mainstream media. This has created a false and negative impression of albinism in the public consciousness, suggesting that people with albinism are supernatural, exotic, and even dangerous. The invisibility of people with albinism in media has contributed to their invisibility in real life, where they often face discrimination and prejudice. In order to counter this negative portrayal of albinism in mainstream media, albino characters should be portrayed in a more positive, realistic, and accurate light. This could reduce the discrimination and stigma that people with albinism often face and help to create a more inclusive society.
Conclusion
Albinism is a condition that affects both the biological and social aspects of life. On the biological side, albinism is an inherited genetic disorder caused by a lack of melanin in the body. It can cause various physical symptoms, ranging from vision and skin-related issues. On the social side, albinism is often stigmatized, leading to discrimination and prejudice against people with albinism. This can result in a lack of social integration and limited job opportunities. It is important to remember that albinism is a condition that does not define a person, and people with albinism should be treated with respect and understanding. Thus, it is vital to be aware of albinism’s medical aspects and be sensitive to the social implications of the condition. With increased awareness and understanding, people with albinism can live full and happy lives.
Works Cited
Altınbay, Deniz. “Refraction and Low Vision Rehabilitation in Patients with Oculocutaneous Albinism.” Pakistan Journal of Ophthalmology, vol. 36, no. 2, 2020, Web.
Brody, David L. “Hearing Problems.” Concussion Care Manual, vol. 1, no. 1, 2019, pp. 138–140, Web.
A number of approaches have been developed by various theorists and psychologists in order to help at managing psychological disorders. Cognitive behavior group therapy and Yalom’s therapy model are considered to be one of the most reliable approaches to evaluate problems within dysfunctional emotions and behaviors.
In this paper, these two models will be analyzed and evaluated in terms of their similarities and differences: the essence of Yalom’s model and cognitive behavior group therapy model, their objectives and structures, and group membership.
Theory
Cognitive behavior group therapy, also known as CBGT, is an approach that is used during the group therapy in order to treat different variants of social phobia. CBGT is one of those models, which can be used in treatment under certain inpatient settings (Christner et al., 2007, p. 509).
Yalom’s therapeutic model assumes that interpersonal interaction is essential for the success of group therapy. Yalom himself suggested that change through group therapy is a complicated process that is facilitated by interplay of human experiences, which he considered as the therapeutic factors.
The theory of cognitive behavior group therapy is based on the ability to conceptualize information for each member of the group and the group as one whole. It is necessary to identity the problem that causes psychological problems and working on the problem so as find workable solutions based on the problems.
This model utilizes the Socrates’ way of knowledge unlike the Yalom’s model because the therapists have a desire to know much about the client using the technique of questioning. It is also based on educational model of doing things with the assumptions that all behaviors and attitudes adopted by individuals are all acquired through learning process (Montgomery, 2002, p. 34).
In cognitive behavior group therapy, the goals of the entire process are set in accordance to the existing problems. It is then that thinking behaviors that are at the center of the behavior problem are modified. On the other hand, Yalom based his practice on the importance of therapeutic factors in finding solutions to psychological problems.
Some of the factors include instilling hope in the patients in order to help them manage their own problems. Therefore. in terms of theory, the two models are different in their own fundamental principles that guide their functionality to the patients.
Group Membership
The two models tend to be joined by the fact that both of them place much emphasis on the importance and relevance of here and now theory in group therapy. Concerning group membership, I can note that with cognitive behavior group therapy it can be applied to a group of people only.
Membership is limited to the one therapist to provide services to a number of clients. This can even be done over computer programs. In cognitive behavior group therapy, emphasis is not put much on the number of members attending the sessions with the therapist.
It works because the interaction between the therapist and the patients, and the patient and the patient actually matters in the success of the approach. To a greater extent, cognitive behavior group therapy is a collaborative process between the patients and their therapist. In other terms, if there is no cordial relationship between the two, then the approach cannot work at all (Yalom and Leszcz, 2005, 153).
This is unlike the case in the Yalom’s therapy model; whereby the whole thing is a group affair whereby the larger the numbers the better the clients benefit because they need each other’s experience so as to find solutions to psychological problems affecting them. Therefore the number of clients attending the sessions in this model really matters to the success of the approach.
Yaloms model does not need so much the collaboration between the client and the therapist. In terms of composition of members it is clear that Yalom’s model uses certain criteria in the selection of membership. For instance, exclusion criteria are often used in the selection process (Yalom and Leszcz, 2005, p.153).
Inclusion criteria are also adopted in the model, basing on the level of motivation between members. This is unlike the situation in the cognitive behavior model. But overall, both models of behavior change have membership and the involved members, who attend the therapy sessions for them to find solutions to their psychological problems.
Aims and Objectives
Looking at the aims and objectives of both models, it is vital to underscore the fact that both models aim at improving the behavior of the clients through the psychological processes (Callahan, 2004, p.502). They therefore help the client to overcome psychological problems that threaten their existence in the world.
Cognitive behavior group therapy model can be looked at to be targeting a patient-therapists communication and patient-patient communication as well in order to help solve psychological problems within the group and provide them with a chance to fight against their social phobia.
The Yalom’s model can be considered to be focused on creating a group environment to facilitate sharing of experiences between the clients in order to learn from each others experiences and solve their own psychological problems.
Process Structure
In terms of process and structure of the models, it is important to point out that Yalom’s model is organized in the way that the groups form the basic structure of the model. The clients with psychological problems are involved in certain group activities for their own benefits. Group participation in this model is greatly enhanced by creating the necessary cognitive structures and further clarification of misconceptions (Callahan, 2004, p.502).
However, in this model, group cohesiveness is emphasized because of the benefits, which are inherent to the group members. According to the proponent of this model, cohesiveness is a precondition for the success of the therapy, because it determines the functionality of the other therapeutic factors. Some of them are doomed not to work if this precondition is not adequately addressed.
This structure is not the same as that of cognitive behavior group therapy, whereby group cohesiveness is not a precondition for the success of the therapy. In this approach, the members do not enjoy the love and warmth of the other group members. The sense of belonging and unconditional acceptance in not found in the process of cognitive behavior group therapy because lack of this cohesiveness.
In group therapy and Yalom’s model, the clients in groups are likely to reach high levels of self-awareness unlike in the other case. This is through such important techniques like feedback that mainly imparts on the life of others, who are in the same group. This cannot be the same in the cognitive behavior group therapy (Corey 2005, p.461).
Furthermore, in Yalom’s model form of therapy, patients are thoroughly questioned and after the one discovers what he needs in life. It enables one understand a reality on issues such as death, this form obesity form according to enable one to understand how freedom and responsibility go hard in hard. Yalom includes one specialist and an individual faced with a problem. One person is thoroughly questioned unlike for CBT where we can have a group of people therapy 6- 10.
According to there is no fixed life for an individual. In Yalom’s form of therapy, the individual with a problem is the only one who meets with the therapist unlike for the CBT whereby we can have a group that can consist of six people or more. Another difference is that in Yalom’s model, one is asked questions and the help he gets depends on the evaluation made by the therapist (Corey, 2005, p.153).
In terms of process, it is important not to overlook the fact that, in both models, the feedback is provided and is quite essential for the personal development of each client. There is also the issue of giving out to receive in both models in the sense that in Yalom’s model one has to understand the value of giving before having the intrinsic drive to share out experiences with others and at the same time gain from others.
In the cognitive behavior model it becomes inevitable for the client to be willing to give out information after a cordial relationship is established with the therapist (Corey, 2005, p. 490). In both models, there is the imparting of information to the clients. This is normally through instructional methods, giving of advice and making suggestions to the clients. In both models, there is evidence of the therapist instilling the aspect of hope in the clients.
This is very essential to keep the clients in the process of therapeutic change. Without hope in the process, most clients would fall out before they archive the desired results. In Yalom’s model, faith is itself a therapeutic process and can facilitate change in the behavior of the client.
Conclusion
In conclusion, it is important to note that the two models of psychiatry under consideration share things, which are in common and differ in a number of areas as it has already been mentioned. The success of each of them remains attached to the commitment of both the client and the therapist in the process.
The interpersonal process within a group has had a considerable impact on me personally. Firstly, I have gained a lot in terms of self-awareness from both the group and even from the outside. From inside the group, I was able to interact with all the group members, and we had a very cordial relationship that facilitated openness to one another.
I could not believe hearing what some of my friends were revealing to me. From this interaction, I can say that I have been able to discover more about myself as an individual than I used to be in the past before the therapy. Outside the group, I managed to open up well to inside the group and was able to discover much about my behavior. During the therapy, I was involved in numerous group discussions too much, and it turned out to be very useful to me.
These group discussions were very free, and everybody was willing to give out his/her own contribution; such activities were actually too exciting, because as it was necessary, each shared own experiences and emotions (Christner, et al., 2007, p.359). It was very easy to respond to the questions from the group members and ask them more questions that helped to disentangle some mysteries.
Through this kind of feedback, it was so easy to find solutions to some of the behavior problems that I had. Another important issue to mention is all about the appearance in the group activities. I can say that my presence in the group was easily noticeable by other group members. Through the processes in the therapy, I also understood better what is actually required in terms of the group process.
Now, I better comprehend the issues, which are important for the success of the entire process: they are the composition of the group and proper selection of its members. Now, I am in the better informed position concerning the issue of group organization that should be planned on a high level (Christner, et al., 2007, p. 150) and participation of the members and this have had an impact on my organizational skills.
I am also able to form a group in the same setting and help the members go through the process successfully in order to get solutions to their psychological problems. The theory that I have learnt concerning psychological problems was easily applied in my real life situation. By this, I mean that I experienced instances of rising anxiety within me.
For instance, when there was an intense argument within the group members concerning an obvious issue. I was feeling anxious and I have gradually been able to manage the anxiety by applying the theories I have learnt toward the end. I never clued with any one in the group and other with me in the result of understanding of own feelings, values, and anxiety.
During the group activities, I cannot fail to mention that I managed to express emotions that I have not experienced in the past. For example, there is a group member, who gave out a very strong revelation, and I can tell that I was really feeling for her just because of what she has had to go through. The way, she brought out the story, got into me so much that I was feeling that I was the one going through the same situation.
My experience helped me to comprehend one simple idea that has been already suggested by many other scholars: interpersonal-psychodynamic group therapy is considered to be a really powerful means and approach for those, who want to improve own life and get rid of past problems (Callahan, 2004, p.491).
In general, I can conclude by noting that the group therapy, I went through, has greatly impacted on my life in a very positive way as far as psychological development is concerned. I have achieved self-improvement by means of the process of interaction with both the group members and outside the group.
Reference List
Billow, R. (2005). Bion Today. International Journal of Group Psychotherapy 55(4), 613-23.
Callahan, K. L., Price, J. L., and Hilsenroth, M. J. A Review of Interpersonal-Psychodynamic Group Psychotherapy Outcomes for Adult Survivors of Childhood Sexual Abuse. International Journal of Group Psychotherapy 54(4), 491-519.
Christner, R. W., Stewart, J. L., and Freeman, A. (2007). Handbook of Cognitive-Behavior Group Therapy with Children and Adolescents: Specific Settings and Presenting Problems. New York, NY: Routledge.
Corey, G. (2005). Theory and Practice of Counselling and Psychotherapy. Pacific Grove, CA: Brooks-Cole.
Joyce A., S., Piper W.E., and Ogrodniczuk J. S. (2007). Therapeutic Alliance and Cohesion Variables as Predictors of Outcome in Short-Term Group Psychotherapy. International Journal of Group Psychotherapy, 57(3), 269-97
Montgomery, C. (2002).Role of Dynamic Group Therapy in Psychiatry. Advances in Psychiatric Treatment, 8(1), 34-41.
Yalom, I. D. and Leszcz, M. (2005). The Theory and Practice of Group Psychotherapy. New York: Basic Books
Electroconvulsive Therapy (ECT) is a psychiatric treatment method introduced in the late 1920s to cure a number of psychological illnesses and disorders such as depression, maniacs, acute psychotic conditions and catatonia.
ECT basically involves the introduction of mild electronic current to the neurological pathways of an anesthetized patient’s brain which induces brief clonic seizures that are regarded to be curative to the patient. ECT treatment is normally carried out after a patient fails to respond to drugs and hence considered as a last resort.
The treatment is administered twice a week on average, over a period of three months to one year. There are two forms of ECT that vary in the way seizures are induced whereby the electric stimulus can either be introduced through electrodes placed on various parts of the patient’s cranium or through electrical waves.
Brief History of ECT
Seizures were originally induced using Camphor and Metrazol in an attempt to cure schizophrenia in 1928 by Ladislas J. Meduna, a neuropsychiatrist based in Hungary (Rose et al, 2003).
According to Faedda et al (2009), neuropsychiatrists Ugo Cerletti and Lucio Bini posited in 1937 that Metrazol could be replaced by electric shocks to stimulate seizures, a hypothesis that was supported by animal experiments. This proved to be a breakthrough in the psychiatry field and the procedure was subsequently adopted in the U.S and the U.K in the 1940s, being referred to as electroshock therapy (Faedda et al, 2009).
Attention soon shifted to the side-effects of ECT and consequently unilateral electrode placements and brief pulses were introduced in an effort to control memory disruption and other side-effects attributed to ECT. Succinylcholine, a muscle relaxant and anesthesia were later introduced to the treatment process in 1951 to help control the convulsions patients experienced since patients would at times fracture or break their bones (Faedda et al, 2009).
The American Psychiatric Association task force report released in 1978 outlined the requisite standards for ECT and largely recommended the treatment amid a rapid decline of ECT due to negative representation of the treatment in the media(Lutchman et al, 2001).
The National Institute of Mental Health and National Institutes of Health ECT conference in 1985 further underscored the benefits of the treatment (Duffett & Lelliot, 1998). The American Psychiatric Association task force report released in 2001 documented the contemporary standards and accentuated the need for training and civic education pertaining to ECT (Duffett & Lelliot, 1998).
Depictions of ECT in the media
It has been established through various studies that the perception of ECT among the public has either been neutral or negative. According to Lutchman et al (2001), the main reason for the negative opinion has been the misconstrued representation of ECT in the media especially in fictitious and semi- fictitious work such as movies, books and entertainment articles. Movies have in particular drifted from the essential norm of ECT to represent the therapy as a crass, barbaric, medieval and inhumane form of treatment.
Movies such as Frankenstein show ECT as a technique used to reanimate corpses, “Requiem for a Dream, Insanitarium, Next to Normal” and “One Flew over the Cuckoo’s Nest”, symbolize ECT as a torture device or a tool used to radically but provisionally control psychological disorders (Philpot et al, 2004).
Such representation has fundamentally demonized the procedure and promoted stigmatization among the public, the result being that fewer individuals want to undergo the treatment (Lutchman et al, 2001).
Significance of ECT
ECT is definitely an effective treatment for acute depression and bi polar disorders. Studies have revealed that antidepressant medication is not only mildly effective but costly as well. ECT on the other hand has been shown to typically have a remission rate of 60-70 % (Lutchman et al, 2001).
In addition, ECT has been shown to be less costly when compared to other forms of therapy and the pulse version of ECT is regarded to have minimal side-effects. ECT has however been publicized to have side-effects with some being severe, for instance the loss of memory and changes in the cognitive functions(Rose et al, 2003).
Experiments on patients undergoing ECT showed that some patients lost significant portions of their long term memory ranging from weeks to years prior to the instigation of the treatment (MacQueen et al, 2007). Other studies reported substantial cognitive deficits on patients with some failing to identify common or familiar objects (Philpot et al, 2004).
Some critics of ECT suggest that the procedure causes brain damage by stimulating extensive local hemorrhaging to certain areas of the brain and also damages numerous somatic and neural cells in the brain (Duffett & Lelliot, 1998). It has been observed that ECT is mostly effective when combined with drug therapy (Rose et al, 2003). Patients who undergo ECT as the only form of treatment are more likely to relapse hence a combination of drugs and ECT is the most effective form of treatment (MacQueen et al, 2007).
Conclusion
It is evident that the advantages of ECT far outweigh the disadvantages of the treatment. Patents suffering from bi polar disorders and psychotic states will normally have reduced cognitive functions hence the use of ECT under such circumstances does not adversely impair a patient.
The main disadvantage of ECT can be cited as the loss of memory, a condition that is reversible albeit gradually, after the patient is through with the treatment. ECT is therefore a beneficial procedure to mentally unstable patients especially individuals suffering from acute depression considering patients are normally suicidal and irrational.
References
Duffett, R and Lelliot, P. (1998). Auditing electroconvulsive therapy: the third cycle. British Journal of Psychiatry. Vol.17, No.2, pp.401–405.
Faedda, G., et al. (2009). The origins of electroconvulsive therapy: Prof. Bini’s first report on ECT. Journal of Affective Disorders. Vol.1, No.3, pp.12–15.
Lutchman, R. et al. (2001). Mental health professionals’ attitudes towards and knowledge of electroconvulsive therapy. Journal of Mental Health. Vol.10, No.20, pp.141–150.
MacQueen, G., et al. (2007). The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder. Journal of Psychiatry and Neuroscience. Vol.32, No.4, pp. 241–249.
Philpot, M., et al. (2004). Eliciting users’ views of ECT in two mental health trusts with a user-designed questionnaire. Journal of Mental Health. Vol.13, No.4, pp. 403–413.
Rose, D., et al. (2003). Patients’ perspectives on electroconvulsive therapy: systematic review. British Medical Journal. Vol. 3, No.26, pp.1363–1365.
Electroconvulsive therapy is a psychiatric treatment that is used to treat severe depression, catatonia and mania in patients through the use of electronically induced seizures. The patient is anaesthetized during the entire treatment process. The treatment is given to patients who do not respond to antidepressants or mood stabilizing medications. Electroconvulsive therapy is administered over a period of two weeks in a series of treatments; usually six to twelve.
Through-out the entire procedure, the patient is closely monitored. A rubber block is put in the mouth of the patient to prevent them from biting their tongue. Once the patient is unconscious, an electrical current is passed through the brain causing a grand-mal seizure that lasts up to twenty seconds. According to the American Psychiatric Association (1), the patient regains consciousness after half an hour.
Experts cannot pin-point how ECT works but the procedure is believed to relieve symptoms of depression, mania and catatonia. It causes changes in the chemical balances of the brain thus relieving some of the symptoms of mental disorder. The treatment varies in three ways: the positioning of the electrodes, the frequency of the treatments and the electrical waveform. However the effects of ECT do not last a long time and the patient has to go back for further treatments.
Using ECT in Bipolar Patients
Bipolar disorder is a psychiatric mood disorder where the patient experiences extreme mood swings. The illness is known to cause changes in lifestyle and health. Bipolar patients experience highs and lows in their moods otherwise known as depression and mania.
Depression is whereby the patient feels helpless, sad, despairing and worthless while mania is where the patient feels creative, has feelings of grandeur and is hyperactive. According to Malhi (3), sometimes, both the feelings of depression and mania can appear at the same time causing the patient to go into a “mixed state.”
Treatment of bipolar disorder varies among individuals. Some individuals may not respond to drugs used to treat bipolar. As mentioned earlier, ECT is used to treat cases where the patient fails to respond effectively to prescribed drugs. When other forms for managing the disorder aren’t effective, the psychiatrist is recommended to start using ECT in order to be able to manage the disease effectively.
Psychiatrists select bipolar patients for ECT on the following basis: the patients have acute psychosis, have severe mania such that they place their own and others’ well-being in danger, are pregnant and cannot or do not want to take medication, are at immediate risk of death by suicide, and their physical condition rules out the use of antidepressants.
Effectiveness of Using ECT as a Treatment for Bipolar
ECT has been used to treat the mania, depressive and mixed states effectively. The treatment has very little evidence to show that it is effective in treating of elderly patients suffering from bipolar. There are documented cases where they fail to respond to ECT treatment. A study was conducted to establish the effectiveness of ECT as a form of treatment for bipolar disorders. Three studies were used to assess the outcomes of treating acute mania with ECT. 308 patients were chosen to take part in the randomized controlled study.
The patients were divided into two categories where some of the patients received ECT followed by lithium maintenance treatment. According to the group of researchers (2), the other patients received lithium as both acute and maintenance treatment. Those who received ECT followed by lithium maintenance showed significant improvements within a period of eight weeks. In another study, thirty manic patients were treated with chlorpromazine but were randomly grouped.
One group was given six ECT sessions while the other group received sham ECT sessions. Conditions of the patients that received the sham ECT sessions worsened as compared to those who received the actual ECT (2). The treatment has also been effectively used to treat bipolar depression. According to a UK ECT review group in 2003, it was concluded that ECT was a more effective treatment for treating depressive disorders in bipolar than drug therapy (2).
Moreover, bilateral ECT was more effective than unilateral ECT as was high doses as compared to low doses. In the review of the trials, some of the reviews included depressed patients who were diagnosed with bipolar and unipolar disorder. Even though the studies of ECT in treating bipolar disorder were old, they still exhibited its effectiveness. Most of the studies done to investigate the effectiveness of ECT showed that the procedure was equal or superior to the use of antidepressant drugs.
Treatment for mixed state has not been thoroughly investigated and there are no prospective, randomized or controlled studies on the use of ECT as a controlled treatment. Even though it is believed that ECT may be effective in treating the mixed state, there lacks conclusive evidence to support this (3).
Disadvantages of ECT in Treating Bipolar
When treating a patient with bipolar depression, there exists a risk of the patient developing hypomania. However, the risk seems to be greater if the patient is treated using antidepressants. If ECT is used alone, there are chances that there will be a high relapse rate. The psychiatrist may also lack information in the kind of prophylactic medication to give to ECT patients.
The treatment is also associated with memory loss. However memory can be minimized by using brief pulse rather than sine wave ECT. The electrodes will be unilaterally placed by using the least number of treatments possible and by titrating the electrical current wave to according to the patient’s seizure threshold.
There have been a number of incidences where the use of lithium during the ECT treatment has been known to cause neurotoxicity. Recent reviews show that there have been no links between neurotoxicity and the use of lithium in ECT treatments. Nevertheless, cases of neurotoxicity do exist.
Patients often complain about confusion, headaches, nausea, muscle soreness and heart disturbances. There exist some long term effects of memory loss especially among older patients. Some people complain that their memories have been completely erased even though memory is expected to return after the course of ECT treatment is over.
Other patients have complained about undergoing a personality change once they have gone through the therapy. They claim that the skills they possessed and talents are lost and cannot be recovered due to memory loss. Another problem associated with ECT treatment is the stigma associated with it. This is based on early treatments which were considered to be barbaric and inhumane.
The patients were usually chained and high doses of electric currents were administered. The patients were usually left un-monitored and at the end of the treatment had broken bones or other physical injuries (2). Some of these treatments even resulted in death. The patients were administered with the treatment against their own will. In addition, the treatment was done without any form of anesthesia.
However, through many adjustments, the treatment has today been made safer and the currents used are controlled and the patient is closely monitored to prevent serious injuries or adverse side effects. The stigma of the procedure being terrifying and inhuman still exists, though. Furthermore, the patient is given the option of choosing whether they prefer ECT as a form of treatment or not.
Conclusion
In conclusion, ECT treatment seems to be the most effective form of treatment for patients who do not respond to treatment through drugs. ECT requires continuous treatment so as to ensure the disease is properly managed. The treatment is highly recommended due to its rapid onset action. This makes it a good form of treatment for severe illness with suicidal risk.
Le Masurier M, Herrmann LL, Coulson LK, Ebmeier KP. Physical treatments in bipolar disorder. In: Young AH, Ferrier IN, Michalak, EE, editors. Practical management of bipolar disorder. New York, NY: Cambridge University Press; 2010. p. 62-72.
Malhi GS. Diagnosis of bipolar disorder: who is in a mixed state? The Lancet. 2013;381(9878),1599-1600.
Is psychological intervention with kids more complex than intervention with adults? What methods do you consider most effective with young populations?
Health professionals who are concerned with maintaining the psychological welfare of children encounter several obstacles in their practice. Relative to adults, children have more complex psychological needs that require better-developed intervention programs and strategies.
One of the major barriers to effective psychological intervention in children is their inability to make personal decisions in important matters of life. In addition, the inability of children to express their feelings and thoughts effectively adds to the complexity of psychological intervention in children.
This complexity exists because age is a critical aspect in the selection of psychological treatment, the objectives of the treatment are important, and the symptoms of the disorder that are evident in a child are considered. There are four main classes of psychological interventions that are applied by health professionals. These include individual psychotherapy, behavior modification, remedial therapies and education, and social and cognitive behavioral therapy (Ebert et al, 2008).
Several approaches are used in individual psychotherapy. They include client-centered therapy, child and adolescent psychoanalysis, supportive psychotherapy and exploratory psychotherapy (Ebert et al, 2008). Supportive therapy is a highly selective approach that does not have a single theoretical basis that may be considered humanistic in nature.
It is best suited for treatment of adjustment disorders. Client-centered therapy is considered play therapy that is highly effective in psychological interventions children. In this therapeutic approach, a therapist uses several methods that encourage a child to explore personal feelings in a way that helps the therapist understand the feelings of the child. It is best suited for treatment of mild anxiety disorders and adjustment reactions (Ebert et al, 2008).
Exploratory psychotherapy integrates both play therapy and verbal therapy. A therapist uses interpretations that are based on the child’s play, verbal behavior and non-verbal behavior to resolve the child’s unconscious psychological struggles. This approach is effective in the treatment of anxiety, somatoform and several other personality disorders. The difference between psychoanalysis and exploratory psychotherapy is that psychoanalysis is more intense.
It is recommended for children under the age of 5 because it focuses on unconscious psychological conflicts in the child. It is effective in treatment of borderline personality disorders, anxiety and traumatic experiences. Interpersonal psychotherapy focuses on problem-solving approaches and the self-awareness concept to treat adolescents with major depression (Ebert et al, 2008). These treatments are not effective in the treatment of severe psychological disorders, hence not recommended for these disorders.
I notice great value and effectiveness in music therapy, play therapy, ropes courses, music therapy and animal therapy. These therapies use approaches that encourage children to participate in therapy hence increasing their effectiveness. For example, play therapy creates an environment in which children are comfortable to express their feelings and thoughts.
The fact that play therapy focuses on the emotions of children helps them in their emotional and spiritual development (McKinney and Power, 2012). Play therapy has many benefits. For example, secure attachment is associated with play therapy and intense free play.
References
Ebert, H., Loosen, T., Nurcombe, B., and Leckman, F. (2008). Current Diagnosis and Treatment Psychiatry 2nd Ed. New York, NY: McGraw Hill Companies, Inc.
McKinney, C., and Power, L. (2012). Childhood Playtime, Parenting, and Psychopathology in Emerging Adults: Implications for Research and Play Therapists. International Journal of Play Therapy, 21(4), 215-231.
Sylvia Wen Hsin-Chen and Donna S. Davenport (2005) conducted a study about the changes that have to be applied to the process of cognitive-behavioral therapy for Chinese American patients due to the cultural differences. The authors of the research have done a vast and all-embracing job by incorporating major studies related to the topic.
The choice of the literature for the review was predetermined by three key factors, i.e., the need to represent the phenomenon of cognitive-behavioral therapy, the necessity to outline key cultural specifics of the Chinese American patients, and the need to define the key stages of cognitive-behavioral therapy for Chinese Americans. Most of the sources were 5-10 years old at the time that the research came out.
The research participants were Justin, a 26-year-old Chinese American, and his therapist. The setting was a university in the Southwest of the USA, where Justin actually started facing issues and where the changes within his behavioral patterns could be observed. Speaking of the setting, though, one must mention that the experiment had to be conducted so that Justin could be affected by the factors that he is usually surrounded with, which meant that not only the college, but also his home should be included into the list of experiment settings.
Thus, it can be assumed that the research took place in two settings, one replacing another on a daily basis. To make the matter more complicated, Justin had to undergo daily sessions in the college counseling center. Therefore, there were three key settings created for the research. While the given detail complicated the experiment considerably, it allowed for defining the key features of Chinese Americans’ behavioral patterns more precisely and, therefore, coming up with more exact research results.
The findings were rather unexpected and demanded that piety, one of the key features of Chinese people’s character, should be taken into account when molding an appropriate CBT strategy. In contrast to what was expected, the CBT approach towards Chinese Americans does not require a complete reconsideration of the existing CBT techniques.
However, it does require that the healthcare specialist should adjust the strategies chosen to address the problem towards the patient’s cultural specifics. To start with, it is crucial that the patient and the therapist should form a rapport. The second major conclusion is that a therapist should help his/her patient create an action plan, which is acceptable within the context of Chinese cultural norms – anything that goes beyond these boundaries will most likely fail to work for the patient’s benefit.
The efficacy of nondirective techniques in CBT for Chinese American patients, such as guided imagery, dream analysis and sentence stem, should be mentioned as well, Wen Hsin-Chen and Davenport stress. Finally, according to the results of the research, when working with a Chinese American patient, a therapist must elicit emotions from his patient, appealing to his/her feelings as well as his/her rationality.
The authors suggested that the therapy chosen to address the issues that Justin had to face in his academic and personal life was conducted successfully (Wen Hsin-Chen and Davenport 110). However, authors note that, due to huge diversity in Chinese American community, a therapist must search for unique approaches in CBT with each patient. Not only cultural, but also socioeconomic specifics of a patient’s background should be taken into account.
Works Cited
Wen Hsin-Chen, Sylvia and Donna S. Davenport. “Cognitive-Behavioral Therapy with Chinese American Clients: Cautions and Modifications.” Psychotherapy: Theory, Research, Practice, Training 42.1(2005), 101–110.
Cognitive behavioural therapy has been a form of therapeutic treatment for persons with several mental disorders for quite some time. It is described as a talking therapy since it involves the use of psychoanalytical facilities testing certain behavioural and cognitive elements (Saunders, 2005).
Social phobia is a manifest form of disorder that hampers an individual’s interaction with the wider society (Leahy, 2003). Social phobia can be specific where it relates to only one aspect e.g. fear of talking to strangers, it can be social anxiety where the individual is generally apprehensive about being in a situation requiring social interaction or it can be social anxiety disorder which is an excessive fear of interaction that borders on mental illness and has to be treated clinically with the help of mental health professionals.
While it is common for people to feel self-conscious or nervous on occasion, social phobia which in this case refers to social anxiety disorder is an extreme form that goes beyond occasional nervousness or shyness (MHF, 2011).
Normal social anxiety occurs commonly during interviews, while anticipating a public speech, meeting strangers e.t.c. However, people with social anxiety disorder have an unfounded fear of embarrassing themselves before others so much so that they go to extraordinary lengths to avoid any kind of social contact that would trigger a moment of social anxiety.
Social phobia can prevent an individual from leading a normal life and thus it needs to be rectified clinically with the help of mental health professionals. It has at times been related to autism and Asperger’s Syndrome (Howlin, 2004).There are several effective treatments for social phobia that involve therapy and other self-help strategies. Of all the kinds of treatments available for social phobia, cognitive behavioural therapy popularly known as CBT has been found to be the most effective.
Understanding social phobia
Before treating social phobia, it is important to understand what it is and what causes it (Rowland, 2000). We also need to know how to identify persons suffering from generalized or specific social phobia from those with an intense form of social anxiety disorder. In general, social anxiety disorder differs from other forms of social phobia by the manner in which the persons suffering from it go to great lengths to avoid social triggers for their condition.
The situations known to trigger social anxiety disorder include simple activities such as public speaking, participating in group activities, making small talk with strangers, debating, performing or even taking foods or drinks in public. These situations act as triggers since they put the individual on the spot yet they prefer to stay away from other people’s focus and attention.
When confronted with the above situations, persons with social phobia develop nervousness and feel jittery. However, for those with mild forms of social phobia i.e. generalized or specific, they can still make it through these activities without incident or resulting to avoidance tactics (Persons, 1989).
For persons with social anxiety disorder, they will exhibit the following psychological symptoms; excessive fear that they will embarrass or humiliate themselves, intense anxiety and worry days, weeks or even months before the social event, extreme self-consciousness in their day to day social encounters, excessive caution while talking to others, avoidance of triggering situations to such a level that ordinary social life becomes hindered or disrupted and excessive fear that others will notice their anxiety and that they will be judged or criticized (Janet, 1976).
There are several physical symptoms that are exhibited by people who suffer from social anxiety disorder. These include chest constriction, muscle tension, a high heartbeat, a trembling that is uncontrolled, nausea, stuttering, faintness, stammering, dizziness, hurried breathing as well as blushing. In children, social anxiety disorder causes the child to avoid playing with others, truancy and feigning sickness to avoid going to school (Jackson, 2002).
Using a CBT Model to understand social phobia
As stated earlier, Cognitive Behavioural Therapy (CBT) is one of the most effective and popular methods for combating social phobia. CBT works on the notion that the various recurring behaviours and thought patterns of individuals are intrinsic to the physical and emotional symptoms of social phobia (Scott et al, 1991).
The CBT process involves the identification, analysis and change of these behaviours and thought patterns with an aim to achieve a counter effect on social phobia and anxiety. The therapy has been effectively applied to assist people with social anxiety producing better results than any psychological technique or medication. This is because of its simple theoretical framework that thoughts affect outward behaviour and vice versa which means that if both are re-programmed, the condition can be reversed.
There have been several cognitive and behavioural models that seek to solve forms of social phobia especially social anxiety disorder. However, the most popular CBT model is the one designed by Clark and Wells (1995). The model attempts to show the various processes that are involved in development of social anxiety. It can assist us to understand the causes of social anxiety/phobia.
The model refers to a trigger situation which relates to the social situation that causes or brings about the feeling or bout of anxiety in the person suffering from social phobia. These situations are as described above and they are all activities that bring about nervousness and jitters even in normal people.
According to Clark and Wells (1995), the trigger situation is responsible for activating the beliefs and assumptions that the individual has about himself or herself, the previous social experiences in the same situation and the specific trigger situation itself.
The second element which is the activation of beliefs and assumptions refers to the ideas, notions and opinions that the individual holds about himself/herself, previous social experiences and the specific trigger situation. Examples include; ”They think I am a nerd”, “they must be judging me negatively”, “I’m not good at this”, ‘there is something wrong with me’ or “people think I am inferior to them.” (Melinda & Ellen, 2011)
The third element “The situation is perceived as socially dangerous” is the cumulative effect of the trigger situation and the negative thoughts that the individual has accumulated about a particular situation and the perception by the person that the situation is threatening or dangerous.
This perception activates three kinds of responses. The first kind is a safety response. Safety behaviours are those that the individual develops to reduce the anxiety of the time or further exposure to the trigger situation. A good example is running away from a conversation, skipping school or work on the day scheduled for public speaking or changing the subject in the course of a discussion to a more comfortable or general topic.
The second response is one of self-consciousness. Here the individual’s senses become heightened when they become a centre of attention. They become aware of their own responses to the trigger situation such as noticing that they are talking in a shaky voice, their hands are sweaty e.t.c.
The last response is the physical reaction to the trigger situation. It includes a pounding heart, tight chest, sweaty hands, quivering voice, heavy breathing and shaking. The three types of responses are correlated. Anxiety increases with self consciousness and this is reflected in the individuals increased perception of danger which causes him to display the physical symptoms of anxiety.
Using Cognitive Behaviour Therapy to solve social phobia
Using the cognitive behavioural model from Clark and Wells, we have identified the causes and process of social anxiety that eventually lead to social phobia. From what we have learnt, it is now possible to recommend solutions for the problem of social phobia using cognitive behaviour therapy. These solutions are meant to be self-help measures for the individual to use to reduce or totally eliminate social anxiety.
Butler (1999) states that more often than not, people are referred to a psychiatrist by their doctors when they exhibit social anxiety disorder. Butler is of the opinion that such a referral is already difficult enough for the person suffering from the disorder since they find it difficult talking to strangers about their condition in the first place.
Another problem is that the demand for therapists may cause the individual to be placed in a long waiting list. Instead, Butler (1999) recommends that the individual might benefit more from group therapy and self help programmes of cognitive behavioural techniques.
The first step in CBT is the identification of the individual’s beliefs. This is because an individual’s perceptions play a huge role in social anxiety. These thoughts can be divided into beliefs, attitudes and assumptions and grouping thoughts into these three categories is the first step in knowing how to change them. Beliefs form that category of thoughts that the individual holds to be true. Butler (1999) states that most of these beliefs are informed by previous bad experiences especially those that occur during childhood and adolescence.
While many socially anxious people hold so many beliefs about their predicament, they have never taken time to examine and question the validity of their beliefs. Some beliefs may be very hard to identify since they may have been formed a long time ago as a response to a traumatic situation which has since been forgotten (Padesky & Greenberger, 1995b).
These beliefs influence behavioural responses greatly e.g. people who perceive others as being hostile are likely to avoid talking about themselves before these people or make small talk with them.
The best way to identify ones beliefs is to think of a specific occasion where one felt socially anxious. Reliving such a situation enables the individual to take particular note of the feelings and thoughts that come to their mind. These feelings and thoughts especially those concerning the individual’s perception of his or her shortfalls, other people’s judgements and attitudes help the individual in identifying their beliefs.
Once the individual has identified his or her beliefs, the next step is to question them to see whether they are valid. More often than not, these beliefs though subconscious are often misplaced and once the individual finds out that their beliefs are false, then they are able to change them appropriately.
Change of belief transforms the individual’s behaviour when confronted by the same situation e.g. when one believes that another is hostile and then finds out that they are actually very friendly, they are more likely to interact with them in a more relaxed and freer way.
The third step in CBT is the identification of behaviour. This involves the individual’s analysis of their reaction when faced with an anxious situation. Again the individual should try to relive a situation when they were socially anxious and then identify the negative behaviours in reaction to the situation.
These negative behaviours may have included; rehearsing words before saying them, locking knees to avoid shaking, holding on tightly to things, keeping a keen eye on an escape route, avoiding full involvement, sticking with persons considered ‘safe’, not taking chances and doing a post-mortem after a bad situation (critically analyzing socially anxious situations after they have happened).
More often than not, these behaviours are informed by incorrect or misplaced beliefs about people or situations. These behaviours usually act as a counter to the threat of social anxiety. Once the individual analyzes their thoughts and behaviours, then they become aware of the causes of their anxiety and can then change their behaviours.
Changing behaviour is the last step in CBT. Heimberg et al (1995) describe a guide to changing behaviour by first listing ones changed beliefs and also becoming aware of one’s behaviours in anxious situations. The individual should then attempt to act differently in the same situation.
The best strategy would be for the individual to take up the role of a behavioural scientist. This would involve placing oneself deliberately in socially anxious situations and avoiding safety behaviours or any other avoidance tactics. Regular exposure to uncomfortable situations helps to grow the individual’s confidence and reduce self consciousness. Growth in self-confidence would lead to a remarkable reduction in social anxiety.
Other strategies for tackling social phobia
One of the most crucial and beneficial techniques for solving anxiety problems that arise out of social phobia are relaxation techniques (Roth & Fonagy, 2003). Relaxation helps to calm the individual down and avoid a panic mood that comes with social anxiety. These techniques should be practiced on a daily basis to produce the best effect and if properly utilized, they can greatly reduce the intensity or frequency of anxiety throughout the day (Wills, 2008).
Yoga is another recommended solution for social anxiety problems. Some therapists recommend Yoga especially the relaxing type that includes meditation (Salkovskis, 1996a; Beck, 1995; Clark & Fairburn, 1996). It is known to soothe the mind and revitalize the body making the individual generally calm and relaxed which eases anxious moments.
Medication could be another solution for social anxiety disorder. While it may relieve the symptoms, it does not cure the disorder. It should thus be used in addition to self-help techniques or therapy (MHF, 2011). Generally, there are three kinds of medication that can lower social anxiety (Salkovskis, 1996b). These are; Beta Blockers which relieve anxiety by blocking the flow of adrenaline released when one is nervous.
They are effective in controlling the physical signs of anxiety but not the emotional symptoms. Antidepressants are used in treating the worst forms of social anxiety disorder. Examples are Effexor, Zoloft and Paxil which have been recommended by therapists as being effective in countering the effects of social phobia. Finally, there are Benzodiazepines which usually provide quick relief for anxiety. They are often addictive and sedating in nature and should therefore be used as a last resort (American Psychiatric Association, 2004).
Another excellent way to relax the mind is hypnotism. However, private hypnotherapists are quite expensive and one session may cost up to £50 sterling (Melinda & Ellen, 2011). Roth & Fonagy (1996) suggest that changing one’s lifestyle can also help to relax the mind and reduce social phobia. This could be by ensuring one gets enough sleep, avoiding caffeine, drinking alcohol in moderation and avoiding smoking.
These measures are recommended by the World Health Organization (WHO,1992).Though these measures may lower the intensity of social phobia, they cannot completely cure it. Finally, one can reduce their social anxiety by joining group clubs such as drama and debating which boost one’s stage confidence and expose him or her to more anxious moments until they learn to cope (McKenna, 2006).
Conclusion
As we have seen above, CBT is a very effective method of reducing social phobia. This condition limits the individual’s interaction with others which may hinder their day to day social life. However, CBT provides simple and practical solutions to the problem. The effectiveness of CBT however relies on the individual’s openness to learn and willingness to change (Padesky & Greenberger, 1995a). It is an involving process that requires an individual’s zeal to become a socially healthy person.
References
American Psychiatric Association, (2004). Diagnostic and Statistical Manual for Psychiatric Disorders. Washington DC, USA.
Beck. J. S (1995). Cognitive Therapy, Basics and Beyond. New York: Guilford Press
Butler, G., (1999). Overcoming Social Anxiety and Shyness: A self help guide using Cognitive Behavioural Techniques. London: Robinson
Clark, D.M., & Fairburn, C.G. (1996). The Science and Practice of Cognitive Behaviour Therapy. New York: Oxford University Press
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. New York: Guilford.
Heimberg, R.G., Liebowitz, M.R., Hope, D.A., Schneier, F.R., (1995). Social Phobia: Diagnosis, Assessment, and Treatment. New York: The Guildford Press
Howlin, P., (2004). Autism and Asperger Syndrome: preparing for adulthood. USA & Canada: Routledge
Jackson, L., (2002). Freaks Geeks and Asperger Syndrome: A User Guide to Adolescence. London: Jessica Kingsley
Janet, P. (1976). Les obsessions et la psychasthenie. New York: Arno Press
Leahy, R.H. (2003). Cognitive therapy techniques. New York: Sage
McKenna, P. (2006). Instant Confidence: The Power to go for anything you want. Bantam Press
Mowrer, OH. (1960). Learning theory and behavior. Wiley: New York.
Neale, John M.; Davison, Gerald C. (2001). Abnormal psychology (8th Ed.). New York: John Wiley & Sons
Persons, J.B. (1989). Cognitive Therapy in Practice: A case formulation approach. New York: Norton & Co
Padesky, C. A. and Greenberger, D (1995 a). Clinicians guide to mind over mood. New York: Guildford Press
Padesky, C. A and Greenberger, D (1995 b). Mind over Mood. New York: Guildford Press
Roth, A. & Fonagy, P. (1996). What works for whom: A Critical Review of Psychotherapy Research. New York: Guildford Press
Roth, A. and Fonagy, P. (2003). What works for whom: A Critical Review of Psychotherapy Research. New York: Guilford Press
Rowland. N, S. (2000). Evidence-Based Counselling and Psychological Therapies: Research Applications. London: Routledge.
Salkovskis, P. (1996 a). Trends in Cognitive and Behavioural Therapies. New York: John Wiley & Sons
Salkovskis, P. (1996 b). Frontiers of Cognitive Therapy. New York: Guildford Press
Saunders, D. & Willis, F. (2005). Cognitive Therapy, An Introduction. London: Routledge
The history of hypnosis therapy can be traced back to the prehistoric times. However, it is not until the middle of the 20th century that the use of hypnotherapy in clinical psychology became official and popular. At present, the benefits of hypnosis in clinical care are widely recognized.
Thousands of people throw themselves into the state of altered consciousness to improve their health and wellbeing. Of course, the way hypnosis influences the human organism is difficult to understand.
For many clinical psychologists, its mechanism is still unclear. Nevertheless, it is possible to say that hypnotherapy will become much more popular, as the whole health care system is shifting towards non-traditional, alternative methods of health regulation.
The History of Hypnotherapy
As stated earlier, the use of hypnotherapy in psychology is not new. The first descriptions of hypnosis and its power can be found in ancient writings (Whorwell, 2005). However, until the 18th century, the study of hypnosis and hypnotherapy had been very unsystematic.
The first time hypnotherapy became a matter of professional concern was when Franz Anton Mesmer, Austrian physician, described the state of animal magnetism (Whorwell, 2005). Mesmer believed that physical health depended on the balance of the so-called “distribution” fluids, and the use of magnetic fields could potentially restore that balance.
He also claimed that placing the patient into a trance-like state was essential to the healing process (Whorwell, 2005). Mesmer was well-known for his eccentric personality, but his idea of animal magnetism eventually survived. With time, magnetism and hypnosis became popular medical approaches in Europe and the United States.
In the middle of the 19th century, Manchester surgeon James Braid was put into the state of trance by a travelling French demonstrator (Whorwell, 2005). He became very interested in the hypnosis technique and wrote a whole book about it. It is in his work that the word “hypnotism” was used for the first time; it came to replace the term “animal magnetism” that originated in Mesmer’s writings.
Almost at the same time, another professor of medicine in London was starting to apply the hypnosis technique in his practice (Whorwell, 2005). He had to resign and start a private practice, because his experiments and their outstanding results were generating hostility in the medical community (Whorwell, 2005).
During WWII, hypnosis was already used to deal with post-traumatic stress disorder. Hypnotic susceptibility scales were developed to make the use of hypnosis more professional and advanced. Today, hypnosis is quite popular among clinical psychologists and it is actively used to address the most controversial health conditions.
The Case of Anna O.: Hypnosis that Changed the World
The case of Anna O. was truly a turning point in the evolution and popularization of hypnotherapy. It is possible to say that the outcomes of the case served as a very good basis for the development of hypnosis as an official therapy in clinical psychology in other medical fields.
The first time Anna O. was attended by a physician was in 1880. She complained having nervous cough and had the symptoms of physical deterioration, which developed as a result of “overzealous nursing of her very sick father” (MacMillan, 1997, p.4). Her behaviors were quite peculiar, and it was not surprising that the physician immediately diagnosed her as being mentally ill (MacMillan, 1997).
Those symptoms included a strange, even weird, tendency to be sleeplike and autohypnotic in the afternoons (MacMillan, 1997). At times, the sleeplike state would give place to increased, unreasonable excitement (MacMillan, 1997).
The decision to use hypnosis was justified by the fact that Anna O. could not remember what was happening to her during her sleeplike states, nor could she clearly explain what was responsible for her shaking psychological state. The psychiatrist used hypnosis to make Anna O. speak about her problems. He wanted to discover the secret of her disease, and it worked.
The case of Anna O. was, probably, the first time hypnosis was officially used in psychiatry and psychology. With Anna O., hypnosis helped obtain additional knowledge about her emotional and mental health state. What Anna O. shared during hypnosis sessions was used by her counselor to develop the list of topics and discuss them during their meetings (MacMillan, 1997).
The outcomes of hypnotherapy were very promising. The case showed that hypnotherapy was a self-directed cure. The patient provided the information needed to guide further counseling sessions. The case of Anna O. changed the world of clinical psychology and introduced hypnosis as a good alternative to medicines and coercive treatment of mentally ill patients.
Hypnotherapy: Definition and How It Works
Hypnosis can be defined as “a temporary condition of altered attention in the subject which may be induced by another person and in which a variety of phenomena may appear spontaneously or in response to verbal and other stimuli” (Whorwell, 2005, p.1061). Hypnosis is always associated with the changes in consciousness.
In this state of mind, individuals produce unexpected responses and are sensitive to suggestions (Whorwell, 2005). It is not uncommon to see a counselor or psychiatrist speak to a patient in the state of hypnosis.
In the hypnotic state, the psychologists can either induce or remove muscle rigidity and even paralysis; vasomotor changes may also take place (Whorwell, 2005). Hypnosis changes the world around and in the patient, opening new spaces for discussion and analysis.
Hypnosis is particularly useful in the analysis of various subconscious events and motives. Millions of people around the world face problems or behave in ways that cannot be explained. Unfortunately, hypnotherapy is still poorly explored. Even psychologists and psychiatrists, who are expected to have at least the basic knowledge of the technique, often have no direct experience with hypnosis (Whorwell, 2005).
The mechanism of the hypnotic process is surrounded by a lot of controversy. This misunderstanding is further reinforced by the stereotypes and folklore beliefs about hypnotherapy. Many patients still believe that hypnosis is dangerous to their health. They have a fear of being hypnotized against their will.
They think that, while in the state of hypnosis, their minds can be changed or taken over, and they will lose any control over their behaviors and decisions (Whorwell, 2005). In reality, hypnotherapy implies the use of trance and relaxation. The patient is allowed to speak about the most hidden thoughts and even make suggestions for improvement.
At present, hypnotherapy is actively used to treat acute stress disorder, irritable bowel syndrome, and smoking cessation problems. The main benefit of hypnotherapy is that it treats most health conditions as psychological, not physical. As a result, it is possible to avoid the heavy loads of pharmaceutical prescriptions and, instead, enjoy the relaxing atmosphere during hypnotherapy.
How Hypnosis Therapy Is Used
Present-day researchers actively explore the benefits and effects of hypnotherapy on different groups of patients. The most common associations are with acute stress disorder, irritable bowel syndrome, and smoking cessation.
Acute Stress Disorder (ASD)
In terms of ASD, hypnotherapy is often used in combination with other cognitive and behavioral therapies. Patients with the symptoms of ASD can be placed in the state of hypnosis, followed by the use of cognitive-behavioral or any other therapy (Bryant, Moulds, Guthrie & Nixon, 2005).
The research shows that patients, who undergo hypnosis and CBT, have fewer symptoms of ASD and better chances to improve their quality of life. Nevertheless, the exact way in which hypnosis therapy influences individuals with ASD needs to be better understood.
Smoking Cessation
Hypnosis therapy is often used to make the process of smoking cessation easier and less painful. It is no secret that individuals, who want to quit smoking, have to go through numerous and very serious changes to give up their harmful habit. Not everyone has the power and strength to resist the smoking temptation.
In this context, hypnotherapy can become a good alternative to the traditional methods of smoking cessation. Hypnosis does not eliminate the smoking cramps, but it helps manage thoughts about smoking more effectively (Riegel & Tonnies, 2011). Hypnosis transforms the ways, in which individuals think about smoking. They find it easier to cope with the desire to smoke a puff.
Irritable Bowel Syndrome
It has become quite common to use hypnotherapy in the management of irritable bowel syndrome (IBS). IBS was found to influence every fourth human at some point of their lives (Houghton, Heyman & Whorwell, 1996; Whorwell, Prior & Colgan, 1987). IBS greatly increases the burden of gastroenterological diseases.
Apart from the direct colonic symptoms, including disordered bowel habit, IBS also leads to the development of non-colonic health problems, such as backache (Houghton et al., 1996). Earlier methods of treatment have proved to be relatively or somewhat effective. Hypnotherapy has been a measure of last resort, but now it gives patients with IBS much more hope that their health can improve.
Hypnotherapy not only reduces the symptoms of IBS but also improves patients’ quality of life. Patients with IBS experience chronic pain, and hypnosis helps reduce its scope (Elkins, Jensen & Patterson, 2007). It is not difficult to imagine that, because of IBS, thousands of people should leave work and stay at home. Thus, hypnotherapy also has some economic benefits.
Conclusion
Hypnosis therapy is becoming more popular. By placing patients into the state of trance, clinical psychologists have better chances to understand their most complicated problems. Hypnotherapy suggests that most health problems have psychological roots. As a result, it is possible to replace traditional and costly methods of pharmacological treatment with hypnosis.
Today, hypnosis is actively used to treat acute stress disorder, posttraumatic stress disorder, irritable bowel syndrome, and even make the process of smoking cessation easier. Patients who have experience with hypnosis report improved health, wellbeing, and the quality of life.
Nevertheless, the knowledge of hypnotherapy and its mechanisms is quite poor. Moreover, the use of hypnotherapy in clinical psychology is still surrounded by myths. Many people believe that, while in hypnosis, someone can take over the control over their behaviors and lives.
Undoubtedly, the current understanding of hypnotherapy is still in its infancy, but hypnosis does have the potential to become a cost-effective model of treatment in many health states and disorders. Through better education and research, clinical psychologists will be able to make hypnosis an acceptable form of medical treatment.
References
Bryant, R.A., Moulds, M.L., Guthrie, R.M. & Nixon, R.D. (2005). The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. Journal of Consulting and Clinical Psychology, 73(2), 334-40.
Elkins, G., Jensen, M.P. & Patterson, D. (2007). Hypnotherapy for the management of chronic pain. International Journal of Clinical and Experimental Hypnosis, 55(3), 275-287.
Houghton, L.A., Heyman, D.J. & Whorwell, P.J. (1996). Symptomatology, quality of life and economic features of irritable bowel syndrome – The effects of hypnotherapy. Alimentary Pharmacology & Therapeutics, 10, 91-95.
MacMillan, M. (1997). Freud evaluated: The complete arc. Amsterdam, Netherlands: MIT Press.
Riegel, B. & Tonnies, S. (2011). Hypnosis in smoking cessation: The effectiveness of some basic principles of hypnotherapy without using formal trance – A case study. Journal of Smoking Cessation, 6(2), 83-84.
Whorwell, P.J., Prior, A. & Colgan, S.M. (1987). Hypnotherapy in severe irritable bowel syndrome: Further experience. Gut, 28, 423-425.
Whorwell, P.J. (2005). Review article: The history of hypnotherapy and its role in the irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 22, 1061- 1067.