Concepts Of Psychology : Distinct Approaches

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Concepts Of Psychology : Distinct Approaches

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Describe about the Concepts of Psychology for Distinct Approaches.

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Introduction
Cognitive behavioral therapy (CBT) and psychodynamic approach are the two distinct approaches, which can be applied to various problems. Cognitive behavioral therapy (CBT) is the most widely used approach, which is a psychological intervention and designed to treat depression (Hofmann et al, 2012, p. 427). It is also used to manage the mental disorders and psychological distress in patients. Psychodynamic approach refers to a range of different treatments that are based on psychoanalytic concepts and methods (Shedler, 2012). The main focus of CBT is to develop the coping skills in the patients of depression by solving current concerns and changing the cognitive patter (i.e. attitude, thoughts and belief). This paper aims to provide the evidence based approach of Cognitive behavioral therapy (CBT) and psychodynamic approach.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy is used to treat the patient with various personality disorders and depression patients. According to the Bandura’s Socio-Cognitive Theory “suggests that self-efficacy beliefs – client perception of their ability to perform in a specific domain – regulate affective states” and thus it further influence depression (Stack, p. 6). According to the study of Dutch adolescents, it was found that low level of the self efficacy contributes to different symptoms of anxiety and depression. The main idea of the cognitive behavioral theory is to maintain and manage depression. How people think is called as cognition, feelings are called as emotions, and acting in a specific manner stands for behavior. All these things interact together and influence the thoughts. Thoughts further influence he behavior of a person. It is identified that mood of an individual is influenced by thinking, where negative thinking can result in depressive mood. This approach focuses on the mood that can reduce negative thoughts. “In this dysphoric state individuals become vulnerable to distorted self perpetuating cognitions, negatively framing their self concept, social interactions and environmental functioning, and resulting in depression” (Stack, p. 6). Vulnerability can be the result of childhood trauma, occupational success or other challenging events in life. Negative thoughts results in depression and distress.
The efficacy of CBT was reviewed through meta-analysis that identified 16 quantitative reviews with 332 clinical trials (Butler et al, 2006, p. 17). This study provided the effectiveness of the cognitive behavioral therapy through meta-analysis. The greater effect was seen on the “unipolar depression, generalized anxiety disorder, panics disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders” (Butler et al, 2006, p. 19). The study further found that moderate effect of CBT was seen in relationship problems, aggression, chronic pains and childhood somatic disorders, and chronic pain. CBT was found to be superior to antidepressants in treating depression in adult patients. CBT was found to as effective as behavioral therapy in the treatment of obsessive compulsive disorder and depression in the adult patient.
The empirical study of Zimmermann et al. (2005), provided the sample of 1484 patients to describe the positive symptoms of CBT. The meta-analysis of the study proved that significant reduction was noticed in the depression and acute psychotic episodes by CBT. “CBT is a particularly promising adjunct to pharmacotherapy, for schizophrenia patients who suffer from an acute episode of psychosis rather than a more chronic condition”(Zimmermann et al. 2005, p. 5). The study of Van Straten et al. (2010), conducted the meta-analysis of randomized control trial to evaluate the effect of the psychological treatment in patients with 10 different mental disorders and high level of depression. Out of 23 studies included in the research, 15 studies proved that effect of CBT was found to be positive in controlling depression. The studies that compare cognitive behavior theory and psychodynamic approach found mixed results (Cuijpers et al, 2010, p. 174).

Psychodynamic Therapy
Study of Fonagy (2015) provides the meta-analysis of the effectiveness of the psychodynamic therapy for various mental disorders. The psychodynamic approach underpins the psychodynamic structure to treat the depressive personality. Psychodynamic psychotherapy is the approach that deals with in-depth psychology. The main focus of the approach is to reveal the unconscious thought content of the patient’s psyche in order to understand the psychotic tension. According to the Freudian psychoanalysts view, the loss of the primary family members and care givers results in the self directed anger in the patient. When such anger is repressed, it results in depressive personality of the patient. Thus, psychodynamic approach is mental to indentify this depressive and repressed condition and restore it with positive emotions (Kazak et al, 2010, p. 85).
“Empirically substantiated clinical judgment underpins professional accountability and transparency in health care, and increasingly so in mental health” (Fonagy, 2015, p. 138). Another study reveal the overall effect of the different psychodynamic treatments that proved the efficacy of the psychodynamic therapy. The study of Lipsey, & Wilson, (1993), provided the result of 18 meta-analyses, which displayed the median effect of .75. A recent extensive meta-analysis of psychodynamic psychotherapy, which was published by the Cochrane Library, included randomized control trials of 1431 patients. The patients were compared with different mental disorders and also received short term psychodynamic therapy under control. In the short term treatment effect size was .95, while in the long term treatment effect size was 1.51. Different studies evaluated the efficacy of the psychodynamic psychotherapy (Shedler, 2012), for these studies 1,845 participants were included and the most common form of the treatment used was STPP. The findings of these studies suggest the effectiveness of the psychodynamic psychotherapy in the patients of depression and anxiety. The long term treatments are more effective than short term treatment in the patients suffering with depression, anxiety and other general psychiatric disorders. The treatment may continue to affect the patient even after termination of the treatment. Follow-up measurements are required; however, they generally have very less changes in depression and anxiety.
It has also been observed that Psychodynamic psychotherapy is a superior approach than treatment as usual (TAU). Effectiveness of psychotherapies is considered in treating depression. “The effects of psychodynamic psychotherapy beyond the termination of treatment are equivocal. The findings of most studies suggest that the effects, are at least maintained at follow up” (van Straten, 2010; Fonagy, 2015; Johansson et al, 2010).
Conclusion
Cognitive behavior therapy and psychodynamic psychotherapy are the two different approaches that are used to treat the patients suffering with depression, anxiety and other mental disorders. The paper discussed various empirical studies to develop the understanding towards efficacy of both approaches. Psychodynamic psychotherapy focuses mainly on those aspects of the personality, which are hidden or unknown, but CBT focuses on thoughts, content and belief of a person. Both the approaches have their importance, but according to some evidences cognitive behavioural therapy (CBT) is considered to be more effective than psychodynamic psychotherapy (Gaskin, 2012). The behavioral studies are found to be more effective as they can easily identify the development of the disorder. The negative and vague thinking leads to development of mental disorders. that can be identified easily by CBT. Thus it becomes more effective.

References
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of
cognitive-behavioral therapy: a review of meta-analyses.Clinical psychology review, 26(1), 17-31.
Cuijpers, P., Smit, F., Bohlmeijer, E., Hollon, S. D., & Andersson, G. (2010). Efficacy of
cognitive–behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias. The British Journal of Psychiatry, 196(3), 173-178.
Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: an update. World
Psychiatry, 14(2), 137-150.
Johansson, P., Høglend, P., Ulberg, R., Amlo, S., Marble, A., Bøgwald, K.-P. (2010). The
mediating role of insight for long-term improvements in psychodynamic therapy. Journal of Consulting and Clinical Psychology, 78, 438-448.
Gaskin, C. (2012). The effectiveness of psychodynamic psychotherapy: A systematic review of
recent international and Australian research.Melbourne: PACFA.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of
cognitive behavioral therapy: a review of meta-analyses.Cognitive therapy and research, 36(5), 427-440.
Kazak, A. E., Hoagwood, K., Weisz, J. R., Hood, K., Kratochwill, T. R., Vargas, L. A., & Banez,
A. (2010). A meta-systems approach to evidence-based practice for children and adolescents. American Psychologist, 65(2), 85.
Lipsey, M. W., & Wilson, D. B. (1993). The efficacy of psychological, educational, and
behavioral treatment: confirmation from meta-analysis.American psychologist, 48(12), 1181.
Shedler, J. (2012). The efficacy of psychodynamic psychotherapy. InPsychodynamic
Psychotherapy Research (pp. 9-25). Humana Press.
Stack, G. Critically evaluate the contribution of cognitive and psychoanalytical models to our
understanding of mental health difficulties in terms of emergence, maintenance and intervention.
van Straten, A., Geraedts, A., Verdonck-de Leeuw, I., Andersson, G., & Cuijpers, P. (2010).
Psychological treatment of depressive symptoms in patients with medical disorders: a meta-analysis. Journal of psychosomatic research, 69(1), 23-32.
Zimmermann, G., Favrod, J., Trieu, V. H., & Pomini, V. (2005). The effect of cognitive
behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis. Schizophrenia research, 77(1), 1-9.

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