Unit 8 Assignment 2

Assessing, comparing and evaluating psychological perspectives and their approaches to health and social care practices.
Within this assignment I aim to assess, compare and evaluate the different psychological perspectives and their different approaches to both health and social care practices, beginning with an explanation of the different perspectives, and how different psychological perspectives are able to effect both areas of health and social care.
Behaviourist psychology
Firstly behaviourist theories within psychology, generally believe that all behaviour is learnt and can be shaped through principles of conditioning, which was suggested by two different psychologists, ‘Skinner’ and ‘Pavlov’. This approach is to be able to understand different aspects of human behaviour, this is sometimes referred to as the learning theory. These can result from either classical conditioning or operant conditioning.
Behaviourist psychology refers to how behaviour can be modified and altered in relation to obtain a desired behaviour, behaviourism is primarily concerned with observable behaviour, as opposed to internal events like thinking and emotion. Observable behaviour can be objectively and scientifically measured. Internal events, such as thinking should be explained through behavioural terms.
The behavioural learning model learning is the result of conditioning. The basis of conditioning is that a reward following a desirable response acts as a reinforcement and increases the likelihood that the desirable response will be repeated. Reinforcement is the core of the behaviourist approach. Continuous reinforcement in every instance of desirable behaviour is useful when a behaviour is being introduced. Once a desired behaviour is established, intermittent reinforcement maintains the behaviour. Behaviourist theory approaches are frequently used in weight loss, smoking cessation, assertiveness training, and anxiety-reduction programs. The importance of regularly and consistently rewarding desired behaviour immediately and not rewarding undesirable behaviour is crucial to the success of a behaviourist approach to learning.
Behaviourist psychology can be used in effecting health practice in relation to using operant conditioning to reduce anxiety and increase weight gain in helping people with anorexia nervosa, by providing a form of learning, which encourages the individual to associate pleasure or displeasure with types of behaviour, this is to increase the chance of the behaviour being repeated, in the case where the aim is to hopefully increase weight gain to a healthy level, with the overall aim being that the individual will be able to function well enough to enter therapy.
We also use this in social care by people attending a rehabilitation centre following a stroke can regain lost skills by re-learning behaviours using a systematic approach.
Social learning
The idea of social learning theory states that we are able to learn through watching others, this theory was developed by ‘Albert Bandura’ (1925 - ) who is an American psychologist, he called this form of learning observational learning, in which the individual being observed is known as the model and imitating the behaviour is known as modelling for learning to take place five factors are required to exist.
It is important to remember that the way we behave influences the way in which other people respond to us, this can be seen within a two-way interaction of how we behave and how others perceive us and behave towards us can consequences for future behaviour and expectations, which is known as the self-fulfilling prophecy. There is a similarity between role theory and the self-fulfilling prophecy in that this theory suggests that, because we live within a particular culture, society and social groups, we are influenced by other people. Since we all take on many different roles our behaviour will change according to role we are currently in.
Social learning theory combines cognitive learning theory, which posits that learning is influenced by psychological factors and behavioural learning theory, which assumes that learning is based on responses to environmental stimuli. Albert Bandura integrated these two theories and came up with four requirements for learning through observation, environmental, retention cognitive, reproduction cognitive, and motivation which is both. This integrative approach to learning was called social learning theory.
One of the most famous experiments performed by Bandura is the famous bobo doll experiment. Children observed as adults model either violent or passive behaviour towards the doll, and this observation was found to influence the manner in which the children subsequently interacted with the dolls. Children who observed violent behaviour behaved violently toward the doll and vice versa.
An example of how the social learning theory links into both health and social practices, is in relation to the practice of smoking, within health care practices, social learning theory is used in relation to preventing and controlling smoking within college aged students, Smoking is linked to 30% of cancer deaths, and around 80% of deaths from chronic obstructive pulmonary disease (COPD) and early cardiovascular disease, with effective cessation interventions at this time provide an opportunity to drastically reduce premature mobility and morbidity.
Behaviours are picked up and developed from the environment, through the process of observational learning. According to Bandura we all learn from one another, every day through observation, imitation and modelling. Bandura believed that the environment caused behaviour and that behaviour cause the environment. He also believed that we pay more attention to the things we enjoy, can be persuaded to succeed and that the positive feedback makes the likelihood of us to improve greater.
Systemic or family therapy can highlight problems in the interactions between social groups and systems, rather than in one individual.
Through people joining an informal group for example, a community based craft club to improve their self-esteem by succeeding in learning new skills and receiving praise.
Psychodynamic
The psychodynamic approach is associated with the Austrian psychologist ‘Sigmund Freud’ (1856 – 1939) who was responsible for developing the theory of psychodynamic psychology and the treatment known as psychoanalysis.
Freud was one of the earliest thinkers to bring to public attention the idea that we are not always aware of all aspects of ourselves, Freud suggested that what we are aware of is represented in our conscious mind but that many of our memories, feelings and past experiences are locked up in a part of our mind he called the ‘unconscious. We cannot get access to the contents of our unconscious, but we often have dreams which are related to parts of our subconscious. Freud believed that the conscious mind was small in comparison to the subconscious.
Another psychologist who harmonised with much of Freud’s theories in so far as he thought that we developed through a series of conflicts, was ‘Erik Erikson’ (1904 – 1994), however he thought that these continued throughout our lifetimes and were essentially social in nature. He also believed that Freud put too much emphasis on our desire for individual gratification of needs and not enough on our need to be accepted part of society and lead a meaningful life.
The psychodynamic approach draws upon the ideas regarding the unconscious mind and how we as children develop and form attachments that affect us later in life. Freud used hypnosis and talking therapies to patients with mental illnesses by making unconscious thoughts conscious, for example, an individual who experienced bereavement as a child and has never had the opportunity to talk about it. A psychologist would work with a person by listening to their thought and feelings and helping the individual work through their issues.
People may feel highly uncomfortable talking about their issues in a one to one setting, but may feel more comfortable and at ease writing their thoughts and feelings down to show to someone they trust or a counsellor in an informal group setting.
Humanistic
Humanistic psychology describes an approach to understanding human experience from the position of the individual, it focuses on the idea of free will and the belief that we are all capable of making choices. Two psychologists associated with this approach are ‘Abraham Maslow’ (1908 – 1970) and ‘Carl Rogers’ (1902 – 1987).
Maslow was an American psychologist who believed that we are all seeking to become the best that we can possibly be, spiritually, physically, emotionally and intellectually to name a few, he called this his self-actualisation. He constructed a theory known as the hierarchy of needs in which he explained that every individual requires certain basic needs to be met before they can approach the next level, based on his suggestion where an array of needs are required to be met in order to progress within oneself with their needs. Maslow wanted to understand what motivates people. He believed that people possess a set of motivation systems unrelated to rewards or unconscious desires.
Another psychologist was ‘Carl Rogers’ he was particularly interested in the concept of self, there are many aspects of the self but two are especially important here, self-concept refers to how we view ourselves, this includes both physical and biological tributes, such as being male or female, blonde or brunette, tall or short as well as personality traits such as being, kind, humble, assertive, hard-working. The self-concept is formed from an early age and young children internalise the judgements made of them by others, which then become part of their self-concept. Self-esteem is slightly different however and it refers to how much we feel we are able valuable, it’s quite clear, the amount of esteem we give ourselves. Someone with high self-esteem will believe they are loved and lovable and that they are important and valued, by contrast, an individual with low self-esteem may feel themselves to be worthless, of no value to anyone else, unloved and unlovable.
Humanist learning theorists view learning as a function of the whole person and believe that learning cannot take place unless both the cognitive and affective domains are involved. The individual’s capacity for self-determination is an important part of humanist theory. For example, humanist theory is used to help post myocardial infarction patients regain a sense of personal control over their health care management. It is possible to select elements of each theory that you find useful in patient teaching.
Humanistic approach is treating the individual as a whole, and not just the seen condition, for example dementia, by focusing on what attributes make an individual unique, such as personality, hobbies, life experiences and interests and aspirations. In health care a nurse would be able to improve the person centred care they offer to each service user through using this approach, for example someone with dementia would been viewed as the individual which they are as opposed to only seeing the condition and becoming mindless of all the aspects which make the person themselves as a whole.
This approach can be applied to care planning by using a person centred approach in a residential care home for older adults, for example some service users might be self-medicating, some may have a preference to a bath or a shower, it is greatly important to care for individuals as themselves and to provide choice.
Cognitive
A huge body of research has gone into understanding cognitive processes such as attention, memory, reception, information processing, problem solving, thought, language and other aspects of cognition. Two theorists which worked on this approach were ‘Jean Piaget’ and ‘George Kelly’.
The cognitive approach emphasises the importance of mediational processes, such as perception and thinking, which occur between a stimulus and a response. The research carried out by cognitive psychologists has supported our understanding of these different processes. There has been practical insights offered into such issues as how memory might be altered in how effective it is to improve problem solving skills.
There are two different psychologists who worked through the principle of cognitive psychology, Jean Piaget (1896 – 1980) was a Swiss psychologist who showed advanced academic ability from an early age. Into his early adulthood he worked on research into measuring intelligence and became interested in the types of mistakes that children made at the same age, however bright they were. He came to the conclusion that cognition develops through a series of stages each new stage building on the previous one and George Kelly (1905 – 1967), who developed a unique psychological theory known as the ‘Psychology of personal constructs’. He sees the individual as a scientist in their own right, capable of making predictions about the future, testing them and, if necessary, revising them according to the new found evidence.
Cognitive psychology is often used in relation to cognitive behavioural therapy (CBT) which can be either held in one to one or group sessions and is based around what we understand about how people think and learn; and how our thinking and previous learning shapes our feelings and behaviour. There are current research about cognitive distortion and the role in which they play in violence which will help clinicians working with people which difficult issues.
The cognitive approach is used in social care in relation to CBT, in which participating in a game in which people agree to a set rules, the group then get a problem to solve which requires ‘thinking skills’
Biological
A biological perspective is relevant to the study of psychology in three ways;
Comparative method- different species of animal can be studied and compared. This can help in the search to understand human behaviour.
Physiology- how the nervous system and hormones work, how the brain functions, how changes in structure and/or function can affect behaviour. For example, we could ask how prescribed drugs to treat depression affect behaviour through their interaction with the nervous system.
Investigation of inheritance- what an animal inherits from its parents, mechanisms of inheritance (genetics). For example, we might want to know whether high intelligence is inherited from one
The process of maturation was described by Shaffer (1993) as ‘a biological unfolding of the individual according to a plan contained in the genes.
The biological approach is often used in health care through medical diagnosis, using magnetic resonance imaging (MRI) and positron emission tomography (PET) scans to investigate brain activity, and these are used to understand how the brain works to process information.
The results of a PET or MRI scan may show that an individual has epilepsy, may no longer be permitted to drive a car and might have to introduce changes to their lifestyle to accommodate such a change. An occupational therapist would visit the individual at home and work to assess their needs and work with them to implement changes into their lifestyle, which would be in addition to medication.
Compare two approaches in term of their approaches to health and social care provisions.
Cognitive psychological approach
The cognitive approach emphasises the importance of mediational processes, such as perception and thinking, which occur between a stimulus and a response. The research carried out by cognitive psychologists has supported our understanding of these different processes. There has been practical insights offered into such issues as how memory might be altered in how effective it is to improve problem solving skills. Psychological approaches are therefore not just about being a good listener, or being caring although both are important. Psychological approaches apply ‘proven knowledge and evidence’ to helping people change aspects of themselves, cope better, or adapt to new situations.
A service users of ‘Mersey care psychological services’ states that “upon seeing my psychologist I found it very hard to open up or even speak about my difficulties. But she was very patient and understanding and when I did eventually trust her enough to tell her about my thoughts and feelings, she helped me to make sense of it all. This came as a huge relief to me and together we started to find a solution or sometimes a resolution to the problem. For me therapy has been a life-enhancing experience.
Cognitive psychology has been influenced by developments in computer science and analogies are often made between how a computer works and how we process information. Based on this computer analogy cognitive psychology is interested in how the brain inputs, stores and outputs information, however we are much more sophisticated than computer systems and an important criticism directed at the cognitive approach is that it often ignores the way in which other factors, such as past experiences and culture influence how we process information.
Loftus and Palmer's (1974) study of eyewitness testimony demonstrates how the cognitive process of memory can be distorted by other information supplied after an event. This highlights that memory is not merely a tape recording but is a dynamic process which can be influenced by many events such as leading questions. The study also shows that memory is a dynamic process and changes to make sense of experiences, when we behave in a particular way towards another person it is likely that we attempt to understand how the other person is thinking and feeling. Baron-Cohen's (1997) study shows that our behaviour can be influenced by a cognitive process called a theory of mind. Having a theory of mind enables a person to appreciate that other people have thoughts and beliefs that are different from their own. Baron-Cohen's study attempts to demonstrate that the central deficit of autism is a failure to fully develop this cognitive process of a theory of mind.
Biological
The theory proposes that development occurs according to a sequence of maturational processes, for example, development in the womb follows a fixed set of stages, and for example, the heart begins to forms first in relation to the rudimentary nervous systems
A wide variety of scanning techniques exist, these are used to provide, biological data, rather than psychological. Scanning techniques include, PET, MRI, fMRI and MEG scans. Only PET scans and MRI scans are studied as part of the methodology for the biological approach.
Scans have scientific purposes. They are commonly used to investigate for possible tumours, strokes or other abnormalities. However, they can be used as research methods too, such as aiding psychologists into understanding of both ‘normal differences’ between brains, ‘such as differences between a male and a female brain’, and ‘abnormal differences, ‘such as the differences between the brain of a murderer and a non-murderer.
MRI scans
Magnetic resonance imaging, is used to look at structure, it studies the tissues, looks for abnormalities and can measure the blood flow, and it involves injecting a dye into the body to help show organs and relevant areas. A strong magnetic field is passed over the body to pick up radio waves from hydrogen atoms in water molecules, to build up a detailed image of the brain.
Pet scans
Positioning emission tomography is used to a function, it studies brain activity levels and can be used to look for evidence of a stroke. It involves injecting a radioactive tracer into the bloodstream with a chemical used by the body, such as glucose to see where most of the blood is flowing.
Comparisons
In comparison the cognitive approach has a good success rate similar to the biological approach, however they both have long waiting lists.
Biological is an expensive approach which the use of highly expensive equipment and the appropriate facility, however it has a quick diagnosis time.
Given the lack of laboratory condition or subject materials to conduct the study in relation to cognitive psychology would be highly considered inexpensive, and possibly simplistic its means of creation as it doesn’t require any special specialised equipment or expensive facilities, however it is quite time consuming as it takes time for therapies like counselling to show and improvement with the individual.
Evaluation
Strengths and weaknesses of the biological approach
An example of a weakness in relation to biological psychology would be that animals are greatly different to humans, where an example of strength could be Gesell’s assessment scale is an easier aspect to understand in relation to more complex psychological principles. The idea of prescribed medication alters and effects different people in different ways, an example of which is anti-depressants which effect the nervous system which in relation and in contrast impacts and affects behaviour.
In assessing the strengths and weaknesses, it is clear to see how using the biological approach, a main weakness is that the biological approach is an expensive approach with the need for the specialist equipment, however a great strength is that they can be used for other medical conditions, such as strokes and tumours.
Strengths and weaknesses of the cognitive approach
A strength of this study and its idea could be that the behaviour is being able to be explored to discover an underlying rooted cause, as opposed to creating assumptions. However an example of a weakness could be that in order to discover the underlying cause there could be some form of disruption in relation to the behaviour patterns to others.
Cognitive psychology studies our mental processes or cognitions. These mental processes that cognitive psychologists focus on include memory, perception, thinking and language. The main assumption of the cognitive approach is that information received from our senses is processed by the brain and that this processing directs how we behave or at least justifies how we behave the way that we do.
Cognitive processes are examples of hypothetical constructs. That is, we cannot directly see processes such as thinking but we can infer what a person is thinking based on how they act. It has been argued that humans are unique in possessing the ability to communicate with language which involves very sophisticated cognitive skills. However this argument is challenged by the study from Savage-Rumbaugh et al. (1986) who studied the language capabilities in pygmy chimpanzees.
A main strength of cognitive psychology is that this approach has tended to use a scientific approach through the use of laboratory experiments. A strength of using laboratory experiments is that they are high in control therefore researchers are able to establish cause and effect. For example Loftus and Palmer were able to control the age of the participants, the use of video and the location of the experiment. All participants were asked the same questions (apart from changes in the critical words), and the position of the key question in the second was randomised. Furthermore, such standardised experiments are easy to test for reliability. However, as many cognitive studies are carried out in laboratory settings they can lack ecological validity. When cognitive processes such as memory and theory of mind are studied in artificial situations it may be difficult to generalise the findings to everyday life.
A further strength of the cognitive approach is the useful contributions that have arisen from this approach. For example, many modern types of therapy are based on the cognitive approach. Understanding cognitive processes allows us to help people to improve their cognitive processes such as memory and language. The Baron-Cohen et al. study enables us to better understand the behaviour of people with autism, Loftus and Palmers? Study highlights the limitations of eye-witness testimonies and the ape research may offer strategies to help children with language difficulties to develop language or to use strategies such as the lexigram system. Furthermore the cognitive approach has become the dominant approach in psychology particularly since it has become allied with neurology. The cognitive approach nowadays is often called cognitive science and is able to provide a very sophisticated understanding of how the brain processes information. A weakness of the cognitive approach relates to the validity of measuring cognitive processes. We can only infer what a person is thinking and therefore the cognitive approach relies heavily on self-report measures and observation. There are a number of reasons why we have to question the validity of self-report measures and observation. For example we can only infer that adults with autism have theory of mind difficulties from the results of the Eyes Task or that pygmy chimps are really using language when they communicate through a Lexigram. However, because of the developments of brain scanning techniques we are able to record the active parts of the brain more accurately nowadays and cognitive science is providing a more and more detailed description of how cognitive processes work. For example, brain scanning techniques are giving great insights about how memory works. It has been argued that a weakness of the cognitive approaches reliance on the computer analogy leads to a reductionist and mechanistic description of experiences and behaviour. Reductionism is the idea that complex phenomena can be explained by simpler things. The cognitive approach often takes this narrow focus and ignores social and emotional factors which may impact on cognition. For example, the autism study investigated just one central cognitive deficit as an explanation for autism. However the reductionist approach does have strengths. An advantage of the reductionist view is that by breaking down a phenomenon to its constituent parts it may be possible to understand the whole. This type of single mindedness has led to some great discoveries in psychology as it has in the 'natural' sciences.
Conclusion
All patients grow with success and do better when achievements are recognized and reinforced. Respecting the whole person in a supportive environment can encourage learning. Learning is also fostered through structuring information appropriately and presenting it in meaningful segments with appropriate feedback.