Question

Explain and discuss why psychophysiologically based interventions are not in wide use.

Answer 1

Before we discuss about psychological interventions lets first talk about intervention what does it mean. The term “intervention” means “the act or a method of interfering with the outcome or course especially of a condition or process (as to prevent harm or improve functioning)” or “acting to intentionally interfere with an affair so to affect its course or issue”

These definitions emphasize two constructs an action and an outcome. Psychosocial interventions capitalize on psychological or social actions to produce change in psychological, social, biological, and/or functional outcomes. CONSORT-SPI emphasizes the construct of mediators, or the ways in which the action leads to an outcome, as a way of distinguishing psychosocial from other interventions, such as medical interventions. Based on these sources, modified for mental health and substance use disorders, the committee proposes the following definition of psychosocial interventions.

Now let us talk about why the psychological intervention is not widely used is because: The Mental Health Acts are open to social abuse and elderly patients can be more defenceless in this respect. Specifically they may be: invoked to control behaviour; misused for material gain and implicated in subtle expressions of revenge. They are sometimes invoked to hasten divorce proceedings and to secure the custody of children by a specific parent. They are also used to control the behaviour of children by their parents. Mental Health Acts designed to control psychiatric patients are being enacted and enforced in some underdeveloped countries that lack an efficient tribunal system to monitor their effects.

A patient who has been detained is at risk of repeat detention and someone who has been inappropriately assessed becomes increasingly vulnerable to control on psychiatric grounds. The experience of being detained involuntarily has a reductive effect on behaviour after discharge – it may induce anxiety or post-psychiatric depression. The awareness of being deemed to require compulsory detention generates such negative attitudes as self-denigration, fear and unhealthy repression of anger. It may also impede self-direction and the normal sense of internal control and may encourage the view that in a world perceived as being divided into camps of mutually exclusive ‘normal’ and ‘abnormal’ people, the patient is in the latter category. Compulsory detention may lead to suicide because the patient loses their sense of integration within their own society. Furthermore, the fear and anxiety associated with involuntary admission delays the recovery process. There are other frequently occurring barriers to recovery for those affected such as, loss of capabilities, whether real or imagined, ineffectual medication due to poor elicitation of symptoms because of patient’s lack of cooperation and negative drug side effects.

Depressed patients have a higher suicide risk than the population at large and one of the reasons for detention is suicidality. Some of the subjective symptoms of depression can be ameliorated by denying them, while compulsory detention may reinforce depressive symptoms. Detention gives carers a false sense of security and this may lead them to relax their vigilance towards the patient. The Mental Health Acts increase the stigma associated with psychiatric illness and with the exuberant expression of emotions. Patients who are under section or are frightened of being placed under section may deliberately mask their symptoms in an attempt to have the section lifted or to avoid sectioning. So in these cases psychological intervention is not widely used and is not applicable to use in these cases.