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Causal explanations of mental illness and perceived credibility of psychological therapy

Mc Auliffe, Liam; (2020) Causal explanations of mental illness and perceived credibility of psychological therapy. Doctoral thesis (D.Clin.Psy), UCL (University College London). Green open access

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Abstract

Aim Biological explanations of mental health difficulties have remained dominant in recent decades, particularly in the case of psychosis. Research has shown that these explanations can lead to reduced empathy and a bias towards offering pharmacological rather than psychological intervention. This study aimed to explore whether this bias can be reduced by presenting evidence that CBT for psychosis (CBTp) also brings about neurobiological changes (i.e. neuroplasticity). This was examined both in samples from the general population (Study 1) and mental health clinicians (Study 2). Method An experimental design was employed in which participants read a vignette of a person with psychosis. Participants were asked to report which treatment they would recommend (i.e. medication versus psychological therapy) and how effective they perceived each to be. These ratings were elicited before and after reading information about the effects of CBTp: either control information about its clinical effectiveness or evidence of CBTp-led neuroplasticity. Results In Study 1, the predominantly biological description of psychosis elicited lower therapy effectiveness and higher medication effectiveness ratings compared to the predominantly psychosocial description, replicating previous work. Therapy effectiveness ratings were higher and medication effectiveness ratings were lower after either type of CBTp effectiveness evidence was presented. In Study 2, evidence of CBTp-led neuroplasticity had a greater impact than the control information on treatment recommendation ratings amongst psychologists, but not psychiatrists. Conclusions We replicate a previous finding that when biological factors are emphasised in patient information, it biases people to choose medication rather than psychological therapy as a treatment option. When the general population are presented with any type of evidence that CBTp is an effective treatment, they are likely to rate psychological therapy as a more effective treatment method. The impact amongst clinicians is more varied, depending on their training background.

Type: Thesis (Doctoral)
Qualification: D.Clin.Psy
Title: Causal explanations of mental illness and perceived credibility of psychological therapy
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10111068
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