PSYCH 1XX3 Lecture Notes - Lecture 1: Mind-Wandering, Fetus, Systematic Desensitization
Psychological Treatments
***Aside from possessing symptoms for their specific psychological disorder, individuals with mental health issues often
feel overwhelmed by the about of help options, experiencing both internal (ie. Self-defeating thoughts of crying spells in
treatment) and external (ie. Lack of funds to pay for treatment) barriers that add more anxiety to the situation. ***
Section 1: Diversity of Treatment Consumers
- of the 10% of the population 15 years old or younger with reported symptoms of anxiety, depression, bipolar, or
substance – related disorders in the past year, 22% said that they would want help but would not get it
Tailoring treatment to the disorder
- psychological disorders and thus treatments is not a one-size-fits-all operation
- Conceptualization: accurate and comprehensive clinical diagnosis of psychological disorders
- we must ask ourselves the four D's (deviance, distress, dysfunction, and danger) to determine whether or not we need
to seek help
- Ego syntonic disorders: where individuals with the disorder have symptoms that they believe are valued or
advantageous (ie. Obsessive-compulsive personality disorder with perfectionistic tendencies)
- Ego dystonic disorders: where individuals with the disorder have symptoms that they believe are undesirable (ie. OCD
with irrational behaviours)
Tailoring treatment to the individual
- treatments for one person with a specific psychological disorder are not universal for all individuals with that disorder
- select risk and protective measures impact the development of expression of mental health issues, so effective
treatment must take the individual, family, social, circumstantial, and cultural aspects of their life into account
- Prochaska and DiClemente coined the phrase stages of change that identify a stepwise progression of thoughts and
actions, marking effective change in problematic thoughts or behaviours
1) Precontemplation: refers to the inability or and willingness of acknowledging the fact that there is a problem
(ego systonic)
2) Contemplation: individually no leaching the existence of a problem, being unsure or unwilling to change it (ego
dystonic)
3) Preparation: recognizing the problem and preparing for change
4) Action: taking appropriate action to change the issue
5) Maintenance: continuation of healthy habits that were formed at the action stage, looking out for potential
stressors that can trigger reemergence of unhealthy behaviours
- Relapse: (sometimes, hopefully not) in the treatment of a substance related disorders, refers to a full
reemergence of past unhealthy behaviours
Section 2: Diversity of Treatment Providers:
Range of Provider Backgrounds and Licensure:
- providers of mental health services come from a wide range of professional backgrounds and experiences
- practitioners of non-traditional methods have room for creative practice
- laws and regulations exits to provide consumer protection and clarity in advertising
- psychologist: restricted to individuals who hold a doctoral degree in psychology
- therapist: freely available to be used by any provider of mental health services
• Licenced psychologist= psychologists with specific training and certification in clinical or counselling psychology
• Psychiatrists= medical doctors who have advanced training and certification in the practice of psychiatry
- Both are professional who engage in the practice of psychological treatment, but not all offer all forms of treatment or
any treatment.
- there are other individuals who offer treatment: social workers, counsellors, mental health workers, marriage and
family counsellors etc.
- all of which are subject to license requirements (ethical and professional standards)
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The Art of Science of Psychological Treatment:
• Therapeutic relationship: key factor that has been shown to have an important effect on treatment outcome,
relationship between the patient and the therapist
- a good therapeutic relationship accounts for as much of the treatment
outcome as does the treatment methods
Relationship qualities shown to be demonstrably effective:
- degree to which the patient and therapist are able to form a working
alliance (in individual therapy)
- show group cohesion (in group therapy)
- degree to which the therapist is able to demonstrate empathy, an
uderstadig of the patiet’s eotios ad thoughts
- degree to which the therapist collects and responds to feedback from the patient
Qualities shown to be probably effective include:
- positive regard, the therapist views the patient as a fundamentally good person
- goal consensus
- collaboration
Section 3: Diversity of Treatment Options
- treatment for a psychological disorders are in 2 categories:
1) Psychological Treatments
2) Biomedical Treatments
- sometimes they are given in the form of combination treatments
Evidence-Based Practice Movement
- understanding the utility of treatments for psychological disorders (and researchers in psychological treatment) was
majorly emphasized in the past three decades; proposes that
1) patient care is enhanced by up-to-date knowledge
2) there is a gap between advances in knowledge and clinicians ability to keep up with these advances
3) summarizes evidence from experts to bridge this gap
- led to the creation of expert panels in major professional bodies of psychology that set rule for evaluating evidence for
specific treatments and apply such rules for therapies of psychological disorders
- criticisms: (a) amount of clinicians being forced to restrict their practice to treatments on the list by managed-care
companies or threat of potential malpractice lawsuit; (b) list existence limiting the treatments used (ie. using the ones
that lacked formal research support and were not new or innovative); (c) treatment validity, being empirically
supported; (d) concerns addressed issues of treatment efficacy and effectiveness
1) Efficacy: ability of a treatment to produce a desired effect in highly controlled settings
• efficacy studies: studies (for an "ideal" patient) with a highly controlled setting such that the
medication leads to a desired effect on a certain medical condition
• randomized controlled trial: design where patients with only the certain condition are randomly
assigned to treatment groups with the medication or control groups with placebo in either
- single-blind trial: participants are unaware of what group there in
- double playing trial: participants and researchers are unaware of what group they're in
• issues include identifying patients with one specific condition of interest, selecting appropriate
treatment and placebos, blinding both for dispense and researchers, and evaluating treatment outcomes
• criticized for lack of differentiation between statistical significance and clinical significance, but
are deemed empirically supported
2) Effectiveness: treatment’s ability to produce a desired effects in real-world or ordinary or naturalistic settings
1. Alliance
5. Positive Regard
2. Cohesion
6. Goal Consensus
3. Empathy
7. Collaboration
4. Feedback
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• studies have estimated high prevalence of comorbidity of psychological disorders (or exaggerating
and depression tend to coexist)
• through this 4000 individuals receive treatment for mental illness in which nine of 10 reported
symptom improvement after treatment, such that this improvement did not differ depending on
the therapist profession or individuals psychotherapy and/or medication
• issues arise from the fact that these individuals were either representative sample of the
population that sought out and persisted with treatment, or could potentially not be a
representative sample of the population, as well as the absence of control groups (unable to
detect placebo effects), potential bias in self-report data, and limitations of the scale of that
improvements were measured
- Alan Kazdin outlines he following questions that ask the effectiveness of treatment versus no treatment, whether
specific components lead to positive change or add to optimize change, characteristics of treatments that improve the
outcome, effectiveness of treatment compared to others for this problem, which contextual features mediate or cause
and moderator influence therapeutic change, and what street when effects can be generalized for several issues
Section 4: Historical Psychological Treatments
• Psychotherapy: talk therapy, the process of treating mental and emotional problems through verbal
communication between patient and therapist
Psychoanalytic and Psychodynamic Therapy:
- “igud Freud’s -1939) psychoanalysis is generally thought of as the first of the talk therapies
- he worked with female patients suffering from hysteria (common condition of the time) Freud developed rich theories
on the origins and treatment of psychological disorders
- some of his ideas have been heavily criticized, but are well-represented in the treatment options available to us today
Conceptualization of psychological maladjustment:
- classic psychoanalysis: distress is thought to arise from the presence of internal, unconscious conflict (usually rooted in
trauma associated with childhood development)
- Freud’s ie: the mind (or psyche) contains three levels of awareness:
1) The conscious: containing the thoughts and feeling you have access to at any given moment
2) The preconscious: the contents of which can be actively brought to mind as needed
3) The unconscious: vast repository of inaccessible thoughts, repressed traumatic memories and primitive urges
resides
- Three Segments that reside at different levels of consciousness:
1) The id: operating at the unconscious level, is motivated to fulfill our innate, primitive instincts
2) The ego: bridging the unconscious, preconscious and conscious levels of awareness, is responsible for executing
the urges of the id in a way that is acceptable to the external environment
3) The superego: bridges all three levels of consciousness and seeks to govern your behaviour in such a way that is
congruent with internalized parental and societal standards of mortality
***Any conflicting urges of the id, ego and superego at an unconscious level is thought to drive unhealthy behaviour and
cause anxiety and stress.***
- catharsis: the process of resolving unconscious conflicts brought into conscious awareness and is thought to relieve
psychological stress
Therapeutic Techniques:
- patient must bring thoughts, emotions, memories and actions of the unconscious into conscious awareness
- this is a difficult task due to ego defence mechanisms: prevent the unconscious material from coming to the surface
- analyst must bring down these defences
- Major techniques:
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Document Summary
Psychological disorders and thus treatments is not a one-size-fits-all operation. Conceptualization: accurate and comprehensive clinical diagnosis of psychological disorders. We must ask ourselves the four d"s (deviance, distress, dysfunction, and danger) to determine whether or not we need to seek help. Ego syntonic disorders: where individuals with the disorder have symptoms that they believe are valued or advantageous (ie. obsessive-compulsive personality disorder with perfectionistic tendencies) Ego dystonic disorders: where individuals with the disorder have symptoms that they believe are undesirable (ie. ocd with irrational behaviours) Treatments for one person with a specific psychological disorder are not universal for all individuals with that disorder. Select risk and protective measures impact the development of expression of mental health issues, so effective treatment must take the individual, family, social, circumstantial, and cultural aspects of their life into account. Relapse: (sometimes, hopefully not) in the treatment of a substance related disorders, refers to a full reemergence of past unhealthy behaviours.
