Treatment of Abnormality and Research Methods
develop drugs that would reverse the bodily processes known to cause the disorder
after discovery of chlorpromazine
Reduce symptoms of psychosis (loss of reality testing, hallucinations, delusions)
Saved people locked away in psychiatrist hospitals
Clozaril, Chlorpromazine, haloperidol
Visual disturbances , involuntary movements of the face
Reduce symptoms of depression (sadness, loss of appetite, sleep disturbances)
Hydrazine used for fuel V-2 rocket during WWII (Germany)
Inhibit enzymes in the brain reuptake neurotransmitters, serotonin and dopamine
Prozac selective serotonin reuptake inhibitors
40 million take ^
Nausea, diariah headache, failure to achieve an orgasm, insomnia
Increased suicidality in children and adolescents
Reduce symptoms of anxiety (far, worry, tension)
Barbiturates suppressed the central nervous system
Highly addictive in use 6 weeks +profuse sweating, heart rate, irritability
Toxic interactions with alcohol and other drugs
Valium , pentobarbital
Use lithium metallic element present in water, animals and plant tissue
Anticonvulsants and calcium channel blockers
Severe side effects
Electroconvulsive Therapy (ECT)
Pass electrical current through the head which triggers seizures
Originally treatment for schizophrenia in early 20 century
Results found effective for depression instead
Patients are anaesthetized and give muscle relaxers not to be conscious while seizures
70-150 volts passed through
Significant permanent cognitive damage
People who do not respond to medication ECT effective for them
Remove part of the brain thought to be implicated in the disorder
Procedure prefrontal lobotomy
Very rarely used Severe side effects
Do not know exactly which part of brain causes disorder
Repetitive Transcranial Stimulation
Uses powerful magnets to stimulate targeted areas of the brain
Daily for a week for depression experience relief from symptoms
Long term changes in neurotransmission / Only headache as side effect
What is Psychotherapy?
Psychological approach to treatment
Individual, group, family, couple
Advantages and disadvantages of individual vs. group
Psychodynamic, interpersonal, behavioural, cognitive, humanistic,
Unconditional positive regard
Development of trust
Foster expectancy of hope and change
Goals of most Psychotherapy’s
Fostering insight, awareness, and self-understanding
Reducing emotional distress
Encouraging catharsis—acknowledgement and release of affect
Providing new information
Assigning outside therapy tasks
Development of hope and positive expectations
1. Sigmund Freud’s ideas brought us the first psychotherapy. His techniques are
used by almost no one today. Some of his ideas still exist in the psychodynamic
2. A quick review of psychoanalysis…
1. We are constantly in a struggle with ourselves. Our struggles hearken
back to a childhood struggle with our parents.
2. We do things as “grown ups” because we have repressed memories and
desires and our unconscious drives us to do them.
3. Psychoanalytic therapy tries to dig down into a person’s unconscious (the part of
the iceberg below the water) and root out the causes of the struggles. Then the
struggles can be relieved.
1. Freud first tried to dig into the unconscious with hypnosis, then trashed
the idea. 2. He next turned to free association where people speak freely and
quickly. The idea is that they’ll speak their unconscious and a
psychoanalyst will be able to decipher it.
1. If a person stops speaking freely, the analyst sees it
as resistance – the person is suppressing something they don’t
want to surface.
3. Freud turned to dream analysis and what he called the “latent content”
– the hidden but symbolic meaning of things in dreams.
1. Patients may feel strong emotions and transfer those onto the
4. A weakness of psychoanalysis is that it’s so subjective – it’s one analyst's opinion
and it can’t be objectively proven.
Goal is insight into one’s inner life
Help clients gain insight into unconscious motives and conflicts, thought analysis
of free associations, resistances, dreams and transferences
Examines early relationships with parents
Some therapists use hypnosis to uncover repressed material
3-4 sessions a week over many years
Interpersonal psychotherapy is a 12-16 session treatment that has been successful
with treating depression.
o It tries to dig up the cause of their depression. But the real goal is to cut
back the symptoms of depression.
o Whereas a psychodynamic therapist focuses on finding the root cause of
the problem, the interpersonal psychotherapist tries to do this too, but
really wants a more real result. Often the real result is improving
relationships with others
Working through – going over painful memories to weave them as self-definition to accept them
Catharsis – the expression of emotions connected to memories and conflicts, central to healing
Transference – Patient displaces affect and feeling about others onto the therapist
Counter transference – Therapists’ emotional responses to patient
client reacts to the therapist as if an important part of early development
Abnormal behaviour develops in the same way as normal behaviour
Same principles of classical and operant conditioning
Behaviorists disagree that resolving unconscious conflicts or getting to
know yourself will solve your mental issues. Behaviorists say you’ve
learned these things through rewards and punishments. But, just as
you’ve learned them, you can unlearn them too.
1. Behaviorism got its start with Ivan Pavlov and his dogs.
1. In behaviorism, a person (or dog), is conditioned to associated two things
2. Bed-wetting was classically conditioned with being awakened by an
alarm. This stopped the bed-wetting.
2. Counterconditioning is where we “unlearn” something by conditioning or pairing
a trigger stimulus with a new response.
1. For example, suppose a person has acrophobia—fear of heights Behaviour modification
The application of operant learning principles to bring about a specific
Behaviour Therapy Techniques
Rewards might be food or “token economy”. This is receiving tokens
which can be spent for things like candy, TV time, etc. It’s like earning
points in a video game which can be used for various things.
Critics say behavior modification means the behaviors are done just to
get silly things like plastic tokens. Behaviorists say they slowly take a
person off the tokens, and ask, “Their behavior is better, so where’s the
Relaxation Training – helps the individual voluntarily control psychological
manifestations of anxiety
Assertiveness Training -
Social Skills Training – help people with communications
Exposure therapy exposes people to what they try to avoid. It tries to associate
the bad thing (heights) with a good thing (like eating). Slowly, the person is
moved closer to the ledge or higher up. Eventually, the height is associated with
Systematic desensitization says you can’t be worried and relaxed at the same
time. So, while relaxed, you “face your fears” in small baby steps and work up to
the “big fear.”
1. The therapist trains you to use “progressive relaxation” to keep calm
when you feel the first hints of anxiety.
2. The trick here is to take it very slowly, in baby steps
Modeling – models desired behaviours so that client can learn through
Based on theories of Beck and Ellis
Influences behaviour and emotions by modifying cognitions
Attempts to help clients change misconceptions about the self, others, and world
First goal is to assist clients in identifying their irrational and maladaptive
Key aspects of cognitive therapy
Presentation of therapy rationale to patient
Focus on the “here and now”
Open-ended, Socratic questions
Maintain daily records of mood, behavior, and dysfunctional thoughts
Carry out informal experiments to test thoughts, beliefs, and assumptions Techniques
In vivo, flooding, implosive
Identifying and challenging negative automatic thoughts and core beliefs
1. Humanists believe that people are good-at-heart and try to help people grow to reach their
1. The humanist approach and psychoanalysis are called insight therapies because
they both have the person look inside to figure things out.
2. Humanist therapies differ from psychoanalysis in that humanism (1) focuses on the present
instead of the past, (2) the conscious instead of the unconscious, (3) holds a person
accountable for his actions instead of the unconscious, and (4) it promotes growth rather
than a cure.
3. Carl Rogers innovated client-centered therapy where the patient speaks and, through
self-awareness, moves himself toward his own conclusion. It's "self-help". The therapist
listens without judgment and with as little input as possible.
1. Rogers encouraged therapists to show genuineness, acceptance, and empathy. In other
words, be real, don’t judge, and feel their pain.
2. Rogers thought this encouraged the patients to “open up” and seek to grow and move on.
3. Rogers spoke of active listening where the listener echoes what’s heard, restates it, then
4. Rogers #1 thing was that a therapist use unconditional positive regard – that they listen
without judging. The hints to listening…
1. Paraphrase what you hear.
2. Seek clarification to see if you got it right.
3. Reflect the feelings that you’re hearing/sensing.
Emphasis on people’s needs to confront questions about meaning and
direction of their lives
Group therapy provides a number of factors that contribute to psychological and
E.g., cognitive-behavioural group therapy, process groups
Family and marital therapy
Group therapy is the most common type of therapy—it saves therapist time and
It shows patients that they are not alone and that others share their problems.
Family therapy is a type of group therapy. It stresses the importance of being an
individual and a member of a family. Family therapy sees a person not solely as an individual but as a
component. It’s like a spark plug as a part of an engine—both individual
yet part of the whole.
Usually, family-therapy seeks to help a relationship issue.
Does Psychotherapy work?
Eysenck’s study no
Smith & Glass Metaanalysis yes
NIMH collaborative study yes
The Consumer Reports Study yes
Empirically Supported Therapies – yes
A list of therapies that are superior to placebo or another form of therapy
Issues in psychotherapy
Specifying the problem
Specifying the treatment
Specific and nonspecific elements of therapy
Therapist training and fidelity
Research design issues (e.g., single case and RCTS)
Internal validity issues (e.g. measurement of outcome, sample size, blindness)
External validity issues (e.g., setting, flexibility of treatments)
Concerns about reliance on ESTs
ESTs are limited by the methodology of psychotherapy research (e.g. RCT)
Some therapies are easier to test (e.g. CBT)
Some problems are more difficult to treat and therefore have fewer ESTs
Just because a therapy is not listed as an EST does not mean it could not be
Treatment research might not generalize to clinical settings
ESTs are too restrictive in general clinical practice
There is a need for dissemination research Third party payers might misuse lists of ESTs
Reasons for hospitalization
Behaviour poses threat to self or others
Behaviour intolerable to community
Outpatient treatment failed
Treatment requires controlled setting
Withdrawal from drugs or alcohol
Physical illness complicated by mental disorder requiring continuous care
Legislation exists to hospitalize patients against their will if required for safety
Types of hospitalization
May or may not have passes to leave hospital
When complete hospitalization not required
Day, evening, or weekend care
For patients who can live at home but need structure and social interaction
The Scientific Method
1) Specify the topic as clearly and precisely as possible.
2) Review the relevant literature.
3) Define the variables:
Independent variables are conditions or factors that are being studied or
Dependent variables are what you observe as outcomes
1) Develop a specific hypothesis or hypotheses.
2) Select a research strategyhow will the hypothesis be tested?
3) Conduct the study.
4) Analyze the results, using descriptive and/or inferential statistics. The former
describe the sample (e.g. means, s.d.) and the latter provide probabilistic
5) Report the findings.
Detailed clinical description of a single subject
Provides important ideas or hypotheses regarding a specific disorder or theory
May be useful for rare disorders, such as DID (multiple personality disorder)
Correlational Research Examines the relationships between variables without manipulating any of the
Provides useful preliminary information, but are limited in that they cannot
determine causal relationships
Crosssectional assessment is conducted at one point in time
Longitudinal assessment is conducted at several points in time with the same
group of individuals
Followup assessment is conducted at several points in time with the same
group of individuals, usually to examine the impact of an intervention