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PSYB32H3 Chapter Notes -Mental Health Professional, Canadian Mental Health Association, Clinical Psychology

Course Code
Konstantine Zakzanis

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Chapter 1: Definitional and Historical Considerations and
Canada’s Mental Health System
Bretts Childhood
His recent inability to maintain an erection when making love to his wife was the immediate reason for his seeking
Brett didn’t have a happy childhood. His mother died suddenly when he was only 6 and for the next 10 yrs he lived
either with his father or with a maternal aunt. His father drank heavily and the mans moods were extremely variable;
he had even been hospitalized with a diagnosis of manic depressive psychosis
Brett often became depressed for no apparent reason and sometimes this was followed by periods of manic
He felt self conscious with ppl who he felt had authority over him and he was esp sensitive about his clothes which
were old compared to his peers
He entered the police academy and he had hopes that his badge and uniform would give him the instant respect that he
seemed incapable of earning on his own
He wondered if he was actually avoiding the responsibility of having a child
He attacked her both verbally and physically about her alleged infidelity and then got help
Psychopathology- the field concerned with the nature and development of abnormal beh thoughts and feelings
Challenge in studying abnormal psych is the need to remain objective
Abnormal psysh is most popular but it has one distinct disadvantage which is that all of us bring to your study
preconceived notions of what the subject matter is
Challenge is how to define it
Abnormal beh- patterns of emotion, thought and action deemed pathological for one or more of the following
reasons: infrequent occurrence, violation of norms, personal distress, disability or dysfunction and unexpectedness
Statistical infrequency
One aspect of abnormal beh is that its infrequent
Normal curve or bell shaped curve- places majority of ppl in the middle as far as any particular characteristic is
concerned; very few ppl fall at either extreme.
An assertion that a person is normal implies that he or she does not deviate much from the average in a particular trait
or beh patterns
Statistical infrequency is used explicitly in diagnosing mental retardation
When an indiv IQ is below 70 his or her intellectual functioning is considered sufficiently below subnormal to be
designated as mental retardation
Violation of norms
Consider whether the beh violates norms or threatens or makes anxious those observing it
Violation of norms is too broad and too narrow
Cultural diversity can affect how ppl view social norms. What is the norm in one culture may be abnormal in another
Personal distress
Personal suffering ; that is beh is abnormal if it creates distress and torment in the person experiencing it
But some disorders don’t involve distress
Disability or dysfunction
Disability –impairment in some important area of life cuz of the abnormality can also be a part of abnormal beh
It applies to some but not all disorders.
Ex transvestism (Cross dressing for sexual pleasure) is diagnosed as a mental disorder if it distresses the person but
isn’t necessarily a disability

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Distress and disability are considered abnormal when they are unexpected responses to environmental stressors
There are approx 3,600 practising psychiatrist, 13000 psych and psych associate and 11000 nurses in the metal health
area in Canada
2.15% respondents had consulted with a pscyh one or more times in the preceding 12 months. This is = to 515,000 ppl
in the Canadian population aged 12 yrs and older
Psychological services are underused
Psych services are more available in urban areas than in rural
Clinician- a health professional authorized to provide services to ppl suffering from one or more pathologies
Clinical psychologist- an indiv who has earned a Ph.D degree in psychology or a Psy.D and whose training has
included an internship in a mental hospital or clinic. Entails 4 to 7 yrs of graduate study
A psych may have a either a doctoral or a M.A degree
In some areas psych are for doctoral level and psych associates are for M.A
1995 Agreement on Internal Trade (AIT) was developed so credentials of psych would be recognized from one part of
Canada’s would be recognized in other parts
mutual agreement was signed in June 2001. person has to have obtained 5 core competencies in order to become
registered as a psych 1) interpersonal relationships 2) assessment and evaluation (including diagnosis) 3)intervention
and consultation 4) research 5)ethics and standards
training for a Ph.D in clinical psych is similar to that in other psych specialities. It requires a heavy emphasis on lab
work, research design, statistics and the empirically based study of human and animal beh. The Ph.D is a research
degree and are require to research and write on it. Those in clinical psych learn two more things 1) learn technique of
assessment and diagnosis of metal disorders----- Diagnosis- the determination that a patient’s set of symptoms or
problems indicates a particular disorder
-2) they practise psychotherapy --a primarily verbal mans of helping troubled indiv change their thoughts, feelings
and behaviours to reduce distress and to achieve greater life satisfaction
the new Psy.D degree (doctor of psych) is similar to Ph.D but there is less emphasis on research and more on clinical
training. The Ph.D is more of a scientific practitioner model and the Psy.D is more of a scholar practitioner model
psychiatrist- a physician (M.D) who has taken specialized post doctoral training called a residency in the diagnosis,
treatment, and prevention of mental disorders
Psychoactive drugs chemical compounds having a psychological effect that alters mood or thought process. Ex:
Psychoanalyst- a therapist who has taken specialized postdoctoral training in psychoanalysis after earning an M.D or
a Ph.D degree. Can take up to 10 yrs of graduate work
Social worker- a mental health professional who holds a master of social work (M.S.W) degree
Counselling psychologist- a doctoral level mental health professional whose training is similar to that of a clinical
psychologist though usually with less emphasis on research and serious psychopathology
Psychiatric nurse- a nurse who has obtained additional training in the mental health field
Early demonology
Demonology- the doctrine that an evil being such as the devil may dwell within a person and control his or her mind
and body. Ex found in records of early Chinese, Egyptians, Babylon’s and Greeks
Since they thought ab beh was caused by possession its treatment involved
exorcism -- the casting out of evil spirits by ritualistic chanting or torture. Elaborate rites of prayer, noisemaking,
forcing the afflicted to drink terrible tasting brews, and flogging/starvation
Trepanning (of skulls) - the act of making a surgical opening in a living skull by stone age or Neolithic cave dwellers
was quite widespread. This act was sometimes performed cuz of the belied that it would allow evil spirits to leave the
Thought evil sprits would escape through the opening. Introduced into Americas from Siberia. The practise was most
common in Peru and Bolivia three aboriginal specimens have been found in Canada in B.C
The openings were located in the same area in all three, the upper central occipital

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Hippocrates father of modern medicine separated medicine from religion, magic and superstition. He rejected the
Greek belief that the gods sent serious physical diseased an mental disturbances as punishment and insisted instead
that such illnesses had natural causes
H. regarded the brain as the organ of consciousness, of intellectual life and emotion; thus he thought that deviant
thinking and beh were indications of some kind of brain pathology. H is often considered one of the very earliest
proponents of somatogenesis the notion that something wrong with the soma or physical body, disturbs thought and
Psychogenesis- in contrast is the belief that a disturbance has psych origins
H. classified mental disorders into 3 categories: mania, melancholia and phrenitis (or brain fever)
The ab beh became more imp for physicians than priests
For melancholia he prescribed tranquility, sobriety, care in choosing food and drink and abstinence from sexual
H. believed in natural rather than supernatural causes
Mental health was dependent on balance of four humours or fluids of the body: blood, black bile, yellow bile and
phlegm. An imbalance produced disorders
Sluggish and dull the body contained a preponderance of phlegm. Black bile was the explanation for melancholia, too
much yellow bile explained irritability and anxiousness and too much blood changeable temperament
H humoural physiology didn’t withstand but his basic statement that an beh is produced by some kind of psychical
imbalance or even dance was good
H held a somatogenic view of ab beh considering psychopathology a disease of the brain
The dark ages and demonology
Death of Galen the 2nd cen Greek who is regarded as last major physician of the classical era marked the beginning of
the dark ages for western European medicine and for the treatment and investigation of ab beg
Christian montesaries replaced physicians on mental disorder. Monks cared for the sick
The persecution of witches
Ppl in Europe became obsessed with the devil. Witchcraft instigated by Satan was seen as a heresy and a denial of god
Manual Malleus Maleficarum (the witches hammer) to guide the witch hunts
Those accused of witchcraft were to be tortured if they did not confess; those convicted and penitent were to be
imprisoned for life and those convicted and unrepentant were to be hand over to the law for execution. The manual
specified that a persons sudden loss of reason was a symptom of demonic possession and that burning was the usual
method of driving out the supposed demon
Witchcraft and Mental Illness
For some time they thought it was the mentally ill of the middle ages who were witches
Sometimes the accused reported having sex with the devil and these were interpreted as delusions and hallucinations
and indicated that some of the so called witches were psychotic
Many of the accused however were not mentally ill. Many more sane than insane people were tried. The delusion like
confessions were obtained during brutal torture. In England where torture was not allowed the confessions had no
From the 13th cen hospitals began to come under secular jurisdiction. Municipal authorities gaining in power tended to
supplement or take over some of the activities of the church on e of these being taking care of the ill
mid 14th century specified the purposes of the hospital among them that the “mad are kept safe until they are restored
of reason”. English laws during this time allowed both the dangerously insane and the incompetent to be confined in a
hospital. The ppl who were confined were not described as being possessed
beginning in the 13th century “lunacy” trials to determine a persons sanity were held in England. A judgement of
insanity allowed the crown to become guardian of the lunatics estate
Development of Asylums
until the end of the crusades in the 15th cen there were very few mental hospitals in Europe
confinement of the ill began in the 15th and 16th cen
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