Chapter 14: Psychological Disorders
The medical model: proposes that it is useful to think of abnormal behaviour as a disease. –
disorder, psychopathology (pathology refers to disease). view of sympathy without fear
18 century belief of demons, disorders treated by chants, rituals and exorcisms. People were
chained, tortured, put in dungeons and put to death.
Thomas Szasz belief that body can be sick minds cannot, simply deviation from norms of
society and living. Medical model converts questioning about acceptable behaviour into medical
Diagnosis: distinguishing one illness from another
Etiology: the apparent causation and developmental history of an illness
Prognosis: forecast about probable course of an illness.
Deviance: people who are outliers to social norms violating standards and expectations.
Exampletransvestic fetishism: sexual disorder in which a man achieves sexual arousal by
dressing in women’s clothing
Maladaptive behaviour: adaptive behaviour is impaired. Key criteria in diagnosis of substance
use disorders. When use of serious drugs like cocaine interfere with social functioning a
substance use disorder exists.
Personal distress: anxiety or depression depicted subjective pain and suffering to others.
People cannot be classified distinctively (abnormal vs normal, mental health vs illness).
Diagnose disorders when extremely, deviant, maladaptive and distressing.
MYTHS AND FALLACIES
Psychological disorders are incurable many people do not benefit from treatment but they are
greatly outnumbered by those who do get better spontaneously or through formal treatment.
People with psychological disorders are violent and dangerous only a modest association,
strongest predictor of violence is past violence, no significant risks of patients with disorder and
substance abuse producing violent behaviour.
People with psychological disorders behave in bizarre ways and are very different from normal
people minority cases involving severe disorders.
Rosenhan used pseudopatients who claimed to hear voices but behaved normally, got admitted
into hospital. Diagnostic inaccuracy distinguishing normal/abnormal.
Diagnositc and Statistical Manual of Mental Disorders (DSM) DSMIV
Axis I: Clinical Syndromes: disorders diagnosed in infancy, childhood or adolescence (ADD,
autism, enuresis, stuttering). Organic mental disorders (temporary por permanent dysfunction of
braintissue by diseased or chemicals (delirium, dementia and amnesia), substancerelated
disorders (maladaptive use of drugs and alcohol), Schizophrenia and other psychotic disorders
(over six months symptoms), mood disorders (emotional disturbance depression, bipolar,
dysthmymic disorder and cyclothymic disorder), anxiety disorders (panic, generalized anxiety),
somatoform disorders (resembles physical illness), dissociative disorders (sudden temporary
alteration or disfunction in memory, consciousness and identity), sexual and gender identity
disorders, and eating disorders
Axis II: Personality disorders (extreme patterns, inflexible personality traits that are deviant,
aladaptive and lead to impaired functioning or distress) Before 18 years old (ie Borderline
personality disorder (rule out dependent personality disorder)
Axis III: Medical conditions (diabetes, arthiritis and haemophilia)
Axis IV: psychosocial and environmental problems (negative life event, an environmental
difficulty or deficiency, personal stress, inadequate social support or resources). Axis V: global assessment of functioning 100 superior, 10 persistent danger of severely hurting
self or others.
Comorbidity: the coexistence of two or more disorders
categorical approach to diagnoses replaced by dimensional approach describe pathology in
terms of score on limited number of continuous dimensions (ie. how they exibit anxiety,
depression, agitation, hypochondira paranoia and so forth). DSM 5 will retain categorical
approach but there is a significant movement to dimensional in diagnosis and treatment.
Epidemiology: study of the distribution of mental or physical disorders in a population.
Prevalence: refers to the percentage of a population that exhibits a disorder during a specified
most interesting data is lifetime prevalence enduring disorder in a lifetime
In North America most common: substance disorders, anxiety disorders and mood disorders.
Anxiety disorders: class of disorders marked by feeligns of excessive apprehension and anxiety.
More in females.
Gernalized anxiety disorder: marked by chronic, high level of anxiety that is not tied to any
specific threat “free floating anxiety” nonspecific
Phobic disorder: marked by a persistent and irrational fear of an object or situation that
represents no realistic danger. Typically realize irrationality but unable to calm themselves.
acrophobia (fear of heights claustrophobia (fear of small closed spaces, brontophobia (fear of
storms, hydrophobia (fear of water, and various animal and insect phobia.
Panic disorder: characterized by recurrent attacks of overwhelming anxiety that usually occur
suddenly and unexpectedly. Diagnosed typically late adolescence or early childhood.
Agoraphobia: panic disorder of social/public situations afraid to leave home.
Nonclinical panic: differs from diagnosable panic attack (differing only in quantity)
Obsessive compulsive disorder (OCD): persistent, uncontrollable intrusions of unwanted
thoughts (obsessions) and urges to engage in senseless rituals (compulsions)
*Both an anxiety and personality disorder
Howie Mnadel (Deal or No Deal) knuckle bump mysophobia obsession with germs and
contamination. Summerfeldt, Antony and colleagues research heterogeneous disorder= factor
analysis of symptoms, obsessions,symmetry and order, cleanliness and washing and hoarding.
PostTramatic stress disorder: an anxiety disorder developed from a traumatic event.
Concordance rate: indicates the percentage of twin pairs or other pairs of relatives who exhibit
the same disorder
Risk factors for anxiety disorders temperament, sensitivity, alteration of neurotransmitter
activity at GABA synapses (arousal), and neural circuits of serotonin (correlated with panic and
may be acquired by classical conditioning and maintained through operant conditioning
fear through classical conditioning person starts avoiding anxietyproducing stimulus. The
avoidance response is negatively reinforced because it causes reduction of anxiety=operant
Seligman’s Theory of Preparedness: biological prepared b evolutionary history to acquire some
fears more easily. Explanation for fear of evolutionary threats like snakes, spiders more readily
than modern things like electrical outlets or hot irons.
Cognitive factors misinterpret harmless situations, focus on excessive attention to threats,
selectively recall information that seems threatening. Dissociative disorders: class of disorders in which people lose contact with portions of their
consciousness or memory, resulting in disruptions in their sense of identity.
Dissociative amnesia: sudden loss of memory for important personal information that is too
extensive to be due to normal forgetting
may be due to experience of even a single trauma causing severe personal stress
Dissociative fugue: people lose their memory for their entire lives along with their sense of
memory only for operational activity (drive a car, do math)
Dissociative identity disorder (multiple personality disorder): involves coexistence in one person
of two or more largely complete and usually very different personalities, each has their own
name, memories, traits and physical mannerisms.
SpanosSkeptical theory: engaging in intentional roleplaying touse mental illness as a face
saving excuse for personal failings. Some can “emerge” each personality.
Books: Sybil – initially thought 3 personalities have climbed to 15.
Michelle Remembers possible related to childhood torture by a satanic cult.
very little is known about the true cause of disorder but some clinicians believe it is a valid
Mood disorders: class of disorders marked by emotional disturbances of varied kinds that may
spill over to disrupt physical perceptual, social and thought processes.
Major diepressive disorder: persistenet feelings of sadness and despair and a loss of interest in
previous sources of pleasure
more in women NoelenHoekeema: believes depression is more prevalent in women due to
more susceptibility to abuse, poverty, harassment and role constraints.
Anthedonia: diminishd ability to experience pleasure
Dysthymic disorder: chronic depression that is insufficient tin severity to justify diagnosis of a
major depressive episode
Bipolar disorder (manic depressive disorder): characterized by experience of one or more manic
episodes as well as periods of depression. Equal in males and females.
Manic episodes: although positive can escalate to higher levels and become disturbing
Cyclothymic disorder exhibit chronic but relatively mild symptoms of bipolar disorder
Seasonal affective disorder: type of depression that follows a seasonal pattern
Postpartum depression: type of depression that can occur after childbirth, includes both
depression and mania
Men more likely to actualy comit suicide upon attempt women attempt more times than men,
Twin studies suggest that genetic factors are predispositions involved in mood disorders
Disruptions in neurotransmitters serotonin and norepinephrine. Antidepressent drugs promotes
serotonin, responsible for neurogenesis (research shows that there is a shrinking in the
hippocampus correlated with depression).
Hypothalamicpituitaryadrenocortical axis: overactivity in response to stress is related to
depression, elevated levels of cortisol (key stress hormone produced by HPA activity). Hormone
changes affect brain structure and functioning.
sePerfectionism: associated with depression
Selforeinted perfectionism: tendency to set high standarsds for oneself, otheroriented
perfectionism: refers to setting high standards for other, and social prescribed perfectionism:
tendency to perceive that others are setting high standards for oneself.
also correlation with eating disorders, problematic relationships, other heath problems and
postpartum. Ten signs: you can’t stop thinking about a mistake, no asking for help (flaw or weakness),
grammatic “you’re a perfectionist” not “your” correction.
Specific variables associated with depression
Retrospective designs: look backward in time from known outcomes.
Eck Theory sociotropic individuals: invested in interpersonal relationships (please others,
autonomous individuals oriented toward their own independence and achievement.
Blatt Theory between introjective personality orientation excessive self criticism, anaclitic
orientation involving overdependence on others.
These theories are persistent with congruency model that suggests that personality variables
operate as vulnerabilities in response to stressors related to that specific disposition. Ex,
dependentdepressive symptoms related to interpersonal relationships.
Beck’s theory: negative cognitive triad: reflects negative views on self, world and future.
Dysfunctional schemas (schema: organized cluster of knowledge from experience).
Seligman’s learned helplessness model giving up behaviour produced by unavoidable aversive
events *uncontrolled electric shock in laboratory). Pessimistic explanatory style.
Hopelessness theory: a pessimistic explanatory style is only one of more factors, along with high
stress, low selfesteem and so forth= learned hopelessness.
Schizophrenic disorders: class of disorders marked by delusions hallucinations, disorganized
speech and deterioration of adaptive behaviour. Usual loss of normal functioning and apparent
neglect of hygiene. Diagnosed during adolescence or early childhood manifesting by age 30.
peculiar behaviour, cognitive and social deeficits.
*disturbed thought whereas mood disorders=disturbed emotion
Delusions: false beleifs that are maintained thoughthey are clearly out of touch with reality
Delusions of grandeur: people maintain that they are famous or important. Thinking is chaotic,
loosening of associations (shifting of topics in disjoined ways).
Flat/Blunt affect: little emotional responsiveness.
Emotionally volatile: overreaction in erratic and unpredictable ways. Sometimes inappropriate
Hallucinations: sensory perceptions that occur in the absence of real, external stimulus or are
gross distortions of perceptual input
Paranoid schizophrenia: dominated by delusions of persecution along with delusions of grandeur
Catatonic schizophrenia: marked by striking motor disturbances, ranging from muscular rigidity
to random motor activity. Uncommon diagnosis.
Catatonic stupor: remain virtually emotionless and seem oblivious to environment for long
periods of time.
Catatonic excitement: they become hyperactive and incoherent.
Disorganized schizophrenia: particularly severe deterioration of adaptive behavior
Undifferentiated schizophrenia: marked by idiosyncratic mixtures of schizophrenic symptoms.
Associated with aimless babbling and giggling, complete social withdrawal, frequent
incoherence, emotional indifference. Delusions often center on bodily functions (ex, belief that
brain melting out of ears)
Undifferentiated schizophrenia: idiosyncratic mixtures of schizophrenic symptoms, fairly
Because there have been undifferentiated cases causing some difficulty with etiology, prognosis
or response treatment. Negative symptoms: involve behavioral deficits such as flattened emotions, social withdrawal,
apathy, impaired attention and poverty of speech.
Positive symptoms: involve behavioral excess or peculiarities such as hallucinations, delusions,
bizarre behavior and wild flights of ideas.
most patients who exhibit both symptoms vary only in the degree to which dominates
enhancing understanding of schizophrenia.
The dopamine hypothesis: schizophrenia attributed with excess dopamine, drugs dopamine
dopamine. This has become more nuanced over the years the nature of the dysregulation may
vary in different brain regions, also may be associated with glutamate.
Debate cannabis might contribute to schizophrenia. Critics suggest that emerging psychotic
symptoms causes young people to turn to marijuana to selfmedicated. Recent study in Germany
showed no selfmedication explanation controlling age, sex, social class, use of other drugs,
occurrence of childhood trauma and other disorders study found marijuana use roughly doubled
the risk of psychotic disturbance. THC may increase neurotransmitter activity in dopamine
circuits in certain brain areas.
CT and MRI scans show that enlarged ventricles (hollow, fluidfilled cavities in the brain)
which are assumed to reflect the degeneration of nearby brain tissue is associated with
schizophrenic disturbance. Still under debate; may be consequence of schizophrenia or may be a
Neurodevelopmental hypothesis: poses that schizophrenia is caused by various disruptions in the
normal maturational processes of the brain before or at birth. –Brain has sensitive phases of
development that if disrupted can cause subtle damage that elevates schizophrenia vulnerability.
Research focused on malnutrition during prenatal development, viral infections, and obstetrical
complications during birth process.
Research on factors related to Schizophrenia=exposure to influenza and other viral infections
during prenatal development. Prenatal malnutrition (exposed to severe famine due to Nazi
blockade). Severe maternal stress: Obstetrical complications (problems with delivery or labor).
Minor physical abnormalities (slight anatomical defects of head, hands and feet and face)
consistent with prenatal neurological damage.
Expressed emotion (EE): the degree to which a relative of a schizophrenic patient displays
highly critical or emotionally overinvolved attributes toward the patient.
resentment, excessive emotional involvement (overprotective, overconcerned attributes). Good
predictor of the course of illness, after hospitalization when returned to a family with high in
expressed emotion relapse more than return to a family with low expression. High stress can
also cause relapse.
Personality disorders: a class of disorders marked by extreme, inflexible personality traits that
cause subjective distress or impaired social and occupational functioning.
Avoidant personality disorder: excessively sensitive to potential rejection, humiliation or
shame; socially withdrawn.
Dependent personality disorder: lacking in selfreliance and selfesteem passively allowing
others to make all decisions, constantly subordinating own needs to others’ needs.
OCD: organization, rules, schedules lists, and trivial details.
ODD/ECCENTRIC CLUSTER Schizoid personality disorder: defective in capacity for forming social relationship, absence of
warm, tender feelings for others.
Schizotypal personality disorder: showing social deficits and oddities of thinking, perception
and communication that resemble schizophrenia
Paranoid personality disorder: showing pervasive and unwarranted suspiciousness and mistrust
of people; overly sensitive; prone to jealousy
Histrionic personality disorder: overly dramatic; tending to exaggerate expressions of emotion;
egocentric; seeking attention
Narcissistic personality disorder: grandiosely selfimportant; preoccupied with success fantasies,
expecting special treatment lacking interpersonal empathy
Borderline personality: unstable in selfimage, mood and interpersonal relationships; compulsive
Antisocial personality disorder: sociable, superficially charming, friendly, choose to reject
accepted social norms regarding moral principles regarding behaviour. Impulsive, callous,
manipulative, aggressive and irresponsible behaviour.
interchanged with “psychopathic/psychopath/psychopathy”
genetic vulnerability shown in twin studies. Some support of underarousal. *Emphasis on
inadequate socialization and family systems (abuse/neglect).
Autism: refers to a developmental disorder characterized by social and emotional deficits along
with repetitive and stereotypic behaviours, interests and activities. Egocentricity.
Pervasive developmental disorders
Kanner’s research on Donald T first patient with autism. Mania for spinning blocks and objects,
when someone tried to interrupt he would throw a tantrum. He exhibited an oddly detatched
orientation. Autistic aloneness: barrier between inner consciousness and ouside world. –later
considered a spectrum of disorders including Asperger’s disorder.
Deficit in development of language and communication. > echola: mimic what they heard from
others and repeat back sentences (sometiemes delayed).
Some OCD behaviour rocking, spinning and being comfortable with order and familiarity
higherorder repetitive behaviour: may have a special interest in topics, videogames, TV
Treatment: individualized, difficult and labourous, early and extensive intervention is ideal.
EIBI intensive behavioural interevention, 60000 per year, 40 hours a week everyday, 52 weeks
in a year. Individual skll broken down into steps with successful acquisition reinforced
Tony and Lori psychologist and social worker had a son Zachary who was stabbed to death by
neighbor Lucia Piovesan was the soul of her deceased son.
Not criminally responsible for the murder due to mental illness.
Insanity Laws, Defence
(NGRI) designation of not guilty by reason of insanity changed to “not legally responsible on
account of mental disorder (NCRMD) Criminal acts must be intentional. Not a diagnosis. Most
people with diagnosed psychological disorders would not qualify as insane. People who qualify
are troubled with severe disturbances that display delusional behavior. *Very rare success
M’Naghten’s rule: insanity exists when a mental disorder makes a person unable to distinguish
right from rule.
Originated when a delusional man attempted to kill prime minister and shot his assistant in
England became the basis of all insanity laws. >An increase demand for psychiatry and clinical psychology for diagnosis and evaluations for
the legal system.
Unfit to stand trial and if found later fit to stand trial and acknowledge the quality and
wrongfulness of act may be found not criminally responsible on account of mental disorder.
=dischanged, conditional discharge or offered to a psychiatric facility.
Automatism: not be held responsible for behaviour one cannot control. (physical injuriy to the
head, carbon monoxide poisoning, sleep walking and others). “A successful (noninsane)
automatism verdict means that the dfendent is not guilty and is released without onditions.
realistic view: the criteria of mental illness vary greatly across cultures and that there are no
universal standards of normality and abnormality DSM diagnostic system reflects enthocentric
Wester, urban middleand upperclass cultural orientation that limited relevance in other cultural
Pancultural viw argue that citeriai of mental illness are much the same around the world and
basic standards of normality and abnormality are universal. Typically maintain that Western
diagnostic conscepts have validity and utility in other cultural context.
Some contradictions to whether some disorders (anxiety, hypochondria, narcissistic personality)
are “run of the mill” difficulties and peculiarities rather than disorders
Culture bound disorders: abnormal syndromes found only in a few cultural groups
Koro: an obsessive fear that one’s penis will withdraw into one’s abdomen, is seen only among
Chinese males in Malaya.
Windigo: involves an intense craving for human flesh and fear that one will return into a
cannibal is seen among Algonquin cultures
Pibloktoq: type of Arctic hysteria associated with Inuit.
Anorexia nervosa: typically western cultures, involves an intense fear of gaining weight,
disturbed body image, refusal to maintain normal weight and dangerous measures to loose
Restricting type anorexia: people drastically reduce food intake
Bingeeating/purging type anorexia nervosa: forcing vomit, misusing laxatives and diuretics and
engaging in excessive exercise.
Amenorrhea: loss of menstrual cycle. Osteoporosis: loss of bone density. Also causes metabolic
problems, gastrointestinal problems, low blood pressure, and cardiac arrest or circulatory
Bulimia nervosa: involves habitually engaging in outofcontrol overeating followed by
unhealthy compensatory efforts such as selfinduced vomiting, fasting, abuse of laxatives and
diuretics and excessive exercise.
Bingeeating disorder: distressinducing eating that are not accompanied by purging fasting and
excessive exercise. Less severe, people tend to be disgusted by bodies nad distraught about their
over eating and are frequently overweight.
not as strong genetically but there is a correlation.
The more biological components supporting the disorder the more it is expressed in similar
ways in various cultures.
Depression: variable symptoms: guilt and selfdepreciation in Western cultures and non
western cultures: somatic symptoms: fatigue, headaches, backaches.
Biopsychosocial approach and Disorders
Stressvulnerability models for mood and schizophrenic disorders.
Vulnerability: heredity, genetics. Thinking About Mental Illness
Representative heuristic: estimated probability of an event is based n how similar the event is to
the typical prototype of that event
The conjunction fallacy: occurs when people estimate that the odds of two uncertain events
happening together are greater than the odds of ether event happening alone.
The availability heuristic: estimated probability of an event is based on the ease with which
relevant instances come to mind.
Chapter 15: Treatment of Psychological Disorders
Insight therapy: Freud psychoanalysis individual or group. Clients engage in complex verbal
interactions with the therapists, goal= pursue increased insight regarding nature of diffciulties,
and sort through possible solutions.
Behaviour therapies based on the principles of learning efforts to alter problematic responses
and maladaptive habits. Involves (classical, operant and observational learning)
Biomedical therapies: interventions on individual’s biological functioning. Drug therapy and
electroconvulsive (shock) therapy. 57% psychotherapy clients administered drugs. *Psychiatry
therapeutic triad (therapist, treatments and clients) greatest diversity is in the clients. Median
delay in seeking treatment 6 years bipolar and drug dependence, 8 years for depression and 10
for panic disorder.
Clinical psychologist training emphasis on treatment of fullfledged disorders. Counseling
psychologists training with everyday adjustment problems.
(PhD, PsyD, or Ed.D) to practice 5 to 7 years on top of a bachelor degree.= Psychologist
Psychologists may have a PhD or MA (two years). MA degree= Psychological associate
MD degree= Psychiatrists are physicians who specialize in the diagnosis and treatment of
psychological disorders. More time on severe disorders, schizophrenia and mood.
Insight therapy: involves verbal interactions intended to enhance selfknowledge and thus
promote healthful changes in personality and behaviour
Psychoanalysis: insight therapy that emphasizes the recovery of unconscious conflicts, motives,
an defenses through techniques such as and transference.
Free association: clients spontaneously express their thoughts and feelings exactly as they occur
with as little censorship as possible
shout out words in response to those proposed by the therapist.
Dream analysis: therapist interprets symbolic meaning of the client’s dreams.
clients are encouraged and trained to remember dreams to describe in therapy and therapist
Interpretation: therapist’s attempt to explain the inner significance of client’s thoughts, feelings,
memories and behaviours.
Resistance: refers to largely unconscious defensive manoeuvres intended to hinder the progress
Transference: occurs when clients unconsciously start relating to their therapist in ways that
mimic critical relationships in their lives.
psychoanalyst often encourage transference so that clients can reenact relationships with
crucial people in context of therapy to help bring repressed feelings and conflicts to surface
confusing highly charged emotions in client
> other central features of modern psychodynamic therapies: 1) focus on emotional experience,
2) exploration of efforts to avoid distressing thoughts and feelings, 3) identification of recurring patterns in patients’ life experiences, 4) discussion of past experience, especially those of
childhood, 5) analysis of interpersonal relationships, 6) focus on therapeutic relationship itself
and 7) exploration of dreams and other aspects of fantasy life.
Clientcentered therapy: insight therapy that emphasizes providing a supportive emotional
climate for clients, who play a major role in determining the pace and direction of their therapy.
The client and therapists are equals little guidance and keeps interpretation and advice to a
minimum. Therapists like mirrors, reflecting statements with enhanced clarity.
Roger’s theory about neurotic anxieties incongruence between a selfconcept and reality.
Inaccurate feedback of characteristics you believe you have and what others view of you.
Excessive incongruence is root of seeking approval of others. This type of therapy focuses on
selfacceptance and personal growth
Therapeutic alliance, according to Bordin: emotional bond between therapist and client, along
with agreement on goals for the therapy and agreement on therapeutic tasks. Critical to success
According to Rogers the process is not as important as the emotional climate
1) Genuineness: therapist must communicate honestly and spontaneously, not phony or
2) Unconditional positive recard: complete nonjudgmental acceptance of client as a person.
3) Empathy: therapist must understand client’s point of view and communicate that.
Rogerian therapy through email is a new trend that has started
Les Grenberg developed “emotion focused couples therapy” initially from individual emotion
focused therapy based on the belief that cognitiveehavioural therapy missed out on dealing
with ccore problems. Focuses on emotions to the treatment of dysfunctional relationships.
Nature of relationship issues and underlying emotions are identified, acknowledged needs are
Positive psychology: uses theory and research to understand positive, adaptive, creative and
fulfilling aspects of human existence. Rather than focusing on pathology, weakness and
suffering, more focus on health and resilience.
positive psychology: going past the neutral or I’m OK for now.
wellbeing therap by Giovanni Fava enhances selfacceptance, purpose, autonomy and
positive psychotherapy by Seligman: mainly effective treatment of depression, recognition of
strengths, appreciate blessings, savor positive experiences, forgive those who have wronged
them and find meaning in their lives.
Group therapy: simultaneous treatment of several clients in a group. (4 to 15 people; ideally 8).
A majority of the time it is supposed to be homogenous (people of similar traits, and problems)
(according to the textbook there still is some debate). Participants essentially function as
therapists for one another. Members describe problems, viewpoints, share experiences and
discuss coping. Therapist just stays in the background trying to maintain healthy climate and
establishes cohesiveness–Save time and money.
Also Rogerian therapy started after WWI (large group of veterans, not enough psychologists).
Critical Incident Stress Debreifing “The Mitchell Model” stepwise model developed for
emergency workers. To get people to talk about their feelings, people talk about incident. They
don’t like talking about feelings. Why you’re here, talk about reaction, state rules (focus only
your own perspective). Never ask how they feel. *Asks each person to describe what they saw and what they did. = automatic expression of
*Next question: what kind of thoughts have you been having since or at the event?
*What is the worst part? Which part do you wish never entered your mind? Most irritating?
Couples or marital therapy: treatment of both partners in a committed intimate relationships
which the main focus is on relationship issues
Family therapy: involves the treatment of a family unit as a whole, in which the main focus is
on family dynamics and communication.
usually emerges out of efforts to treat adolescents and children with individual therapy.
Spontaneous remission: recovery from a disorder that occurs without formal treatment.
no automatic assumption recovery is due to treatment
insight therapy is superior to no treatment or to placebo treatment that the effects of therapy are
reasonably durable. Insight therapy equivalent results to drug therapy
Criticism: what does getting better mean? People on the list were probably more severe cases.
Success of insight therapytherapeutic alliance, emotional support and empathetic
understanding, hope and positive expectations in client, provision of rationale for problems and
method of reducing them, opportunity to express feelings, confront problems, gain new insights
and learn new patterns of behaviour.
Behaviour therapies: application of learning principles to direct efforts to change clients’
BF Skinner was able to clearly control and study behaviour.
Assumptions that belief that behaviour is a product of learning, what has learned can be
Systematic desensitization: behaviour therapy used to reduce phobic client’s anxiety responses
weakening association between conditioned stimulus and the conditioned response of anxiety.
Therapist helps client build an anxiety hierarchy. The second step involved training the client in
deep muscle relaxation. The third step: the client tries to work through the hierarchy learning to
remain relaxed while imagining each stimulus
counterconditioning an attempt to reverse the process of classical conditioning by associating
the crucial stimulus with a new conditioned response
Exposure therapies: clients are confronted with situation that they fear so that they learn that
these situations are really harmless sometimes real and sometimes virtual reality (computer
Exposure treatments can be administered in a single session effectively “OST” One Session
Treatment by Ost, involves an intensive three hour intervention that depends on the gradually
increased exposures to specific phobic objects and situation. –ie. approaching a spider in series
of steps, once anxiety subsides the person becomes closer and waits until anxiety is diminished.
Aversion therapy: behaviour therapy in which an aversive stimulus is paired with a stimulus that
elicits an undesirable response.
Treat Alcoholismemetic drug: causes nausea paired with favourate alcoholic drink aversion
Social skills training: behaviour therapy designed to improve interpersonal skills that
emphasizes modeling, behavioural reshearsal and shaping.
social skill training depends on operant conditioning and observational learning
modelling: client is encouraged to watch socially skilled individuals in order t acquire
appropriate responses. Behavioural rehearsal client tries to practice social techniques in structured roleplaying
exercises. Therapist provides feedback and approval to reinforce progress
Shaping: used in that clients are gradually asked to handle more complicated and delicate social
Cognitive behavioural treatment: used carried combinations or verbal interventions and
behaviour modification techniques to help clients change maladaptive patterns of thinking.
Beck’s cognitive therapy= behavioural treatment.
Cognitive therapy: uses specific strategies to correct habitual thinking errors that underlie
various types of disorders.
_According to cognitive behaviour therapy depression is caused by errors in thinking.
Depression prone: blame setbacks on personal inadequacies without considering circumstant