PSYC 372 UNIT 5

What are the underlying convictions of treatment?

Improve the human condition

Maximize functioning, minimize suffering

Believe that people can change

Types of approaches?

Biological

Psychosocial

Sociocultural

Biological approaches

• Psychoactive drugs/medications
• Brain stimulation/shock, surgery
• Complementary/alternative medicine approaches

Psychosocial approaches

• Therapy (aka psychotherapy, counseling, interviewing)
• Self-help (e.g., books, videos, group-based support such as AA)

Sociocultural approaches

• Acculturation Supports
• Socio-Economic Efforts
• Prevention / Public Health

Types of drugs and their purposes

Anxiolytics

-Xanax

Anti-Depressants

-Paxil

Anti-psychotics

-Haloperidol

Mood-Stabilizers

-Lithobid

Theoretical Orientations

Insight-Oriented Therapies

Change-Oriented Therapies

Insight oriented therapies

Goal is to understand

-Psychoanalytic, Psychodynamic, Interpersonal, Person-Centered/Humanistic, Existential, Family Systems/Community

Change oriented Therapies

Goal is symptom remission

-Behavioral, Cognitive & CBT, New Wave

Psychologists who believed in the interpersonal perspective?

Teyber & McClure (Interpersonal-Process model)

Humanistic/Person-Centered Perspective

Primary Theorist: Carl Rogers

• 3 necessary & sufficient conditions for improvement: genuineness, empathy, unconditional positive regard

Existential Perspective

• Many contributors from philosophy and psychology (Sartre,
Kierkegaard, Nietzsche, Heidegger, Becker)
• Famous psychotherapist Irvin Yalom organizes his approach
around 4 core truths:
- Death
- Isolation
- Freedom
- Meaninglessness

Behavioral Perspective

Theorists Included: Watson & Skinner
- Exposure therapy, Aversion Therapy, Modeling, Systematic Reinforcement Approaches, Token Economics, Behavioral Activation

Cognitive & CBT Perspective

Examples include Alber Ellis’ Rational Emotive Behavior Therapy and Aaron Beck’s Cognitive Therapy

Socio-Cultural Level Interventions

• Politics, Law, and Public Policy
- Improvement of acculturation experiences
- Reducing poverty and SES effects
- Decreases in crime / trauma / violence
• Public Health & Prevention
- Awareness/educational campaigns
- Bolstering local resources and engagement
- Addressing stigma, bias, prejudices

How do we estimate the impact of therapy?

Most argue that a decrease in symptoms is a decent indicator, but where shouldthat data originate?
• ask the clinician to rate the client’s symptoms
- but clinicians are inherently biased to believe they are having an impact
• ask the client to rate themselves
- but after committing time and money to therapy, they too are biased toward believing they’ve improved
• ask the client’s friends/family
- but how often is that a reasonable option given the desired privacy of therapy...
• ask for changes to objective behaviors (e.g., drinking, cutting, suicidal thoughts)
- but how often does therapy boil down to just a few concrete things?

While people who get treatment do get better faster and stay better longer, do some get worse?

research shows that approximately 5-10% of clients deteriorate during treatment

Miller Chapter 3 Case Study:

Sally at first seemed to have really simple issues with focusing on her schoolwork/activities, and the intern intially tried asking simple things like, “are you sleeping enough?”, “not interested in your classes?”. However, eventually the intern learned that both of Sally’s parents had died within the last couple years, with both of their deaths being very traumatic on Sally. After understanding the context of Sally’s trauma, the intern was able to connect her grief to her constant distraction.

Main idea of pashak and shedler readings?

While there may be a big push for medical/cbt treatments (medications) for mental health issues, other methods like the psychodynamic perspective used by shedler can be just as effective.

Psychodynamic Perspective

Shedler

• Exploring Emotions
• Examining avoidances
• Identifying recurring patterns
• Discussing past experiences
• Focusing on relationships
• Examining the patient/therapist relationship

Which of the following is NOT a legally protected term (and thus can be used by anyone
providing related services)?

a. Therapist
b. Psychologist
c. Counselor
d. Social Worker

Is therapy helpful?

Yes, mostly (but about 5-10% actually get worse).

Which is the most appropriate analogy or description for therapy?

Collaborative exploration with an unbiased helper seeking improvement.

What is regression to the mean?

When an extreme/rare data point is followed later by a more normative/average data point within the same case, moving closer to the average (mean).

The case study at the end of Dr. Miller’s chapter 3 involved the behavioral counseling of “Sally,” who was seeking treatment for her inability to concentrate when attempting to study for her college classes. What was the most important lesson learned by the intern treating her? In other words, why do you think Dr. Miller chose to share this particular case study?

seemingly simple client problems may have complex contexts (i.e., her distraction appeared to be largely the result of grieving)

Two additional readings were assigned for this unit, one written by your instructor and another by Jonathan Shedler. Which option best summarizes a common theme between them?

Despite the psychiatry-APA’s frequent promotion of psychoactive medications for
mental disorders, and the psychology-APA’s focus on CBT treatments, there is actually strong meta-analytic data supporting the efficacy of other therapies as well, such as psychodynamic.

Which of the following theoretical orientations to psychotherapy could generally be
considered “insight-oriented”?

psychoanalytic`

Data from tightly designed experimental studies (e.g., randomized clinical trials) would
provide support within the __________ framework (focused on specific symptom efficacy).
Meanwhile, broader data including case studies, correlational studies, supervisory advising, and clinical experience could all be considered support within the __________ framework (focused on general effectiveness).

empirically-supported treatments (EST’s); evidence-based practices (EBP’s)

Whereas a clinician using the _____ model may say “client concerns stem from the basic truths of life such as isolation and freedom,” a clinician using the _____ model would instead
argue that “the cause of mental health problems is linked to client’s thought patterns and beliefs.”

existential; cognitive

The __________ model is the best attempt in the field of psychopathology to approach the etiology and treatment of mental disorders through a multi-systems approach, utilizing
research from various areas of science, and addressing all levels of analysis. While complicated, this approach remains the most comprehensive. It’s also an important ‘buzzword’ you should probably include in your personal statement when applying to graduate school!

Biopsychosocial