Summary Psychopathology Chapter 4

Clinical Psychology – Chapter 4 “Treating Psychopathology”

4.1 The nature and Function of treatments for Psychopathology

 Treatments possess characteristics of:
o Relief from the distress cause by symptoms
o Provide the client with self-awareness and insight into the problem
o Enable the client to acquire coping and problem-solving skills to
prevent future problems
o Identify and resolve the causes of the psychopathology
 Drug treatment have a palliative effect: the reduction of the severity of
symptoms and alleviation of distress
o No insight into problems
 Other therapies provide ways of changing behavior but no insight
 Treatment depends on
o The theoretical orientation and training of the therapist
 Therapist must demonstrate continuing professional
development (CPD): regularly updating one’s knowledge
o The nature of psychopathology
 National Institute for health and care excellence
(NICE): an independent UK organization responsible for
providing national evidence-based guidance on promoting
good health and preventing and treating ill health
 Theoretical approaches to treatment
o Psychodynamic approaches
 Reveal unconscious conflicts that developed early in life
 Bring conflict into conscious awareness and develop
strategies for change
 Psychoanalysis (Freud): understand source of conflict
 Free association
 Transference: target for emotional responses, behave
towards therapist as they would behave towards a
person in their life
 Dream analysis
 Interpretation: find conflict
 Multiple sessions per week; takes 3-7 years until
benefits are realized
 But limited effectiveness
o Behavior therapy
 Interventions to change the client’s behavior
 Conditioning – disorders resulting from faulty learning
 Anxiety through classical conditioning
 Behavior acquired through operant conditioning
o Behavior modification/behavior analysis –
unlearn a response
 Therapies based on classical conditioning
 Extinction (unlearning responses)
 Flooding: a form of exposure therapy for the
treatment of phobias and related disorders in which the

, patient is repeatedly exposed to highly distressing
stimuli
 Counterconditioning: a behavior therapy technique
designed to use conditioning techniques to establish a
response that is antagonistic to the psychopathology
 Systematic desensitization: Treatment of phobias an
anxiety disorders during which the client overcomes
their fears through gradual and systematic exposure
 Exposure therapy: treatment in which sufferers are
helped to confront and experience events and stimuli
relevant to their trauma/symptoms
 Reciprocal inhibition: anxiety is eliminated not just
by extinguishing the relationship between the anxiety-
inducting cue and the threatening consequence but
also by attaching a response to the anxiety-inducing
cue which is compatible with anxiety
 Also: addictive disorders, marital conflict, sexual dysfunction
 Aversive therapy: attempts to condition an aversion to a
stimulus or event to which the individual in inappropriately
attracted (addictive behaviors)
 Little evidence that aversive therapy alone has long-
term effects
o Therapies based of operant conditioning
 Used in 3 specific ways
 Understand what rewarding factors might be
maintaining challenging or aggressive behavior
 Use reinforcers to establish new behavior
 Used punishment to eliminate problematic behavior
 Functional analysis: an observational method for
identifying the consistencies between problematic behaviors
and reinforcing consequences
 Token economy
 Response shaping: a reinforcing procedure that is used to
develop new behaviors (like withdrawal)
 Behavioral self-control: the personal use of operant
conditioning principles to change or control one’s own
behavior
 Behavioral self-control scheme to address obesity
 Record time and quantity of food
 Weighing before each meal and before bedtime
 Removal of food from all places in the house (except
kitchen)
 Pairing eating with no other activity
 Setting a weight-loss goal of 1-2 pounds a week
 Slowing down the pace of eating
 Substituting other activities for between-meal eating
 Cognitive therapies

, o Rational emotive therapy (RET): addresses how people construe
themselves, their life and the world (Albert Ellis)
 People carry a set of implicit assumptions determining
perception
 Change a set of core beliefs
o Cognitive therapy: based on the belief that psychological
problems are the products of faulty ways of thinking about the world
 Replacing irrational beliefs
o Beck’s cognitive therapy: an intervention derived from Beck’s
view that depression is maintained by a “negative schema” that
leads depressed individuals to hold negative views about
themselves, their future and the world
 Replace them with more rational schemas
 Objective assessment of beliefs; provide evidence for them –
patients can perceive their existing schemas as biased
o Cognitive behavior therapy (CBT): an intervention for changing
both thoughts and behavior; an umbrella term for many different
therapies that share the common aim of changing both; possesses
characteristics of
 the client keeps a diary of events, moods, thoughts
 the client is urged to identify and challenge irrational
thoughts
 homework in the form of “behavioral experiments” to see
whether thoughts are accurate
 training of new ways of thinking, behaving and reacting in
specific situations
o “Waves” of CBT
 New forms of CBT are known as “waves”
 1st wave: behavioral techniques
 2nd wave: cognitions and emotions
 3rd wave: mindfulness and acceptance
 Mindfulness-based cognitive therapy (MBCT):
treatments emphasize achieving a mental state characterized
by present-moment focus and non-judgmental awareness
 Improve emotional well-being by increasing awareness
of how automatic cognitive and behavioral reactions to
thought, sensations and emotions cause distress
 Focus on present and accept feelings → deal with life
stressors
 Reduce depression and anxiety by countering
avoidance strategies
 Acceptance and commitment therapy (ACT): a “third
wave” CBT intervention that adopts aspects of mindfulness,
but has developed more from Skinnerian approach to
understand behavior
 Teaches patients to notice, accept and embrace
thoughts
 Clarify and act on personal values and increase
psychological flexibility