Chapter 11: Psychological Treatments
Psychiatry: Derived from psyche meaning ‘mind’ and –iatry meaning conceptualizations of psychopathology (called insanity/madness at the
‘the healing of’ time)
Clinical Psychologists: Have a doctorate in clinical psychology but are ● Some thought the movement of the moon/stars could
not medical doctors (can’t prescribe medicine), formally trained in explain abnormal behaviour, giving rise to the term ‘lunatic’
psychological therapies, typically study psychology from a holistic ● Abnormal behaviour was also attributed to the influence of
perspective (physiology, as well as social and environmental devils, witches, spirits and demons
determinants) ● Many thought that compulsions toward abnormal behaviour
Psychiatrists: Specialized medical doctors, receive relatively less were evident of divine punishment for sin/immorality
training in psychological therapy, far more advanced in pharmacology, ● Religion causation of abnormal behaviour → religious
qualified to prescribe medications treatment → exorcisms (religious rituals seeking to cleanse
Efficacy Trials: Studies aimed at evaluating if a treatment works under afflicted individuals of supernatural possession/curses)
perfectly ideal settings (fails in ideal settings = will likely fail in ○ If exorcism failed, physicians/healers would make
"non-ideal" settings of the real world), use relatively small participant the body ‘uninhabitable’ to evil spirits through
groups drawn from highly selected and specific homogenous gruesome methods like forced isolation, beatings
populations and torture
Effectiveness Trials: Experimenter control is critically relaxed, ● Today, supernatural beliefs about psychopathology are
researchers now want to know if treatments shown to work in the limited but most devout members of organized religions will
earlier efficacy trials will still work once tested on most patients in only seek religious treatment for severe disorders as a last
most settings resort
● Efficacy research maximizes the likelihood of observing the ● Modern example: People thinking AIDS was divine
effect of treatment + informs effectiveness research punishment for homosexuality
● Effectiveness research accounts for other factors that may ● Criticism: Suspicious evidence (confessions made under
moderate a treatment’s effect + informs health-care torture were likely to escape further torture, so they should
decisions not have been used as evidence)
Barriers to Treatment: Early Psychological Approaches: Considers psychological, social, and
● Systemic External Barriers: Lack of time/money, local cultural factors to treating abnormal behaviour, has ancient roots
health-care systems not offering needed specialized ● Philosopher Hippocrates believed social stress could induce
treatment psychopathology
● Internal Barriers: Patients’ own restrictive beliefs about their ○ Treatment = removing patients from
disorder stress-inducing families
○ Ego Dystonic: A person with a negative ● Some healers saw ‘insanity’ as a curable natural
relationship to their disorder (dys = phenomenon caused by mental and emotional stress
dysfunctional), dislikes symptoms + effects ○ Treatment = rest and relocation to less stressful
○ Ego Syntonic: A person with a positive environments
relationship to their disorder (syn = synergy), have ● Institutionalization (isolated asylums, low standards of care,
accepted disorder + found ways to embrace it, can dehumanization of patients) became the common way to
act as a coping mechanism manage the mentally ill/abnormal individuals in the 18th
■ If patients don’t recognize their disorder century (however asylums mostly reduced inconvenient
as a problem due to a positive ‘burden’ on society and family rather than treating the
relationship with it, they won't solve it institutionalized)
so treatments often work to ensure the ○ Primary purpose of asylums = asylum keepers
patient has an ego dystonic relationship making money by relieving households of their
with the disordered symptoms burdensome, abnormally behaved relative
The Stages of Change: The stepwise change of problematic thoughts ○ Insanity can cause embarrassment, financial
or behaviours burden and danger to family members
● First Stage → Precontemplation: An inability/unwillingness ● Physicians found that patients allowed normal social
to acknowledge the existence of a problem interaction with minimal restraint/seclusion would
● Second Stage → Contemplation: The individual experience dramatic reduction in symptomology (but this
acknowledges the existence of the problem, but may be was only practical if asylums limited their patients)
unsure/unwilling to change the problem ○ However, shifts towards humane treatment of the
● Third Stage → Preparation: Individuals recognize the institutionalized never took permanent hold
problem and prepare for change (Neither families or asylum keepers wanted the
● Fourth Stage → Action: Involves taking active steps to institutionalized treated and returned due to
change the behaviour money and burden factors)
● Final/Fifth Stage → Maintenance: Individuals continue the ○ As a result, institutionalized patients increased
healthy habits formed at the action stage tenfold making therapeutic care impossible (more
Relapse: The full return of old/unhealthy behaviours, often driving the like prisons than hospitals)
afflicted individual all the way back to the precontemplation stage of ● Soon, psychological disorders were seen as not-yet curable
change, often triggered by stressors brain diseases (until the time of Freud)
Supernatural Approaches: Approach to psychological treatment based Early Biomedical Approaches: Considers physiological explanations
on non-empirical concepts like religion, mythology and astrology that of abnormal behaviour
drove much of the 14th, 15th, 16th and 17th centuries’
Psychiatry: Derived from psyche meaning ‘mind’ and –iatry meaning conceptualizations of psychopathology (called insanity/madness at the
‘the healing of’ time)
Clinical Psychologists: Have a doctorate in clinical psychology but are ● Some thought the movement of the moon/stars could
not medical doctors (can’t prescribe medicine), formally trained in explain abnormal behaviour, giving rise to the term ‘lunatic’
psychological therapies, typically study psychology from a holistic ● Abnormal behaviour was also attributed to the influence of
perspective (physiology, as well as social and environmental devils, witches, spirits and demons
determinants) ● Many thought that compulsions toward abnormal behaviour
Psychiatrists: Specialized medical doctors, receive relatively less were evident of divine punishment for sin/immorality
training in psychological therapy, far more advanced in pharmacology, ● Religion causation of abnormal behaviour → religious
qualified to prescribe medications treatment → exorcisms (religious rituals seeking to cleanse
Efficacy Trials: Studies aimed at evaluating if a treatment works under afflicted individuals of supernatural possession/curses)
perfectly ideal settings (fails in ideal settings = will likely fail in ○ If exorcism failed, physicians/healers would make
"non-ideal" settings of the real world), use relatively small participant the body ‘uninhabitable’ to evil spirits through
groups drawn from highly selected and specific homogenous gruesome methods like forced isolation, beatings
populations and torture
Effectiveness Trials: Experimenter control is critically relaxed, ● Today, supernatural beliefs about psychopathology are
researchers now want to know if treatments shown to work in the limited but most devout members of organized religions will
earlier efficacy trials will still work once tested on most patients in only seek religious treatment for severe disorders as a last
most settings resort
● Efficacy research maximizes the likelihood of observing the ● Modern example: People thinking AIDS was divine
effect of treatment + informs effectiveness research punishment for homosexuality
● Effectiveness research accounts for other factors that may ● Criticism: Suspicious evidence (confessions made under
moderate a treatment’s effect + informs health-care torture were likely to escape further torture, so they should
decisions not have been used as evidence)
Barriers to Treatment: Early Psychological Approaches: Considers psychological, social, and
● Systemic External Barriers: Lack of time/money, local cultural factors to treating abnormal behaviour, has ancient roots
health-care systems not offering needed specialized ● Philosopher Hippocrates believed social stress could induce
treatment psychopathology
● Internal Barriers: Patients’ own restrictive beliefs about their ○ Treatment = removing patients from
disorder stress-inducing families
○ Ego Dystonic: A person with a negative ● Some healers saw ‘insanity’ as a curable natural
relationship to their disorder (dys = phenomenon caused by mental and emotional stress
dysfunctional), dislikes symptoms + effects ○ Treatment = rest and relocation to less stressful
○ Ego Syntonic: A person with a positive environments
relationship to their disorder (syn = synergy), have ● Institutionalization (isolated asylums, low standards of care,
accepted disorder + found ways to embrace it, can dehumanization of patients) became the common way to
act as a coping mechanism manage the mentally ill/abnormal individuals in the 18th
■ If patients don’t recognize their disorder century (however asylums mostly reduced inconvenient
as a problem due to a positive ‘burden’ on society and family rather than treating the
relationship with it, they won't solve it institutionalized)
so treatments often work to ensure the ○ Primary purpose of asylums = asylum keepers
patient has an ego dystonic relationship making money by relieving households of their
with the disordered symptoms burdensome, abnormally behaved relative
The Stages of Change: The stepwise change of problematic thoughts ○ Insanity can cause embarrassment, financial
or behaviours burden and danger to family members
● First Stage → Precontemplation: An inability/unwillingness ● Physicians found that patients allowed normal social
to acknowledge the existence of a problem interaction with minimal restraint/seclusion would
● Second Stage → Contemplation: The individual experience dramatic reduction in symptomology (but this
acknowledges the existence of the problem, but may be was only practical if asylums limited their patients)
unsure/unwilling to change the problem ○ However, shifts towards humane treatment of the
● Third Stage → Preparation: Individuals recognize the institutionalized never took permanent hold
problem and prepare for change (Neither families or asylum keepers wanted the
● Fourth Stage → Action: Involves taking active steps to institutionalized treated and returned due to
change the behaviour money and burden factors)
● Final/Fifth Stage → Maintenance: Individuals continue the ○ As a result, institutionalized patients increased
healthy habits formed at the action stage tenfold making therapeutic care impossible (more
Relapse: The full return of old/unhealthy behaviours, often driving the like prisons than hospitals)
afflicted individual all the way back to the precontemplation stage of ● Soon, psychological disorders were seen as not-yet curable
change, often triggered by stressors brain diseases (until the time of Freud)
Supernatural Approaches: Approach to psychological treatment based Early Biomedical Approaches: Considers physiological explanations
on non-empirical concepts like religion, mythology and astrology that of abnormal behaviour
drove much of the 14th, 15th, 16th and 17th centuries’
