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Summary PS346 - Perspectives in Clinical and Counselling Psychology

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Document contains detailed summaries of all the topics covered in the 2018/2019 lecture series. Written for revision purposes. Topics covered: 1. Introduction - conceptualising and defining abnormal behaviour, exploring early perspectives of psychopathology. 2. Current paradigms - describe contemporary models of psychopathology, compare the strengths and weaknesses of medical and psychological models of psychopathology. 3. Treating psychopathology - describe the nature and function of treatments for psychopathology, compare and contrast different treatments for psychopathology. 4. Classification and diagnosis - describe and evaluate the classification systems for psychopathology. 5. Clinical assessment - describe different methods used in clinical assessment, compare and contrast assessment methods adopted by varying approaches, explain the application of methods of assessment. 6. Anxiety and Obsessive-compulsive disorders - describe the taxonomic system used in conceptualising anxiety and obsessive-related disorders, explain differing perspectives in the aetiology and treatment of anxiety and obsessive-related disorders, including primary therapeutic interventions and efficacy, think critically about current formulations of anxiety and obsessive-related disorders in relation to specific case study examples. 7. Mood disorders - describe the taxonomic system used in conceptualising mood disorders, explain differing perspectives in the aetiology and treatment of mood disorders, including primary therapeutic interventions and efficacy, think critically about current formulations of mood disorders in relation to specific case study examples. 8. Psychotic disorders and schizophrenic spectrum disorders - describe the taxonomic system used in conceptualising psychotic disorders, explain differing perspectives in the aetiology and treatment of psychotic disorders, including primary therapeutic interventions and efficacy, think critically about current formulations of psychotic disorders in relation to specific case study examples. 9. Personality disorders - describe the taxonomic system used in conceptualising personality disorders, explain differing perspectives in the aetiology and treatment of personality disorders, including primary therapeutic interventions and efficacy, think critically about current formulations of personality disorders in relation to specific case study examples. 10. Ethical considerations in mental health care - describe what we mean by ethics in relation to working with individuals with mental health problems, explain ethical issues arising both within the therapist and through the work of the therapist, apply relevant codes of ethics to case study examples, think critically about ethical dilemmas in case study examples.

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PS346: Typed comprehensive notes
for revision
Introduction
 Conceptualise abnormal behaviour
 Critically discuss how abnormal behaviour might be defined
 Describe early views of psychopathology

Conceptualising “abnormal” behaviour:

- Claudie dislikes the word “abnormal” but struggles to find another word to describe such
behaviour. I dislike the word also, however finding another word that best suits this form of
behaviour is difficult.
- Behaviour outside social norms – the context of the situation is very important e.g. different
cultures and different societies have different norms concerning behaviour. Therefore,
behaviour outside social norms is dependent on culture and society. This behaviour will also
be influenced by the individual’s personality traits (if the behaviour is consistent with the
person’s personality, then it won’t be considered abnormal – whereas if it isn’t then it would
be considered abnormal e.g. Phineas Gage).
- Statistical infrequency – measurement and distribution within the population i.e. normal
distribution. If the behaviour is statistically infrequent then it can be considered abnormal.
This is not necessarily an accurate way of measuring abnormal behaviour e.g. elite athletes
are statistically infrequent but are not considered abnormal.
- Deviant behaviour from the “norm” – violating social norms. This definition of abnormal
behaviour is both too broad and too narrow.
- Personal suffering/ distress – behaviour needs to be psychologically distressing to the
individual to be considered abnormal. This is a subjective measurement, however, therefore
may not be an accurate way of measuring abnormal behaviour e.g. psychopathic behaviour
would normally be considered abnormal, but psychopaths do not experience personal
distress. This is difficult to measure empirically.
- Dysfunction – harmful dysfunction seen to appear in abnormal behaviour. This, however,
requires value judgement. This means it is dependent on the individual (again, difficult to
measure due to these individual differences). This definition means that the mechanism is
unable to perform its natural function.
- Judgements of abnormal behaviour different across social group, cultures, ethnic groups etc.
e.g. in some cultures visions would be seen as a religious gift, whereas in others this would
be considered abnormal behaviour, perhaps linked to schizophrenia.
- Could be referred to as “shades of abnormality” i.e. not black and white  behaviour
appears on a scale.

DSM-V definition:

- Mental disorder diagnosed if all four of the following criteria are met: impairment in
functioning, disturbance, present distress and violation of social norms.

Early views:

, - Demonology – abnormal behaviour, now diagnosed as mental disorders, used to be
considered as supernatural powers (likely because they did not have the scientific
knowledge to understand what was happening). Experts thought that these individuals were
possessed by demons (displeasure from Gods). This survived as explanation until the 18 th
century – but, it does still remain the key explanation in some less-developed countries.
 Methods of treatment: exorcism, trephination (drilling holes into the skull to release
pressure etc.), prayers, starvation (starve the demon out the of the person), drinking of
liquids.
- Hippocrates – referred to abnormal behaviour as “the disease of the brain”. Referred to
mania, melancholia and phrenitis. Each of these phenomena have different treatments.
These are caused by an inbalance of bodily fluids in the body e.g. blood, black bile.
- Asylums – “confinement and care” e.g. Bedlam. These buildings used dangerous and harmful
treatments and they were used as a tourist attraction.
- Deinstitutionalisation – 1962 NHS began psychiatric hospitals (individuals were treated as
humans and not as freaks). E.g. medication, talking treatments etc.

Stigma:

- Refers to the destructive beliefs and attitudes held by a society that are ascribed to groups
considered different in some manner e.g. people with mental illnesses.
- Has four main characteristics: distinguishing label, label refers to undesirable attributes,
people with the label are seen differently and people with the label are discriminated
against i.e. the whole situation needs to be negative.
- Interventions to reduce stigma – parity in insurance coverage (insurance companies are not
permitted to deny insurance to somebody based on a mental disorder), reduction in
discriminatory laws, decriminalisation of people with a mental disorder (i.e. the law
considers the mental state of the individual before they are able to testify), housing
strategies, education, mental health evaluations, education and training, education for
individuals and families, support and advocacy groups.
- Should work towards reducing the stigma around giving people drugs to treat psychological
disorders.

Approaches:

- Genetics – Galton was credited for his work on twins. Found that genetics play a role in
mental disorders. It is recognised that most psychological disorders have some genetic
element. Genes interact with the environment, and this interaction is thought to contribute
to several disorders. As well as this, some disorders have been linked to SNPs or copy
variations in gene sequences.
- Biological approaches – suggest that mental disorders are caused by differences in biological
make up e.g. brain structure, brain functioning, NRTs (neuroscience paradigm), hormones
(neuroendocrine approach) etc.
- Freud and psychoanalysis – says that mental disorders are caused by unconscious processes.
Believed that these problems are bought into the conscious thought processes through free
association and transference.
- Behaviourism – thought that mental disorders are influenced by learnt processes – treated
by behavioural treatments e.g. systematic desensitisation.
- Cognition – after the rise of behaviourism, psychologists recognised that mental processes
involved in behaviour need to be considered.

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