1. Abnormality, Therapy, and Social Issues

2. What is “abnormal”?
If we say that abnormal is any behavior significantly different from the average…
Then what about the effect of life stressors or situations?
Then what happens when “average” changes over time?
What about positive (but non-normal) behaviors?
If we say that abnormal is any emotion significantly different from the average….
Don’t we all feel sad, anxious, angry occasionally?
Extremely happy people would be considered mentally ill?
If we say that abnormal is any thought significantly different from the average…
We all have strange thoughts from time to time?
If we say that abnormal is anything that is undesirable…
Aren’t there some undesirable but normal behaviors?
If we say that abnormal is when people feel like they are distressed…
What about people who think they have a problem, but actually don’t?
What about people who don’t have a problem, but believes they do?
If we say that abnormal is based upon the cultural rules…
Each era and society has had its own interpretations of abnormal behavior?

3. Classifying Psychological Disorders
The DSM-IV - Diagnostic and Statistical Manual of Mental Disorders
This manual has been created to establish uniform definitions and standards for diagnosis.
It lists acceptable labels for all psychological disorders.
It lists symptoms and criteria for making diagnoses and contains information on differential diagnosis – how to distinguish a particular disorder from others that are similar to it.

4. Classifying Psychological Disorders
The DSM-IV - Clinical disorders = Axis I.

5. Classifying Psychological Disorders
The DSM-IV – Personality Disorders = Axis II

6. Classifying Psychological Disorders
The DSM-IV
Axis III is for general medical conditions that may influence the person’s mood or behavior.
Axis IV is for psychosocial and environmental problems that may increase the person’s level of stress.
Axis V is a 1-90 scale called the global assessment of functioning. The lower the number assigned by the assessing clinician, the less likely it is that the person being diagnosed is able to function without treatment and support.

7. According to one extensive survey, about half the people in the United States will suffer at least one psychological disorder at some time.

8. Psychotherapy
Psychotherapy is a treatment of psychological disorders by methods that include an ongoing relationship between a trained therapist and a client.
Psychotherapy is provided by…
Clinical psychologists
Counseling psychologists
Psychiatrists
Clinical social workers
Psychiatric nurses
Counselors
There are many techniques of psychotherapy, but all of them seem to depend in large part on the client’s motivation to improve.

10. Schools of Psychotherapy
(1) Psychoanalysis
Psychoanalysis is the oldest “talk” therapy. It attempts to bring unconscious thoughts and emotions to awareness, and help people understand their own thoughts and actions.

11. Schools of Psychotherapy
(2) Behavior therapy
Behaviorists believe that human behavior is learned and can be unlearned.
Uses learning theories like classical conditioning and operant conditioning, such as systematic desensitization and aversion therapy

12. Schools of Psychotherapy
(3) Cognitive Therapy
These are therapies that focus on thoughts and beliefs, and seek to improve people’s functioning by changing how they think and interpret events

13. Schools of Psychotherapy
(4) Humanistic therapy
The source of psychological distress is perceived incongruence between the way an individual’s self-concept and his or her ideal image of self.
The therapist tries to be genuine, empathetic and caring, and tries not to interpret the client’s thoughts or feelings or offer advice.

14. Schools of Psychotherapy
(5) Psychopharmacotherapy
Antianxiety - Valium, Xanax, Buspar
Antipsychotic - Thorazine, Mellaril, Haldol
Antidepressant - Elavil, Tofranil, Prozac, Paxil, Zoloft
Mood stabilizers – Lithium, Valproic acid

15. Psychotherapy How effective is psychotherapy? Why is it effective?
Meta-analysis of many studies of psychotherapy suggests that a majority of people do show improvements after therapy.
No one method of therapy stands out as better than the others.
Why is it effective?
Because of the treatment?
Because of the relationship with the therapist? Social support?
Because of encouragement on regular basis?
Because client engages in self-examination?
Because reinforcing client’s desire to change and improve.

16. Psychotherapy How to choose a therapist?
No one way of doing psychotherapy is right for every client. You need to use your knowledge to “shop” for the therapist who will work best with you.
As with any other “remedy” be skeptical of overconfidence and claims of amazing results.
Expect at least some small improvement within a couple of months of starting, and don’t be afraid to ask for your therapist’s input if this doesn’t happen.
Be an active participant in your own treatment – nobody “fixes” you, rather, you receive help in changing your own life.

17. What is self-help?
Self help = any instance where an individual or a group attempts self-guided improvement, typically through publicly available information.
Books
Audio cassettes
DVDs
Video DVDs
Internet
Motivational speakers
Seminars
Programs
Personal coaching
Support groups

18. How extensive is self-help information?
Billions!
Ingrained into culture
“Twelve step program”
Self-help books -- “Dummies” Guide
“self help psychology” returned over 12million+ hits on Google

19. Why is it so extensive? (benefits)
Within therapy
Therapist uses to give client more information
More information “out-of-office”
Client uses for day-to-day continuing education
Beyond therapy
Can provide help that therapy can not
Experiential knowledge from more experts
Experiential knowledge from people going through the same thing (support group)
Support groups also provide sense of belonging, friendship, identity, peer-to-peer support

20. Criticisms of self-help? (risks)
Without therapist, no trained professional so…
Improper assessment
Inappropriate treatments
Failure may make it worse
Without scientific data to confirm validity, then..
possibly misleading and inaccurate
potentially harmful and dangerous
pseudo-scientific assertions
offering "easy answers" to difficult personal problems

21. Do the risks outweigh the benefits?