ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S

ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S
ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S. Nevid/Spenver A. Rathus/Beverly Greene Chapter 2 Contemporary Perspectives on Abnormal Behavior and Methods of Treatment © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Biological Perspective
The biological perspective, inspired by scientists and physicians since the time of Hippocrates, focuses on the biological underpinnings of abnormal behavior and the use of biologically based approaches, such as drug therapy, to treat psychological disorders. The biological perspective gave rise to the development of the medical model, which remains today a powerful force in contemporary understandings of abnormal behavior. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Nervous System The nervous system is made up of neurons, nerve cells that transmit signals or “messages” throughout the body. Dendrites – The rootlike structures at the ends of neurons that receive messages from other neurons. Axon – The long, thin part of a neuron along which nerve impulses travel. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Nervous System Terminals – The small branching structures at the tips of axons. Neurotransmitters – Chemical substances that transmit messages from one neuron to another. Synapse – The junction between one neuron and another across which neurotransmitters pass. Receptor site – A part of a dendrite on a receiving neuron that is structured to receive a neurotransmitter. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Transmission of Neural Impulses
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Neurotransmitter Functions and Relationships

Central Nervous System
Medulla – An area of the hindbrain involved in regulation of heartbeat, respiration, and blood pressure. Pons – A structure in the hindbrain involved in body movements, attention, sleep, and respiration. Cerebellum – A structure in the hindbrain involved in motor behavior, coordination, and balance. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Reticular activating system – Brain structure involved in processes of attention, sleep, and arousal. Thalamus – A structure in the forebrain involved in relaying sensory information to the cortex and in processes related to sleep and attention. Hypothalamus – A structure in the forebrain involved in regulating body temperature, emotion, and motivation. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Limbic system – A group of forebrain structures involved in emotional processing, memory, and basic drives such as hunger, thirst, and aggression. Basal ganglia – An assemblage of neurons at the base of the forebrain involved in regulating postural movements and coordination. Cerebrum – The large mass of the forebrain, consisting of the two cerebral hemispheres, responsible for higher mental functions. Cerebral cortex – The wrinkled surface area of the cerebrum responsible for processing sensory stimuli and controlling higher mental functions, such as thinking and use of language. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Geography of the Brain

Cerebral Cortex Each hemisphere is divided into four lobes.
Occipital lobe – Primarily involved in processing visual stimuli. Temporal lobe – Involved in processing sounds or auditory stimuli. Parietal lobe – Involved in processing sensations of touch, temperature, and pain. Frontal lobe – Controls muscle movement and includes the prefrontal cortex that regulates higher mental functions such as thinking, problem-solving, and use of language. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Peripheral Nervous System
Somatic nervous system – The division of the peripheral nervous system that relays information from the sense organs to the brain and transmits messages from the brain to the skeletal muscles. Autonomic nervous system – The division of the peripheral nervous system that regulates the activities of the glands and involuntary functions. Sympathetic – Pertaining to the division of the autonomic nervous system whose activity leads to heightened states of arousal. Parasympathetic – Pertaining to the division of the autonomic nervous system whose activity reduces states of arousal and regulates bodily processes that replenish energy reserves. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Evaluating Biological Perspectives
For some disorders, biological processes play the direct causative role. For most disorders, the interaction of biological and environmental factors needs to be examined. Questions about the genetic bases of abnormal behavior touch the long-standing nature versus nurture debate. Scientists today are studying complex interactions between genes and environmental factors to better understand the determinants of abnormal behavior patterns. Epigenetics – The field that focuses on how environmental factors influence genetic expression. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Psychological Perspective

Psychodynamic Models Psychoanalytic theory – The theoretical model developed by Sigmund Freud that is based on the belief that the roots of psychological problems involve unconscious motives and conflicts that can be traced back to childhood. also called psychoanalysis. Conscious – To Freud, the part of the mind that corresponds to our present awareness. Preconscious – To Freud, the part of the mind that contains memories not in awareness but can be brought into awareness by focusing attention on them. Unconscious – To Freud, the part of the mind that lies outside the range of ordinary awareness and that contains instinctual urges. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Structure of the Mind

The Structure of Personality
Id – The original and unconscious psychic structure, present at birth, that contains primitive instincts and is regulated by the pleasure principle. Pleasure principle – The governing principle of the id, involving demands for immediate gratification of needs. Ego – The psychic structure governed by the reality principle. It organizes reasonable ways of coping with frustration and seeks to curb the demands of the id. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Structure of Personality
Reality principle – The governing principle of the ego, which involves considerations of social acceptability and practicality. Superego – The psychic structure that incorporates the values of the parents and important others and functions as a moral conscience. The superego serves as a conscience, or internal moral guardian, that monitors the ego and passes judgment on right and wrong. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Defense Mechanisms Defense mechanisms – The reality-distorting strategies used by the ego to shield the self from awareness of anxiety-provoking impulses. These mechanisms enable us to constrain impulses from the id as we go about our daily business. Freud believed that slips of the tongue and ordinary forgetfulness could represent hidden motives that are kept out of consciousness by repression. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Stages of Psychosexual Development
In Freud’s view, the stages of human development are psychosexual in nature because they correspond to the transfer of libidinal energy from one erogenous zone to another. Freud proposed the existence of five psychosexual stages of development: oral (first year of life), anal (second year of life), phallic (beginning during the third year of life), latency (from around age 6 to age 12), and genital (beginning in puberty). © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Stages of Psychosexual Development
Freud believed that phallic-stage children develop unconscious incestuous desires for the parent of the opposite gender and begin to view the parent of the same sex as a rival. Freud dubbed this conflict the Oedipus complex after the legendary Greek king Oedipus, who unwittingly slew his father and married his mother. Fixation – In Freudian theory, a constellation of personality traits associated with a particular stage of psychosexual development, resulting from either too much or too little gratification at the stage. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Other Psychodynamic Theorists
Swiss psychiatrist Carl Jung developed his own psychodynamic theory called analytical psychology and believed that we not only have a personal unconscious but also inherit a collective unconscious. Archetypes – Primitive images or concepts that reside in the collective unconscious. Karen Horney (1885–1952) stressed the importance of child–parent relationships in the development of emotional problems. Ego psychology – Modern psychodynamic approach originated by Heinz Hartmann (1894–1970) that focuses more on the conscious strivings of the ego than on the hypothesized unconscious functions of the id. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Other Psychodynamic Theorists
Erik Erikson (1902–1994) focused on psychosocial development and attributed more importance to social relationships and formation of personal identity than to unconscious processes. Object-relations theory – The psychodynamic viewpoint developed by Margaret Mahler that focuses on the influences of internalized representations of the personalities of parents and other strong attachment figures (called “objects”). © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Psychodynamic Views on Normality and Abnormality
In the Freudian model, mental health is a function of the dynamic balance among the psychic structures of id, ego, and superego. Freud believed that the underlying conflicts that give rise to psychological disorders originate in childhood and are buried in the depths of the unconscious. Psychosis – A severe form of disturbed behavior characterized by impaired ability to interpret reality and difficulty meeting the demands of daily life. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Learning Models The behavioral perspective is identified with the Russian physiologist Ivan Pavlov (1849–1936), the discoverer of the conditioned reflex, and the American psychologist John B. Watson (1878–1958), the father of behaviorism. Behaviorism – The school of psychology that defines psychology as the study of observable behavior and that focuses on the role of learning in explaining behavior. Watson and other behaviorists, such as Harvard University psychologist B. F. Skinner (1904–1990), believed that human behavior is the product of our genetic inheritance and environmental or situational influences.

Role of Classical Conditioning
Conditioned response – In classical conditioning, a learned response to a previously neutral stimulus. Unconditioned stimulus – A stimulus that elicits an unlearned response. Unconditioned response – An unlearned response. Conditioned stimulus – A previously neutral stimulus that evokes a conditioned response after repeated pairings with an unconditioned stimulus that had previously evoked that response. Classical conditioning – A form of learning in which a response to one stimulus can be made to occur to another stimulus by pairing or associating the two stimuli. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Classical Conditioning Model
FIGURE 2.7 Schematic diagram of the process of classical conditioning. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Role of Operant Conditioning
In operant conditioning, responses are acquired and strengthened by their consequences. Operant conditioning – A form of learning in which behavior is acquired and strengthened when it is reinforced. Reinforcement – Changes in the environment (stimuli) that increase the frequency of the preceding behavior. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Role of Operant Conditioning
Positive reinforcers – Reinforcers that, when introduced, increase the frequency of the preceding behavior. Negative reinforcers – Reinforcers that, when removed, increase the frequency of the preceding behavior. Punishment – Application of aversive or painful stimuli that reduces the frequency of the behavior it follows. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Social-Cognitive Theory
Social-cognitive theory – A learning-based theory that emphasizes observational learning and incorporates roles for cognitive variables in determining behavior. Modeling – Learning by observing and imitating the behavior of others. Expectancies – Beliefs about expected outcomes. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Humanistic Models Self-actualization – In humanistic psychology, the tendency to strive to become all that one is capable of being. The motive that drives one to reach one’s full potential and express one’s unique capabilities. Unconditional positive regard – Valuing other people as having basic worth regardless of their behavior at a particular time. Conditional positive regard – Valuing other people on the basis of whether their behavior meets one’s approval. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Cognitive Models Cognitive theorists study the cognitions—the thoughts, beliefs, expectations, and attitudes—that accompany and may underlie abnormal behavior. They focus on how reality is colored by our expectations, attitudes, and so forth, and how inaccurate or biased processing of information about the world—and our places within it—can give rise to abnormal behavior. Cognitive theorists believe that our interpretations of the events in our lives, and not the events themselves, determine our emotional states. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Information-Processing Models
Information-processing theorists discuss human cognition in terms such as input (sensory and perceptual processes), manipulation (interpreting or processing), storage (placing information in memory), retrieval (accessing information from memory), and output (acting on the information). Psychological disorders are seen as disturbances in these processes. People with schizophrenia, for example, frequently jump from topic to topic in a disorganized fashion, which may reflect problems in retrieving and manipulating information. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Albert Ellis Psychologist Albert Ellis (1977b, 1993), a prominent cognitive theorist, believed that troubling events in themselves do not lead to anxiety, depression, or disturbed behavior. Ellis used an “ABC approach” to explain the causes of the misery. Being fired is an activating event (A). The ultimate outcome, or consequence (C), is emotional distress. But the activating event (A) and the consequences (C) are mediated by various beliefs (B). © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Aaron Beck Aaron Beck proposes that depression may result from errors in thinking or “cognitive distortions,” such as judging oneself entirely on the basis of one’s flaws or failures and interpreting events in a negative light (through blue-colored glasses, as it were). Beck stresses the four basic types of cognitive distortions that contribute to emotional distress: Selective abstraction Overgeneralization Magnification Absolutist thinking © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Sociocultural Perspective

Ethnicity and Mental Health
A recent analysis of ethnic group differences in rates of mental disorders revealed an interesting pattern. Using data from a nationally representative sample of adult Americans, investigators found that traditionally disadvantaged groups (non-Hispanic Black Americans and Hispanic Americans) had either significantly lower rates of psychological disorders or comparable rates, as compared to European Americans (non-Hispanic Whites), but greater chronicity or persistence. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

FIGURE 2.8 Ethnicity and psychological disorders in the United States.

Ethnicity and Mental Health
Native Americans are a traditionally disadvantaged minority group with high rates of mental disorders (Gone & Trimble, 2012). Most commonly alcohol dependence, posttraumatic stress disorder, and depression (Beals et al., 2005). Compared to other Hawaiians, Native Hawaiians experience higher rates of mental health problems, including higher suicide rates among men, higher rates of alcoholism and drug abuse, and higher rates of antisocial behavior. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Evaluating the Sociocultural Perspective
Social causation model – The belief that social stressors, such as poverty, account for the greater risk of severe psychological disorders among people of lower socioeconomic status. Downward drift hypothesis – The theory that explains the linkage between low socioeconomic status and behavior problems by suggesting that problem behaviors lead people to drift downward in social status. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Biopsychosocial Perspective
The biopsychosocial perspective examines the contributions of multiple factors representing biological, psychological, and sociocultural domains, as well as their interactions, in the development of psychological disorders. Even disorders that are primarily biological may be influenced by psychological factors, or vice-versa. For example, some phobias may be learned behaviors that are acquired through experiences in which particular objects became associated with traumatic or painful experiences. Yet, some people may inherit certain traits that make them susceptible to the development of acquired or conditioned phobias. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Diathesis-Stress Model
Diathesis-stress model – A model that posits that abnormal behavior problems involve the interaction of a vulnerability or predisposition and stressful life events or experiences. Diathesis – A vulnerability or predisposition to a particular disorder. In some cases, people with a diathesis for a particular disorder, say schizophrenia, will remain free of the disorder or will develop a milder form of the disorder if the level of stress in their lives remains low or if they develop effective coping responses for handling the stress they encounter. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The Diathesis-Stress Model
You may want to do a refresher on both of these concepts before you even begin on the slide material. For example with Freud, ask students if they recall what the unconscious is from Introduction to Psychology 101. Second, ask students what key factors are associated with Freud (i.e. ID, Superego, Ego), to get a baseline exactly how much they remember from Introduction to Psychology 101. Next, regarding the parental influence and sexual urges discuss the concept of the Oedipus and Electra Complexes, as well as discuss how even currently professionals, and the public tend to blame “the parents” for shortcomings, behaviors, mental illness, etc. In addition, Freud also felt if you engaged in masturbatory behaviors you were more likely to become “mentally ill.” You do not need to go into detail regarding these terms because they are discussed later in the chapter when you get to the current views of abnormal behavior with the psychological models. With Pavlov and Watson as a refresher from Introduction to Psychology you may want to start with a question such as, “What is Ivan Pavlov known for in the field of psychology (i.e., the experiment with the dogs, food, and bell)?” and then you would ask the same question regarding Watson. “What did John B. Watson contribute to the field of psychology?” This again allows you as the professor to gain some information on how much they recall from the Introductory course when you begin lecturing on the different psychological models of abnormal behavior and treatment. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

You may want to do a refresher on both of these concepts before you even begin on the slide material. For example with Freud, ask students if they recall what the unconscious is from Introduction to Psychology 101. Second, ask students what key factors are associated with Freud (i.e. ID, Superego, Ego), to get a baseline exactly how much they remember from Introduction to Psychology 101. Next, regarding the parental influence and sexual urges discuss the concept of the Oedipus and Electra Complexes, as well as discuss how even currently professionals, and the public tend to blame “the parents” for shortcomings, behaviors, mental illness, etc. In addition, Freud also felt if you engaged in masturbatory behaviors you were more likely to become “mentally ill.” You do not need to go into detail regarding these terms because they are discussed later in the chapter when you get to the current views of abnormal behavior with the psychological models. With Pavlov and Watson as a refresher from Introduction to Psychology you may want to start with a question such as, “What is Ivan Pavlov known for in the field of psychology (i.e., the experiment with the dogs, food, and bell)?” and then you would ask the same question regarding Watson. “What did John B. Watson contribute to the field of psychology?” This again allows you as the professor to gain some information on how much they recall from the Introductory course when you begin lecturing on the different psychological models of abnormal behavior and treatment. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Types of Helping Professionals
Clinical psychologists – Have earned a doctoral degree in psychology (either a Ph.D., or Doctor of Philosophy; a Psy.D., or Doctor of Psychology; or an Ed.D., or Doctor of Education) from an accredited college or university. Counseling psychologists – Also hold doctoral degrees in psychology and have completed graduate training preparing them for careers in college counseling centers and mental health facilities. Psychiatrists – Have earned a medical degree (M.D.) and completed a residency program in psychiatry. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Types of Helping Professionals
Clinical or psychiatric social workers – Have earned a master’s degree in social work (M.S.W.) and use their knowledge of community agencies and organizations to help people with severe mental disorders receive the services they need. Psychoanalysts – Typically are either psychiatrists or psychologists who have completed extensive additional training in psychoanalysis. Counselors – Have typically earned a master’s degree by completing a graduate program in a counseling field. Counselors work in many settings, including public schools, college testing and counseling centers, and hospitals and health clinics. Psychiatric nurses – Typically are R.N.s who have completed a master’s program in psychiatric nursing. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Psychotherapy Psychotherapy – A structured form of treatment derived from a psychological framework that consists of one or more verbal interactions or treatment sessions between a client and a therapist. Psychotherapy is used to treat psychological disorders, to help clients change maladaptive behaviors or solve problems in living, or to help them develop their unique potentials. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Psychodynamic Therapy
Psychoanalysis – The first method of psychotherapy developed by Sigmund Freud. Psychodynamic therapy – Therapy that helps individuals gain insight into, and resolve, unconscious conflicts. Free association – The method of verbalizing thoughts as they occur without a conscious attempt to edit or censure them. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Dream Analysis In psychoanalytic theory, dreams have two levels of content: 1. Manifest content: The material of the dream the dreamer experiences and reports. 2. Latent content: The unconscious material the dream symbolizes or represents. Freud believed dreams represented the “royal road to the unconscious.” Transference relationship – In psychoanalysis, the client’s transfer or generalization to the analyst of feelings and attitudes the client holds toward important figures in his or her life. Countertransference – In psychoanalysis, the transfer of feelings or attitudes that the analyst holds toward other persons in her or his life onto the client. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Modern Psychodynamic Approaches
Like Freudian psychoanalysis, the newer psychodynamic therapists explore their client’s psychological defenses and transference relationships – a process described as “peeling the onion” (Gothold, 2009). They focus more on the client’s present relationships and encourage the client to make adaptive behavior changes and treatment entails a more open dialogue. Many contemporary psychodynamic therapists draw more heavily on the ideas of Erik Erikson, Karen Horney, and other theorists than on Freud’s ideas. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Behavioral Therapy Behavior therapy – The systematic application of the principles of learning to treat psychological disorders. Systematic desensitization – A behavior therapy technique for overcoming phobias by means of exposure to progressively more fearful stimuli while one remains deeply relaxed. Gradual exposure – A behavior therapy technique for overcoming fears through direct exposure to increasingly fearful stimuli. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Behavioral Therapy Modeling – A behavior therapy technique for helping an individual acquire a target behavior by observing a therapist or another individual demonstrate the behavior and then imitating it. Token economy – Behavioral treatment program in which a controlled environment is constructed such that people are reinforced for desired behaviors by receiving tokens that may be exchanged for desired rewards. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Humanistic Therapy Humanistic therapists focus on clients’ subjective, conscious experiences. Like behavior therapists, humanistic therapists also focus more on what clients are experiencing in the present—the here and now—than on the past. The major form of humanistic therapy is person-centered therapy (also called client-centered therapy), which was developed by the psychologist Carl Rogers. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Person-Centered Therapy
Person-centered therapy – The establishment of a warm, accepting therapeutic relationship that frees clients to engage in self-exploration and achieve self-acceptance. Person-centered therapy is nondirective. The therapist uses reflection—the restating or paraphrasing of the client’s expressed feelings without interpreting them or passing judgment on them. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Person-Centered Therapy
Unconditional positive regard – The expression of unconditional acceptance of another person’s intrinsic worth. Empathy – The ability to understand someone’s experiences and feelings from that person’s point of view. Genuineness – The ability to recognize and express one’s true feelings. Congruence – The fit between one’s thoughts, behaviors, and feelings. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Cognitive Therapy Cognitive therapy – A form of therapy that helps clients identify and correct faulty cognitions (thoughts, beliefs, and attitudes) believed to underlie their emotional problems and maladaptive behavior. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Rational Emotive Behavior Therapy
Albert Ellis believed that negative emotions such as anxiety and depression are caused by the irrational ways in which we interpret or judge negative events, not by negative events themselves. Rational emotive behavior therapy (REBT) – A therapeutic approach that focuses on helping clients replace irrational, maladaptive beliefs with alternative, more adaptive beliefs. Rational emotive behavior therapists help clients substitute more effective interpersonal behavior for self-defeating or maladaptive behavior. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Beck’s Cognitive Therapy
Psychiatrist Aaron Beck and his colleagues developed cognitive therapy, which, like REBT, focuses on people’s faulty thoughts and beliefs. Cognitive therapists encourage clients to recognize and change errors in their thinking, called cognitive distortions, such as tendencies to magnify negative events and minimize personal accomplishments, that affect their moods and impair their behavior. Cognitive therapists have clients record the thoughts that are prompted by upsetting events and note the connections between their thoughts and their emotional responses. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) – A learning-based approach to therapy incorporating cognitive and behavioral techniques. CBT attempts to integrate therapeutic techniques that help individuals make changes not only in their overt behavior but also in their underlying thoughts, beliefs, and attitudes. CBT draws on the assumption that thinking patterns and beliefs affect behavior and that changes in these cognitions can produce desirable behavioral and emotional changes. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Overview of Major Types of Psychotherapy

Eclectic Therapy Eclectic therapy – An approach to psychotherapy that incorporates principles or techniques from various systems or theories. An eclectic therapist might use behavior therapy techniques to help a client change specific maladaptive behaviors, for example, along with psychodynamic techniques to help the client gain insight into the childhood roots of the problem. Some therapists are technical eclectics. Other eclectic therapists are integrative eclectics. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

FIGURE 2.10 Therapeutic orientations of clinical psychologists.

Group, Family, and Couple Therapy
Group therapy – A form of therapy in which a group of clients meets together with a therapist. Family therapy – A form of therapy in which the family, not the individual, is the unit of treatment. Couple therapy – A form of therapy that focuses on resolving conflicts in distressed couples. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Family Therapy In family therapy, the family, not the individual, is the unit of treatment. Family therapists help family members communicate more effectively with one another—for example, to air their disagreements in ways that are not hurtful to individual members. Family therapists also try to prevent one member of the family from becoming the scapegoat for the family’s problems. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Evaluating Methods of Psychotherapy
Reviews of the scientific literature often utilize a statistical technique called meta-analysis, which averages the results of a large number of studies to determine an overall level of effectiveness. In the most frequently cited meta-analysis of psychotherapy research, M. L. Smith and Glass (1977) analyzed the results of some 375 controlled studies comparing various types of therapies (psychodynamic, behavioral, humanistic, etc.) against control groups. The results of their analyses showed that the average psychotherapy client in these studies was better off than 75% of the clients who remained untreated. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Evaluating Methods of Psychotherapy
Although evidence supports the effectiveness of psychotherapy, researchers lack clarity about why it works—that is, what factors or processes account for therapeutic change (Carey, 2011). Suggests the effectiveness of different forms of psychotherapy may have more to do with the common features. Nonspecific treatment factors – Factors not specific to any one form of psychotherapy, such as therapist attention and support, and creating positive expectancies of change. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Empirically Supported Treatments (ESTs)
Another approach to determining whether particular therapies are effective in treating particular problems is known as empirically supported treatments or ESTs. Efficacy studies speak to the issue of whether a treatment works better than control conditions. Effectiveness studies examine whether particular treatments are effective when used by practitioners. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Multicultural Issues in Psychotherapy
Normal and abnormal behaviors occur in a context of culture and community. Therapists need to be sensitive to cultural differences and how they affect the therapeutic process. We must also recognize that just because a given therapy works with one population does not mean that it will necessarily work with another population. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

African Americans The cultural history of African Americans must be understood in the context of persistent racial discrimination. Therapists need to be aware of the tendency of African American clients to minimize their vulnerability by being less self-disclosing (Sanchez-Hucles, 2000). Therapists must be aware of the cultural characteristics such as strong kinship bonds, strong religious and spiritual orientation, multigenerational households, adaptability and flexibility of gender roles, and distribution of child-care responsibilities among different family members. Therapists must recognize how stereotypes can become destructive to the therapeutic relationships they form with African American clients. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Asian Americans Culturally sensitive therapists not only understand the beliefs and values of other cultures but also integrate this knowledge within the therapy process. Generally speaking, Asian cultures, including Japanese culture, value restraint in talking about oneself and one’s feelings. Public expression of emotions is also discouraged in Asian cultures, which may inhibit Asian clients from revealing their feelings in therapy. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Hispanic Americans Although Hispanic American subcultures differ in various respects, many share certain cultural values and beliefs, such as the importance placed on the family and kinship ties, as well as on respect and dignity (Calzada, Fernandez, & Cortes, 2010). Therapists need to recognize that the traditional Hispanic American value of interdependency within the family may conflict with the values of independence and self-reliance that are stressed in the mainstream U.S. culture. Therapists should also be trained to reach beyond the confines of their offices to work within the Hispanic American community itself, in settings that have an impact on the daily lives of Hispanic Americans. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Native Americans Native Americans remain underserved, partly as a result of underfunding and the cultural gap between providers and recipients. Mental health professionals can help Native Americans if they work within a context that is relevant and sensitive to Native Americans’ customs, culture, and values (Gone & Trimble, 2012). Many Native Americans expect that the therapist will do most of the talking and they will play a passive role in treatment. There may also be differences in nonverbal expression that can impede effective communication between the therapist and the client (Renfrey, 1992). © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Barriers to Use of Mental Health Services by Ethnic Minorities
Barriers that exist for ethnic minorities include the following: Cultural mistrust Mental health literacy Institutional barriers Cultural barriers Language barriers Economic and accessibility barriers © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Biomedical Therapies There is a growing emphasis in American psychiatry on biomedical therapies, especially the use of psychotropic drugs (also called psychiatric drugs). Psychopharmacology – The field of study that examines the effects of therapeutic or psychiatric drugs. Today, roughly one in five adult Americans takes psychotropic drugs (Smith, 2012). Psychosurgery has been all but eliminated as a form of treatment because of serious harmful effects of earlier procedures. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Drug Therapy Different classes of psychotropic drugs are used in treating many types of psychological disorders. But all the drugs in these classes act on neurotransmitter systems in the brain, affecting the delicate balance of chemicals that ferry nerve impulses from neuron to neuron. The major classes of psychiatric drugs are antianxiety drugs, antipsychotic drugs, and antidepressants, as well as lithium, which is used to treat mood swings in people with bipolar disorder. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Antianxiety Drugs Antianxiety drugs – Drugs that combat anxiety and reduce states of muscle tension by reducing central nervous system activity. They include mild tranquilizers, such as diazepam (Valium) and alprazolam (Xanax), as well as hypnotic sedatives, such as triazolam (Halcion). Rebound anxiety – The experiencing of strong anxiety following withdrawal from a tranquilizer. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Antipsychotic Drugs Antipsychotic drugs – Drugs used to treat schizophrenia or other psychotic disorders. The use of neuroleptics has greatly reduced the need for more restrictive forms of treatment for severely disturbed patients, such as physical restraints and confinement in padded cells, and has lessened the need for long-term hospitalization. Neuroleptics are not without their problems, including potential side effects such as muscular rigidity and tremors. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Antidepressants Antidepressants – Drugs used to treat depression that affect the availability of neurotransmitters in the brain. The third class of antidepressants, selective serotonin-reuptake inhibitors, or SSRIs, have more specific effects on serotonin function in the brain. Drugs in this class include fluoxetine (Prozac) and sertraline (Zoloft). © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Electroconvulsive Therapy
Electroconvulsive therapy (ECT) – A treatment in which an electric shock is sent through the patient’s brain, sufficient to induce convulsions. People with major depression show significant improvement following ECT. ECT is associated with memory loss for events occurring around the time of treatment and high relapse rates. ECT is generally considered a treatment of last resort after less intrusive methods have been tried and failed. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Psychosurgery Psychosurgery is yet more controversial than ECT and is rarely practiced today. Although no longer performed today, the most common form of psychosurgery was the prefrontal lobotomy. This procedure involved surgically severing nerve pathways linking the thalamus to the prefrontal lobes of the brain. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

Evaluation of Biological Approaches
There is little doubt that biological treatments have helped many people with severe psychological problems. On the other hand, some forms of psychotherapy may be as effective as drug therapy in treating anxiety disorders and depression. Although we continue to learn more about the biological foundations of abnormal behavior patterns, the interface between biology and behavior can be construed as a two-way street. © 2014, 2011, 2008 by Pearson Education, Inc. All rights reserved.

The End

ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S

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ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S

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