1. Dysfunctional Behaviour
Diagnosis, Definition, Bias
Explanations
Treatments
HEALTH & CLINICAL PSYCHOLOGY
G543

2. 3. Treatments for Dysfunctional Behaviour
Biological: Liebowitz
Behavioural: McGrath
Cognitive: Ost & Westling

3. EXAM STYLE QUESTIONS (ESQ) Treatments
BIOLOGICAL
June 2014
Describe how dysfunctional behaviour could be treated biologically. (10)
Discuss ethical issues in the treatment of dysfunctional behaviour. (15)
BEHAVIOURAL
January 2012
Describe a behavioural treatment for dysfunctional behaviour [10]
Discuss ethical considerations regarding the treatment for dysfunctional behaviour [15]
June 2013
Outline behavioural treatment for dysfunctional behaviour. (10)
Compare approaches to treating dysfunctional behaviour. (15)
COGNTIVE
Describe a cognitive treatment for dysfunctional behaviour [10]
Discuss strengths & limitations regarding the treatment for dysfunctional behaviour [15]

4. Resources: Information Booklet PowerPoint Essay Help Booklet
Exam Style Questions (ESQ)

6. Activity 1 Worksheet 1: KEY WORDS
Complete the key terms related to this topic
You can use the resources and internet to help
Each definition should be at least two sentences long
You should use these terms where appropriate in your essays

7. TO INSERT KEY WORDS

8. Worksheet 2: Summary Notes
Activity 2
Worksheet 2: Summary Notes
Complete summary notes for each section
Biological Approach
Behavioural Perspective
Cognitive Approach
You can use the resources and internet to help

9. 2a. Summary Questions: BIOLOGICAL Liebowitz, 1988
Aims
Method & Procedures
What was the aim of this study?
What research method was used in this study?
What are the details of the sample? Total sample, age range
What is a single-blind placebo controlled trial?
What is the IV?
What is the DV? What measurements were taken?
How were the participants assessed for social phobia?
Why did Leibowitz use a placebo group?
What design did Leibowitz use?
What happened?
Background
What is social phobia?
What does Phenelezine do?
What is Atenolol?
Sample
Results
What was the main finding? Which drug worked better?
What are the details of the sample? Total sample, age range

10. 2a. Summary Information: BIOLOGICAL APPROACH Liebowitz, 1988
Aim
To find out if people with a social phobia could be helped by taking either phenelzine or atenolol.
Background
A social phobia is a fear of interacting with other people. Phenelezine prevents the breakdown of the monoamine neurotransmitters serotonin, melatonin, norepinephrine and dopamine. This leads to an increase in the concentrations of these neurochemicals and therefore an alteration in neurochemistry in the brain, making a patient calmer and less depressed. Atenolol is a beta blocker which slows the heart beat and lowers blood pressure.
Sample
80 patients meeting the DSM-III criteria for social phobia aged and who were not suffering from any other medical or psychological condition took part. Only 41 had completed the trial by the time the paper was published.

11. 2a. Summary Information: BIOLOGICAL APPROACH Liebowitz, 1988
Method/
Procedure
Single blind placebo controlled trial. Patients were given a placebo for seven days to see if they got better. If they did, they were not included in the treatment phase. They were randomised to the three treatments in an independent measures design. Patients were given with phenelzine or matching placebo or atenolol or matching placebo. Eight weeks later they were assessed by independent evaluators and then they continued for a further 8 weeks. After 16 weeks half the patients who were recovering got a placebo for four weeks, while the others continued to get the active drugs. Assessment was by blood tests to check they were taking the medication and a series of rating scales.
Results & Conclusion
Phenelzine but not atenolol was effective in the treatment of the phobia by appearing to reduce anticipatory anxiety and the difference appeared by eight weeks.

12. 2a. Summary Questions: BEHAVIOURAL McGrath, 1990
Aims
Method & Procedures
What was the aim of this study?
What research method was used in this study?
What happened?
How many sessions did Lucy have to have before she became less fearful?
Background
What is systematic desenitisation?
Results
Sample
What happened after the first treatment session?
What happened in subsequent treatment sessions?
What was Lucy able to do by the end of her treatment?
What are the details of the sample? Who was the participant in McGrath’s study on systematic desensitization?

13. 2b. Summary Information: behavioural McGrath, 1990
Aim
To treat a girl with noise phobia using systematic desensitsation.
Background
Fear of loud noises is common in children but for some it impacts on normal life. Lucy, the girl in this study, could not go to parties and school trips or anywhere where fireworks might go off.
Sample
Lucy was a nine-year old of low average intelligence (IQ97). She showed as averagely depressed, fearful and anxious when she was tested and therefore was felt has fear of noise was not part of a wider condition and could b treated.

14. 2b. Summary Information: behavioural McGrath, 1990
Method
Systematic desensitisation was used and written up as a case study.
Procedure
Lucy was taught to relax and then she created a hierarchy of feared noises including doors banging, cap-guns popping, balloons bursting and unexpected explosions of party poppers. Imaging herself at home with her toys and her bed and deep breathing was used to control fear. She also used a gear thermometer, rating her fear from 1 to 10. As she was given the feared object, she paired it with the relaxation and imagery she had learnt until she was calm.
Results & Conclusion
Balloon bursting was the first fear to be tackled and by the fourth session, Lucy could bear it being popped 10 metres away quite calmly. In the fifth session she was able to pop the balloon herself. The other feared objects were then introduced and by the tenth session her fear thermometer scores had dropped from 7/10 to 3/10 for balloons popping and fear of the cap gun from 8/10 to 5/10.

15. 2c.Summary Questions: CoGNITIVE Ost & Westling, 1995
Aims
Method & Procedures
What was the aim of this study?
What research method was used in this study?
How were the patients assessed before treatment?
What happened?
How was data collected?
Background
Which two therapies did Ost and Westling compare?
What does the cognitive approach suggest as a way to treat anxiety disorders?
Results
Sample
What did Ost and Westling find?
How did Ost and Westling explain the similarity in findings between the two therapy groups?
What are the details of the sample? Total sample, average age
How was the sample recruited?
How many were diagnosed with mild agoraphobia?

16. 2b. Summary Information: cognitive Ost & Westling, 1995
Aim
To compare cognitive behavioural therapy (CBT) with applied relaxation to treat panic disorder.
Background
The cognitive therapy of panic disorders proposes that people who experience panic attacks have a well-developed tendency to interpret body sensations in a catastrophic way. This then leads to a vicious cycle of symptoms and interpretations leading to panic attack.
Sample
38 patients who fulfilled the DSM-III criteria for panic disorder, 8 of whom also had mild agoraphobia. They were recruited through referrals from psychiatrists and adverts in the paper and had to have a least three panic attacks and suffered with the condition for at least a year. 26 females and 12 males with an average age of 32.6yrs.

17. 2b. Summary Information: cognitive Ost & Westling, 1995
Method
Patients were randomly assigned to the two treatment and assessment pre- and post-treatment and follow-up one year later. Patients completed questionnaires and were interviewed at the start and instructed in what to do if they got a panic attack and how to keep a panic diary. After the last session the patient again filled out a questionnaire and had a brief interview. One year later they were mailed the questionnaire and had a telephone interview. Both treatments were given, lasting one hour, once a week for 12 weeks. Progressive relaxation techniques and normal CBT approach were used.
Results & Conclusion
CBT patients were 78% panic free after the treatment and 89% panic free after one year. The relaxation patients were 65% panic free immediately after treatment and 82% panic free after one year. So both treatments worked, but CBT was more effective. Both groups reduced their medication to the same extent.

18. Worksheet 3: Evaluation
Activity 3
Worksheet 3: Evaluation
Part 1: DIAGNOSIS
* Write/type up your responses. Elaborate your responses fully.
Part 2: EVALUATION GRID

19. 3a. Evaluation Questions: biological
What is a problem with using rating scales repeatedly?
Is the sample representative?
Identify 2 strengths and 2 weakness of the biological treatment for Dysfunctional Behaviour
Is drug therapy oversimplifying the complexity of social phobia? Does it deal with the root cause of the problem?
Could drug therapy offer a short-term or long-term solution?
Is there any other support for this approach (other research)?
Is there an alternative way to treat dysfunctional behaviour?

20. 3a. Debate Questions: BIOLOGICAL
Why is this a reductionist explanation of phobia?
Could drug therapy be useful as a short-term intervention?

21. 3a. Evaluation & Debates: BIOLOGICAL
Small sample size at the time the paper was published.
The use of rating scales repeatedly by the patients may increase demand characteristics, although it helps with test-retest reliability and use of several different instruments helps construct validity.
This is a reductionism explanation of phobia, reducing it to brain chemistry balance as opposed to a personality disorder.
Usefulness – many people have social phobias, so if a drug treatment is available it would perhaps support them until they could master their fear through CBT.

22. 3b. Evaluation Questions: BEHAVIOURAL
Is systematic desensitisation an effective treatment technique? Is it useful?
Is the sample used in McGrath’s study representative?
Identify 2 strengths and 2 weakness of systematic desensitisation for Dysfunctional Behaviour
Is re-conditioning oversimplifying the complexity of phobia? Does it deal with the root cause of the problem?
Could systematic desensitisation offer a short-term or long-term solution?
Is behavioural therapy useful?
Is there any other support for this approach (other research)?
Is there an alternative way to treat dysfunctional behaviour?
Does this approach use scientific methods?

23. 3b. Debate Questions: BEHAVIOURAL
Nature-Nurture: Can someone have a panicky personality or is it nurtured?
Usefulness – Why would systematic desensitisation be better than drug therapy?

24. 3b. Evaluation & Debates: BEHAVIOURAL
Systematic desensitisation seems to be highly replicable with many different patients and conditions.
Giving the patient control over timing increased the effectiveness, which is interesting because it introduces a cognitive component to a behavioural theory.
Free will vs Determinism could be used because this study suggests our conscious control can be used to treat fears and phobias.
Reductionism could be explored because it reduces a phobia to a learned response.
Psychology as a science - this could be a demonstration of a scientific approach to a treatment.
Usefulness – a very useful treatment with many applications

25. 3c. Evaluation Questions: COGNITIVE
Identify 2 strengths and 2 weakness of CBT for Dysfunctional Behaviour
Is CBT an effective treatment technique? Is it useful?
Is the sample in Ost & Westling’s study representative?
Is self-reporting a reliable measure?
Why is it a problem that Ost & Westling did not have a control group?
Does CBT deal with the root cause of the problem?
Could CBT offer a short-term or long-term solution?
Is there any other support for this approach (other research)?
Is there an alternative way to treat dysfunctional behaviour?

26. 3c. Debate Questions: COGNITIVE
Free Will vs Determinism – Are our thoughts under conscious control?
Reductionism – How is behaviour oversimplified by this approach?
Is CBT a successful treatment?

27. 3c. Evaluation & Debates: COGNITIVE
It is impossible to control for any cognitive changes that might have occurred in the relaxation group.
Self-reports were used to collect data so patients could have shown demand characteristics in changing their responses from the first to the second and third questionnaires as it was expected.
No control group and the patients were not drug free during the trial.
Nature/Nurture: Is there a panicky personality or is it a nurtured condition?
Usefulness- panic disorder is clearly susceptible to treatment and either method would help a patient reduce medication.

30. Worksheet 4: Essay Plans
Activity 4
Worksheet 4: Essay Plans
10 Mark Questions
15 Mark Questions

32. EXAM STYLE QUESTIONS (ESQ) Treatments
BIOLOGICAL
June 2014
Describe how dysfunctional behaviour could be treated biologically. (10)
Discuss ethical issues in the treatment of dysfunctional behaviour. (15)
BEHAVIOURAL
January 2012
Describe a behavioural treatment for dysfunctional behaviour [10]
Discuss ethical considerations regarding the treatment for dysfunctional behaviour [15]
June 2013
Outline behavioural treatment for dysfunctional behaviour. (10)
Compare approaches to treating dysfunctional behaviour. (15)
COGNTIVE
Describe a cognitive treatment for dysfunctional behaviour [10]
Discuss strengths & limitations regarding the treatment for dysfunctional behaviour [15]

34. Biological Treatment [10]
Introduction:
Treatment:
Liebowitz:
Conclusion:

35. Behavioural Perspective [10]
Introduction:
Treatment:
McGrath:
Conclusion:

36. Cognitive Approach [10] Introduction: Treatment: Ost & Westling:
Conclusion: