1. Exam time: 9 am to noon Exam day: Wednesday, December 16 Exam room: Jefferson Labs room 250 PLEASE COMPLETE THE ONLINE COURSE EVALUATION (CUE) Before you leave for break Psy 18 Final Exam

2. Last Meeting!! Treatment Prevention Wrap-Up

3. Psychotherapy versus Drugs advantages of therapeutic relationship addresses underlying issues effects last longer takes longer dependent on skill of therapist dependent on motivation of client quicker action effective for biologically- based symptoms less expensive possibility of relapse when discontinued side effects possibility of dependence does not address underlying issues PsychotherapyDrugs

4. Therapeutic “Common factors” Richards & Richards (2006) Establishing Positive expectancies: Empathy, warmth and genuineness; Hope Negotiation of goals Guidance Commitment Trust in therapist A “safe” place Forming an alliance Flexibility of responsiveness

5. Is Treatment Always Helpful? outcome studies: about 85% of patients are helped between 5% and 10% deteriorate OCD Borderline PD personality conflicts sexual attraction “bad” therapies

6. Evidence-Based Treatment Randomized Controlled Trials (RTCs) outcome measures placebos “blindness” standardization of treatment (manualized therapies) treatment bias dropout bias

7. Internet-based Psychotherapy? afterdeployment.org

8. Prevention emphasis on psychological health rather than disorder reduces suffering reduces expense improves global functioning increases self-efficacy in many areas of life

9. Levels of Prevention Universal interventions general population healthy lifestyle programs DARE Selective interventions specific subgroups at risk Head Start Indicated interventions individuals with subclinical signs and symptoms

10. Concluding Remarks Current state of psychopathology What I hope you have learned

11. Current State of Psychopathology ?

12. Carson12 Predispositions to Depression In 21 st -Century genetics genetics diet diet pace of life of pace of life of children and adults children and adults noise noise ease of survival ease of survival indoor existence indoor existence drug culture drug culture Age of instant gratification Age of instant gratification Age of Information Age of Information de-emphasis on religion de-emphasis on religion loss of the extended family loss of the extended family and the community and the community divorce and loss of nuclear family divorce and loss of nuclear family commercialism and the commercialism and the “more” mentality “more” mentality

13. Carson13 “Psychological Immunization” Against Depression Cognitive Skills Problem-Solving Skills realistic optimism self-acceptance and appreciation world view bigger than self Emotional Regulation Social Skills positive coping strategies stress management problem-solving goal setting making good choices reflective listening assertiveness empathy Self-Care Skills nutrition physical exercise rest moderation

14. What I hope you have learned…