1inhowmanypeople needmentalhealth treatment?

1inhow manypeopleare abusedsexually Whatis psychopathology

1/41/4

Whenaconditioninterfereswithnormallife.Usually becausepatientisavoidingsomething.Requiresempathy onbehalfoftherapist Eachplaysarole,bothaffectyouroutcome.

WhatdidHebbbelieve concerningnaturevs. nurture? Wheredidtheconcept ofthedeviloriginate? Whataboutdevil possession Whatwasthe Episcopalchairof angers

Conceptofdevil:orientalsacredliteraturePossessionof devil:BookofGenisis

AsingleblindstudywhereaBishoptrickedalittlegirlby usingbible/holywatertogetdeviloutofgirlinengland. Providedevidencethatpossessionwasnotthedevilbut biology. Possessedbydevil.Excorcism

WhatdidtheCatholic churchbelievementally illwere?Solution? Excorcism

Therapythatchurchusedtocurementalilness.Attacks devil'spridetodrawdeviloutbcthatwashissin.Usesharsh language,physicalforceanddefilethebodythrough torture/sexualabusetodrawhimout Determinedthatanunwaspossessedbythedevilbecause sheforgottosayherprayersbeforeeating excorcised1000soffliesfromchurchandtheydropped dead,excorcizedcroakingfrogs

WhatwasSt.Gregory attributedwith? WhatdidSt.Ambrose do?

Whowerethe Capuchinmonks?

moksthatarguedagainstbishopsbeliefintheEpiscopal chairofangerssayingthatthedevilknewwhatthebishop wasdoingandtrickedhimbypopingoutbeforethe excorcism. MinisterofSalemwhotookoverbourroughspositionand promotedbickeringandgainedenemies.Burnedhis enemiesforcontrol,citingthemaswitches.Burnedindian caregiversb.c.of2possessedchildren. originalministerofsalem,butresignedbcofbickering betweencongragations.Burneddueto"posession"butsaid ourfatherwhileburning=provedinnocence. upbringingandphysicalfactors.Firsttocombinephysical andenvironmental.Treatedmentallyillwithkindnessand respect

WhowasMr.Parris?

WhowasMr. Burroughs

WhatdidSt.agustin believementalillness wasdoto?Howdidhe treatthementallyill? Whatthreefactors encouragedtheretreat toCustodialism (vchains,lockedup,or abandoned)afterthe progressofthephysical modeofmentalillness? WhatdidSakeldevelop andwhatdidhe observe? WhatdidMeduna develop?

1.Plinyearle'sbook:curitabilityofinsanity,whichpointed outthattreatmentdidnotwork.2.Economic250bedsof Kimbridehospitalwerenotselfsustainable.DorthyDixgot manypeoplefromjailstohospitalscauseingafluxof patients.Peoplereleasedtogetmoneyfromlegislaturesand endedupcyclingthroughhospitals3.massimmigration.Ifon didnotspeakenglish=mentallyill. DevelopedInsulintherapy.Observedthatitincreased appetiteanddecreasedsleepingproblems.Insulinproduced convulsionsandtheygotbetter. Convulsivetherapy.Concludedthateppilepticsdontget schizophreniaandthoughtthiswasbceppilepticshad convulsions.Inducedconvulsionsinschizos. Electricconvulsivetherapyproducedconvulsionswith electrisity. ExperimentthatprovedECTdoesnothavepositiveeffecton schizophreniabutdoesworkforpsychoticdepression.

WhatdidCerletti&Bini develop WhatwereHudson& Gottliebresponsiblefor

Whataretheside effectsofECT? WhydidFreudbelieve ECTworkedfor psychoticdepression? WhatdidMoniz develop?How

lossofshorttermmemoryinitially,destroysbraincells

Depressioniscausedbyguilt,andpainofECTmakes patientfeelpartiallyabsolved.

Prefrontallobotomybabsedonanimalstudy.Observed behaviorchangewithlobotomy.Practicedonmentallyill. Wentthrougheyesandcutfibers.Claimeditwas90% effective. AfterreadingJamesOlinarticlewhoinsertedelectrodesinto pleasurecenterofrats,decidedtotryonschizoswhocould pressbuttonswhentheyfeltliketheyweregoingtoactout andemmitelectrisityfromelectrodesintheirbrain. Tinynow.Someonecanhavecompletecontroloverothers

HowdidHeath contributetothe reamergenceof physicaltherapies? Problemwith electrodes? Whatis Chlorpromazine? Phenothiazines Whydopharmaceutical studiesthrowout placeboeffectin studies? Whathappensto Childrenwhogrowup instateinstitutions? Whydidsomementally illtaketothestreets? Whydomentallyill sufferhorriblyfrom incarceration?

antipsychoticdrug.Peoplewerekilledbyitbcitcaused convulsionsinpeoplewithanxiety. Heavyantipsychoticdrugs Distortsuccessstats.FDAhasfarlessmoneythandrug industryandcannotproperlyprotectpublicfromthis.

Donotexperiencejoyorsocialintereactionwithother children.

Deficientstateinstitutions.Mistreatment.

Takenadvantageof.Jailsdonotprovidecare.Functioning decreasesduetoenvironment.

Whatcureformentally illdidJacobsen develop? ClarkHullwrotea... FTXandBarbervs Hillgard WhatisFreud's conversionisttheory? Psychopathology involvesconflict between?Howisthis conflicteliminated? WhatwasFruedsbasic rule? HowdidCharcotand Breuercontribleto Freudiantheory? WhatwasFreuds seductiontheory DefineTrieb

Musclerelaxation

bookonhypnosisandbroughtitbacktoattention Hillgradarguedthathypnosisneededtobestudied scientifically allsymptomsareavoidance.Reducestress/anxiety.Brain takesover(unconscious)todoso. 2opposingdrives.ConflicteliminatedbyBrain.

Lieonthecouchandletyourmindfree.

CharcothypnosisBreuer"shutupandlistentome"said patient.SoFreudlistenstopatients

Psychopathologisrelatedtosexualtrauma.Originall abandonedtheorybcknewaccusedfather. instinctinGerman.Acombinationofanintactbehaviorthat involvesthemodificationonlearning. Homeostatics.Balancedenergysystem.

Whatispsychicenergy derivedfrom? WhatistheIdgoverned by? Whatistheego governedby? Whatisthesuperego

Pleasureprinciple.Seekpleasureandavoidpain.Biological. Bizzarelearnedthinkingduetoreleaseofourunconscious. realityprincipleandisthesecondarylearningprinciple.

Moralprinciple.Thewayyouwereraisedbecomesyourego 4

governedby? Whatarethethree goalsofthesuperego? Howdoesinfantile sexualitydifferfrom adultsexuality?

idealandyourconsciencetellsyoutodoornottodo. 1.InhibitId2.Persuadeegotoadoptmoralprinciple3. Perfection Thehighestexcitationforchildisnotlocatedingenitalsbut isdispersedamongmanyerogenouszones.Theaimis different,thegoalisnotintercoursebutratherautoerotic forepleasure. Whensexualoraggressiveexcitementisnotpermittedto takeitsnormalcourse resultsfromblockageofunconsciousimpulses.Devlops throughrepression.Webecomeanxiousbecausewewant thingswecanthave.Wefearourwantsandthinktherewil bedisastrousconsequencesifapreviouslypunishedId impulseisallowedexpression 1.Repression2.Displacement3.ReactionFormation4. Regression5.Projection6.Denial7.Rationalization

DefineTraumatic anxiety DefineNeuroticanxiety

Whatare7formsof unconsciouscoping skillsagainstfreudian anxiety? HowdidCarlRogers performclientcentered therapy? HowdidAbraham Maslowuse clientcentered therapy? Whatisthe BehavioralistHumanist dichotomy? CLassicalconditioning isanassociation between...Operant

Unconditionalpositiveregard

Selfactualization.Heirarchyofneeds.

Behavioristsbelieveweareaslavetoourpastexperiences whilehumanistsemphasizefreechoice.

2stimuli.Association.Behaviorandconsequence

conditioningisan associationbetween... AbnormalPsychology scientificstudywhoseobjectivesaretodescribe,explain, predict,andcontrolbehaviorsthatareconsideredstrangeor unusual anattempttodescribeandunderstandanindividual's disorderusingtheirhistoryandsystematicobservationsbya professional. GalenandHippocretes.DevilPossession.

Psychodiagnosis

Pre1792isassociated with Dateofageofreason 17921850 DateYorkRetreatwas developed 18501880 18801930 19271933 1934 1938 Whenwas psychopharmacology revolution Importanttherapistsof 1920s 1970

1735 Pinelmoraltreatment 1796

physicalmodelofmentalillness retreattocustodialism Skelinsulintherapy convulsivetherapy.Meduna ECTcerlettiandbini 1951

CourceandJacobsen.Freud.

BarbervsHillgard.Demandforhypnosistobestudied

scientifically WhatwasFreudborn Therapy 1856.Livedtill1939. anattempttocontrolabnormalbehaviorthroughsystematic interventionwhosepurposeistomodifyaclient'sbehavioral, affective(emotional,orcognitivestate). PHd.orPsyD.Providetherapytoclientsinhospitals, clinics,andprivately.Study,assess,treat,andprevent abnormalbehavior. distressordisabilityofmindorbehaviorwhichsignificantly increasesriskofsuffering,death,pain,disability,oran importantlossoffreedom.Mostimposedirectlyonabilityto functionindailylife(ieaphobiaofsnakesbutlivinginan areawithoutsnakesmeansthephobiaisnottruelyan abnormalbehavior) Partofatraditionalviewofanormalpsychthatafixedsetof mentaldisordersexistswhoseobviousmanifestationscut acrosscultures. thepercentageofpeopleinapop.whosufferfroma disorderatagivenpointintime totalproportionofpeopleinthepop.whohaveeverhada disorderintheirlives. modelinwhichmentaldisordersaretheresultofan interactionofbiological,pschandsocialfactors. stoneagepracticeofusingastonetoboreaholeina person'sheadtoletthe"evilspirit"out. movementthatemphasizeshumanwelfareandtheworth anduniquenessoftheindividual.Believedmentallyillshould betreatedassick,nottorturedormadeaspectacle. symptomstendtooccurinclusters 7

ClinicalPsychology

Abnormalbehavior

Culturaluniversality

Prevalence

Lifetimeprevalence

Biopsychosocialmodel

Trephining

Humanism

syndromes

Catharticmethod

therapeuticuseofverbalexpressiontoreleasepentup emotionalconflicts. stressedtheimportanceofdirectlyobservablebehaviors andtheconditionsorstimulithatevoked,reinforced,and extinguishedthem.Highlysuccessfulintreatingmaladaptive behaviors. Stressestheimportanceofculture,race,ethnicity,gender, age,socioeconomicstatus,etc.asaresultoftheeffectof diversityonthementalhealthprofession. Explainedbyidentifyingwhatfactorsledtothedev.ofthe abnormalbehavior(biological,family,childhoodexperiences, difficultyadaptingtonewenvironments,anger,etc.) Ifapsychologistidentifiesthesourcesofthemaladaptive behaviorcorrectly,theycanpredictthekindsofproblems theywillfaceintherapyandthesymptomstheywilldisplay. However,Peoplemustdisposetruethreatinordertobe involuntarilyhospitalized,becausepeopleareinnocentuntil provenguiltyandpsychologistsoftenoverpredictfuture violence. Distress,Deviance(bizarreness),Dysfunction,and Dangerousness

Behaviorism

Multiculturalpsychology

Howis psychopathology explained? Howcanapsychologist predictabnormal behavior?

WhataretheFourDs ofdetermining abnormality Deviance

behaviorsoccurstatisticallylessfrequentlythanaverage. Antisocialacts,hallucinations,delusions,disorientation,1. Delusionsofgrandeuryouthinkyou'resomeoneimportant likeJesus2.Delusionsofpersecutionthinkyou'rea conspiracyvictim,etc. onesinabilitytosatiatetheresponsibilitiesofacertainrole, ortomatchtheirperformancewiththeirpotential. donttakeintoaccountdifferentculturalnorms,orthatsome deviationsfromthenormcouldbedesirableandothers undesirable.

Dysfunction

Problemswithdefining abnormalbehavior

Hippocrates

Physician.Fatherofmedicine.Qquestionedsuperstitious beliefs.Believedthatmanyabnormalbehaviorswerecaused byimbalancesanddisordersinthebrainandbodyBelieved deviantbehaviorcausedbybrainpathology(disfunctionor diseaseofbrain)coupledwithheredityandenvironment. I.ManiaII.Melancholiareccomendedtranquility,exercise, diet,abstinence,distancingfromfamily,bloodlettingIII Phrenitis(brainfever) reliedonobservationsthatformedbasesofscientific method.Stressedorganiccauses,notdemonic.

WhatareHippocrates' 3classificationson mentalillness Naturalistic explanationsof abnormalbehavior WhodidPlatofeel shouldberesponsible forthementallyill Galen

theresponsibilityoffamilyandshouldnotbepunished.

studiednervoussystemandexplainedtherollithasin mentalfunctioning. Churchdiscoragedscience.Seekingscientificanswerswas heretic.Illnesseswerepunishmentsforsins.Mentallyill weretortured,exorcisticprocedureswereused 1and2areduetostressandfear,socialunrest,plague, famine,pestilence,unstablesocialclimate.

Whatwasmentallyill treatmentlikeduring darkages(5th13thc) WhatwereLycanthropy (victimsimagineselves aswolves)andSt. Vitus(wholetown becamepossessed) actuallydueto? JohnWeer

1563,GermanPhysician,wrotebookthatchallenged foundationsofwitchcraft.Encouragedreformmovement. ReformMovement.ShifttomoreHumantreatment. wrotebookabouthisownmentalcollapse,revealedthe horriblemistreatmentheenduredasapatient,andgained publicsympathy/interest.FoundedMentalHealthAmerica 9

18th19thc CliffordBeers

whicheducatespublicaboutmentalillnessandneedtotreat ratherthanpunish. Kraepelinbelievedthat syndromescouldbe determinedfrom clustersofsymptoms andthattheywere causedby: KraftEbing 1.MetabolicDisturbance2.EndocrineDifficulty3.Brain disease4.Heredity.Allwithacourseandoutcome.Used thistoformulatewhatbecamebasisofDSM.

Germanneurologistinfectedgeneralparesispatiencewith syphilisandnotedthattheirsymptomsdidnotchange= syphilisofbrain.Shaudinnisolatedthemicroorganismand provedthistheory. MesmerofAustriainducedpatienceintoasleeplikestateto relievethemofhysteriaandhavethembecomehighly suggestable.DeemedafraudandforcedtoleaveParis,but methodshadstrongimplicationinpowerofsuggestion. Pinelgavethemworktodotoprovidesenseofpride. Kirkbridehospital.90%effective.DevelopedretreatatYork withTukeusingPinel'smoraltreatment. biologicalviewpoint EditorofJournalismofInsanity.Feltphysicalpressureon braincausedsymptoms.Arguedmentalillnesswas physical.Usedbloodletting. 90%successratedeclined.

Mesmerism

Occupationaltherapy WilliamHenry

18501880 JohnGrey

Whywastherea switchfromhumanist tobiologicalphysical model BenjaminRush

featherofAmericanpsych.Moraltherapistwhowrotearticle thatinspiredJohnGrey. Foundersbelievedthathysteriawasselfhypnosis.Used 10

NancySchool

hypnosistotreathysteriaaswellasinduceitinnormal people=powerofsuggestion. Breuer Breuerfoundthatwhenapatientwashypnotizedtheywere abletotalkabouttramaticexperiences+surpressed memoriesfreelyandwererelievedofsymptoms.Developed catharticmethod. Theimportanceofdirectlyobservablebehaviorsandthe conditionsorstimulithatevoked,reinforced,and extinguishedthem.Highlysuccessfulintreatingmaladaptive behaviors. Staysinmentalhospitalswereshortened,outpatient treatmentdeveloped,deinstitutionalization,+encouraged strongbelievesinbiologicalviewpoint argeorganizationsintheprivatesectorcontroldeliveryof services.Madeattemptstocontainrisinghealthcarecosts fromprivatesources.Broughtaboutfollowingchanges:1. Businessinterestsareexertingcontrol2.Incomeof practicionersarebeingdepressed,moremastersless doctorates3.Psychologistsarebeingaskedtojustify whethertheirtherapiesareempiricallybased,andpotentially deniedinsurance howweareraised,whatvaluesweareinstilledwith,howwe areexpectedtobehave, analogythatscientistsusetodiscussaphenomenonthatis difficulttodescribeorexplain.Usedtoaskquestions, determinerelaventdata,interpret,andconceptualizethe causesofabnormalbehavior. wayoflookingatamentaldisorderinanorganized frameworkforunderstandingthenumerouscausesofthe disorder,thecomplexity,etc. nervecellsthattransmitmessagesthroughoutbody.Have membranesthatisolateandregulatechemicalcontents

WhatdidBehaviorism stress?Whatwasit highlysuccessfulin?

Whatwerethebenefits ofthedrugrevolution

Developmentof ManagedHealthCare

socialconditioning

model

multipathmodel

neurons

11

withinit Dendrites numerousshortrootlikestructureswhosfunctionisto recievesignalsfromotherneurons longerextensionthatsendssignalstootherneurons,some aconsiderabledistanceaway. aminutegapbetweenaxonofasendingneuronand dendritesoftherecievingneuron chemicalsubstancesreleasedbytheaxonthatalowsforan electricalimpulsetocrossthesynapse.Attachthemselves tothedendritesofrecievingneuronsandbind,encouraging othernerveimpulsesorpreventingthem person'sgeneticmakeup. observablephysicalandbehavioralcharacteristicsthat resultfromgenotypeandenvironmentinteraction Meehl1962Rosenthal1970.itisnotaparticularabnormality thatisinheritedbutapredispositiontodevelopillness (diathesis).Environmentalfactors(stressors)myactivate predisposition. viewdisordersastheresultofchildhoodtraumaor anxieties.Believethatmanychildhoodbasedanxieties operateunconsciouslybctheexperiencesaretoo threateningfortheadulttofaceandarethereforerepressed. egoprotectionstrategiesthatshelterindividualfromanxiety, operateunconsciously,anddistortreality. anawarenessofthedemandsoftheenvironmentandofthe needtoadjustbehaviortomeetthesedemands usingparticularmethodsofexplorationtouncoverrepressed materials,helpclientsachieveinsightintotheir subconsciousdesiresandmotivations,andresolve 12

axon

Synapes

Neurotransmitters

Genotype Phenotype

Diathesisstresstheory

Psychodynamic models

Mentaldefense mechanisms realityprinciple

PSychoanalysis

childhoodconflictsthataffectcurrentrelationships. Behavioralmodels concernedwithroleoflearningonabnormalbehavior+ explainhowlearningoccurs voluntaryandcontrollablebehavior,suchaswalkingand thinking,that"operates"onanindividual'senvironment. anindividualcanacquirenewbehaviorssimplybywatching otherpeopleperformthem basedonassumptionthatconsciousthoughtmediatesor modifiesanindividualsemotionalstate/behaviorinresponse tostimuli setofunderlyingassumptionsheavilyinfluencedbya person'sexperienes,values,andpercievedcapabilities. inherenttendencytostrivetowardtherealizationofone'sfull potential.Fulfillingthegranddesignorgeneticblueprint. Pushespeopleforwardandismanifestedincuriosity, creativity,andjoyofdiscovery. howoneviewsone'sownvalue,worth,andhowothers relatetotheself. emphasisonindividualuniqueness,questformeaninginlife, forfreedomandresponsibility,usingthepersonssubjective worldofexperiencetounderstandthem,andbelievingthat theindividualhaspositiveattributesthatwillbeexpressedif notdistortedbyenvironment. modelthatassumesthatthebehaviorofonefamilymember directlyaffectstheentirefamilysystem Inferioritymodelearlyattempttoexplaindifferencesin minoritygroupthatcontendsthatracialandethnicminorities areinferiorinsomerespecttothemajoritypopulation.deficit modelearlyattempttoexplaindifferencesinminoritygroups thatcontendsthatdifferencesaretheresultofcultural 13

Operantbehavior

ObservationalLEarning theory Cognitivemodels

Schema

Selfactualization

selfconcept

Existentialapproach

Familysystemsmodel

Inferiorityanddeficit models

deprivation Multiculturalmodel contemporaryattempttoexplaindifferencesinminorities thatsuggestthatbehaviorsbeevaluatedfromthe perspectiveofagroup'svaluesystem,aswellasbyother standersusedindeterminingnormality/abnormaity MicrovariablesbiologicalfactorsinbehaviorMacro variablesculturalfactorsinbehavior 1.Righthemispherevisualspatialabilitiesandemotional behavior2.Lefthemispherelanguagefunctionsforallright handedandmostleft

MicroandMacro variables Whataretherolesof theleftandright hemispheresofthe brain Forebrain

Controllsallhighermentalfunctionsassociatedwith consciousness,learning,speech,thought,+memory. Containsthalamus,hypothalamus,reticularactivating system,lymbicsystem,andcerebrum. transmitsnerveimpulsesfromonepartofthebrainto another bodydrives(hunger,sex,)+bodyconditions(temperature andhormones) involvedinexperiencingandexpressingemotionand motivation(pleasure,fear,aggression,arousal,pain) involvedinvision,hearing,andwiththehindbrain'shelp, sleep,alertness,andpain+manufacturingchemicals associatedwithmood(dopamine,seratonin) manufacturesseratonin.Heartrate,sleep,respiration. ,anetworkofnervefibersthatcontrolsbodilystates (attention,sleep,alertness).ConnectedtoMidandHindbrain Neuronsdendritesrecievemessage>axonterminals> synapseandneurotransmitters>binding>impulse/lack 14

Thalamus

hypothalamus

Limbicsystem

Midbrain

Hindbrain ReticularFormation

Whathappensonan atomiclevelwhen

sensesrecieve messages? synapticexcitation synapticinhibition Animbalanceofcertain _________inbrainis believedtobe implicatedinmental disorders. HumanGenomeproject

ofimpulse

encouragementtoproduceotherimpulses astatepreventingproductionofimpulses neurotransmitters

locationsofallgeneshadbeenmappedinthenucleusofa humancell(inourchromosomes).somegenesare associatedwithhereditarydiseases. minortranquilizersthatcalmandreduceanxiety.Bindto receptorsitesandbloctransmissionofcertain neurotransmitters tranquilizingeffect.Reducepsycholoticsymptomsand decreasepatient'sinterestinownhallucinations. helpindividualsfeellessdepressed.Somealterbalanceof neurotransmittersinbrain.SSRIsinhibitintakeofseritonin. (ex.lithium)moodcontrollingmedicationsthathelptreat manicdisorderslikebiopolars. whether,when,how,andwhatmentaldisturbancesdevelop. Theconfigurationofagene,thespecificstressors,andthe timesatwhichtheyoccurinsomeoneslifeplayimportant roles.

antianxietydrugs

Antipsychoticdrugs

Antidepressants

Antimanicdrugs

Differentformsofthe samegenes(alleles) andcritical developmentalperiods inlifemaydetermine... AccordingtoFreud, mentalproblemsarea functionoftrauma rootedin....

sexuality,orrepressedimpulsesoflibidoandaggression.

15

Oralstage

Autoeroticphenom.Thumbsuckings.Canabalisticfantacies. Greed(Hoarding) Personalitydevelops.Rectalmucos=pleeasure.Anal eroticism Oedipusandelectracomplex.Repressionofdesires excessivesatisfactionandfrustration 1920s.Believedinpositivethinking."Everyway,everyday,I ambetterandbetter." originalcomponentofpersonalitypresentatbirthand operatesonpleasureprinciple.Seeksimmediate gratificationtoinstinctualneeds,regardlessofmoralsor realisticconcerns. representsrealisticandrationalpartofmind.Decisionsare dictatedbyrealisticconsiderationsratherthanmoral judement moraljudgementsandmoralisticconsiderations. Conscienceinstillsguiltfeelingsandtheegoidealrewards altruismandmoralitywithpride.instinctsgiverisetoour thoughtsandactionsandfueltheirexpression. timeinwhichhumanpersonalitydevelops.Iffixationoccurs duringoneofthestages(arrestingofemotional development),distinctconflictarises.Oral(1styearlife) Anal(2ndyearlife)Phallic(3rd4th)Latency(612)Genital (begginningofpuberty) patientsayswhatevercomestomind,regardlessofhow illogicalorembarassing,forpurposeofrevealing unconscious.Helpsinunderstandingpatientsconflicts, personality,andunconsciousthoughts. therapeutictechniquethatinterpretshiddenmeaningsin dreams.Psychoanalysistsbelievethatwhenpeoplesleep, 16

Analstage

Phallicstage Genitalstage WhatdidCucebelieve inandwhen? Id

Ego

Superego

Psychosexualstages

Freeassociation

Dreamanalysis

defensesandinhibitionsofegoweaken,allowing unnacceptablemotivesandfeelingstosurface. Resistance processwherepatientunconsciouslyattemptstoimpede analysisbypreventingexposureofrepressedmaterial. Therapistpaysattentiontohowpatienttrystoinhibit answersintherapyorredirectitoutofavoidance. patientreenactsearlyconflictsbycarryingoverandapplying totheanalystfeelsandattitudesthatthepatienthadtoward significantothers. therapistsaremoreactiveinsessions,restrictnumberof sessionstheyhavewithclients,placegreateremphasison currentratherthanpastfactors. 1.EmpiricalproceduresbywhichFeudvalidatedhis hypotheseshaveshortcomings.Reliedheavilyoncase studieswhichwereoftenuncontrolled.Usedhisownself analysisasplatformfortheory.Hispatientsfromwhichhe drewuniversalconclusionsrepresentedanarrowsampling in1society.2.Freudtheoryoffemalesexualityand personalityhavedrawnheavycriticismfromFeminists.He failedtoconscidersocialforcesthatshapewomenbehavior andactslikewomenenvythebiologyofmen.3. Psychoanalysiscannotbeappliedtoawiderangeof disturbedpeople.Bestsuitedtowelleducationpeopleofthe middleanduppersocioeconomicclasseswhoexhibit anxietydisordersratherthanpsychoticbehavior. discoveredbyIvanPavlov1.unconditionedstimulusfoodin dogcase2.unconditionedresponsesalivationindog3. neutralstimulusbell.Byrepeatedlyringingthebillbefore presentingthefood,thesoundofthebellelicitedsalvation, becomingaconditionedstimulus.4.conditionedresponse salivationelicitedbybell,alearnedresponsetoapreviously neutralstimulus.5.Repeatedlypairingtheunconditioned stimuluswiththeconditionedone,theconditionedresponse isreinforced(strengthened) Importanceofassociativelearningintheexplanationof 17

Transference

Contemporary psychodynamic theories 3critisicmsof psychodynamicmodel

ClassicalConditioning ParadigmusePavlov examples.

JohnWatson

abnormalbehavioriscreditedtoJohnWatson.explained thatclassicalconditioningcouldexplainphobias,unusual sexualattractions,andextremeemotionalreactions. Behaviorsbasedon clasicalconditioningare controlledby________, butinoperantis controlledby________. InOperant Conditioning:1.People willcontinuetodo destructivebehaviors eveniftheyare destructiveif2.People willavoiddoing productivebehaviorsif Thorndike 3critisicmsof behavioralmodels stimulireinforcers(condequencesthatinfluence)

therearepositivereinforcementsfromdoingthebehavior. (Exheadbanginginchildrenb/ctheirparentsgivethem candyiftheystop)theyarenegativelyreinforced(ex.Student feelsanxietyfromdoingoralreportssotheyswitchintoa classthatdoesnotrequirethem.Negativelyreinforced becausetheuncomfortablestimuliisremovedandthe studentescapesthesituation)

Instrumentalconditioning 1.Itplaceslowimportanceontheinnerdeterminantsof behavior2.Itappliesresultsfromanimalstudiestohumans 3.Toomechanistic,viewinghumansasemptyorganisms. ognitivepsychologists,whoexplainpsych.problemsas beingresultofirrelationalthoughtpatternsthatstemfroman individual'sbeliefsystem. illicitintenseemotionalreactionsandtheresponseswere conditionedthroughearlychildhoodaswellasselfrepition.

AaronBeckandAlbert Ellis,

Withirrationaland maladaptivethinking, thinkingaboutthe event,nottheevent itself,can ABCtheoryof personality

DevelopedbyEllis.Processbywhichanindividualacquires irrationalthoughtsthroughinteractionswithsignificant others:A:event,fact,orindividual'sbehaviororattitudeB: Theperson'sbeliefsaboutAC:Theperson'semotionalor behavioralreaction.AdoesntcauseC,Bdoes.

18

cognitivetherapy consistsofhighly specificlearning experiencesdesigned toteachpatientsto:

1.Monitortheirnegative,automaticthoughts2.recognizethe connectionsbetweencognition,affect,andbehavior3. examineevidenceforandagainsttheir(distorted)automatic thoughts4.Substitutemorerealityorientedinterpretations5. learntoidentifyandaltertheirbeliefsthatpredisposethemto distorttheirexperiences 1.BFSkinnerwarnedthatcognitionsarenotobservable phenomenaandcannotformfoundationsofempiricicm2. Watsonarguedthatscienceofpsychwasobservable behaviorsnotmentalisticconceptions(moredirectly targetingFreud)3.Humanistpsychsarguedthathuman behaviorismorethanjustthoughtsandbeliefs.Feel cognitivemodelsmechanizzethewayhumansthinkandfeel andreduceitdowntosimplycognitiveparts.Can't disturbancescausedistortedthinkingandnotjusttheother wayaround?4.Cognitivetherapycritisizedforgiving psychologisttoomuchpower,authority,and"expertise". Clientscanbeintimidatedintoacceptingtheirtherapist's conclusionsandbemisidentified. 1.People'srealitiesareproductsofuniqueexperiencesand perceptionsoftheworld2.Howapersonconstruesevents ismoreimportantthantheeventsthemselves3.Individuals haveabilitytomakefreechoicesandareresponsiblefor theirowndecisions4.Believeinthewholeness,orintegrity, ofthepersonandviewaspointlessalattempttoreduce humanbeingstoasetofformulas,stimuli,andmeasured responses.5.Peoplehaveabilitytobecomewhatthey want,tofulfilltheircapacities,andtoleadthelivesbest suitedforthem Humanist.hadtheoryofpersonalityreflectinghisconcern withhumanwelfareandhisdeepconvictionthathumanityis good,forwardmoving,andtrustworthy. (significantpeopleinoneslifeonlyacceptsomebutnotallof thatpersonsactions,feelings,andattitudes) placesemphasisontherapist'sattituderatherthan technique.Mustfocusoncommunicatingrespect, 19

4critisicmsofCognitive Model

What5assumptions doeshumanismand existentialismbelieve?

CarolRogers

Conditionalpositive regard nondirectiveor personcentered

therapy

understandingandacceptance,nottryingtoexplainclient's behaviororprescribingactionstofollow. 1.islessoptimisticthanhumanism.Focusesonirrationality, difficulties,andsufferingallhumansencounterinlife.Deals withhumanalienationfromthesocialandspiritualstructures thatnolongerprovidemeaninginanincreasingly technologicalandimpersonalworld2.humanistictherapists attempttoreconstructsubjectiveworldoftheirclients throughempathy.Existantialistsbelievethattheindividual mustbeviewedwithinthecontextofthehumancondition andthatmoral,philisophical,andethicalconsiderationsare partofthatcontext.3.Humanismstressedindividual responsibility.Existentialismstressesnotonlyindividual responsibilityforwhatonebecomesinlifebutalso responsibilitytoothers.Selffulfillmentisnotenough too"fuzzy,"ambiguous,vague.Notsuitedtoscientificor experimentalinvestigation.Focusesonsubjective understandnigratherthanpredictionandcontrol,empathy ratherthanobjectiveinvestigation,andonlyfunctionwitha narrowgroupofclient.Lackofscientificgrounding.Donot workwellwithseverelydisturbed,mostlywelleducatedand relativelynormal. ivelonger,lesslikelytocommitsuicideanddevelop psychiatricdisorderssuchasdepressionandalcoholism, enjoybeterphysicalhealth,happier,moreoptimistic,and recoverquickerafterillness stressedimportanceofteachingmessagesendingand messagerecievingskills dealwithpowerstrugglesthatoccuramongfamilymembers byattemptingtobalanceanddistributethem. attempttoreorganizefamilymembersbctheyareeithertoo involvedornotinvolvedenough. allowseachclienttobecomemoreinvolvedinasocial

Inwhatthreewaysdo Humanismand Existentialismdiffer?

Whatarethecritisisms ofHumanistand Existentialist approaches?

Peoplewithrichsocial connections

conjointfamily therapeuticapproach Strategicfamily approaches structuralfamily approaches Whatarethebenefitsof

20

grouptherapy

situationandseehowtheirbehavioreffectsotherstherapist canseehowclientsrespondinreallifesocialand interpersonalcontextmemberscandevelopnew communicationalandsocialskillshelpmembersfeelless isolatedandfearfulaboutproblemsprovidesmemberswith strongsocialandemotionalsupportcreatessenseof intimacy,belonging,trust,andprotection=motivationto confrontonesproblemsandseektoovercome. 1.Studiesdoneonthesetypesoftherapieshavelacked controls,followupperiodsofoutcome,orgoodmeasures. 2.Sometherapistspointfingersatparticularmembersof familialandsocialinstitutionsandcausemisappropriated guiltinsituationswhereitisactuallynottheirfault. lowersenseofselfcontrol,poorerphysicalhealth,and higherincidenceofdepression=increasedstressors,often whichunderminementalandphysicalhealth. 1.Criticsarguethatadisorderisadisorder,regardlessof culturalcontextinwhichitisconsidered.2.regardlessof whetherthepersonjudgestheoccurencetobedesirableor undesirable,itneverthelessrepresentsadisorder3.Lackof empiricalvalidationconcerningmanyconceptsand assumptions.Toomuchofarelianceoncasestudies, ethnographicanalyses,andqualitativeinvestigations. degreetowhichaprocedureortestwillyieldthesame resultsrepeatedlyunderthesamecircumstances theextenttowhichatestorprocedureactuallyperformsthe functionitwasdesignedto. Intestadministration,theuseofidenticalproceduresinthe administrationoftests:theestablishmentofanormor comparisongrouptowhichanindividual'stestperformance canbecompared achangeinthewayapersonusuallyresponds,triggeredby theperson'sknowledgethatheorsheisbeingobservedor

Whatarethecritisicms ofsocialrelational models

lowersocioeconomic statusisrelatedto

Criticismsof multiculturalmodel

Reliability

Validity

Standardization

Reactivity

21

assessed ProjectivePersonality test testinwhichthetesttakerispresentedwithambiguous stimuli,suchasinkblots,pictures,orincompletesentences, andaskedtorespondtotheminsomeway. anassessmenttoolthatrequirestesttakerstoanswer specificwrittenquestionsortoselectspecificresponses fromalistofalternatives mentalmeasurement,includingitsstudyandtechniques. asystemofdistinctcategories,indicators,and nomenclaturefordifferentpatternsofbehavior,thought processess,andemotionaldisturbances. apredictionofthefuturecourseofaparticulardisorder cooccuranceofdifferentdisorders determineswhetherameasureyieldsthesameresults whengiventoanindividualattwodifferentpointsintime measureisconsideredreliableifvariouspartsofthe measureyieldsimilarorconsistantresults. determinesconsistencyofresponseswhendifferentjudges orratersadministerthemeasure abilityofatestormeasuretopredictorforetellhowaperson willbehave,respond,orperform. determineswhetherameasureisrelatedtothe phenomenoninquestion. seriesoftaskswithonecommontheme:allaredesignedto testwhetherameasureisrelatedtocertainphenomenathat areempiricallyortheoreticallythoughttoberelatedtothat measure

selfreportinventories

Psychometrics Classificationsystem

Prognosis Comorbiditiy testretestreliability

Internalconsistency

Interraterreliability

Predictivevalidity

Criterionrelatedvalidity

Constructvalidity

22

Contentvalidity

thedegreetowhichameasureisrepresentativeofthe phenomenonbeingmeasured. itallowsforsystemicrecordandobservationthroughmany methods

Assessmenttoolsare necessarytothestudy andpracticeofmental healthbecause Interviews

Allowsforthecollectionofdataconcerningaperson's personalityandlifesituationthroughverbalandnonverbal behaviors.Patientscanhide,distort,orlieduringinterviews. Somestruggletoarticulateinnerthoughtsandfeelings,and clinicianscanbebiasedoruseinvalidmeans. 1921.10Symetricalinkblotdesignsthatpatientmustsay whattheyseeandwhy.Provideinfoaboutpersonality dynamicsthatareoutsidetheconsciousawarenessoftest takers. 1935HenryMurray.30picturecardseachdepictingtwo humanfiguresinvagueandambiguousactionsthatmustbe interpreted.Reliesonprojectiontouncoverinfoabout interpersonalrelationships.Patienttellsstoryaboutpeoplein pictureandisassessedbasedonwhattheysayandhow theysayit. Testtoobtainanestimateofaperson'scurrentlevelof cognitivefunctioningcalledtheintelligencequotient. Standardized(Bellcurve)StanfordBinetIntelligenceScale andWechlerAdultIntelligenceScaleKABChighlyreliable andvalidtestforchildren212basedonverbaland nonverbalassessment. popularizedasameansofmeasuringinnateintelligencebut largelyreflectculturalandsocialfactors.Predictivevalidity hasbeenquestioned.Disagreementsovercriterion variables.Onlymeasuresacertainkindofintelligence. Identifiesphysicalandpsychologicalimpairmentsdueto braindamage.

RorschachTechnique

ThematicApperception Test

IntelligenceTests

Criticismsof intelligencetests

Testsforcognitive impairment

23

WhatareNeurological TEsts?Give4 examples.

diagnosecognitiveimpairmentsduetoabnormalbrain functioning/damage.CTscanxraysusedtoprojectthree dimensional,crosssectionalimageofbrainPETscannon invasivestudyofphysiologicalandbiochemicalprocessesin brain.Radioactivesubstanceinjectedintobloodstreamand studieshowbrainmetabolizesit.EEGelectrodesattached toskulltorecordelectricalactivity(brainwaves)MRI createsmagneticfieldaroundpatientandusesradiowaves todetectabnormalities. Confidentiality,invasionofprivacy,clientwelfare,cultural bias,andunethicalpracticesareoftenraisedwhenitcomes touseoftests.Embarassingquestionsareoftenused,test findingscanbeinaccurateandcausemisdiagnosis, advantages:cheaperandgivescliniciansmoretimetodo otherthings,easilyscoresandinterprets,clientspaybetter attentionbecausecomputersarefun,betterstandardized. Validandreliable.disadvantages:can'tdirectlyobserve. Privacyisnot100%protected.Hardtostandardizewhen can'tcontrolforwhatpatientdoeswhiledoingassessment oncomputer(ex.watchingTV).Notprefferedbyclients. a)AxisIClinicalSyndromesandOtherConditionsThatMay BeaFocusofClinicalAttention(allmentaldisorders)b) AXISIIPersonalityDisordersandMentalRetardationc) AxisIIIGeneralMedicalConditions(conditionsreleventto understandingandtreatingpatient)d)AxisIVPsychosocial andEnvironmentalProblems(problemsthataffect diagnosis,treatment,andprognosisofmentaldisorders)e) AxisVGlobalAssessmentofFunctioning(ratingofthe psychological,social,andoccupationalfunctioningofperson 100ptscale) a)Strongmedicalorientationeventhoughmanyofthelisted diagnosesarenotbiologicalinnature.b)Itlacksscientific theoryforitsclassificationofdisordersb/cmostofitwas decidedbynegotiatingnomenclatureoncommittees.c) Somecategoriesareconsideredsexistorculturallybiased. d)tsapplicationtochildrenisinadequateb/citisdesigned foradults.e)Categorizationofdisordersalsoattackedb/cof 24

Whataretheconcerns withassessments?

Whatarethe advantagesand disadvantagesof computersbeingused toadministerandgrade tests?

Whatarethe5 dimensionsofthe DSMIV

Whatare5criticismsof theDSM?

comorbitityandthedistinctionbetweenstatesofaproblem asamatterofkindratherthandegree. GoldfriedandDavison behavioralclassificationschemefordeviantbehaviors. Classifiedaccordingtothevariablesthataremaintainingthe behaviors.Therapistscanisolatevariablesfortreatment purposes. emotionaldisturbancesdividedintoemotionalvalence disturbances,emotionalintensity/regulationdisturbances, andemotionaldisconnections. takesintoconsiderationdimensionalratherthancategorical functioninganddevelopmentalprocesses. 1.Labelingapersonashavingamentaldisordercanresult inovergeneralizations,stigmas,andstereotypes.2.Label mayleadotherstotreatapersondifferently.3.Labelmay leadthosewhoarelabeledtobelievethattheydoindeed possesssuchcharacteristicsormaycausethemtoactout thelabel4.Labelmaynotprovidetheprecise,functional informationthatisneeded Whenanexperimentisrepeatedbyanotherresearcherto reducechancethatfindingsareduetoexperimenterbias, methodological,flaws,orsamplingerrors. methodofinquirythatprovidesforthesystematiccollection ofdata,controlledobservation,andthetestingof hypotheses. aconjectoralstatementthatusuallydescribesarelationship betweentwovariables. groupofprinciplesandhypothesesthattogetherexplain someaspectofaparticularareaofinquiry. definitionsofvariablesthatareconcrete Therateofnaturaloccuranceofaphenomenoninthe 25

Berenbaum'staxonomy ofemotional disturbances Psychodyamic DiagnosticManual 4Objectionsto classificationand labeling

Replication

ScientificMethod

Hypothesis

Theory

Operationaldefinitions BaseRate

populationstudied Experiment atechniqueofsceintificinquiryinwhichprediction,an experimentalhypothesis,ismadeabout2variables.The independentvariableismanipulatedinacontrolledsituation, andchangesinthedependentvariablearemeasured. apredictionconcerninghowanindependentvariablewill affectadependentvariableinanexperiment variableorconditionthatanexperimentermanipulatesto determineitseffectondependentvariable. variablethatisexpectedtochangewhenanindependent variableismanipulated degreetowhichchangesinthedep.variableareduesolely totheeffectofchangesintheindep.variable degreetowhichfindingsofaparticularstudycanbe generalizedtoothergroupsorconditions aninvestigationthatattemptstoreplicateorsimulate,under controlledconditions,asituationthatoccursinreallife aninvestigativetechniqueinwhichbehaviorsandeventsare observedandrecordedintheirnaturalenvironment anintensivestudyofoneindividualthatreliesonclinical data,suchasobservations,tests,andhistoricaland biographicalinfo aexperimentperformedonasingleindividualinwhichsome aspectofthepersonsownbehaviorisusedasacontrolor baselineforcomparisonwithfuturebehaviors asingleparticipantexperimentaldesigninwhichbaselines ontwoormorebehaviorsorthesamebehaviorin2ormore settingsareobtainedpriortointervention

Experimental Hypothesis Ind.variable

Dependentvariable

Internalvalidity

Externalvalidity

Analoguestudy

FieldStudy

Casestudy

singleparticipantstudy

Multiplebaselinestudy

26

Endophenotypes

measurablecharacteristicsthatgivecluesregardingspecific genesinvolvedindisorders unintendedeffectsoftherapy,suchasanunintended changeinbehaviorresultingfromamedicationperscribedor apsychologicaltechniqueemployedbyatherapist thestudyoftherateanddistributionofmentaldisordersina population factorsotherthanindependentvariablethatmayaffectthe dependentvariable 1.usesscientificmethodtoprove/disprovehypothesis2. allowsforselfcorrection3.usesoperationaldefinitions4. considersreliabilityandvalidity5.acknowlegesbaserates6. hasresearchfindingsevaluatedstatistically.determines thatthefindingsarenotduetochancealone groupthatissubjectedtotheindependentvariable Groupthatissimilarineverywaytoexperimentalgroup exceptforthemanipulationoftheindependentvariable. Ensuresthatthedifferencesfoundbetweencontroland experimentalgroupsareduetoindependentvariable externalvalidity(hardertogeneralizetoagroup)

Latrogeniceffects

Epidemiological research confoundingvariables

Whatarethe6 characteristicsof clinicalresearch

ExperimentalGroup ControlGroup

themorecontrolsinan experiment,theless likelyfor PlaceboGroup

Assesseswhetheratreatment/independentvariableis effectiveorbasedonparticipantshavingfaithorexpectancy Compareplacebogrouptoexperimentalgroupandseeif thereissigdifference couldalsoreportsignificantimprovements.Difficultto separatetreatmentfromexpectancyeffects.couldguess thattheyareinplacebogroup,reducingexpectancyeffects. oftentimesparticipantswhoshowstrongbenefiteven whenonlytakingplaceboareeliminatedfromstudy 27

ProblemswithPlacebo controlgroups

Methodsofcontrolfor expectanciesby participantand experimentor Incorrellations, variablesare

blinddesigncliniciansdoinginterviewingarenotawareof purposeofstudydoubleblinddesignneithertherapistnor participantisawareofexperimentalconditions.

notmanipulated,insteadastatisticalanalysisisperformed todeterminewhethertheincreaseofonevariableeffectthe increase/decreaseofanother increaseinonevariableisaccomplishedbyincreasein another increaseinonevariableisaccomplishedbydecreasein another itallowsustostudyphenomusingexperimentaldesigns thatarenotpossiblewithcorrelationalstudies.1.Cangive researchersinsightintotheprocessessthatmightbe involvedinabnormalbehaviorsandtreatment2.Allowsfor assessmentwhenexperimentaldesignsmightnotbe possible(ethicalreasonsorlackofabilitytocreateenough controls) Fieldstudies.determinemassbehaviorafterevensofmajor consequence,personalcrises,etc.

Positivecorrellation

Negativecorrelation

Whatarethe advantagesofanalogue studies

______studiesoften usequestionaires, interviews,andanalysis ofexistingrecords,but primarilyobservation. Theyareoftenused to.... Whatare3problems withfieldstudies

1.determiningdirectionofcausalityisdifficultbecausedata iscorrelationalandiscollectednonexperimentally.2.so manyvariablesareatworkinreallifethatitisimpossibleto controlanddistinguishoftentimesbetweenthem.3. Observerscanneverbeabsolutelysurethattheirpresence didnotinfluencewhattheyobserved. formulatinggenerallawsorprincipleswhiledeemphasizing individualvariationsthroughstudyinglargenumbersof

Nomotheticorientation

28

people Idiographicorientation singleparticipantstudiesthatareindepthconcerningone person. 1.Manylimitations,lackofgeneralizability,but valuableinappliedclinicalwork 2.Releventto psychotherapists 3.Examinesrareorunusual phenomenon,demonstratesanoveldiagnosticortreatment procedure,testsassumptions,generatesfuturehypotheses, collectscomprehensiveinfotobetterunderstandan individual CASESTUDY

Whatkindofstudyis beingdescribed:lacks controlandobjectivity andcannotbeusedto demonstrate causeandeffect. Usedwhensystematic experimental proceduresnot feasible.Helpfulin determiningdiagnosis, characteristics,course, outcomeofadisorder, andformulating hypothesesforlater research. Whatare2qualitiesof singleparticipantand multibaselinestudies besidesthattheycan determinecauseand effectrelationships. Endophenotype Concept characteristicsmustbe

1.Assesseffectivenessoftreatmentonaparticularbehavior bystudyingbehaviorpretreatment,duringtreatment,andif thereisachange,withdrawtreatmentandassesswhether behaviorgoesbacktooriginalstateornot.2.External validityandabilitytogeneralizeoftenscrutinizedwiththese typesofexperiments. 1.associatedwiththedisorder2.heritable3.manifestedin anindividualregardlessofwhetherthedisorderispresent4. foundinahigherrateamongnonaffectedfamilymembers thaningeneralpopulation patientismoreconfidentinerrorsandaccurateinfo,noone 29

Problemswith

hypnotism

canverifyinfo,recollectionsarelessaccuratethanthosenot takeninhypnosis,indivudualismoresuseptableto suggestion,oftenareemotionalrecallratherthanaccurate reflection degreetowhichageneticcharacteristicismanifestedinan individualcarryingaspecificgeneorgenesassociatedwith it usedtodetermineeffectofasubstanceonbehavior.

Penetrance

Biologicalchallenge test SummatetheAPA guidelines

Participantsmustbefullyinformedofproeduresandrisks, mustprovideconsentandarefreetowithdrawatanytime. Mustbetreatedwithdignity,andproceduresmust minimalizepainanddiscomfort,embarassment,and participationiskeptconfidential.In1993,guidelinesfor culturallydiversepopulationswereadded:Considerimpact ofsociopoliticalfactors,becomeawareofhowtheirown culturalbackgroundsmightaffectperceptions,andconsider validityofinstrumentsusedinresearchincrosscultural context. determinedthattheprospectivescientific,applied,or educationalvalueofproposedresearchmustoutweighrisks ofdiscomforttoparticipants. collectingdatafromallorpartofapopulationtoassess relativeprevalence,distribution,andinterrelationshipsof naturallyoccuringphenom observingandevaluatingpeoplesbehaviorsoveralong periodoftimesothatthecourseofadisorderortheeffects ofsomefactorcanbeassessedovertime reconstructingthepastbyreviewingandevaluatingevidence fromhistoricaldocs. focusingontwinsasapop.ofinterestbecuasetwinsare geneticallysimilar.Oftenusedtoevaluateinffluenceof

American PSychological Association Surveyresearch

Longitudinalresearch

Historicalresearch

Twinstudies

30

heredityandenvironment. TreatmentOutcome Studies evaluatingeffectivenessoftreatmentinalleviatingmental disorders.Outcomeisconcernedwithansweringthe questionofwhethertreatmentiseffective analyzehowtherapist,client,orsituationalfactorsinfluence oneanotherduringtreatment.Focusesonhow/why treatmentiseffective tellsuspercentageofindiv.intargetedpopulationwhohave aparticulardisorderduringaspecifictimeperiod.Vitalfor planningtreatmentservices tellsusonsetoroccurancenumberofnewcasesofa disorderthatappearinanidentifiedpopulationwithinspecific timeperiod.Importantforexamininghypothesesaboutthe causes/originsofadisorder.

TreatmentProcess Studies

Prevalencerate

Incidentrate

31