Download Griggs Chapter 10: Abnormal Psychology

Abnormal Psychology
Chapter 10
The scientific study of mental
disorders and their treatment
Prepared by
J. W. Taylor V
Abnormal
Psychology

College reading:
This unit is about…

The Diagnosis and Classification
of Mental Disorders

Three Major Categories of Mental
Disorders

The Treatment of Mental Disorders
What is abnormal behavior?

Write 3 characteristics
Criteria for a Behavior/Thought
Process to be a “Disorder”
1. Is the behavior/thought process atypical?
2. Is the behavior/thought process maladaptive?
3. Is the behavior/thought process personally
distressing?
4. Is the behavior/though process irrational?
Diagnostic and Statistical Manual:
Official book of mental disorders

The DSM-IV, published in 1994 by the
American Psychiatric Association, is the most
widely used diagnostic system for disorders



First appeared in 1952. At
that time, 60 disorders.
Now contains more than 300 disorders
DSM-IV classification required by
health insurance companies
before they will pay for therapy
Perceptual Bias of Labeling
Problem: when we classify
mental disorders we label
people, and this biases our
perception of these people
in terms of the labels

Ex: the word “crazy” has
strong connotations

Mental disorders fall into 4 major categories

Anxiety disorders: highly anxious or fearful behavior
Ex:

Mood disorders: emotional extremes
Ex:

Schizophrenic disorders: disorganized thinking, disturbed
perceptions, inappropriate actions/emotions
Ex:

personality disorders: inflexible, long-standing personality

traits, impaired social functioning, deviate from cultural norms
Ex:
Three Major Categories
of Clinical Disorders
Category
Anxiety
disorders
Specific Disorders within Category
Specific phobia, social phobia,
agoraphobia, panic disorder with and
without agoraphobia, generalized
anxiety disorder, obsessive-compulsive
disorder
Mood
Major depressive disorder, bipolar
disorders
disorder
Schizophrenic Schizophrenia (paranoid, disorganized,
disorders
catatonic, undifferentiated, and residual
subtypes)
By the way…



Be wary of the medical school
syndrome: the tendency to think that
you have a disorder when you read
about its symptoms
It’s normal to feel depressed, spazz
out, have occasional OCD etc…
Remember, to be abnormal your
behavior must be:




Atypical
Maladaptive
Personally distressing
Irrational
Schizophrenic disorder





http://www.youtube.com/watch?v=2QJMWk4
bnMo
What are 3 of Jani’s symptoms/behaviors?
Describe how her behavior fits the definition
of “abnormal”.
Do you feel her parents are responding
appropriately? Why/not?
http://www.youtube.com/watch?v=VuBps0Fn
awg
Schizophrenic
disorder



Is NOT multiple personality disorder
Schizophrenics have one personality, but it is
disorganized and irrational
They typically

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

Have hallucinations (hear voices)
Are delusional (irrational beliefs, ex: “I am a
messenger of God”)
Are paranoid (“the government is spying on me”)
Have erratic emotional responses/violent outbursts
Many homeless people are
schizophrenic
How does the prevalence of schizophrenia
compare to other disorders?
Group assignment – profile of
a schizophrenic





Make a poster describing a person who is
schizophrenic
Include their name, age, living conditions,
personality and other personal identifying
information
Describe their schizophrenic symptoms. Be
descriptive, and realistic (base on research)
Describe an treatment, relapses, family
response etc
Use magazine cut outs, markers etc
Grading criteria
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BEST poster: all members get 11 points!
Second best: all members get 10
Third: 9
And so on
It’s a competition!!
Schizophrenic Disorders

More people are institutionalized
with schizophrenia than any other
disorder

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About 1% of the population suffers
from schizophrenia
The onset tends to be in late
adolescence or early adulthood
Tends to strike men earlier and more
severely, though both sexes are
equally vulnerable
Higher incidence in lower
socioeconomic groups and for people
who are single, separated or divorced
rather than married
Schizophrenic Disorders

Is a psychotic disorder
because it is characterized
by a loss of contact with
reality

Schizophrenia means “split
mind,” as mental functions
do indeed become split from
each other and detached
from reality
Symptoms of Schizophrenia

Positive symptoms are the more active symptoms that
reflect an excess or distortion of normal thinking
or behavior, including hallucinations
(false sensory perceptions) and
delusions (false beliefs)
 Hallucinations tend to be auditory,
such as hearing voices that are not real
 There are different forms of delusions
 Delusions of persecutions involve thoughts of conspiracy
against you
 Delusions of grandeur involve believing that you are a
person of great importance, such as Jesus Christ
 Hallucinations and delusions are positive symptoms
because they refer to things that have been added
Symptoms of Schizophrenia

Negative symptoms refer to things that have
been removed


There are deficits or losses
in emotion, speech, energy
level, social activity, and even
basic drives such as hunger
Disorganized symptoms include disorganized
speech, disorganized behavior, and
inappropriate emotion

When the person’s speech is disorganized, it might be
like a “word salad,” with unconnected words
incoherently spoken together
Technical Definition

According to the DSM-IV, schizophrenia is
defined as the presence, most of the time
during a one-month period, of at least two of
the following symptoms





Hallucinations
Delusions
Disorganized speech
Disorganized or catatonic behavior
Any negative symptoms (such as loss of emotion)
Five Subtypes of
Schizophrenic Disorder
Subtype
Symptoms
Disorganized
Disorganized speech, disorganized behavior, or
inappropriate emotion
Catatonic
Extreme movement symptoms ranging from excessive
motor activity to posturing (immobility for long periods)
Paranoid
Organized cognition and emotion, but with
hallucinations and delusions that are usually
concerned with persecution
Undifferentiated Mixed-bag category—symptoms fit the criteria of more
than one of the above three types or none of them
Residual
There has been a past schizophrenic episode, but
presently only some negative symptoms and no
positive symptoms (hallucinations and delusions)
Type I and Type II

Another distinction is
between Type I and Type II schizophrenia


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Type I schizophrenia is characterized by
positive symptoms
Type II schizophrenia is characterized by
negative symptoms
Type I is more acute, as the person functioned
normally before the disorder strikes and has a
better chance of recovery because Type I can
usually be alleviated with drugs, whereas Type II
tends to stem from more permanent brain
abnormalities
Causes of Schizophrenia


Concordance rate is about 50%, although no
particular genes have been identified, and it is
possible different genes might be involved in the
different types of schizophrenia
One hypothesis involves prenatal viral infections


People are at increased risk if there was a flu epidemic
during the middle of their fetal development
In the northern hemisphere, people born in the
winter/spring months, January through April, following the
fall/winter flu season, are more at risk than people born
other months of the year
Causes of Schizophrenia

A second hypothesis involves
neurotransmitters

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Schizophrenics have
elevated levels of dopamine
activities in certain areas of
their brains
A third hypothesis involves
various brain abnormalities,
especially among those with Type II schizophrenia


Shrunken cerebral tissue and enlarged fluid filled areas
The thalamus seems to be smaller and the frontal lobes
less active in many schizophrenic brains
Causes of Schizophrenia

A popular bio-psycho-social explanation is the
vulnerability-stress-model that contends that
genetic, prenatal, and postnatal biological
factors render a person vulnerable to
schizophrenia, but environmental stress
determines whether it develops

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A person’s level of vulnerability interacts with the
stressful social-cognitive events in their live to
determine the likelihood of schizophrenia
The disorder does tend to strike in late adolescence
and early adulthood, periods of unusually high stress
levels
Perspectives

The causes of abnormal
behavior and thinking can
be found in the four major
research perspectives
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Biological
Behavioral
Cognitive
Sociocultural
However, no one perspective adequately explains even
one disorder
The biopsychosocial approach to explaining abnormality
examines the interaction between biological, behavioral,
cognitive, and social/cultural factors
Treatment

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Fortunately, schizophrenia can be
successfully treated with antipsychotic
medications
If the patient continues to take them, the
disorders stays away
If they stop, the symptoms return
Problem: many schizophrenics don’t identify
as such, or are too paranoid to swallow pills
Create a profile

http://www.schizophrenia.com/szfacts.htm
Anxiety Disorders
Disorders in which excessive anxiety leads to personal
distress and atypical, maladaptive and irrational behavior
Specific Phobia
Social Phobia & Agoraphobia
Panic Disorder
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
Specific Phobia

Indicated by a marked and persistent fear of
specific objects or situations (such as snakes
or heights) that is excessive or unreasonable

The anxiety and fear
of the specific stimulus
may be rational to an
extent, but in the case
of a specific phobia,
the anxiety and fear
are in excess of what
is typical
Specific Phobia

For example, there was
woman with a specific
phobia of birds.
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She became housebound because of her fear of
encountering a bird. Any noises she heard within the
house she thought were birds that had broken in to
get her.
When she did leave the house, she was careful not
drive near any birds, because if she hit a bird, they
would take revenge on her.
She knew her fears were irrational, but she could not
control their effects on her behavior and thinking.
Causes of Specific Phobias

Classical conditioning


In Watson and Rayner’s study on the infant Little
Albert, they conditioned the infant to fear white
rats by pairing together a loud startling noise (an
unconditioned stimulus) with a white rat (a
conditioned stimulus)
Biological predispositions

Certain associations (such as taste and sickness)
are easy to learn, while others (such as taste and
electric shock) are much more difficult to learn
Social Phobia

A marked and persistent
fear of one or more
social performance
situations in which there
is exposure to unfamiliar
people or scrutiny by
others

For instance, a person
may fear eating in public,
rejecting all lunch and
dinner invitations
Agoraphobia

A fear of being in places or situations from
which escape might be difficult or
embarrassing

Includes being in a crowd, standing in line, and
traveling in a crowded bus or train or in a car in
heavy traffic

To avoid such situations a person won’t leave the
security of their homes
Panic Disorder

A condition in which a person experiences recurrent
panic attacks (i.e., sudden onsets of intense fear)

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Some panic attacks occur when a person
is faced with something he dreads, such
as giving a speech, but other attacks occur
without any apparent reason
Panic disorder can occur with or without
agoraphobia.
One explanation for panic disorder is
a fear-of-fear hypothesis:

Agoraphobia is the result of the fear of having a
panic attack in public; thus, agoraphobia is a case of
classical conditioning in which the fear and avoidance
response is a conditioned response to the initial panic attack
Generalized Anxiety Disorder

A disorder in which the person has
excessive, global anxiety and worry
that they cannot control, for a period
of at least 6 months


The anxiety is not tied to any specific object
or situation (as it is in a phobic disorder)
May be related to a biochemical
dysfunction in the brain, which
involves GABA, a major inhibitory
neurotransmitter

People with generalized anxiety disorder
may have problems with activation of
GABA, allowing more and more neurons to
get excited
Obsessive-Compulsive Disorder

A person experiences recurrent obsessions or
compulsions that are perceived by the person as
excessive or unreasonable, and cause significant
distress and disruption in the person’s daily life


An obsession is a persistent
intrusive thought, idea,
impulse, or image that
causes anxiety
A compulsion is a repetitive
and rigid behavior that a
person feels compelled to
perform to reduce anxiety
Obsessive-Compulsive Disorder

Although it is not known for sure what
causes obsessive-compulsive disorder,
recent research suggests that a
neurotransmitter imbalance involving
serotonin may be involved

Antidepressent drugs that increase serotonin
activity (e.g., Prozac and Anafranil) help many
obsessive-compulsive patients
Obsessive-Compulsive Disorder

Two parts of the brain, the orbital region of
the frontal cortex (the area just above our
eyes) and the caudate nucleus (an area in
the basal ganglia), have significantly higher
than normal level of activity in
obsessive-compulsive people

These two areas help filter
out irrelevant information
and disengaging attention,
two central aspects of
obsessive-compulsive disorder
Obsessive-Compulsive Disorder

One strange case of obsessive-compulsive
disorder highlights the importance of the
frontal lobe region

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
A man with obsessive-compulsive disorder got
severely depressed and attempted suicide
He shot himself in the head, but fortunately
survived and was cured of his disorder
The bullet removed some his orbital front cortex
and the disorder with it
Mood Disorders

Involve dramatic changes in a person’s
emotional mood that are excessive and
unwarranted
Major Depressive Disorder
Bipolar Disorder
Major Depressive Disorder


To be classified as major depressive
disorder, a person must have experienced
one or more major depressive episodes
A major depressive episode is
characterized by symptoms such as
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Feelings of intense hopelessness, low selfesteem and worthlessness, and extreme fatigue
Dramatic changes in eating and sleeping behavior
Inability to concentrate
Greatly diminished interest in family, friends, and
activities for a period of two weeks or more
Major Depressive Disorder

It is important to note that feelings of sadness
and downward mood following stressful life
events (such as a death in the family) are
understandable and normal, and given time
usually are self-correcting


Such feelings under such
circumstances do not
necessarily indicate a
major depressive disorder
Women suffer from major
depressive disorder twice
as often as men
Major Depressive Disorder

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A leading biological explanation involves
neurotransmitter imbalances, primarily
inadequate serotonin and norepinephrine
activity
There also appears to be a biological
predisposition to the disorder

For identical twins, the concordance rate is 50%,
much higher than for fraternal twins and the base
rate of occurrence in the general population
Major Depressive Disorder

Non-genetic factors are also important

For example, the “pessimistic explanatory
style” in which a person explains events in
terms of causes that are internal (their own
fault), stable (here to stay), and global
(applies to all aspects of their life)
Bipolar Disorder

The person’s mood takes dramatic
swings between depression and
mania, with recurrent cycles of
depressive and manic episodes

A manic episode is a period of at
least a week of abnormally elevated
mod in which the person experiences
such symptoms as inflated self-esteem
with grandiose delusions, a decreased
need for sleep, constant talking,
distractibility, restlessness, and poor
judgment
Bipolar Disorder

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In bipolar I disorder, the person has both
major manic and depressive episodes
In bipolar II disorder, the person has fullblown depressive episodes, but the manic
episodes are milder
The concordance rate for bipolar is 70%, so
biological causes are the most common
explanation

In fact, current research is trying to identify the
specific genes that make a person vulnerable to
this disorder
The Treatment
of Mental Disorders
Biomedical Therapies
Psychotherapies
Different Types of Mental
Health Professionals
Type
Credential and Job Description
Clinical
psychologist
Doctoral degree in clinical psychology; provides therapy
for people with mental disorders
Counseling
psychologist
Doctoral degree in psychological or educational
counseling; counsels people with milder problems such
as academic, job, and relationship problems
Psychiatrist
Medical degree with residency in mental health; provides
therapy for people with mental disorders; only therapist
who can prescribe drugs or other biomedical treatment
Psychoanalyst
Any of the above credentials, but with training from a
psychoanalytic institute; provides psychoanalytic therapy
for psychological disorders
Clinical social Master’s or doctoral degree in social work with
worker
specialized training in counseling; helps with social
problems (e.g., family problems)
Two Major Types of Therapy
Biomedical
Therapy
Involves the use
of biological
interventions,
such as drugs
Psychotherapy
Involves the use
of psychological
interventions
Biomedical Therapies

The earliest use to biomedical therapy may
date to the Stone Age, when trephination
was used


Here, a trephine (a stone tool) was used to cut
away a section of the person’s skull, supposedly
to let evils spirits causing the disorder to exist the
body
In the early 1800s, the “tranquilizing chair”
was used, in which the patient was strapped
into a chair, with their head enclosed inside
a box for a long periods of time

Such restriction was designed to calm the person
Biomedical Therapies

Even modern biomedical therapies are not
without controversy


Direct biological interventions have a downside in
that they involve potential dangers and possible
serious side effects
High levels of some drugs can be toxic and
potentially fatal if not monitored carefully
Biomedical Therapies
Electroconvulsive
Therapy
Drug
Therapy
Psychosurgery
Drug Therapy
Lithium
Antianxiety
Drugs
Antidepressants
Antipsychotic
Drugs
Lithium


Not a drug, but rather a naturally occurring metallic
element (a mineral salt) that is used to treat bipolar disorder
Around 1950, John Cade, a psychiatrist, injected guinea
pigs with a mixture of uric acid, which he thought was the
cause of manic behavior, and mixed lithium with it so that
the acid more easily liquefied



Instead of becoming manic, the guinea pigs became lethargic,
and later tests with human showed that lithium stabilized the
mood of bipolar patients
Lithium levels in the blood must be monitored
carefully because of possible toxic effects
Because of lithium’s side effects, anticonvulsant drugs are
now sometimes prescribed for people with bipolar disorder
Antidepressant Drugs

Monoamine oxidase (MAO) inhibitors break down
neurotransmitters such as serotonin and norepinephrine
in the synaptic gap



This means that MAO inhibitors increase the
availability of these neurotransmitters by
preventing their breakdown
Can have very dangerous side effects,
particularly interactions with several different
foods and drinks that lead to high blood
pressure and possibly death
Tricyclics are agonists for norepinephrine, serotonin,
and dopamine and make these neurotransmitters more
available by blocking their reuptake during synaptic gap
activity
Antidepressant Drugs

The most common anti-depressant drugs are
selective serotonin reuptake inhibitors
(SSRIs)




They selectively block the reuptake of serotonin in
the synaptic gap, keeping the serotonin
active and increasing its availability
Examples include Prozac, Zoloft,
and Paxil
Very mild side effects
Usually required 3-6 weeks to being
to see mood improvement
Antidepressant Drugs

Neurogenesis is the growth of new neurons


The neurogenesis theory of depression assumes
that neurogenesis in the hippocampus stops during
depression, and neurogenesis resumes, the depression
lifts
Research has shown that SSRIs lead to
increased neurogenesis in other animals


It takes about 3-6 weeks for new cells to mature, the
same timeframe it takes SSRI patients to improve
This means that, in the case of the SSRIs, the
increased serotonin activity may be responsible for
getting neurogenesis going again and lifting our moods
Antidepressant Drugs

There is controversy about the effectiveness
of antidepressant drugs


Some research suggests a placebo effect,
improvements due to expectations of getting
better
Why would placebo effects make people feel
better?

It may also be the case that positive thinking, in
the form of a strong placebo effect, might also
get neurogenesis going again
Antianxiety Drugs


Drugs that treat anxiety
problems and disorders
Benzodiazepines reduce
anxiety by stimulating receptor
sites for GABA
and also increasing the
receptivity of these sites,
which increases GABA activity

Examples of benzodiazepines
include Valium and Xanax
Antipsychotic Drugs


Drugs that reduce psychotic symptoms
Early antipsychotic drugs (e.g., Thorazine and
Stelazine) greatly reduced the positive symptoms
of schizophrenia, but had little impact on the
negative symptoms


Greatly reduced the need to institutionalize
people with schizophrenia
Produced side effects in motor movement
caused by their antagonistic effect on
dopamine
Antipsychotic Drugs

New-generation antipsychotic drugs (e.g.,
Clozaril amd Risperdal) are more selective in
where in the brain they reduce dopamine
activity

Consequently, they do not produce the severe
movement side effects, such as tardive
dyskinesia, in which the person has
uncontrollable facial tics, grimaces and other
involuntary movements of the lips, jaw, and
tongue
Electroconvulsive Therapy (ECT)


A biomedical therapy for severe depression that
involves electrically inducing a brief brain seizure
Electrodes are placed on one or both sides of the
head, and a very brief electrical shock is
administered causing a brain
seizure that leads the patient
to convulse for a few minutes

Patients are given anesthetics,
so they are not conscious during
the procedure, and muscle
relaxants to minimize the convulsions
Electroconvulsive Therapy (ECT)

We really do not understand why
ECT works in treating depression



One explanation is that the electric
shock increases the activity of serotonin
and norepinephrine, which improves mood
ECT may also increase neurogenesis,
which it has been demonstrated to do in rats
ECT does not lead to any type of
detectable brain damage or long-term cognitive
impairment, but there is memory loss for events
prior to and following the therapy
Psychosurgery


The destruction of specific areas in the brain
to treat the symptoms of disorders
A lobotomy, the most famous type of
psychosurgery, involves cutting the
neurological connections between the frontal
lobes to lower areas of the brain

Was the common means to “treat” schizophrenia
in the 1940s and 1950s, until drugs became
available
Psychosurgery

Psychosurgery still exists but not in terms of
frontal lobe lobotomies

For instance, cingulatomies, in which dime-sized
holes are surgically burnt in specific areas of the
frontal lobes (the cingulate gyrus) are sometimes
performed on severely depressed or obsessivecompulsive patients who have not responded to
other types of treatment
Psychotherapies

Four major types
Psychoanalysis
Behavioral
Humanistic
Cognitive
Psychotherapies

Psychoanalysis and humanistic therapies
are called insight therapies because they
stress that a person achieve understanding
of the causes of their behavior and thinking

Behavioral and cognitive therapies are
usually referred to as actions therapies
because they stress that the actions of the
person must change for therapy to be
effective
Psychoanalysis


A style of psychotherapy
originally developed by
Sigmund Freud in which
the therapist helps the
person gain insight into the
unconscious sources of
their problems
Psychoanalysts must
collect data from a
multitude of sources
Psychoanalysis

Free association is a technique in which the
patient spontaneously describes, without
editing, all thoughts, feelings, or images that
come to mind


The assumption is that free association will provide
clues to the unconscious conflicts leading to a
person’s problems
A resistance is a patient’s unwillingness to
discuss particular topics

When a resistance is hit, it may provide clues into
unconscious conflicts
Psychoanalysis


Dream interpretation also provides clues into
unconscious conflicts
Dreams have two levels of meaning:



The manifest content is the surface, literally meaning of
the dream; it is what the dream reports when awakening
The latent content is the underlying, true meaning of the
dream and is of primary interest to the psychoanalyst
When we dream, we are not inhibited, and this
dreams allow us the chance to symbolically
experience our unconscious conflicts
Psychoanalysis

Transference occurs when the patient acts
toward the therapist as she did or does
toward important figures in her life, such as
her parents

Transference is like
a reenactment of
earlier or current
conflicts with
important figures in
the patient’s life
Psychoanalysis


Psychoanalysis requires
a lot of time because the
therapist must piece together
clues with only vague
circumstantial evidence
Critics question the validity of
psychoanalysis’ main
construct, unconscious
conflicts and their impact on
behavior and thinking
Humanistic Therapy

The most influential humanistic therapy
is Carl Rogers’s client-centered therapy,
also called person-centered therapy

A style of psychotherapy in which the therapist
uses unconditional positive regard,
genuineness, and empathy to help the person
to gain insight into their true self-concept
Humanistic Therapy

To achieve this goal, the therapist
is non-directive



The therapist doesn’t attempt to steer the
dialogue in a certain direction; rather, the client
decides the direction of each session
The therapist’s job is to create the conditions that
allow the client to gain insight into their true
feelings and self-concept
The therapist establishes an environment of
acceptance by giving the client unconditional
positive regard
Humanistic Therapy

To achieve this goal, the therapist
is non-directive


The therapist demonstrates genuineness by
honestly sharing his own thoughts and feelings
with the client
To achieve empathetic understanding of the
client’s feelings, the therapist uses active
listening to gain a sense of the client’s feelings,
and then uses mirroring to echo these feelings
back to the client, so the client can gain a clearer
image of their true feelings
Behavioral Therapy


A style of psychotherapy in which the
therapist uses the principles of classical and
operant conditioning to change a person’s
behavior from maladaptive to adaptive
The assumption is that maladaptive
behaviors are learned and must be
unlearned for therapy to be effective
Behavioral Therapy


In counterconditioning, a maladaptive
response is replaced by an incompatible
adaptive response
Systematic desensitization is a
counterconditioning procedure in which a
fear response to an object or situation is
replaced with a relaxation response in a
series of progressively increasing feararousing steps
Behavioral Therapy

For example, a person with
a specific phobia of spiders
might find that planning a
picnic to be a situation that
evoked slight fear because of the possibility that a
spider might be encountered on the picnic


Seeing a picture of a spider might evoke more fear, and
being in the same room with a spider would evoke even
greater levels of fear
Once this “hierarchy” of fear-provoking situations is
established, the patient starts working through the
hierarchy and attempts to relax at each step
Behavioral Therapy


In flooding, another counterconditioning technique,
the patient is immediately exposed to the feared
object or situation
Behavioral therapists also use operant conditioning
to reinforce desired behaviors and extinguish
undesirable behaviors


A token economy is an environment in which desired
behaviors are reinforced with tokens (secondary reinforcers,
such as stickers) which can be exchanged for rewards such
as candy or television privileges
This technique is often used with institutionalized patients,
and has been fairly effective in managing people with autism,
mental retardation, and some schizophrenic populations
Cognitive Therapy

A style of psychotherapy in which the
therapist changes the person’s thinking from
maladaptive to adaptive


The assumption is that the person’s through
processes and beliefs are maladaptive and need
to change
The therapist identifies the irrational thoughts
and unrealistic beliefs that need to change, and
then helps the person to execute that change
Cognitive Therapy

In Ellis’s rational-emotive therapy, the
therapist directly confronts and challenges the
patient’s unrealistic thought and beliefs to
show that they are irrational


Such irrational thoughts are marked by words
such as “must,” “always,” and “every”
A rational-emotive therapist will show a person the
irrationality of his thinking and how to make it
more realistic
Cognitive Therapy

This is achieved by Ellis’s ABC model
A refers to the Activating event (e.g., failure to be perfect
at everything)
B refers to the person’s Belief about the event (e.g.,
feeling like a failure for normal levels of imperfection)
C is the resulting emotional Consequence (e.g.,
depression)


According to Ellis, A does not cause C; rather, B
causes C
Rational-emotive therapy is very direct and
confrontational is getting people to see the errors of
their thinking
Cognitive Therapy

A therapist using Beck’s cognitive therapy
works to develop a warm relationship with the
person and has a person carefully consider
the objective evidence for their beliefs to see
the errors in their thinking

For instance, a student who failed a test may
think she blew her chance to get into medical
school, so the therapist would have the student
examine statistics on how few students actually
have a perfect GPA and the GPAs of students
admitted to medical school
Is psychotherapy effective?

Spontaneous remission is getting better with the
passage of time without receiving any therapy


A meta-analysis (i.e., the pooling of results from a
large number of studies into one analysis) of 475
studies involving different types of psychotherapy
revealed that psychotherapy is indeed effective


Thus, the effect of psychotherapy must be statistically
significantly greater than that due to spontaneous
remission
The average psychotherapy client is better off than about
80% of people not receiving any therapy
No one particular type of psychotherapy, however, is
superior to the others
Psychotherapy vs. No Treatment