Psychology - Mr. Duez - Learning Targets

Psychological Disorders & Treatment

If you learn only 7 things from this unit...

1. The (DSM) Diagnosis and Statistical Manual of Psychiatric Disorders is the handbook used by mental health professionals to diagnose psychiatric disorders.

2. There are many types of disorders, but they all involve debilitation that makes routine life situations difficult.

3. Schizophrenia is not dissociative identity disorder. It is a disorder that involves a break with reality and auditory hallucinations.

4. Personality disorders are the most difficult disorders to diagnose and treat. The most common treatment is medication (most have side effects).

5. Medication is effective as a treatment, but it is often combined with a form of “talk therapy” to provide a more complete therapeutic technique.

6. Behavioral and cognitive therapists are very popular forms of “talk therapy.”

7. Freudian therapy, though well known, is not utilized much anymore.


TERMS TO KNOW:

affective disorder - disorder in which an individual’s moods are extreme enough to interfere with regular life activities.

amnesia - memory disturbance, such as the inability to recall certain events or even one’s identity.

autistic disorder - developmental disorder marked by severe communication and interpersonal difficulties and cognitive impairment.

bipolar disorder - disorder in which one goes to the opposite extremes of mania and depression.

compulsions - repetitive, ritualized behaviors.

delusions - unshakable beliefs that are obviously not true.

dissociative disorders - disorders in which sufferers escape from a painful situation by disconnecting from certain parts of themselves, such as by developing amnesia or multiple personalities.

dysthymic disorder - moderate depression that last for at least two years.

etiology - origin or cause of a disorder.

hallucinations - experiences of sensations of something that isn’t there, such as hearing voices or seeing visions.

obsessions - recurrent, unwanted thoughts.

personality disorders - disorders that involve long-standing maladaptive personality traits that are often more disturbing to others than to the individual.

psychotic disorders - disorders in which an individual loses contact with reality.

schizophrenia - psychotic disorder marked by confused thoughts, incoherent speech, delusions, hallucinations, flat or inappropriate emotions, paranoia, or disturbances of movement.

somatoform disorders - disorders which physical symptoms arise from psychological causes.

active listening - repeating, restating, or asking for clarification of what the client has said.

aversive conditioning - extinguishing an undesirable behavior by replacing positive reinforcement for it with a punishment or unpleasant consequence.

behavior modification - changing a behavior by changing the response a person receives for that behavior.

biologically based therapy - treatment of psychological disorders through the use of drugs and other medical procedures.

cognitive restructuring - identifying and changing irrational statements that are part of one’s automatic and ongoing “self-talk.”

counterconditioning - pairing a stimulus for an unwanted behavior with a new and more acceptable behavior.

flooding - exposing a client to a harmless stimulus until the fear response to the stimulus is extinguished.

lobotomy - severing of the connections between emotional centers of the brain and higher thinking centers.

modeling - demonstrating how another person deals successfully with a situation.

person-centered therapy - approach with the client talks and the therapist uses active listening. The client, not the therapist, interprets.

phenomenology - theory that subjective experience (feeling) is equally as important as objective knowledge.

psychosurgery - removing or disconnecting parts of the brain.

psychotherapy - treatment of psychological problems and disorders through an interaction between a client and a caring and highly trained mental health professional.

Systematic desensitization - stepwise process for extinguishing a fear response.

In this chapter you will learn of some of the ways in which a psychologist distinguishes normal from abnormal behavior. When you hear the words “abnormal psychology,” you may think of people who hear voices or have multiple personalities. Psychological disorders also include such varied problems as substance abuse, depression, attention-deficit disorder, and personality disorders. Psychologists do not always agree on the causes of these disorders. Our knowledge of this area is very tenuous and always developing. Nature or Nurture? Chemical Imbalances? Social problems? Many disorders seem to be triggered by a combination of factors.

In diagnosing mental illness, psychologists and psychiatrists look for signs of abnormal behavior - of whether an individual’s behavior is maladaptive, irrational, unpredictable, or bizarre, or if it causes distress to him or herself or others. Disorders are classified according to their symptoms. Some major categories of psychological disorders are anxiety disorders, somatoform disorders, dissociative disorders, affective or mood disorders, psychotic disorders, and disorders of childhood. Biological issues - such as genetics or chemical imbalances - as well as psychological issues - such as internal conflicts, faulty thinking or learning, and thwarted ambitions- may trigger psychological disorders. Today, most psychologists assert that many psychological disorders are the result of a combination of biological and psychological factors.

Many different types of mental health professionals work in a variety of settings, from public health clinics to private practice and from hospitals to home visits. Therapists work with individuals, couples, families, and groups. The treatment for phobias alone range from behavioral desensitization therapy that can extend over several months to a single visit with a Gestalt therapist. There may be as many as 250 different therapeutic approaches to psychological problems. Many of them are derived from or are combinations of the traditional psychological approaches detailed in this chapter.

A wide range of treatment is available for the 20% of adult Americans who have a mental illness serious enough to seek treatment. Attitudes toward mental health have changed from the past, when people with mental disorders were blamed for their conditions and treated poorly. Psychoanalytic therapy, behavioral therapy, cognitive-behavioral therapy, humanistic therapies, and biomedical therapies offer different approaches to meet the range of psychological disorders and client preferences. Professional mental health caregivers accept ethical standards for their interaction with patients.

SOME STATISTICS:

Psychological disorders are not rare. According to Myers, the prevalence of psych disorders is higher than one might think:

1. Roughly 2 million people in the US are inpatients in psychiatric units. These people are essentially under lock and key because they have the most serious disturbances.

2. Over 2.4 million people in the US are residents in group homes. Group homes are shared living spaces that provide patients with assistance potentially to transition back into the community. Residents of group homes typically are able to come and go, but they are under the supervision of staff that provides support.

3. Roughly 15% of Americans utilize services for treatment of a psychological disorder. This number represents people who either use medication to treat a disorder (such as Xanax for anxiety) or are under the treatment of a psychotherapist. This number is probably a low estimate, as some have speculated that many homeless people should - but do not - receive some psychological assistance.

4. Over 400 million people worldwide are in need of some form of psychological assistance.*

*Would even more people around the world qualify as having a psych disorder if medical facilities were more widespread? For example, Sub-Saharan Africa or South East Asia... how many may be suffering from a psych disorder and they have not been identified? Of course, some may have more serious issues to contend with other than psychological needs (hunger, shelter, safety).

WHAT MAKES SOMETHING A PSYCHOLOGICAL DISORDER?

  1. Atypical - Behavior displayed by someone who has a psychological disorder is not what might be considered normal. The behavior is not just quirky, however; it is considered extremely odd.
  2. Maladaptive - Makes everyday life difficult for an individual. Typically interferes with ability to lead a normal life.
  3. Unjustifiable - Not easy to explain to most people. EX) Might lead a person to engage in behavior that calls a great deal of attention to her. Behavior may not make sense to the outsider, but the person with the disorder does not know how to act otherwise.

CATEGORIES OF PSYCHOLOGICAL DISORDERS

As categorized by the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV):

ANXIETY DISORDERS: General combination of physical, cognitive, & psychological symptoms in which a person’s sympathetic nervous system has initiated a fight-or-flight response. Anxiety is very common among people in the US.

GENERALIZED ANXIETY DISORDER (GAD): The most common form of anxiety, GAD occurs when someone suffers from general anxiety with no specific cause for longer than two weeks. Symptoms include an unfocused feeling of being out of control, being jittery, and having problems sleeping.

PHOBIC DISORDER: A phobia (an irrational fear of an object or situation) becomes so disruptive that it interferes with normal functioning. Most have some phobia, but it does not interfere with their lives to a large degree.

POST-TRAUMATIC STRESS DISORDER (PTSD): PTSD occurs when someone has gone through a traumatic event. That event, or the memory of that event, causes the person to continuously re-experience the stress associated with that event. The re-experiencing of the event can take the form of a panic attack.

PANIC DISORDER: A panic disorder occurs when someone has uncontrollable panic attacks for an extended period of time (longer than two weeks). The typical panic attack involves shortness of breath, racing heart, and an unfocused feeling of being out of control. The attacks come on rapidly and are debilitating.

OBSESSIVE-COMPULSIVE DISORDER (OCD): Having obsessive stress or anxiety over a particular event or issue & performing ritualistic or compulsive behavior to ameliorate the stress. Obsessive behavior is fairly common: it becomes a disorder when the compulsive behavior impairs everyday life.


DISSOCIATIVE DISORDERS: A break in the connection between reality & perception of reality. In most cases, this gives rise to an inability to deal with reality; what is real and what seems real are not the same.

PSYCHOGENIC FUGUE: A person forgets his past & essentially creates a new history. In fact, the person isn’t aware that he has had another past. Rather, the invented past is the only reality that he knows. Fugue also involves “fleeing” - going to a new location.

PSYCHOGENIC AMNESIA: One forgets her past but realizes she has forgotten it. To be diagnosed as a psychogenic amnesia, there must be no form of biological insult to the brain; the amnesia must stem from a psychological cause.

DISSOCIATIVE IDENTITY DISORDER (DID): [Previously called multiple personality disorder] DID occurs as a result of trauma. During that trauma, the personality is split into distinct personalities. Those personalities are called forth under different circumstances, and often, one personality does not know about the others. Controversial!


SOMATOFORM DISORDERS: Suffers from some form of physical ailment, when there is, in fact, no real cause for that ailment to occur.

CONVERSION DISORDER:  Suffering from a great deal of stress concerning an upcoming event. As a strategy for dealing with the stress, the person will “convert” the stress into some physical ailment. EX) if a person is anxious because she has to give an oral presentation to her class, she might suddenly develop a cause of laryngitis the day before. In such a situation, the stress was “converted” into the problem of not being able to talk.

HYPOCHONDRIA: Believes he has a major medical malady, yet doctors find nothing physically wrong. The patient seeks treatment for an “ailment” that he believes exists.


MOOD DISORDERS: An inability to control or stabilize mood. In a disorder of this type, a patient will have trouble emerging from a depressed state or will lack the ability to maintain mood at a constant level.

MAJOR CLINICAL DEPRESSION: So depressed that he is unable to engage in the basic behaviors required for normal functioning. Not just “being down” about something; being so depressed that even the thought of getting out of bed is too overwhelming. In addition, the depression must last for longer than 2 weeks. Depression is more common in women than men. Learned helplessness (a term by Martin Seligman): No matter what a person does, he cannot avoid the pain or bad consequences, so he “learns to give up.”

BIPOLAR DISORDER: Vacillates between periods of extreme hyperactivity (mania) and periods of deep depression. The person is unable to maintain an appropriate level of stabilized mood.


SCHIZOPHRENIA: Is not the same thing as dissociative identity disorder (or multiple personality disorder).

2 major symptoms:

(1) Auditory hallucinations (the person hears voices)

(2) A break between reality and perception of reality. A person suffering from schizophrenia has a difficult time dealing with reality and often suffers because he cannot articulate the issue. There are several types of schizophrenia marked by various symptoms, yet all share this basic feature.

PARANOID SCHIZOPHRENIA: What differentiates it is the paranoia. Will have both delusions of grandeur (belief that she is someone very important) & extreme suspiciousness of others’ actions. The typical person (if there is such a thing) afflicted with this disorder believes that because she is someone important, many people are out to “get her.” She will likely have trouble communicating this, but it has a big impact on her behavior.

DISORGANIZED SCHIZOPHRENIA: Difficulty communicating & has auditory hallucinations, but without a significant degree of paranoia. Neglect his appearance & has difficulty fitting in, but he does not believe that people are plotting against him. Displays a flat affect: showing very little emotion at all, or an inappropriate affect, where behavior conflicts with what would be expected (laughing uproariously at a funeral, for example).

CATATONIC SCHIZOPHRENIA: Looks very much like disorganized schizophrenia but, in addition, is marked by periods of complete immobility: waxy flexibility. Will stop moving & remain in that position for several minutes. The person’s arms can be moved, & they will remain in that position until the catatonic phase passes. Some have attributed this immobility to mild epileptic seizures, but we are not certain why the disorder occurs.


PERSONALITY DISORDERS: Pervasive pattern of behavior involving difficulty interacting with others. Personality disorders are some of the most misunderstood disorders in psychology, & to date, we have neither a complete grasp of the causes nor an adequate strategy for treatment.

BORDERLINE PERSONALITY DISORDER: Results in a repeated pattern of difficulty in maintaining relationships. A person with borderline personality disorder views other people - she sees people as either good or bad. If a friend violated some perceived trust boundary, they would perceive that friend as being bad.

ANTISOCIAL PERSONALITY DISORDER (APD): One of the most severe of the personality disorders: repeatedly violates rights of others with no remorse. Typically, patterns of behavior will emerge early (in the teen years) but will become more evident as the person reaches the 20s & 30s. Some APD people are violent & engage in horrific behavior, though the majority are not. They all commonly violate rights of others & have very little concern for the consequences of their behavior.


TREATMENT OF ABNORMAL BEHAVIOR: Treating psychological disorders poses one of the biggest problems for psychologists. It is important to have a realistic perspective: we can treat the symptoms, but according to most perspectives, we cannot cure the disorders.

DRUG THERAPY: The first course of treatment for many psychological disorders is to provide relief of the symptoms. Drugs are often the most effective strategy for doing this.

DEPRESSION: Antidepressants, selective serotonin reuptake inhibitors, such as Prozac, Wellbutrin, Zoloft.

ANXIETY DISORDERS: Anxiolytics, such as Xanax or Paxil.

SCHIZOPHRENIA: Early antipsychotics included drugs that caused side effects such as tardive dyskinesia (dyskinesia disorder resulting in involuntary, repetitive body movements that can be tardive, having a slow or belated onset). Tardive dyskinesia was 1st discovered after antipsychotic medications were introduced around 1960. A devastating blow for those who suffered from it, because antipsychotic medications were effectively dealing with their schizophrenia, & now these side effects made them even more vulnerable to the outside world. Some patients were so upset & humiliated by these symptoms that it led them to discontinue the medications altogether. Most well-known of these drugs was chlorpomazine (Thorazine). More recent drugs, such as Zeprexa and Risperdal, reduce the effects on the muscle systems.

Drug therapy is typically combined with “talk therapy” to alleviate symptoms overall and to help the afflicted person handle the disorder more effectively. Of the various “talk therapies,” the techniques of Sigmund Freud have served as the face of psychology. What is interesting about this is that Freud offered some of the least testable techniques of any of the therapies.

FREUD’S THERAPEUTIC TECHNIQUE: Goal: help patient uncover unconscious conflicts that give rise to anxiety. Anxiety typically causes a person difficulty in dealing with everyday life. Cause of anxiety is, according to Freud, deep-rooted in conflicts set in the unconscious. To get at them, the therapist must use a variety of techniques, including intensive one-on-one therapy: psychoanalysis. It is a long-term commitment: it typically lasts 1 hour a day, several days a week - possibly for several years. Various techniques are used to get to the unconscious, but the setup, according to Freud, is important. Therapist should sit behind a client in a chair, & client should lie in a chaise lounge so she can relax. Therapist asks questions, & client answers as honestly as possible. Therapy takes so long because techniques to get to unconscious cannot be direct. To uncover what is in the unconscious, therapist must use techniques that require interpretation before the true meaning can be divined.

DREAM ANALYSIS: Freud: dreams were the “royal road to the unconscious.” Using dream analysis, a therapist could take notes on the manifest content (the dream itself) and then interpret the latent content (hidden, underlying symbolic meaning of the dream). Using what Freud knew about the symbolism of dreams a therapist can determine some of the potential causes of anxiety.

TRANSFERENCE: Freud discovered that some of his patients developed strong feelings about him: some of love, some of hate, but after contemplation he realized that these patients were experiencing strong emotions for their loved ones & temporarily transferring those to their therapist. Freud had the great insight that this transference was an unconscious process and, indeed, a way that he could illuminate this issue & help the patients see the unresolved conflicts with people they were close to.

HYPNOSIS: Freud practiced hypnosis early in his career. He believed that hypnosis would ease the grip that the repression had on the unconscious and allow some of those issues to percolate to consciousness. He later argued, however, that it was far less effective than he once believed.

FREE ASSOCIATION: Free association was Freud’s preferred method of therapy. With free association, a person says the first thing that comes to mind when a therapist says something. If a person does this fast enough, according to Freud, the first thing he says can be a “glimpse” into the unconscious. By getting such a glimpse, the therapist can determine the causes of the anxiety.

DRUGS: Freud also believed that a variety of drugs (including cocaine) could be used to alleviate anxiety.

Freud did not spend much of the therapeutic situation practicing these techniques but, rather, collecting detailed histories of his clients. He believed that small details of one’s childhood could be critical in explaining how the anxiety had developed. After years of intensive therapy and after much of the unconscious has been laid bare through the treatment, the client is presumably “cured.” Other forms of psychoanalysis also focused on determining the cause of the anxiety in the unconscious but used different techniques. The underlying assumption is that therapy should uncover the issues in the unconscious that are the root of anxiety.

COGNITIVE THERAPY: Cognitive therapies assume that people suffer from problems when their beliefs about the world are disconnected from reality itself. One feels anxiety because the perspective that one brings to the world is inconsistent and, typically, much worse than reality. People who see a cognitive therapist will describe their perspective on reality, to which the therapist responds by helping them see reality more clearly. In the technique called cognitive restructuring, the therapist helps the client restructure his thoughts to make them more consistent with reality.

Cognitive therapies have been used with a variety of disorders, but the most common disorder they help is depression. Aaron Beck (among others) pioneered the use of cognitive therapy with depression when he learned that depressed people tend to catastrophize issues in their lives. That is, they tend to view issues as being worse than they are. Cognitive restructuring helps these individuals realize that life situations are not as severe as they perceive. With that understanding, they can deal more effectively with their depression.

HUMANISTIC THERAPY: The most well-known therapy is the approach championed by Carl Rogers. According to Rogers, and humanistic theory in general, people are inherently good and strive to reach their potential. Therapy is designed to help people understand the essential human characteristics and help them work towards achieving their potential.

Essentially, the philosophy of humanistic therapy is to provide a sounding board for people to voice their opinions and thoughts. The therapist gives the client unconditional positive regard. By doing this, he helps the client understand conditions of worth, which in turn helps her understand how to deal better with situations in life.

Much of this therapeutic approach is reflective toward the person; all that might be required is for a person to hear an objective opinion. Humanistic psychologists do this by parroting back to the client what she says. This technique is known as active listening and it is important part of the humanistic approach, because it helps people feel that someone is listening to them and that their concerns are being validated. Humanistic psychologists often view those whom they work with not as patients but as clients, so the term often used for this approach is client-centered therapy.

BEHAVIORAL THERAPY: Assumes that psychological disorders are really behavior disorders. To treat the “disorder,” we need only treat the behavior. The techniques that modify human behavior are appropriate to dealing with the disorders. Essentially the goal of behavioral therapy is to create an environmental context that is in conflict with the behaviors demonstrated by the person with the disorder. When that occurs, we are able to alter behavior because the reinforcement is stronger for the alternative behavior choice than it is for the disordered behavior.

The best example of behavior therapy is called systematic desensitization. This technique was developed by Joseph Wolpe and is most effective in dealing with phobias. The technique borrows from the progressive relaxation literature. First, a client is taught how to relax. This is more than just relaxing the way one might do while watching a baseball game - it is systematic approach to relaxation.

In progressive relaxation, a person is taught to relax each body part in sequence. The relaxation is made observable to the client by using biofeedback (a technique that allows one to see a measure of heart rate, breathing rate, etc.). Finally, in very small steps, the phobia-causing stimulus is introduced. When the client feels anxiety, she is told to practice relaxation. In such a way, and in small steps, the client can learn to relax in the presence of the phobia-causing stimulus. Behavior approaches have been shown to be very effective treatments for a wide variety of disorders.

Review Questions:

1. In the DSM-IV, multiple personality disorder is categorized as a(n)

(schizophrenic disorder, dissociative disorder, anxiety disorder, personality disorder)

2. Franco hears voices and believes he is wanted by the CIA. He would most likely be diagnosed with

(schizophrenic disorder, dissociative disorder, anxiety disorder, personality disorder)

3. Suzanne reports persistent irrational thoughts that produce tension and repetitive impulses to perform certain acts that cause significant impairment. She would most likely be diagnosed with

(schizophrenia, obsessive-compulsive disorder, Tourette’s syndrome, post-traumatic stress disorder)

4. Psychological disorders are said to be atypical, unjustifiable, and maladaptive. In this sense maladaptive means

(interfering with a person’s daily life, dangerously violent and a menace to society, out of the ordinary or unusual, violating the rights of others without remorse)

5. The DSM-IV is used to

(establish best practices for treatment, provide patients with information about support groups for their disorders, document case studies of people w/ severe disorders, establish guidelines for diagnosing disorders)

6. Which of the following is NOT a common symptom of schizophrenia?

(delusions, auditory hallucinations, inappropriate acts, panic attacks)

7. A person who alternates between periods of depression and periods of mania is probably suffering from

(depression, schizophrenia, bipolar disorder, amnesia)

8. The disorder that is marked by auditory hallucinations and a fear of persecution is

(catatonic schizophrenia, clinical depression, antisocial personality disorder, paranoid schizophrenia)

9. With what disorder is learned helplessness most commonly associated?

(depression, PTSD, generalized anxiety disorder, dissociative fugue)

10. A person with most of the following disorders would be MOST likely to get into an altercation with law enforcement because she frequently violates the rights of others?

(antisocial personality disorder, hypochondriasis, disorganized schizophrenia, obsessive-compulsive disorder)

11. Richie is having problems with his hip, but doctors can find nothing wrong with it. As an athlete, Richie is preparing for the biggest race of the year. The hip problem is likely going to keep him from competing. Richie most likely suffers from

(schizophrenia, a conversion disorder, depression, hypochondriasis)

12. Fred has no regard for the rights of privileges of others and consistently violates those rights with no remorse. He probably suffers from

(schizophrenia, antisocial personality disorder, obsessive-compulsive disorder, bipolar disorder)

13. Which of the following disorders is more likely to be found in women than in men?

(depression, post-traumatic stress disorder, obsessive-compulsive disorder, bipolar disorder)

14. Jane wakes up one morning and can’t remember where she is from. She struggles with even simple chores because she doesn’t know where anything is in her own house. Eventually, she realizes that she can’t remember who she is and simply leaves and wanders around for a few days. She eventually starts a new identity. Jane is a victim of

(psychogenic amnesia, schizoid personality disorder, psychogenic fugue, multiple personality disorder)

15. Which of the following disorders is most associated with Freudian psychology?

(anxiety disorders, schizophrenia, depression, bipolar disorder)

16. Someone who suffers from paranoid schizophrenia is NOT likely to experience

(extreme suspicion, delusions of grandeur, auditory hallucinations, depression)

17. While at school, Joel experiences an acute onset of anxiety. His heart rate increases, his blood pressure increases, and he feels jittery. Joel is probably experiencing a(n)

(heart attack, panic attack, episode of mania, psychotic break)

18. Carla and her best friend Curtis, both aged 25, have been close since third grade, but Curtis said something unkind about Carla’s latest haircut. Carla decided he was a mean and evil person, and she didn’t want anything to do with him. Curtis complains that this is a pattern for Carla - she consistently identifies people as being good or bad. Carla is likely to be experiencing symptoms of

(anxiety disorder, antisocial personality disorder, borderline personality disorder, obsessive-compulsive disorder)

19. Waxy flexibility is a symptom most closely associated with

(paranoid schizophrenia, catatonic schizophrenia, bipolar disorder, hypochondriasis)

20. Karen is afraid of heights. This fear inhibits her daily life. This is an example of

(phobic disorder, panic disorder, somatoform disorder, anxiety disorder)

21. The concept most associated with Rogerian or client-centered therapy is

(flooding, free association, unconditional positive regard, positive reinforcement)

22. The concept most associated with a form of behavioral therapy is

(dream analysis, free association, unconditional positive regard, positive reinforcement)

23. A client goes to see a psychiatrist and is diagnosed with schizophrenia. He is likely to be prescribed

(Haldol, Prozac, Risperdal, Zoloft)

24. Which of the following psychologists developed the concept of systematic desensitization?

(Freud, Rogers, Skinner, Wolpe)

25. Patient is given the task of restructuring the way she thinks about issues in her life. This is _____ therapy.

(cognitive, psychoanalytic, humanistic, behavioral)

26. A patient who suffers from a phobia will most likely be treated with

(psychoanalytic therapy, drug therapy, systematic desensitization, cognitive restructuring)

27. Which of the following is NOT a technique utilized by practitioners of Freudian psychoanalysis?

(Progressive relaxation, transference, free association, dream analysis)

28. A client is asked to express his perspective no matter what people think of him. The therapist is going to give him unconditional positive regard and accept the person for who he is. This is a form of

(client-centered therapy, Freudian therapy, cognitive therapy, drug therapy)

29. If a person was seeking a therapist who would help her get her life back together and offer very direct ways that she could fix her problems, which of the following therapists would she be LEAST successful with?

(cognitive therapist, psychoanalyst, behavioral therapist, client-centered therapist)

30. A client feels as though he is beginning to develop feelings for the therapist. He previously had the same feelings for someone else. According to Freudian theory, this is a process called

(projection, repression, regression, transference)

31. The goal of cognitive therapy is to

(understand the theories of behavior, treat the symptoms of the client, help the client see inconsistencies in thoughts and behaviors, understand the reasons behind the disorder)

32. You have a dream that you go to class but have forgotten an important assignment. You are embarrassed as the teacher points out to everyone that you did not follow instructions. According to Freud, this description of the dream is the  ( deep structure, surface structure, manifest content, latent content)

33. You have a dream that you go to class but have forgotten an important assignment. You are embarrassed as the teacher points out to everyone that you did not follow instructions. If Freud said that it was really a response to a threat and you were feeling scared of dealing with that threat, that would be called _____ of the dream.

(deep structure, surface structure, manifest content, latent content)

34. Jim realizes that his fear of heights is becoming overwhelming and he really needs a therapist who can most effectively “fix” him in the least amount of time. He doesn’t want to know where the fear comes from, but just wants it gone. What type of therapy would be best for Jim?

(psychoanalysis, behavioral therapy, cognitive therapy, client-centered therapy)

35. Therapy is a difficult process. One reason stated in the text is that

(it is expensive, it is time consuming, it is not effective, we treat the symptoms and not the disease)

36. According to cognitive therapists, clients who think that their problems are much bigger than they actually are are said to be  (confabulating, exaggerating, catastrophizing, projecting)

37. Which of the following techniques was NOT used by Sigmund Freud?

(dream analysis, hypnosis, free association, cognitive restructuring)

38. “A person suffers from depression because she has been reinforced for acting depressed in the past.” Which of the following perspectives might provide this explanation for depression?

(behavioral, cognitive, Rogerian, psychoanalytic)

39. Client-centered therapy was originally developed by  (Wolpe, Rogers, Freud, Skinner)

40. Patients who have been on antipsychotic medications for many years may experience a disabling series of side effects such as repetitive movements, rapid eye blinking, and grimacing. This collection of side effects is known as  (tardive dyskinesia, systematic desensitization, Tourette syndrome, post-traumatic stress)