Psychology 1B

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students are expected to consult and prepare for assessments.
 Eduvos and the Flipped Classroom

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 Weekly quiz reminder
Take note of the following:
• This week (Week 6) your fourth quiz opens on
the ASSESSMENTS TILE.

• It opens on Monday, 9th June and closes on

Sunday, 15th June at 23:00. It covers Chapters 14
and 15.

• Take note that this counts towards your formative

mark. There is no deferred opportunity.
What will be covered in this session?

What will be covered in these slides:

Week 6 Changing treatment of psychological disorders

Insight therapies
Chpt 15: Action therapies
Psychological Factors influencing effectiveness of therapy
Therapies Biomedical therapies
 Week 6: Assessment Criteria

6.1 Describe how the treatment of psychological disorders has changed throughout history.
6.2 Describe the basic elements of Freud’s psychoanalysis and psychodynamic approaches
today.
6.3 Identify the basic elements of the humanistic therapies known as person-centred therapy and
Gestalt therapy.
6.4 Explain how behaviour therapists use classical and operant conditioning to treat disordered
behaviour.
6.5 Summarise the goals and basic elements of cognitive and cognitive-behavioural therapies.
6.6 Identify factors that influence the effectiveness of therapy.
6.7 Categorise types of drugs used to treat psychological disorders.
6.8 Explain how electroconvulsive therapy and psychosurgery are used to treat psychological
disorders.
6.9 Identify some of the newer technologies being used to treat psychological disorders.
 Treatment of psychological disorders:
Past to present
• Until the late 1700’s mental illness attributed to demons or evil spirits.

• Middle 16th C in England – first organized effort to do something

• Bethlehem Hospital in London converted into an asylum.

• Treatments: bloodletting, ice-baths, beatings, induced vomiting

• 1793 – ‘moral treatment’ = treat mentally ill with kindness and guidance.

• Philippe Pinel:
• personally unchained the inmates at La Bicêtre Asylum in Paris, France,
beginning the movement of humane treatment of the mentally ill.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Treatment of psychological disorders:
Past to present
Biomedical therapy:
Therapy • therapy for mental disorders in
which a person with a problem is
treated with biological or
• Treatment methods aimed at medical methods to relieve
symptoms
making people feel better and
function more effectively.
Psychotherapy:
• Two kinds: • therapy for mental disorders in
• Psychotherapy Combination
which a person with a problem
talks with a psychological
• Biomedical therapy professional

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Two types of psychotherapy

The goal of most psychotherapy is to help both mentally healthy and

psychologically disordered persons understand themselves better.

• Goal = gain insight or understanding of your

Insight behaviour, thoughts and feelings
Therapy • E.g. Psychodynamics & humanistic approach

• Goal = change disordered or inappropriate

Action behaviour directly
Therapy • E.g. Cognitive & cognitive-behavioural
approach (CBT)

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Involvement of therapist differs
between the two approaches

Directive
• Sessions are pre-planned
• Therapist tells client what to do

Non-Directive
• Sessions are client-led
• Therapist facilitates but does not direct

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Approaches to
Therapy
• Psychoanalysis
• Person-centered therapy
• Gestalt Therapy
• Cognitive therapy
• Cognitive-behavioural
therapy (CBT).
• Rational emotive behaviour
therapy (REBT)
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Approaches to Therapy
Rational
Person- Cognitive-
Cognitive Emotive
Aspect Psychoanalysis Centered Gestalt Therapy Behavioural
Therapy Behaviour
Therapy Therapy (CBT)
Therapy (REBT)
Aaron T. Beck
Founder Sigmund Freud Carl Rogers Fritz Perls Aaron T. Beck Albert Ellis
(and others)
Identifying
Self- Changing Changing
Unconscious Awareness, and
actualization, negative irrational
Main Focus conflicts, early here-and-now correcting
personal thoughts and beliefs to
childhood experiences distorted
growth behaviours rational ones
thinking
Driven by Neutral; Capable of
Inherently good Capable of Tend toward
View of Human unconscious influenced by change through
with potential for awareness and irrational thinking
Nature desires and thoughts and thought/behaviour
growth choice but can change
instincts beliefs work
Expert Active and Guide who
Facilitator; non- Directive,
Therapist’s interpreter of confrontational helps client Collaborative
directive and disputing
Role unconscious in the here and recognize teacher or coach
empathetic irrational beliefs
processes now thought errors
 Approaches to Therapy
Cognitive- Rational Emotive
Person-Centred Cognitive
Aspect Psychoanalysis Gestalt Therapy Behavioural Behaviour
Therapy Therapy
Therapy (CBT) Therapy (REBT)
ABC model
Cognitive Thought records,
Free association, Unconditional Empty-chair (Activating event
restructuring, behaviour
Techniques Used dream analysis, positive regard, technique, role- – Belief –
Socratic experiments,
transference active listening playing Consequence),
questioning exposure
disputation
Emotions result
Expression and Emotions are Change emotional
View on Emphasized Result from from beliefs;
understanding of experienced in the response by
Emotions through empathy thoughts change beliefs →
repressed ones present changing thoughts
change emotion

Present-focused Present-focused
Present and Present and
Time Orientation Past-focused Present-focused with some with attention to
future-focused future-oriented
attention to past belief origins

Insight into Self- Change Eliminate

Identify and
unconscious and understanding Integration of maladaptive irrational beliefs
Goal of Therapy change cognitive
resolution of and self- fragmented self thoughts and and develop
distortions
conflicts acceptance behaviours rational thinking
Insight Therapy: The
Psychodynamic
Approach

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Psychoanalysis

● Developed by Freud.
● Emphasis on revealing unconscious conflicts and hidden, repressed urges and
desires.
● These unconscious thoughts used to prevent anxiety and cause disordered emotions
and behaviour.
● Cannot easily be brought to consciousness.

● Therapy designed to help patients feel more relaxed, open, & able to explore their
innermost feelings without fear of embarrassment or rejection.

● Tools of therapy for accessing unconscious:

● dream interpretation, free association
Other components: resistance and transference
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Dream interpretation

● Repressed material often surfaces in dreams in symbolic

form.
● The actual dream is referred to as manifest content.
● Latent content relates to the hidden, symbolic meaning of
dreams.
● Correct interpretations reveal unconscious conflicts responsible
for creating the ‘nervous disorder’ or anxiety.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Questions for Discussion
1. In both Western and African cultures a frog represent
abundance and fertility…
Is dream 2. In most African cultures

interpretation 1. Dreaming of water represents life, purification, and the initiation

of change…
valid? 2. Dreaming of a wedding generally signifies death

3. In most Western cultures

1. Dreaming of a wedding generally signifies new beginnings,

commitment, and unity, often reflecting desires in love or
other areas

2. Dreaming of water represents maternity, healing, wisdom,

as well as destruction
 Free association

● Technique for revealing the unconscious mind.

● Revised by Freud’s co-worker, Joseph Breuer.

● Client says freely whatever comes to their mind without fear of
being negatively evaluated.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Resistance and transference

● Resistance: the patient becomes unwilling to talk about certain

topics. How?
● Change topic; become silent

● Transference: the therapist becomes a symbol of a parental

authority figure from the past.
● Counter Transference: is experienced by a therapist as a
reaction of transference.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Evaluation

● Freud’s original theory lacked scientific research to support claims; unwilling to believe
things revealed by his clients if they contradicted his world view; obsession with sex
and sexuality as root of problems.
● .Modern Psychodynamic therapy:
● Client sits face to face with therapist;
● Therapist is more directive - asking questions, suggesting helpful behaviour, giving
opinions and interpretations.
● Shorter duration
● Less focus on id and more on ego and sense of self as motivators
● Client needs to be intelligent and verbally expressive

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Insight Therapy:
Interpersonal
psychotherapy
 Interpersonal psychotherapy (IPT)
Freepik (2024))

● Developed to address depression.

● Focuses on relationships with self & others & the
interplay between mood & the events of everyday life.
● Derived from psychodynamics; combines aspects of
humanistic & cognitive-behavioural therapies.
● Research supports its effectiveness in treating
depression when combined with medication.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Weiten (2022, p. 549

Insight Therapy:
Humanistic
therapy
 Humanistic therapy

● Does not focus on the unconscious, or hidden conflicts.

● Focus is on:
● Conscious, subjective experiences of emotion & people’s sense
of self
● The immediate experiences in their daily lives.
● Choices and potential to change
● Carl Rogers’s Person-Centered Therapy & Fritz Perls’s Gestalt
Therapy.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Rogers’ Person-Centered Therapy

What did Rogers believe?

● We have a real self (how people see their actual traits & abilities) & an
ideal self (how people think they should be).

● The closer they match up, the happier & more well adjusted the person.

How do we close the gap?

● People need to receive unconditional positive regard (love, warmth,

respect, & affection without conditions attached), to close the gap.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Rogers’ Person-Centered Therapy

● Goal of therapy:
● provide unconditional positive regard that has been absent from the
troubled person’s life, &
● help the person to recognise the discrepancies between real self and
ideal self.

● Non-directive: the person does all the real work, with the therapist merely
acting as a sounding board.

● Person-centered: the person is the center of the process.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Basic elements for PCT

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
There are 3 key elements for successful person-therapist relationship:
Unconditional positive
Authenticity Empathy
the genuine, open, and regard the ability of the therapist to
honest response of the the warmth, respect, and understand the feelings of
therapist to the client accepting atmosphere created by the client
the therapist for the client in
person-centered therapy
Reflection:
● Technique in which the therapist restates what the client says rather than interpreting those
statements
● Allows the client to continue to talk & have insight without the therapist’s interference.
 Humanstic therapy: Motivational
interviewing (MI)

Motivational interviewing (MI)

• Variation of person-centered therapy
• In contrast to client-centered therapy, MI has
specific goals:
• to reduce ambivalence about change and
• to increase intrinsic motivation to bring that change
about.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Gestalt therapy

● Developed by Fritz Perls.

● Belief is that people’s problems stem from hiding important parts of
their feelings from themselves.
● Focus is on the whole picture (gestalt).
● Therapist is very directive - using experiments and planned
experiences to increase self-awareness.
● Focus on the denied past - still in the here and now.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Gestalt therapy

• Gestalt therapy is a form of directive insight

therapy in which the therapist helps clients
accept all parts of their feelings and subjective
experiences.

• Therapist uses leading questions and planned

experiences such as role-playing and the
empty chair technique.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson Image: Ciccarelli & White (2021, p. 613)
 Humanistic therapy: Evaluation

• Person-centered therapy:
• Used to treat psychological disorders, help people make career choices, deal
with workplace problems, and counsel married couples.
• Can be a very “hands-off” form of therapy as so nondirective.
• Therapist runs a lower risk of misinterpretation.

• Many therapeutic approaches benefit from humanistic influences

• E.g., the importance of the client-therapist relationship (therapeutic
relationship).
• Humanistic therapies are not based in experimental research and work best with
intelligent, highly verbal persons.
• Less practical choice for treating more serious mental disorders like
schizophrenia.
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Action
Therapies
Key Characteristics of Action Therapies:

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Differences between Insight Therapies
and Action Therapies
So… how does Insight Therapy differ from Action Therapy?
Action Therapies Insight Therapies

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Differences between Insight Therapies
and Action Therapies
So… how does Insight Therapy differ from Action Therapy?
Characteristic
1. Focuses on understanding unconscious motives and past
experiences
2. Emphasizes changing current behaviours and thoughts
3. Therapist acts as a guide to self-awareness
4. Structured, goal-oriented, and often short-term
5. Helps clients develop insight through discussion and reflection
6. Uses practical techniques like exposure, role-play, and behaviour
tracking
7. Often non-directive and emphasizes the therapeutic relationship
8. Therapist is more active, like a coach orCiccarelli,
teacher S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Differences between Insight Therapies
and Action Therapies
So… how does Insight Therapy differ from Action Therapy?
Action Therapies Insight Therapies
2 1

4 3

6 5

8 7
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Behavioural and Cognitive therapies

Behavioural Therapy

● Change maladaptive behaviour

• All behaviours are learned, through
classical or operant conditioning, therefore
behaviour can be changed by using the
same learning techniques.

Cognitive Therapy

• Change the maladaptive thoughts

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behaviour therapies: Therapies based
on classical conditioning

● Involves the pairing of stimuli.

● Involuntary responses are learned by pairing a stimulus
Classical that normally causes a particular response, with a new
neutral stimulus.
Conditioning: ● After enough pairings, the new stimulus will also cause
the response to occur.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behaviour therapies: Therapies based
on classical conditioning
• 1. Learn to relax through muscle relaxation training.
• 2. Construct a fear hierarchy.
Systematic • 3. Expose yourself step by step with relaxation; starting with least
desensitisation feared object/situation and working up the hierarchy.
• How it works: Fear object paired with new relaxation response
that is incompatible with fear arousal.

• Undesired behaviour is paired with an aversive (bad)

stimulus to decrease behaviour e.g. rapid smoking
Aversion therapy technique – puff every few seconds resulting in negative
side effects.

• Expose to fear-related stimuli under controlled conditions

• For phobias: gradual or rapid (flooding) exposure to
Exposure therapy anxiety-provoking stimulus.
• Exposure can be real (in vivo), imaginal or VR (virtual
reality).
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Please go to MyLMS and watch the
videos

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behavioural therapies: Therapies
based on operant conditioning

● Techniques to change the

Operant Conditioning:
frequency of voluntary behaviour
include reinforcement, extinction,
reinforcement and modeling

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behavioural therapies: Therapies
based on operant conditioning

• Participant modelling - a model demonstrates the

Modelling desired behaviour.
• Model may be in the same room or viewed on video.

• Positive/negative reinforcement; token economy or

Reinforcement contingency contract with all the tasks, penalties,
rewards stipulated.

• Removal of the reinforcer to reduce the frequency of

Extinction a particular response e.g. time-out

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behavioural therapies: Therapies
based on operant conditioning

● Used successfully with depression.

● Depression – person limits involvement with others and
Behavioural activities.
● Behavioural activation involves reintroducing individuals
activation to their regular environment and routines to increase
opportunities for positive reinforcement.
● E.g. actively schedule activities

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Behaviour therapies: Evaluation

● Quick and efficient way to eliminate or reduce symptoms.

● Some behavioural paradigms are not simple to establish or implement
● Behavioral activation is an effective intervention for depression and is either
comparable or superior to antidepressant medication in the short term and superior to
cognitive therapies.
● Behaviour therapies are more effective than other therapies for specific behavioural
problems:

BED- DRUG
OVEREATING PHOBIAS
WETTING ADDICTION

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Cognitive Therapies

● Developed by Aaron T. Beck:

● Change ways of thinking, rather than behaviour.
● Focus is on distorted thinking and unrealistic beliefs that lead
to the maladaptive behaviour.
● Goal: Test the truth of beliefs and assumptions in an objective,
scientific way or to consider attribution of others’ behaviour and their
own behaviour.
● Use this therapy in Depression!

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Cognitive Therapies
Arbitrary Magnification and Overgeneralization: Personalization: Selective
inference: minimization: Draw sweeping Take thinking:
responsibility or Focus on only
Jumping to Blow bad thing out of conclusions from one
one aspect
conclusions proportion while not incident and assume blame for events
leaving out other
without evidence emphasizing the the conclusion not connected to
relevant facts
good things. applies to areas of the individual. that might make
life unrelated to the things seem less
original event. negative

Identify the distortions in the examples below:

Jabu goes on a blind date which does
not turn out well. Instead of viewing this David’s friend cancels his plan to meet
as a one-time occurrence, Jabu says ‘I with him for lunch. David automatically
always mess up relationships and I will assumes it is because he finds his
never find someone who likes me. I will company boring.
be on my own for the rest of my life.” Answer: Personalisation
Answer: Overgeneralization Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Cognitive-behavioural therapy (CBT)

● Use combination of behaviour and cognitive therapy: focus on the

present.
● Assume that disorders come from illogical, irrational cognitions and that
changing these to more logical, rational cognitions will relieve the
symptoms of the disorder.
● Three elements of CBT:
● Cognitions affect behaviour,
● cognitions can be changed,
● behaviour change can result from cognitive change.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Three goals of CBT

Relieve the symptom and help clients to resolve the

problem

Help clients develop strategies to cope with future

problems

Help clients to change their thinking patterns to rational,

self-helping, positive thoughts

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Rational emotive behaviour therapy
(REBT)
● Albert Ellis - REBT (a version of CBT)
● Clients taught to actively challenge their own irrational beliefs.
● Examples of irrational beliefs:
● Everyone should love and approve of me (if they don’t, I am awful and unlovable).
● When things do not go the way I wanted and planned, it is terrible, and I am, of course,
going to get very disturbed. I can’t stand it!
● Replace irrational beliefs with more rational helpful statements.
● Therapists are directive, challenging the client, assigning homework, using behavioural
techniques to modify behaviour and arguing with clients about the rationality of their
statements.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Cognitive and cognitive behaviour
therapies: Evaluation

● Shorter & less expensive than insight therapy.

● Treats symptoms, not the cause - this is a feature but also
criticism.
● Effective for depression, anxiety disorders and personality
disorders.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Table 15.2: Ciccarelli & White, 2021, p. 623
 Does psychotherapy really work?

Summary of the research on the effectiveness of psychotherapy:

• Study by Hans Eysenck in the 1950’s created a controversy:
• People receiving psychotherapy did not recover at any higher rate
than those who had no psychotherapy and the passage of time
alone could account for all recovery.

• Other studies have found therapy to be effective.

• Surveys suggest that
• psychotherapy is more effective than no treatment at all.
• 75 – 90% of people who receive therapy report

Freepik (2024)
improvement - the longer a person stays in therapy the
better the improvement - and psychotherapy works as well
alone as with drugs.
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Does psychotherapy really work?

Summary of the research on the effectiveness of psychotherapy:

• Some types of psychotherapy are more effective for certain types of problems;
• no one psychotherapy method is effective for all problems.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Differences between Insight Therapies
and Action Therapies
So… how does Insight Therapy differ from Action Therapy?
Action Therapies Insight Therapies
Focus on behavioural change Focus on self-awareness and understanding

Often structured and directive Usually non-directive or exploratory

Emphasize present and future Often explore the past

Therapist is often a coach or teacher Therapist is a guide or facilitator

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Activity: Case study

Samantha is a 28-year-old woman who has been A)Based on the case, which
experiencing intense fear of public speaking for the last type of therapy – Action
two years. She avoids giving presentations at work and Therapy or Insight Therapy –
has turned down career opportunities because of this would be more appropriate for
fear. She recognizes that this fear may stem from a Samantha? Justify your answer.
humiliating experience in high school, but she now (3 marks)
wants immediate help managing the anxiety so she Action Therapy: Samantha
can confidently deliver a presentation next month. wants practical, structured
techniques to reduce her
Samantha is highly motivated and prefers practical anxiety in a short time frame.
tools and structured strategies over long discussions She prefers present-focused,
about her past. She says, "I don’t just want to talk results-oriented methods –
about my fear – I want to learn how to get past it." hallmarks of Action Therapy.
 Activity: Case study
B. From the list below, select three techniques that would best
fit the chosen therapy type and Samantha's goals. Briefly explain
why each technique is appropriate. (2 marks each = 6 marks)
Technique Justification
1) Free Association Gradual exposure to public
2) Exposure Therapy 2. Exposure speaking situations can reduce
Therapy her anxiety through
3) Dream Analysis desensitization.
4) Thought Record 4. Thought
Helps identify and challenge
negative thoughts about
5) Empty Chair Technique Record
speaking, building confidence.
6) Challenging Irrational Beliefs
6. Challenging Reframes unrealistic fears like
(REBT) Irrational "Everyone will laugh at me" into
7) Exploring Childhood Beliefs (REBT) rational beliefs.
Memories 8. Role- Provides a safe space to
8) Role-playing Presentations playing practice and build presentation
Presentations skills with feedback.
 Characteristics of effective therapy

Eclectic
● Use a variety of methods to fit the client and/or specific problem

Common factors approach

• Focus on factors that are common to successful outcomes.
• Most important common factor of successful psychotherapy is the therapeutic alliance
(relationship between client and therapist) – warm, caring atmosphere; empathy, mutual respect.
• Therapy should offer: Protected setting; opportunity for catharsis (relieve pent up emotions);
learning and practice of new behaviours; positive experiences.
Evidence-based treatment (empirically-supported)
• Focus on techniques or interventions (therapies) that have produced desired outcomes or
therapeutic change in controlled studies.
• Includes controlled studies to study the effectiveness of psychotherapy & psychopharmacology.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Characteristics of effective therapy

Neuroimaging of psychotherapy
● Neuroimaging done to evaluate psychological treatment.
● Research shown psychotherapy can alter brain activity in certain areas

Telepsychology
• Use of email, phone, text, mobile devices to provide psychological services.
• There are both benefits and risks
• Ensure therapist has appropriate training and credentials
• Avoid personal virtual relationships
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Cultural, ethnic and gender concerns in
psychotherapy
Four barriers to effective psychotherapy exist when
the culture/ethnic background of a client and
Cultural difference makes it therapist differ:
• Culture-bound values: each group has own ideals
difficult for therapists to and values; you might struggle from a Western
understand the exact nature perspective for example with a polygamous marriage
of their clients’ problems and • Class-bound values: funds for therapy, transport
for clients to benefit from concerns
therapies that do not match • Language: competence in language, psychometric
their needs. testing not in 1st language
• Non-verbal communication: body language, eye
contact

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Activity: Case study and discussion

Mary is a forty-year-old so-called ‘Coloured’ woman who lives in the Cape • Which barriers are
Flats and has three children. Mary is married and her husband, David, highlighted here?
works far away. David provides financial support, but is rarely physically
present. Mary goes to see a psychologist at the local clinic about her
• What was the
difficulties with one of her children. The psychologist is a ‘white’ Afrikaans result for the
woman who suggests that the family needs to come for family therapy, client?
and indicates that David should take time off work to come home and • How could the
help with the children. She tells Mary that David is selfish to work so far therapist have
away from the family, as he is not doing his duty as a father. Mary is upset
that the psychologist does not understand that David needs to work far
handled this
away because of their finances. She feels misunderstood by the therapist better?
and does not come back to therapy. Answer: Culture & class
bound values. Therapist
Adapted from Cooper 2007 as cited in Ciccarelli & White, 2017 p. 597 projects own values onto
client.
Biomedical
therapies
 Biomedical therapies

• Biomedical therapies are therapies that directly affect the

biological functioning of the body and brain;
• Therapies for mental disorders in which a person with a
problem is treated with biological or medical methods to
relieve symptoms.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Biomedical therapies – True or False
Read each clinical statement carefully. Write T (True) if the statement is
correct and F (False) if it is incorrect. Each correct answer is worth 1 mark.
1) A patient showing symptoms of hallucinations and delusions is likely to
be prescribed an antipsychotic drug such as risperidone.
2) Benzodiazepines are suitable for long-term treatment of generalized
anxiety disorder due to their low risk of dependence.
3) Lithium, a mood stabilizer, is commonly used to prevent manic episodes
in bipolar disorder.
4) SSRIs (Selective Serotonin Reuptake Inhibitors) are prescribed to treat
schizophrenia.
5) A patient experiencing panic attacks may benefit from fast-acting anti-
anxiety medication like Alprazolam. Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Biomedical therapies – True or False
Read each clinical statement carefully. Write T (True) if the statement is
correct and F (False) if it is incorrect. Each correct answer is worth 1 mark.
6) Antidepressant medications typically begin to show therapeutic effects
within 24–48 hours.
7) A person with major depressive disorder may be prescribed fluoxetine,
which helps increase serotonin levels.
8) Mood stabilizers can be used in combination with antipsychotics when
treating schizoaffective disorder.
9) Tricyclic antidepressants are first-line medications due to their minimal
side effects compared to newer drugs.
10) Withdrawal symptoms can occur if anti-anxiety drugs like lorazepam are
stopped abruptly. Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Biomedical therapies – True or False
Q# Answer Explanation
1 T Antipsychotics like risperidone reduce positive symptoms of schizophrenia.

2 F Benzodiazepines are not recommended long-term due to risk of dependence.

3 T Lithium is effective in preventing mania in bipolar disorder.
4 F SSRIs treat depression and anxiety, not schizophrenia.
5 T Alprazolam is a fast-acting benzodiazepine, useful for panic attacks.
6 F Antidepressants often take 2–4 weeks for therapeutic effects.
7 T Fluoxetine (Prozac) is an SSRI used to treat major depressive disorder.
Combination therapy may be used in complex conditions like schizoaffective
8 T
disorder.
9 F Tricyclics have more side effects and are not usually first-line treatment today.
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
10 T Benzodiazepine withdrawal can cause rebound anxiety, seizures, etc.
 Biomedical therapies

Psychopharmacology - use of drugs to control or relieve the

symptoms of a psychological disorder.
• This may be used alone or in combination with other therapies.
• Combined treatment is more effective!

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Antipsychotic drugs

Treats psychotic symptoms (hallucination, delusions, & bizarre behaviour).

• Two categories: the typical antipsychotics (Haloperidol), and newer atypical
antipsychotics (Risperidone, Clozapine)

Typical antipsychotic drugs:

● Block dopamine receptors (D2 receptors) in the brain.
● Also cause side-effects after long-term treatment:
● Movement disorders similar to those in Parkinson’s disease, called extrapyramidal
symptoms
● Tardive dyskinesia is a syndrome caused by long-term treatment - person makes facial
and tongue movements like chewing, grimacing’ involuntary jerks or dance-like
movements of arms and legs.
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Antipsychotic drugs

Atypical antipsychotic drugs:

• Fewer negative side-effects.
• Newer classes of atypical antipsychotics include partial dopamine agonists
that affect the release of dopamine rather than blocking its receptors.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Anti-anxiety drugs

Relieve symptoms of anxiety.

● Minor tranquilisers (benzodiazepines)
● Xanax, Ativan, Valium.
● These have sedative effects, but also potential for
addiction and abuse.
● Antihistamines and antidepressants also used.

Freepik (2024)

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Mood-stabilising drugs

Treat bipolar disorder and episodes of mania.

• Lithium - Evens out the highs and lows of bipolar disorder.

• Also taken as a maintenance dose.
• Anticonvulsant drugs, normally used to treat seizure disorders,
have also been used to treat mania.
• Some atypical antipsychotics work as mood stablisers.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Antidepressant drugs

Antidepressant drugs ( 3 types)

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Antidepressant drugs

Monoamine oxidase inhibitors:

• Blocks the activity of an enzyme called monoamine oxidase (MAO).
• MAO breaks down norepinephrine, serotonin & dopamine (all involved in
mood).
• Normally excess neurotransmitters are broken down after they have done
their “job” in mood control.
• In depression, these neurotransmitters need more time to do their job, and
the MAOIs allow them that time by inhibiting the enzyme’s action.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Antidepressant drugs

Tricyclic antidepressants:
• Increase the activity of serotonin and norepinephrine by preventing their reuptake
into the synaptic vesicles of the neurons.

Selective Serotonin Re-uptake inhibitors (SSRI’s)

• Inhibit the reuptake process of just serotonin.
• Fewer side-effects

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Antidepressant drugs

• Antidepressant medication takes about 2 – 6 weeks to produce an

effect.
• In recent times antidepressant drugs have also been used to treat
anxiety, panic disorder, OCD and PTSD.
• Less risk of abuse and fewer side effects.

• There is also research examining the potential use of subanaesthetic

doses of ketamine as an antidepressant.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
Ciccarelli & White, 2021, p. 639
Ciccarelli & White, 2021, p. 639
 Electroconvulsive therapy (ECT)

What is it used for?

• Treats severe depression and other disorders like
schizophrenia or severe mania that are:
• resistant to treatment
• where medication side effects are not

Freepik (2024)
acceptable
• suicide/attempted suicide Side effects:
• Affects the process of consolidation
and prevents the formation of long-
How does it work? term memories.
• Application of an electric shock (one or both sides • This causes both retrograde amnesia,
of brain) resulting in seizure that appears to the loss of memories for events that
normalize the balance of neurotransmitters within happen close to the time of the
the brain. treatment, and anterograde amnesia,
the rapid forgetting of new material.
Maintenance therapy required.
Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Psychosurgery

• Involves cutting into the brain to remove or destroy brain tissue for the
purpose of relieving symptoms of mental disorders.
• In the 1900s – lobotomies, but discontinued.

Freepik (2024)
• Today the bilateral anterior cingulotomy is used for OCD, and
depression or bipolar disorder.
• Bilateral anterior cingulotomy: electrode wire is inserted into the
anterior cingulate gyrus, with the guidance of magnetic resonance
imaging, to destroy a very small portion of that brain area with electric
current.
• Used as a last resort.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 Emerging techniques

Freepik (2024)
Repetitive transcranial magnetic
Deep brain stimulation (DBS) is
stimulation (rTMS) and transcranial
invasive and investigated as a
direct current stimulation (tDCS) are
possible treatment for depression,
non-invasive and evaluated as
OCD and resistant anorexia nervosa.
treatments for PTSD and depression.

Ciccarelli, S.K., & White, J.N. (2021). Psychology: Global Edition (6th ed.). Pearson
 What Happens Next?
Take note of the following:
• Complete your fourth and final quiz on the
ASSESSMENTS TILE. It closes on Sunday 15th June
June at 23:00 and covers Chapters 14 and 15.

• Take note that this counts towards your formative mark.

• There is no deferred opportunity.
• Start studying for your summative exam in week 8.
References

Ciccarelli, S.K. & White, J.N. (2017). Psychology: An exploration: Global and Southern African Perspectives

(1st ed.). Pearson Education Limited.

Ciccarelli, S., & White, J.N. (2021). Psychology: Global Edition. (6th ed). Pearson Education Limited.

Kershner, K. (2024, April 16). How electroconvulsive therapy works. [Image]. HowStuffWorks.

https://science.howstuffworks.com/life/inside-the-mind/human-brain/electroconvulsive-therapy.htm

Weiten, W. (2022). Psychology: Themes and Variations. (11th ed.) Cengage