Chapter 19. Treatment of Psychological Disorders

Chapter Resources

Leanne Stevens; Jennifer Stamp; Kevin LeBlanc (editors - original chapter); and Jessica Motherwell McFarlane (editor - adapted chapter)

Review Questions

Multiple Choice Questions

  1. Who of the following does not support the humane and improved treatment of mentally ill persons?
    1. Philippe Pinel
    2. medieval priests
    3. Dorothea Dix
    4. All of the above
  2. The process of closing large asylums and providing for people to stay in the community to be treated locally is known as ________.
    1. deinstitutionalisation
    2. exorcism
    3. deactivation
    4. decentralisation
  3. Skylar was convicted of domestic violence. As part of their sentence, the judge has ordered that Skylar attend therapy for anger management. This is considered ________ treatment.
    1. involuntary
    2. voluntary
    3. forced
    4. mandatory
  4. Today, most people with psychological problems are not hospitalised. Typically they are only hospitalised if they ________.
    1. have schizophrenia
    2. have insurance
    3. are an imminent threat to themselves or others
    4. require therapy
  5. The idea behind ________ is that how you think determines how you feel and act.
    1. cognitive therapy
    2. cognitive-behavioural therapy
    3. behaviour therapy
    4. client-centred therapy
  6. Mood stabilisers, such as lithium, are used to treat ________.
    1. anxiety disorders
    2. depression
    3. bipolar disorder
    4. ADHD
  7. Clay is in a therapy session. The therapist asks them to relax and say whatever comes to their mind at the moment. This therapist is using ________, which is a technique of ________.
    1. active listening; client-centred therapy
    2. systematic desensitisation; behaviour therapy
    3. transference; psychoanalysis
    4. free association; psychoanalysis
  8. A treatment modality in which 5–10 people with the same issue or concern meet together with a trained clinician is known as ________.
    1. family therapy
    2. couples therapy
    3. group therapy
    4. self-help group
  9. What happens during an intake?
    1. The therapist gathers specific information to address the client’s immediate needs such as the presenting problem, the client’s support system, and insurance status. The therapist informs the client about confidentiality, fees, and what to expect in a therapy session.
    2. The therapist guides what happens in the therapy session and designs a detailed approach to resolving each member’s presenting problem.
    3. The therapist meets with a couple to help them see how their individual backgrounds, beliefs, and actions are affecting their relationship.
    4. The therapist examines and discusses with the family the boundaries and structure of the family, e.g., who makes the rules, who sleeps in the bed with whom, and how decisions are made.
  10. What is the minimum amount of treatment time addicts should receive if they are to achieve a desired outcome?
    1. 3 months
    2. 6 months
    3. 9 months
    4. 12 months
  11. When an individual has two or more diagnoses, which often includes a substance-related diagnosis and another psychiatric diagnosis, this is known as ________.<
    1. bipolar disorder
    2. comorbid disorder
    3. codependency
    4. bi-morbid disorder
  12. Gage was drug-free for almost six months. Then Gage started hanging out with their addict friends again, and they have now started abusing drugs again. This is an example of ________.
    1. release
    2. reversion
    3. re-addiction
    4. relapse
  13. The sociocultural perspective looks at you, your behaviours, and your symptoms in the context of your ________.
    1. education
    2. socioeconomic status
    3. culture and background
    4. age
  14. Which of the following was not listed as a barrier to mental health treatment?
    1. fears about treatment
    2. language
    3. transportation
    4. being a member of the ethnic majority

Critical Thinking Questions

  1. People with psychological disorders have been treated poorly throughout history. Describe some efforts to improve treatment; include explanations for the success or lack thereof.
  2. Usually someone is hospitalised only if they are an imminent threat to themselves or others. Describe a situation that might meet these criteria.
  3. Imagine that you are a psychiatrist. Your patient, Pat, comes to you with the following symptoms: anxiety and feelings of sadness. Which therapeutic approach would you recommend and why?
  4. Compare and contrast individual and group therapies.
  5. You are conducting an intake assessment. Your client is a 45-year-old single, employed male with cocaine dependence. He failed a drug screen at work and is mandated to treatment by his employer if he wants to keep his job. Your client admits that he needs help. Why would you recommend group therapy for him?
  6. Lashawn is a 24-year-old African American female. For years she has been struggling with bulimia. She knows she has a problem, but she is not willing to seek mental health services. What are some reasons why she may be hesitant to get help?

Personal Application Questions

  1. Do you think there is a stigma associated with mentally ill persons today? Why or why not?
  2. What are some places in your community that offer mental health services? Would you feel comfortable seeking assistance at one of these facilities? Why or why not?
  3. If you were to choose a therapist practicing one of the techniques presented in this section, which kind of therapist would you choose and why?
  4. Your best friend tells you that they are concerned about their cousin. The cousin — a teenager — is constantly coming home after curfew, and your friend suspects that their cousin has been drinking. What treatment modality would you recommend to your friend and why?
  5. What are some substance-related and addictive disorder treatment facilities in your community, and what types of services do they provide? Would you recommend any of them to a friend or family member with a substance abuse problem? Why or why not?
  6. What is your attitude toward mental health treatment? Would you seek treatment if you were experiencing symptoms or having trouble functioning in your life? Why or why not? In what ways do you think your cultural and/or religious beliefs influence your attitude toward psychological intervention?

Review Question Answers

Multiple Choice Question Answers

  1. B
  2. A
  3. A
  4. C
  5. A
  6. C
  7. D
  8. C
  9. A
  10. A
  11. B
  12. D
  13. C
  14. D

Critical Thinking Question Answers

  1. Beginning in the Middle Ages and up until the mid-20th century, the mentally ill were misunderstood and treated cruelly. In the 1700s, Philippe Pinel advocated for patients to be unchained, and he was able to affect this in a Paris hospital. In the 1800s, Dorothea Dix urged the government to provide better funded and regulated care, which led to the creation of asylums, but treatment generally remained quite poor. Federally mandated deinstitutionalisation in the 1960s began the elimination of asylums, but it was often inadequate in providing the infrastructure for replacement treatment.
  2. Frank is severely depressed. He lost his job one year ago and has not been able to find another one. A few months after losing his job, his bank foreclosed on the mortgage on his home, and his wife left him. Lately, he has been thinking that he would be better off dead. He’s begun giving his possessions away and has purchased a handgun. He plans to kill himself on what would have been his 20th wedding anniversary, which is coming up in a few weeks.
  3. I would recommend psychodynamic talk therapy or cognitive therapy to help the person see how her thoughts and behaviours are having negative effects.
  4. In an individual therapy session, a client works one-on-one with a trained therapist. In group therapy, usually 5–10 people meet with a trained group therapist to discuss a common issue, such as divorce, grief, eating disorder, substance abuse, or anger management.
  5. The rationale behind using group therapy for addiction treatment is that addicts are much more likely to maintain sobriety when treatment is in a group format. It has been suggested that it’s due to the rewarding and therapeutic benefits of the group, such as support, affiliation, identification, and even confrontation. Because this client is single, he may not have family support, so support from the group may be even more important in his ability to recover and maintain his sobriety.
  6. One reason may be that her culture views having a mental illness as a stigma. Additionally, perhaps she doesn’t have insurance and is worried about the cost of therapy. She could also be afraid that a white counsellor would not understand her cultural background, so she would feel uncomfortable sharing things. Also, she may believe she is self-reliant and tell herself that she’s a strong woman who can fix this problem on her own without the help of a therapist.

Key Terms

Key Terms

  • asylum: institution created for the specific purpose of housing people with psychological disorders
  • aversive conditioning: counterconditioning technique that pairs an unpleasant stimulant with an undesirable behaviour
  • behaviour therapy: therapeutic orientation that employs principles of learning to help clients change undesirable behaviours
  • biomedical therapy: treatment that involves medication and/or medical procedures to treat psychological disorders
  • cognitive therapy: form of psychotherapy that focuses on how a person’s thoughts lead to feelings of distress, with the aim of helping them change these irrational thoughts
  • cognitive-behavioural therapy: form of psychotherapy that aims to change cognitive distortions and self-defeating behaviours
  • comorbid disorder: individual who has two or more diagnoses, which often includes a substance abuse diagnosis and another psychiatric diagnosis, such as depression, bipolar disorder, or schizophrenia
  • confidentiality: therapist cannot disclose confidential communications to any third party, unless mandated or permitted by law
  • counterconditioning: classical conditioning therapeutic technique in which a client learns a new response to a stimulus that has previously elicited an undesirable behaviour
  • couples therapy: two people in an intimate relationship who are having difficulties and are trying to resolve them with therapy
  • cultural competence: therapist’s understanding and attention to issues of race, culture, and ethnicity in providing treatment
  • deinstitutionalisation: process of closing large asylums and integrating people back into the community where they can be treated locally
  • dream analysis: technique in psychoanalysis in which patients recall their dreams and the psychoanalyst interprets them to reveal unconscious desires or struggles
  • electroconvulsive therapy (ECT): type of biomedical therapy that involves using an electrical current to induce seizures in a person to help alleviate the effects of severe depression
  • exposure therapy: counterconditioning technique in which a therapist seeks to treat a client’s fear or anxiety by presenting the feared object or situation with the idea that the person will eventually get used to it
  • family therapy: special form of group therapy consisting of one or more families
  • free association: technique in psychoanalysis in which the patient says whatever comes to mind at the moment
  • group therapy: treatment modality in which 5–10 people with the same issue or concern meet together with a trained clinician
  • humanistic therapy: therapeutic orientation aimed at helping people become more self-aware and accepting of themselves
  • individual therapy: treatment modality in which the client and clinician meet one-on-one
  • intake: therapist’s first meeting with the client in which the therapist gathers specific information to address the client’s immediate needs
  • involuntary treatment: therapy that is mandated by the courts or other systems
  • nondirective therapy: therapeutic approach in which the therapist does not give advice or provide interpretations but helps the person identify conflicts and understand feelings
  • play therapy: therapeutic process, often used with children, that employs toys to help them resolve psychological problems
  • psychoanalysis: therapeutic orientation developed by Sigmund Freud that employs free association, dream analysis, and transference to uncover repressed feelings
  • psychotherapy: (also, psychodynamic psychotherapy) psychological treatment that employs various methods to help someone overcome personal problems, or to attain personal growth
  • rational emotive therapy (RET): form of cognitive-behavioural therapy
  • relapse: repeated drug use and/or alcohol use after a period of improvement from substance abuse
  • Rogerian (client-centered therapy): non-directive form of humanistic psychotherapy developed by Carl Rogers that emphasises unconditional positive regard and self-acceptance
  • strategic family therapy: therapist guides the therapy sessions and develops treatment plans for each family member for specific problems that can be addressed in a short amount of time
  • structural family therapy: therapist examines and discusses with the family the boundaries and structure of the family: who makes the rules, who sleeps in the bed with whom, how decisions are made, and what are the boundaries within the family
  • systematic desensitisation: form of exposure therapy used to treat phobias and anxiety disorders by exposing a person to the feared object or situation through a stimulus hierarchy
  • token economy: controlled setting where individuals are reinforced for desirable behaviours with tokens (e.g., poker chip) that can be exchanged for items or privileges
  • transference: process in psychoanalysis in which the patient transfers all of the positive or negative emotions associated with the patient’s other relationships to the psychoanalyst
  • unconditional positive regard: fundamental acceptance of a person regardless of what they say or do; term associated with humanistic psychology
  • virtual reality exposure therapy: uses a simulation rather than the actual feared object or situation to help people conquer their fears
  • voluntary treatment: therapy that a person chooses to attend in order to obtain relief from her symptoms

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The reference list for this chapter has been excluded from this file to reduce page count. The full reference list can be viewed online at opentextbc.ca/psychologymtdi/chapter/treatment-chapter-resources/.

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Chapter Attribution

This chapter is largely based on the “Treatment” chapter in Introduction to Psychology & Neuroscience (2nd Edition) edited by Leanne Stevens, Jennifer Stamp, & Kevin LeBlanc, which is licensed under a CC BY 4.0 licence. It was adapted by Jessica Motherwell McFarlane to add some new resources and sections.

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Chapter Resources Copyright © 2024 by Leanne Stevens; Jennifer Stamp; Kevin LeBlanc (editors - original chapter); and Jessica Motherwell McFarlane (editor - adapted chapter) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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