Abnormal Psychology

Discussion 1

In Reading #3 (ATTACHED) and the Lecture Notes, you learned about the different Theoretical Viewpoints on The Etiology of Mental Illness (e.g., Psychoanalytic, Behavioral, Cognitive, etc.). Which viewpoint do you think best explains the development of mental disorders? In 300-400 words

Introduction to Sociology

Response 1

Please respond to the following prompt in no less than 300-400 words. In your response, you must fully answer all aspects of the question and support your answer with reference to course materials (textbook, supplementary readings, videos, etc).

After reading about the history and development of sociology, 

1. How do you believe sociology fits in with other scientific disciplines? 

2. What makes sociology unique in the world of science and scientific research? 

3. How does it compare to other courses you’ve taken in disciplines, such as psychology, philosophy, and economics, that also study human life?

Response 2

Please respond to the following prompt in no less than 300-400 words. In your response, you must fully answer all aspects of the question and support your answer with reference to course materials (textbook, supplementary readings, videos, etc.).

Pick one of the sociological theories you’ve learned about in this unit. 

1. What are its core assumptions about how society and social life work? 

2. What are its strengths? its weaknesses? 

3. What makes it different from other theories you’ve learned about?

Juvenile Delinquency

Discussion 1

Read the Juvenile Population Characteristic’s sections.

View the Website https://www.ojjdp.gov/ojstatbb/population/overview.html (Links to an external site.) National Center for Juvenile Justice (n.d.) Juvenile Population overview and read through the Juvenile Population Characteristic’s sections.

In 3-4 paragraphs, 

1. Define juvenile delinquency. 

2. What is the nature of juvenile proceedings? 

3. Do you believe these proceedings are fair?

Discussion 2

In 3-4 paragraphs, explain the arrest and questioning procedures in regard to juveniles. 

· Should juveniles be treated differently in these types of situations? Cite sources

Course Syllabus: Introduction to Sociology

4000 Sunset Boulevard Approved by:

Steubenville, OH 43952

Telephone: (740) 264-5591 _____________________

Course Information
Course Title: Introduction to Sociology Credit Hours: 3	Course Number: SOC101

Course Description

This course introduces students to the scientific study of human group behavior. In so doing, it addresses the methods of scientific research, the nature and functioning of culture and society, the impact of the social environment on individual behavior, and the interrelationships among social institutions such as family, education, religion, economics and politics.

This course introduces you to sociology. That means that we will investigate both what it is to be sociological—that is, to understand the world with the benefit of sociological knowledge—and what it is to be a sociologist—that is, a person who acts within this particular discipline. In doing so, we will treat intra-disciplinary disagreements not as calls-to-arms in which we must choose sides, but rather opportunities to engage important social questions from multiple perspectives. We will discover the compelling tools that sociological training provides for interpreting the world, its history, and oneself in relation to it, and we will pay attention to the many ways in which the work of academic sociologists actually applies to our everyday lives.

Course Learning Outcomes

Since the social and cultural forces examined in the field of Sociology are at work in virtually all of our daily activities and experiences, all students will be expected to establish a basic working understanding of the language, principles and theories of sociology as applied to everyday human activities. Beyond establishing a basic knowledge of the field of sociology, the course will also address several of the following broader College-Wide Outcomes:

1. communication skill

2. information literacy

3. critical thinking skill

4. cultural and social literacy

The specific Course Outcomes, and their relationships to the College-Wide Outcomes are as follows:

1. Students must demonstrate, recall, comprehend and appropriate the use of the vocabulary of the field of sociology. (College-Wide Outcome: 1)

1. Students must demonstrate an understanding of the ways in which sociologists gather, interpret, and evaluate data, including both quantitative and qualitative methodologies. (College-Wide Outcomes: 3 and 4)

1. Students must demonstrate an understanding of the elements of social structure and the organization of society. (College-Wide Outcome: 4)

1. Students must understand the forces and dynamics at work in the “cultural civil war.” (College-Wide Outcome: 4)

1. Students must be conversant with the three major approaches present in sociology, their origins, and their impact on today’s societies. (College-Wide Outcome: 4)

1. Students must be conversant with the major sociological theories, their origins, and their socio-cultural impact. (College-Wide Outcome: 4)

1. Students must demonstrate ability to critically examine world and national events (as presented in broadcast/cable, on-line and print media) using sociological concepts. (College-Wide Outcomes: 2, 3 and 4)

Course Requirement

None

Important Information

Attendance and Academic Withdrawal

EGCC faculty report attendance for each in-seat session. Students in traditional face-to-face courses will be academically dropped from a course for never attending the first two weeks of the course meeting during the semester if they have not made prior arrangements with faculty. Students in online/hybrid courses will be academically dropped from courses for never participating (completing an assignment/discussion) in the first two weeks of the course meeting during the semester if they have not made prior arrangements with faculty. For specific information relevant to online students, please see the next section below.

In such cases, there will be no letter grade on the student’s transcript and the student’s class load will be reduced by the course credits, and this may affect his/her full-time or part-time student status. If a student has been dropped due to this attendance policy, the faculty may reinstate the student only if the faculty made a mistake or the student verifies extenuating circumstances beyond his/her control.

Students also may be academically withdrawn during the third through the tenth week of the semester for excessive, continuous or cumulative absences (one consecutive week of a course meeting time or five or more absences in a 10 week or less period of time).

A faculty member may choose to initiate the academic withdrawal for excessive, continuous, or cumulative absences if, as specified in the course syllabus, the minimum course objectives cannot be met due to the student’s excessive absences or lack of assignment completion in online/hybrid courses. Such action may be taken after the faculty member has attempted to notify the student on three different occasions by Early Alert, phone, email, mail, or in other courses that excessive absence has potentially placed the student in academic jeopardy. There is no forgiveness of tuition and fees for an academic withdrawal and the withdrawal will be recorded on the student’s transcript with a “W.” If the student has been withdrawn due to this attendance policy, the faculty may reinstate the student only if the faculty made a mistake or the student verifies extenuating circumstances beyond his/her control.

Attendance: Specific information for online students

The US Department of Education defines program integrity rules that involve tracking a student’s attendance in online classes. Eastern Gateway requires students to participate in all instructional activities as defined by the instructor of the course. Since these courses are fully online, participation is defined differently than in face-to-face classes.

Students who do not maintain active participation, as defined by the instructor of the course, will be dropped from the course and will receive an Instructor Withdrawal. This will affect your financial aid and scholarships.  As long as students meet all course work and attendance requirements as defined by each instructor, students will meet the online attendance requirements. It is the student’s responsibility to read the course syllabus, course messages, and course announcements and to be aware of the requirements for each class.

Attendance vs. Nonattendance Comparison

Attendance Activities	Nonattendance Activities
Adhering to due dates	Logging into the course
Participating in online discussion forums	Emailing classmates
Completing quizzes and tests by the deadline	Planning to complete all assessments at the end of the term
Assignment submission before or on due date	Reading course materials

At EGCC, the instructors will drop inactive students and note a last date of attendance. Attendance is not determined as the last day the student logged into the course. Logging in and out of a course does not constitute active participation. Students must complete work as defined by the instructor. Consult your course syllabus, messages, and announcements for your instructor’s attendance policy.

Students who do not participate in class, that is, who consistently do not complete assignments, quizzes, respond to forums or turn in other work, will be notified that they may be dropped or withdrawn from the class for non-participation.

Weekly attendance is mandatory in all online/hybrid courses. Students are expected to log into their online course(s) weekly. However, simply logging into an online course does not constitute attendance. Progress towards satisfactory completion of weekly assignments is expected on a weekly basis. No progress could jeopardize good standing and financial aid.

Academic and Student Integrity

Student integrity and scholastic honesty are an integral part of the College’s scholastic standard, academic quality, and a foundation for our society.

The College will not tolerate the breach of this integrity through cheating, plagiarism, or other forms of academic dishonesty. Faculty and staff will take precautions to prevent academic dishonesty, but it is also the student’s joint responsibility to report known infractions to any College employee. Infractions impact the final grade/GPA of all students as well as the reputation of the College and the value of the degree earned. Confirmed violations may result in a failing grade on an assignment(s) or in the course(s).

Repeated incidents of scholastic dishonesty or a flagrant single offense may warrant action beyond a failing grade in the course.

Offenses which may warrant additional disciplinary action including disciplinary probation, professional probation, suspension, or expulsion, include the following:

1. Cheating, plagiarism, or other forms of scholastic dishonesty, including the use, without permission, of tests or other academic material belonging to a member of the college faculty or staff.

2. Furnishing false information to the College with intent to deceive.

3. Forgery, alteration or misuse of College documents, records, or identification cards.

4. Misuse of computer privileges, including unauthorized use of software, an account number, password, program or file. (see Computer Use Procedure)

The student may appeal any actions affecting enrollment or grade using the Student Complaints/Appeals Process described in this catalog. Students should read the Academic Honesty and Student Integrity Policy posted on the College’s web site at www.egcc.edu.

Assessment Types

Student progress will be assessed in three ways:

1. Responses. Students are responsible for responding to readings and/or lectures via ten numbered “Response” assignments attached to each unit. For each Response, you may choose from a list of prompts. You must respond to one of these prompts in a substantial reflection of at least one full paragraph. Online students additionally must respond substantially to at least two other students’ Responses.

2. Midterm Exam. There will be one examination, to occur at midterms. Rather than factual recall, this test measures students’ ability to think carefully about the material.

3. Final Project. At the end of the semester, students will be responsible for a Final Project. The Final Project is an application of theories and concepts learned in the course to one of the specific applied areas of sociology described in the textbook but not covered during the first seven weeks. For in-seat students, the Final Project may take the form of a group presentation and/or an informal written review. For online students, the Final Project is due in the seventh week for 8-week classes and in the fifteenth week for 16-week classes.

Evaluation/Grading of Tasks

Students must complete all course components in order to pass the course. Failure to complete any assigned discussions, quizzes, or other assigned work may result in a failing grade no matter the point value of the assignment or the number of points accumulate.

Responses: 10 at 20 pts. each = 200 pts.

Midterm Exam = 100 pts.

Final Project: = 100 pts.

TOTAL: = 400 pts.

Grades

A: 90-100% B: 80-89% C: 70-79% D: 60-69% F: <60%

Course requirements are subject to change at the discretion of the instructor/college. Any change will be communicated to the class by the instructor. Lack of academic progress and absences may result in academic withdrawal from the college.

Textbook

WikiBooks. 2012. Introduction to Sociology. Retrieved from

https://www.oercommons.org/courses/introduction-to-sociology/view

.

The textbook and supplementary readings are embedded in the course.

NOBA

Therapeutic Orientations

Hannah Boettcher, Stefan G. Hofmann & Q. Jade Wu

In the past century, a number of psychotherapeutic orientations have gained popularity for
treating mental illnesses. This module outlines some of the best-known therapeutic
approaches and explains the history, techniques, advantages, and disadvantages associated
with each. The most effective modern approach is cognitive behavioral therapy (CBT). We also
discuss psychoanalytic therapy, person-centered therapy, and mindfulness-based
approaches. Drug therapy and emerging new treatment strategies will also be briefly explored.

Learning Objectives

• Become familiar with the most widely practiced approaches to psychotherapy.
• For each therapeutic approach, consider: history, goals, key techniques, and empirical

support.

• Consider the impact of emerging treatment strategies in mental health.

Introduction

The history of mental illness can be traced as far back as 1500 BCE, when the ancient Egyptians
noted cases of “distorted concentration” and “emotional distress in the heart or mind” (Nasser,
1987). Today, nearly half of all Americans will experience mental illness at some point in their
lives, and mental health problems affect more than one-quarter of the population in any given
year (Kessler et al., 2005). Fortunately, a range of psychotherapies exist to treat mental

illnesses. This module provides an overview of some of the best-known schools of thought in
psychotherapy. Currently, the most effective approach is called

Cognitive Behavioral Therapy

(CBT); however, other approaches, such as psychoanalytic therapy, person-centered therapy,
and mindfulness-based therapies are also used—though the effectiveness of these
treatments aren’t as clear as they are for CBT. Throughout this module, note the advantages
and disadvantages of each approach, paying special attention to their support by empirical
research.

Psychoanalysis and Psychodynamic Therapy

The earliest organized therapy for mental disorders was psychoanalysis. Made famous in the
early 20th century by one of the best-known clinicians of all time, Sigmund Freud, this approach
stresses that mental health problems are rooted in unconscious conflicts and desires. In order
to resolve the mental illness, then, these unconscious struggles must be identified and
addressed. Psychoanalysis often does this through exploring one’s early childhood
experiences that may have continuing repercussions on one’s mental health in the present
and later in life. Psychoanalysis is an intensive, long-term approach in which patients and

CBT is an approach to treating mental illness that involves work with a therapist as well

as homework assignments between sessions. It has proven to be very effective for

virtually all psychiatric illnesses. [Image: DFAT, https://goo.gl/bWmzaa, CC BY 2.0, https://

goo.gl/BRvSA7]

Therapeutic Orientations 2

therapists may meet multiple times per week, often for many years.

History of Psychoanalytic Therapy

Freud initially suggested that mental health problems arise from efforts to push inappropriate
sexual urges out of conscious awareness (Freud, 1895/1955). Later, Freud suggested more
generally that psychiatric problems are the result of tension between different parts of the
mind: the id, the superego, and the ego. In Freud’s structural model, the id represents pleasure-
driven unconscious urges (e.g., our animalistic desires for sex and aggression), while the
superego is the semi-conscious part of the mind where morals and societal judgment are
internalized (e.g., the part of you that automatically knows how society expects you to behave).
The ego—also partly conscious—mediates between the id and superego. Freud believed that
bringing unconscious struggles like these (where the id demands one thing and the superego
another) into conscious awareness would relieve the stress of the conflict (Freud, 1920/1955)
—which became the goal of psychoanalytic therapy.

Although psychoanalysis is still practiced today, it has largely been replaced by the more
broadly defined psychodynamic therapy. This latter approach has the same basic tenets as
psychoanalysis, but is briefer, makes more of an effort to put clients in their social and

interpersonal context, and focuses more
on relieving psychological distress than on
changing the person.

Techniques in Psychoanalysis

Psychoanalysts and psychodynamic therapists
employ several techniques to explore
patients’ unconscious mind. One common
technique is called free association. Here,
the patient shares any and all thoughts that
come to mind, without attempting to
organize or censor them in any way. For
example, if you took a pen and paper and
just wrote down whatever came into your
head, letting one thought lead to the next
without allowing conscious criticism to
shape what you were writing, you would be
doing free association. The analyst then

Building on the work of Josef Breuer and others, Sigmund Freud

developed psychotherapeutic theories and techniques that

became widely known as psychoanalysis or psychoanalytic

therapy. [Image: CC0

Public Domain, https://goo.gl/m25gce]

Therapeutic Orientations 3

uses his or her expertise to discern patterns or underlying meaning in the patient’s thoughts.

Sometimes, free association exercises are applied specifically to childhood recollections. That
is, psychoanalysts believe a person’s childhood relationships with caregivers often determine
the way that person relates to others, and predicts later psychiatric difficulties. Thus, exploring
these childhood memories, through free association or otherwise, can provide therapists with
insights into a patient’s psychological makeup.

Because we don’t always have the ability to consciously recall these deep memories,
psychoanalysts also discuss their patients’ dreams. In Freudian theory, dreams contain not
only manifest (or literal) content, but also latent (or symbolic) content (Freud, 1900; 1955). For
example, someone may have a dream that his/her teeth are falling out—the manifest or actual
content of the dream. However, dreaming that one’s teeth are falling out could be a reflection
of the person’s unconscious concern about losing his or her physical attractiveness—the latent
or metaphorical content of the dream. It is the therapist’s job to help discover the latent
content underlying one’s manifest content through dream analysis.

In psychoanalytic and psychodynamic therapy, the therapist plays a receptive role—
interpreting the patient’s thoughts and behavior based on clinical experience and
psychoanalytic theory. For example, if during therapy a patient begins to express unjustified
anger toward the therapist, the therapist may recognize this as an act of transference. That is,
the patient may be displacing feelings for people in his or her life (e.g., anger toward a parent)
onto the therapist. At the same time, though, the therapist has to be aware of his or her own
thoughts and emotions, for, in a related process, called countertransference, the therapist may
displace his/her own emotions onto the patient.

The key to psychoanalytic theory is to have patients uncover the buried, conflicting content
of their mind, and therapists use various tactics—such as seating patients to face away from
them—to promote a freer self-disclosure. And, as a therapist spends more time with a patient,
the therapist can come to view his or her relationship with the patient as another reflection
of the patient’s mind.

Advantages and Disadvantages of Psychoanalytic Therapy

Psychoanalysis was once the only type of psychotherapy available, but presently the number
of therapists practicing this approach is decreasing around the world. Psychoanalysis is not
appropriate for some types of patients, including those with severe psychopathology or
mental retardation. Further, psychoanalysis is often expensive because treatment usually

Therapeutic Orientations 4

lasts many years. Still, some patients and therapists find the prolonged and detailed analysis
very rewarding.

Perhaps the greatest disadvantage of psychoanalysis and related approaches is the lack of
empirical support for their effectiveness. The limited research that has been conducted on
these treatments suggests that they do not reliably lead to better mental health outcomes (e.
g., Driessen et al., 2010). And, although there are some reviews that seem to indicate that
long-term psychodynamic therapies might be beneficial (e.g., Leichsenring & Rabung, 2008),
other researchers have questioned the validity of these reviews. Nevertheless, psychoanalytic
theory was history’s first attempt at formal treatment of mental illness, setting the stage for
the more modern approaches used today.

Humanistic and Person-Centered Therapy

One of the next developments in therapy for mental illness, which arrived in the mid-20th
century, is called humanistic or person-centered therapy (PCT). Here, the belief is that mental
health problems result from an inconsistency between patients’ behavior and their true
personal identity. Thus, the goal of PCT is to create conditions under which patients can
discover their self-worth, feel comfortable exploring their own identity, and alter their behavior
to better reflect this identity.

History of Person-Centered Therapy

PCT was developed by a psychologist
named Carl Rogers, during a time of
significant growth in the movements of
humanistic theory and human potential.
These perspectives were based on the
idea that humans have an inherent drive
to realize and express their own
capabilities and creativity. Rogers, in
particular, believed that all people have
the potential to change and improve, and
that the role of therapists is to foster self-
understanding in an environment where
adaptive change is most likely to occur
(Rogers, 1951). Rogers suggested that the
therapist and patient must engage in a

The quality of the relationship between therapist and patient is

of great importance in person-centered therapy. [Image: CC0

Public Domain, https://goo.gl/m25gce]

Therapeutic Orientations 5

genuine, egalitarian relationship in which the therapist is nonjudgmental and empathetic. In
PCT, the patient should experience both a vulnerability to anxiety, which motivates the desire
to change, and an appreciation for the therapist’s support.

Techniques in Person-Centered Therapy

Humanistic and person-centered therapy, like psychoanalysis, involves a largely unstructured
conversation between the therapist and the patient. Unlike psychoanalysis, though, a therapist
using PCT takes a passive role, guiding the patient toward his or her own self-discovery.
Rogers’s original name for PCT was non-directive therapy, and this notion is reflected in the
flexibility found in PCT. Therapists do not try to change patients’ thoughts or behaviors directly.
Rather, their role is to provide the therapeutic relationship as a platform for personal growth.
In these kinds of sessions, the therapist tends only to ask questions and doesn’t provide any
judgment or interpretation of what the patient says. Instead, the therapist is present to provide
a safe and encouraging environment for the person to explore these issues for him- or herself.

An important aspect of the PCT relationship is the therapist’s unconditional positive regard
for the patient’s feelings and behaviors. That is, the therapist is never to condemn or criticize
the patient for what s/he has done or thought; the therapist is only to express warmth and
empathy. This creates an environment free of approval or disapproval, where patients come
to appreciate their value and to behave in ways that are congruent with their own identity.

Advantages and Disadvantages of Person-Centered Therapy

One key advantage of person-centered therapy is that it is highly acceptable to patients. In
other words, people tend to find the supportive, flexible environment of this approach very
rewarding. Furthermore, some of the themes of PCT translate well to other therapeutic
approaches. For example, most therapists of any orientation find that clients respond well to
being treated with nonjudgmental empathy. The main disadvantage to PCT, however, is that
findings about its effectiveness are mixed. One possibility for this could be that the treatment
is primarily based on unspecific treatment factors. That is, rather than using therapeutic
techniques that are specific to the patient and the mental problem (i.e., specific treatment
factors), the therapy focuses on techniques that can be applied to anyone (e.g., establishing
a good relationship with the patient) (Cuijpers et al., 2012; Friedli, King, Lloyd, & Horder, 1997).
Similar to how “one-size-fits-all” doesn’t really fit every person, PCT uses the same practices
for everyone, which may work for some people but not others. Further research is necessary
to evaluate its utility as a therapeutic approach.

Therapeutic Orientations 6

Cognitive Behavioral Therapy

Although both psychoanalysis and PCT are still used today, another therapy, cognitive-
behavioral therapy (CBT), has gained more widespread support and practice. CBT refers to
a family of therapeutic approaches whose goal is to alleviate psychological symptoms by
changing their underlying cognitions and behaviors. The premise of CBT is that thoughts,
behaviors, and emotions interact and contribute to various mental disorders. For example,
let’s consider how a CBT therapist would view a patient who compulsively washes her hands
for hours every day. First, the therapist would identify the patient’s maladaptive thought: “If
I don’t wash my hands like this, I will get a disease and die.” The therapist then identifies how
this maladaptive thought leads to a maladaptive emotion: the feeling of anxiety when her
hands aren’t being washed. And finally, this maladaptive emotion leads to the maladaptive
behavior: the patient washing her hands for hours every day.

CBT is a present-focused therapy (i.e., focused on the “now” rather than causes from the past,
such as childhood relationships) that uses behavioral goals to improve one’s mental illness.
Often, these behavioral goals involve between-session homework assignments. For example,
the therapist may give the hand-washing patient a worksheet to take home; on this worksheet,
the woman is to write down every time she feels the urge to wash her hands, how she deals
with the urge, and what behavior she replaces that urge with. When the patient has her next
therapy session, she and the therapist review her “homework” together. CBT is a relatively

Pattern of thoughts, feelings, and behaviors addressed through cognitive-

behavioral therapy.

Therapeutic Orientations 7

brief intervention of 12 to 16 weekly sessions, closely tailored to the nature of the
psychopathology and treatment of the specific mental disorder. And, as the empirical data
shows, CBT has proven to be highly efficacious for virtually all psychiatric illnesses (Hofmann,
Asnaani, Vonk, Sawyer, & Fang, 2012).

History of Cognitive Behavioral Therapy

CBT developed from clinical work conducted in the mid-20th century by Dr. Aaron T. Beck, a
psychiatrist, and Albert Ellis, a psychologist. Beck used the term automatic thoughts to refer
to the thoughts depressed patients report experiencing spontaneously. He observed that
these thoughts arise from three belief systems, or schemas: beliefs about the self, beliefs
about the world, and beliefs about the future. In treatment, therapy initially focuses on
identifying automatic thoughts (e.g., “If I don’t wash my hands constantly, I’ll get a disease”),
testing their validity, and replacing maladaptive thoughts with more adaptive thoughts (e.g.,
“Washing my hands three times a day is sufficient to prevent a disease”). In later stages of
treatment, the patient’s maladaptive schemas are examined and modified. Ellis (1957) took
a comparable approach, in what he called rational-emotive-behavioral therapy (REBT), which
also encourages patients to evaluate their own thoughts about situations.

Techniques in CBT

Beck and Ellis strove to help patients identify maladaptive appraisals, or the untrue judgments
and evaluations of certain thoughts. For example, if it’s your first time meeting new people,
you may have the automatic thought, “These people won’t like me because I have nothing
interesting to share.” That thought itself is not what’s troublesome; the appraisal (or
evaluation) that it might have merit is what’s troublesome. The goal of CBT is to help people
make adaptive, instead of maladaptive, appraisals (e.g., “I do know interesting things!”). This
technique of reappraisal, or cognitive restructuring, is a fundamental aspect of CBT. With
cognitive restructuring, it is the therapist’s job to help point out when a person has an
inaccurate or maladaptive thought, so that the patient can either eliminate it or modify it to
be more adaptive.

In addition to thoughts, though, another important treatment target of CBT is maladaptive
behavior. Every time a person engages in maladaptive behavior (e.g., never speaking to
someone in new situations), he or she reinforces the validity of the maladaptive thought, thus
maintaining or perpetuating the psychological illness. In treatment, the therapist and patient
work together to develop healthy behavioral habits (often tracked with worksheet-like
homework), so that the patient can break this cycle of maladaptive thoughts and behaviors.

Therapeutic Orientations 8

For many mental health problems, especially anxiety disorders, CBT incorporates what is
known as exposure therapy. During exposure therapy, a patient confronts a problematic
situation and fully engages in the experience instead of avoiding it. For example, imagine a
man who is terrified of spiders. Whenever he encounters one, he immediately screams and
panics. In exposure therapy, the man would be forced to confront and interact with spiders,
rather than simply avoiding them as he usually does. The goal is to reduce the fear associated
with the situation through extinction learning, a neurobiological and cognitive process by which
the patient “unlearns” the irrational fear. For example, exposure therapy for someone terrified
of spiders might begin with him looking at a cartoon of a spider, followed by him looking at
pictures of real spiders, and later, him handling a plastic spider. After weeks of this incremental
exposure, the patient may even be able to hold a live spider. After repeated exposure (starting
small and building one’s way up), the patient experiences less physiological fear and
maladaptive thoughts about spiders, breaking his tendency for anxiety and subsequent
avoidance.

Advantages and Disadvantages of CBT

CBT interventions tend to be relatively brief, making them cost-effective for the average
consumer. In addition, CBT is an intuitive treatment that makes logical sense to patients. It
can also be adapted to suit the needs of many different populations. One disadvantage,
however, is that CBT does involve significant effort on the patient’s part, because the patient
is an active participant in treatment. Therapists often assign “homework” (e.g., worksheets
for recording one’s thoughts and behaviors) between sessions to maintain the cognitive and
behavioral habits the patient is working on. The greatest strength of CBT is the abundance of
empirical support for its effectiveness. Studies have consistently found CBT to be equally or
more effective than other forms of treatment, including medication and other therapies
(Butler, Chapman, Forman, & Beck, 2006; Hofmann et al., 2012). For this reason, CBT is
considered a first-line treatment for many mental disorders.

——————————————————————————————————————————————————

Focus Topic: Pioneers of CBT

The central notion of CBT is the idea that a person’s behavioral and emotional responses are
causally influenced by one’s thinking. The stoic Greek philosopher Epictetus is quoted as
saying, “men are not moved by things, but by the view they take of them.” Meaning, it is not
the event per se, but rather one’s assumptions (including interpretations and perceptions) of
the event that are responsible for one’s emotional response to it. Beck calls these assumptions

Therapeutic Orientations 9

about events and situations automatic thoughts (Beck, 1979), whereas Ellis (1962) refers to
these assumptions as self-statements. The cognitive model assumes that these cognitive
processes cause the emotional and behavioral responses to events or stimuli. This causal
chain is illustrated in Ellis’s ABC model, in which A stands for the antecedent event, B stands
for belief, and C stands for consequence. During CBT, the person is encouraged to carefully
observe the sequence of events and the response to them, and then explore the validity of
the underlying beliefs through behavioral experiments and reasoning, much like a detective
or scientist.

——————————————————————————————————————————————————

Acceptance and Mindfulness-Based Approaches

Unlike the preceding therapies, which were developed in the 20th century, this next one was
born out of age-old Buddhist and yoga practices. Mindfulness, or a process that tries to
cultivate a nonjudgmental, yet attentive, mental state, is a therapy that focuses on one’s
awareness of bodily sensations, thoughts, and the outside environment. Whereas other
therapies work to modify or eliminate these sensations and thoughts, mindfulness focuses
on nonjudgmentally accepting them (Kabat-Zinn, 2003; Baer, 2003). For example, whereas
CBT may actively confront and work to change a maladaptive thought, mindfulness therapy
works to acknowledge and accept the thought, understanding that the thought is spontaneous
and not what the person truly believes. There are two important components of mindfulness:
(1) self-regulation of attention, and (2) orientation toward the present moment (Bishop et al.,
2004). Mindfulness is thought to improve mental health because it draws attention away from
past and future stressors, encourages acceptance of troubling thoughts and feelings, and
promotes physical relaxation.

Techniques in Mindfulness-Based Therapy

Psychologists have adapted the practice of mindfulness as a form of psychotherapy, generally
called mindfulness-based therapy (MBT). Several types of MBT have become popular in recent
years, including mindfulness-based stress reduction (MBSR) (e.g., Kabat-Zinn, 1982) and
mindfulness-based cognitive therapy (MBCT) (e.g., Segal, Williams, & Teasdale, 2002).

MBSR uses meditation, yoga, and attention to physical experiences to reduce stress. The hope
is that reducing a person’s overall stress will allow that person to more objectively evaluate
his or her thoughts. In MBCT, rather than reducing one’s general stress to address a specific
problem, attention is focused on one’s thoughts and their associated emotions. For example,

Therapeutic Orientations 10

MBCT helps prevent relapses in depression
by encouraging patients to evaluate their
own thoughts objectively and without
value judgment (Baer, 2003). Although
cognitive behavioral therapy (CBT) may
seem similar to this, it focuses on “pushing
out” the maladaptive thought, whereas
mindfulness-based cognitive therapy focuses
on “not getting caught up” in it. The
treatments used in MBCT have been used
to address a wide range of illnesses,
including depression, anxiety, chronic pain,
coronary artery disease, and fibromyalgia
(Hofmann, Sawyer, Witt & Oh, 2010).

Mindfulness and acceptance—in addition
to being therapies in their own right—have
also been used as “tools” in other cognitive-

behavioral therapies, particularly in dialectical behavior therapy (DBT) (e.g., Linehan,
Amstrong, Suarez, Allmon, & Heard, 1991). DBT, often used in the treatment of borderline
personality disorder, focuses on skills training. That is, it often employs mindfulness and
cognitive behavioral therapy practices, but it also works to teach its patients “skills” they can
use to correct maladaptive tendencies. For example, one skill DBT teaches patients is called
distress tolerance—or, ways to cope with maladaptive thoughts and emotions in the moment.
For example, people who feel an urge to cut themselves may be taught to snap their arm with
a rubber band instead. The primary difference between DBT and CBT is that DBT employs
techniques that address the symptoms of the problem (e.g., cutting oneself) rather than the
problem itself (e.g., understanding the psychological motivation to cut oneself). CBT does not
teach such skills training because of the concern that the skills—even though they may help
in the short-term—may be harmful in the long-term, by maintaining maladaptive thoughts
and behaviors.

DBT is founded on the perspective of a dialectical worldview. That is, rather than thinking of
the world as “black and white,” or “only good and only bad,” it focuses on accepting that some
things can have characteristics of both “good” and “bad.” So, in a case involving maladaptive
thoughts, instead of teaching that a thought is entirely bad, DBT tries to help patients be less
judgmental of their thoughts (as with mindfulness-based therapy) and encourages change
through therapeutic progress, using cognitive-behavioral techniques as well as mindfulness

One of the most important advantages of mindfulness based

therapy is its level of accessibility to patients. [Image: Wayne

MacPhail, https://goo.gl/aSZanf, CC BY-NC SA 2.0, https://goo.gl/

Toc0ZF]

Therapeutic Orientations 11

exercises.

Another form of treatment that also uses mindfulness techniques is acceptance and
commitment therapy (ACT) (Hayes, Strosahl, & Wilson, 1999). In this treatment, patients are
taught to observe their thoughts from a detached perspective (Hayes et al., 1999). ACT
encourages patients not to attempt to change or avoid thoughts and emotions they observe
in themselves, but to recognize which are beneficial and which are harmful. However, the
differences among ACT, CBT, and other mindfulness-based treatments are a topic of
controversy in the current literature.

Advantages and Disadvantages of Mindfulness-Based Therapy

Two key advantages of mindfulness-based therapies are their acceptability and accessibility
to patients. Because yoga and meditation are already widely known in popular culture,
consumers of mental healthcare are often interested in trying related psychological therapies.
Currently, psychologists have not come to a consensus on the efficacy of MBT, though growing
evidence supports its effectiveness for treating mood and anxiety disorders. For example,
one review of MBT studies for anxiety and depression found that mindfulness-based
interventions generally led to moderate symptom improvement (Hofmann et al., 2010).

Emerging Treatment Strategies

With growth in research and technology,
psychologists have been able to develop
new treatment strategies in recent years.
Often, these approaches focus on
enhancing existing treatments, such as
cognitive-behavioral therapies, through
the use of technological advances. For
example, internet- and mobile-delivered
therapies make psychological treatments
more available, through smartphones and
online access. Clinician-supervised online
CBT modules allow patients to access
treatment from home on their own
schedule—an opportunity particularly
important for patients with less geographic
or socioeconomic access to traditional

Recent improvements in video chat technology along with the

proliferation of mobile devices like smartphones and tablets has

made online delivery of therapy more commonplace. [Image:

Noba, CC BY 2.0, https://goo.gl/BRvSA7]

Therapeutic Orientations 12

treatments. Furthermore, smartphones help extend therapy to patients’ daily lives, allowing
for symptom tracking, homework reminders, and more frequent therapist contact.

Another benefit of technology is cognitive bias modification. Here, patients are given
exercises, often through the use of video games, aimed at changing their problematic thought
processes. For example, researchers might use a mobile app to train alcohol abusers to avoid
stimuli related to alcohol. One version of this game flashes four pictures on the screen—three
alcohol cues (e.g., a can of beer, the front of a bar) and one health-related image (e.g., someone
drinking water). The goal is for the patient to tap the healthy picture as fast as s/he can. Games
like these aim to target patients’ automatic, subconscious thoughts that may be difficult to
direct through conscious effort. That is, by repeatedly tapping the healthy image, the patient
learns to “ignore” the alcohol cues, so when those cues are encountered in the environment,
they will be less likely to trigger the urge to drink. Approaches like these are promising because
of their accessibility, however they require further research to establish their effectiveness.

Yet another emerging treatment employs CBT-enhancing pharmaceutical agents. These are
drugs used to improve the effects of therapeutic interventions. Based on research from animal
experiments, researchers have found that certain drugs influence the biological processes
known to be involved in learning. Thus, if people take these drugs while going through
psychotherapy, they are better able to “learn” the techniques for improvement. For example,
the antibiotic d-cycloserine improves treatment for anxiety disorders by facilitating the
learning processes that occur during exposure therapy. Ongoing research in this exciting area
may prove to be quite fruitful.

Pharmacological Treatments

Up until this point, all the therapies we have discussed have been talk-based or meditative
practices. However, psychiatric medications are also frequently used to treat mental disorders,
including schizophrenia, bipolar disorder, depression, and anxiety disorders. Psychiatric drugs
are commonly used, in part, because they can be prescribed by general medical practitioners,
whereas only trained psychologists are qualified to deliver effective psychotherapy. While
drugs and CBT therapies tend to be almost equally effective, choosing the best intervention
depends on the disorder and individual being treated, as well as other factors—such as
treatment availability and comorbidity (i.e., having multiple mental or physical disorders at
once). Although many new drugs have been introduced in recent decades, there is still much
we do not understand about their mechanism in the brain. Further research is needed to
refine our understanding of both pharmacological and behavioral treatments before we can
make firm claims about their effectiveness.

Therapeutic Orientations 13

Integrative and Eclectic Psychotherapy

In discussing therapeutic orientations, it is important to note that some clinicians incorporate
techniques from multiple approaches, a practice known as integrative or eclectic
psychotherapy. For example, a therapist may employ distress tolerance skills from DBT (to
resolve short-term problems), cognitive reappraisal from CBT (to address long-standing
issues), and mindfulness-based meditation from MBCT (to reduce overall stress). And, in fact,
between 13% and 42% of therapists have identified their own approaches as integrative or
eclectic (Norcross & Goldfried, 2005).

Conclusion

Throughout human history we have had to deal with mental illness in one form or another.
Over time, several schools of thought have emerged for treating these problems. Although
various therapies have been shown to work for specific individuals, cognitive behavioral
therapy is currently the treatment most widely supported by empirical research. Still, practices
like psychodynamic therapies, person-centered therapy, mindfulness-based treatments, and
acceptance and commitment therapy have also shown success. And, with recent advances in
research and technology, clinicians are able to enhance these and other therapies to treat
more patients more effectively than ever before. However, what is important in the end is
that people actually seek out mental health specialists to help them with their problems. One
of the biggest deterrents to doing so is that people don’t understand what psychotherapy
really entails. Through understanding how current practices work, not only can we better
educate people about how to get the help they need, but we can continue to advance our
treatments to be more effective in the future.

Therapeutic Orientations 14

Outside Resources

Article: A personal account of the benefits of mindfulness-based therapy
https://www.theguardian.com/lifeandstyle/2014/jan/11/julie-myerson-mindfulness-based-cognitive-therapy

Article: The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-
Analytic Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848393/

Video: An example of a person-centered therapy session.

Video: Carl Rogers, the founder of the humanistic, person-centered approach to
psychology, discusses the position of the therapist in PCT.

Video: CBT (cognitive behavioral therapy) is one of the most common treatments for a
range of mental health problems, from anxiety, depression, bipolar, OCD or schizophrenia.
This animation explains the basics and how you can decide whether it’s best for you or not.

Web: An overview of the purpose and practice of cognitive behavioral therapy (CBT)
http://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/

Web: The history and development of psychoanalysis
http://www.freudfile.org/psychoanalysis/history.html

Discussion Questions

1. Psychoanalytic theory is no longer the dominant therapeutic approach, because it lacks
empirical support. Yet many consumers continue to seek psychoanalytic or psychodynamic
treatments. Do you think psychoanalysis still has a place in mental health treatment? If so,
why?

2. What might be some advantages and disadvantages of technological advances in
psychological treatment? What will psychotherapy look like 100 years from now?

3. Some people have argued that all therapies are about equally effective, and that they all

Therapeutic Orientations 15

affect change through common factors such as the involvement of a supportive therapist.
Does this claim sound reasonable to you? Why or why not?

4. When choosing a psychological treatment for a specific patient, what factors besides the
treatment’s demonstrated efficacy should be taken into account?

Therapeutic Orientations 16

Vocabulary

Acceptance and commitment therapy
A therapeutic approach designed to foster nonjudgmental observation of one’s own mental
processes.

Automatic thoughts
Thoughts that occur spontaneously; often used to describe problematic thoughts that
maintain mental disorders.

Cognitive bias modification
Using exercises (e.g., computer games) to change problematic thinking habits.

Cognitive-behavioral therapy (CBT)
A family of approaches with the goal of changing the thoughts and behaviors that influence
psychopathology.

Comorbidity
Describes a state of having more than one psychological or physical disorder at a given time.

Dialectical behavior therapy (DBT)
A treatment often used for borderline personality disorder that incorporates both cognitive-
behavioral and mindfulness elements.

Dialectical worldview
A perspective in DBT that emphasizes the joint importance of change and acceptance.

Exposure therapy
A form of intervention in which the patient engages with a problematic (usually feared)
situation without avoidance or escape.

Free association
In psychodynamic therapy, a process in which the patient reports all thoughts that come to
mind without censorship, and these thoughts are interpreted by the therapist.

Integrative ​or eclectic psychotherapy​
Also called integrative psychotherapy, this term refers to approaches combining multiple
orientations (e.g., CBT with psychoanalytic elements).

Therapeutic Orientations 17

Integrative or ​eclectic psychotherapy
Also called integrative psychotherapy, this term refers to approaches combining multiple
orientations (e.g., CBT with psychoanalytic elements).

Mindfulness
A process that reflects a nonjudgmental, yet attentive, mental state.

Mindfulness-based therapy
A form of psychotherapy grounded in mindfulness theory and practice, often involving
meditation, yoga, body scan, and other features of mindfulness exercises.

Person-centered therapy
A therapeutic approach focused on creating a supportive environment for self-discovery.

Psychoanalytic therapy
Sigmund Freud’s therapeutic approach focusing on resolving unconscious conflicts.

Psychodynamic therapy
Treatment applying psychoanalytic principles in a briefer, more individualized format.

Reappraisal, or ​Cognitive restructuring
The process of identifying, evaluating, and changing maladaptive thoughts in psychotherapy.

Schema
A mental representation or set of beliefs about something.

Unconditional positive regard
In person-centered therapy, an attitude of warmth, empathy and acceptance adopted by the
therapist in order to foster feelings of inherent worth in the patient.

Therapeutic Orientations 18

References

Baer, R. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical
review. Clinical Psychology: Science and Practice, 10, 125–143.

Beck, A. T. (1979). Cognitive therapy and the emotional disorders. New York, NY: New American
Library/Meridian.

Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey,
S., Speca, M., Velting, D., & Devins, G. (2004). Mindfulness: A proposed operational definition.
Clinical Psychology: Science and Practice, 11, 230–241.

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive
behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31.

Cuijpers, P., Driessen, E., Hollon, S.D., van Oppen, P., Barth, J., & Andersson, G. (2012). The
efficacy of non-directive supportive therapy for adult depression: A meta-analysis. Clinical
Psychology Review, 32, 280–291.

Driessen, E., Cuijpers, P., de Maat, S. C. M., Abbass, A. A., de Jonghe, F., & Dekker, J. J. M. (2010).
The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis.
Clinical Psychology Review, 30, 25–36.

Ellis, A. (1962). Reason and emotion in psychotherapy. New York, NY: Lyle Stuart.

Ellis, A. (1957). Rational psychotherapy and individual psychology. Journal of Individual
Psychology, 13, 38–44.

Freud, S. (1955). The interpretation of dreams. London, UK: Hogarth Press (Original work
published 1900).

Freud, S. (1955). Studies on hysteria. London, UK: Hogarth Press (Original work published 1895).

Freud. S. (1955). Beyond the pleasure principle. H London, UK: Hogarth Press (Original work
published 1920).

Friedli, K., King, M. B., Lloyd, M., & Horder, J. (1997). Randomized controlled assessment of
non-directive psychotherapy versus routine general-practitioner care. Lancet, 350,\\n1662–
1665.

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy. New\\
nYork, NY: Guilford Press.

Hofmann, S. G., Asnaani, A., Vonk, J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive
behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36, 427–440.

Hofmann, S. G., Sawyer, A. T., Witt, A., & Oh, D. (2010). The effect of mindfulness-based therapy
on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical

Therapeutic Orientations 19

Psychology, 78, 169–183

Kabat-Zinn J. (2003). Mindfulness-based interventions in context: Past, present, and future.
Clinical Psychology: Science and Practice, 10, 144–156.

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients\\
nbased on the practice of mindfulness meditation: Theoretical considerations and
preliminary results. General Hospital Psychiatry, 4, 33–47.

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime
prevalence and age of onset distribution of DSM-IV disorders in the National Comorbidity
Survey Replication. Archives of General Psychiatry, 62, 593–602.

Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic
psychotherapy: A meta-analysis. Journal of the American Medical Association, 300,1551–1565.

Linehan, M. M., Amstrong, H.-E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-
behavioral treatment of chronically suicidal borderline patients. Archives of General
Psychiatry, 48, 1060–1064.

Nasser, M. (1987). Psychiatry in ancient Egypt. Bulletin of the Royal College of Psychiatrists, 11,
420-422.

Norcross, J. C. & Goldfried, M. R. (2005). Handbook of Psychotherapy Integration. New York, NY:
Oxford University Press.

Rogers, C. (1951). Client-Centered Therapy. Cambridge, MA: Riverside Press.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy\\nfor
Depression: A New Approach to Preventing Relapse. New York, NY: Guilford Press.

Therapeutic Orientations 20

About Noba

The Diener Education Fund (DEF) is a non-profit organization founded with the mission of re-
inventing higher education to serve the changing needs of students and professors. The initial
focus of the DEF is on making information, especially of the type found in textbooks, widely
available to people of all backgrounds. This mission is embodied in the Noba project.

Noba is an open and free online platform that provides high-quality, flexibly structured
textbooks and educational materials. The goals of Noba are three-fold:

• To reduce financial burden on students by providing access to free educational content
• To provide instructors with a platform to customize educational content to better suit their

curriculum

• To present material written by a collection of experts and authorities in the field

The Diener Education Fund is co-founded by Drs. Ed and Carol Diener. Ed is the Joseph Smiley
Distinguished Professor of Psychology (Emeritus) at the University of Illinois. Carol Diener is
the former director of the Mental Health Worker and the Juvenile Justice Programs at the
University of Illinois. Both Ed and Carol are award- winning university teachers.

Acknowledgements

The Diener Education Fund would like to acknowledge the following individuals and companies
for their contribution to the Noba Project: The staff of Positive Acorn, including Robert Biswas-
Diener as managing editor and Peter Lindberg as Project Manager; The Other Firm for user
experience design and web development; Sockeye Creative for their work on brand and
identity development; Arthur Mount for illustrations; Chad Hurst for photography; EEI
Communications for manuscript proofreading; Marissa Diener, Shigehiro Oishi, Daniel
Simons, Robert Levine, Lorin Lachs and Thomas Sander for their feedback and suggestions
in the early stages of the project.

Copyright

R. Biswas-Diener & E. Diener (Eds), Noba Textbook Series: Psychology. Champaign, IL: DEF
Publishers. DOI: nobaproject.com

Copyright © 2018 by Diener Education Fund. This material is licensed under the Creative
Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy
of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_US.

The Internet addresses listed in the text were accurate at the time of publication. The inclusion
of a Website does not indicate an endorsement by the authors or the Diener Education Fund,
and the Diener Education Fund does not guarantee the accuracy of the information presented
at these sites.

Contact Information:

Noba Project
2100 SE Lake Rd., Suite 5
Milwaukie, OR 97222
www.nobaproject.com
info@nobaproject.com

How to cite a Noba chapter using APA Style

Boettcher, H., Hofmann, S. G., & Wu, Q. J. (2013). Therapeutic orientations. In R. Biswas-Diener
& E. Diener (Eds), Noba textbook series: Psychology. Champaign, IL: DEF publishers. DOI:
nobaproject.com.

Therapeutic Orientations
Learning Objectives
 Introduction
Psychoanalysis and Psychodynamic Therapy
History of Psychoanalytic Therapy
Techniques in Psychoanalysis
Advantages and Disadvantages of Psychoanalytic Therapy
Humanistic and Person-Centered Therapy
History of Person-Centered Therapy
Techniques in Person-Centered Therapy
Advantages and Disadvantages of Person-Centered Therapy
Cognitive Behavioral Therapy
History of Cognitive Behavioral Therapy
Techniques in CBT
Advantages and Disadvantages of CBT
Acceptance and Mindfulness-Based Approaches
Techniques in Mindfulness-Based Therapy
Advantages and Disadvantages of Mindfulness-Based Therapy
Emerging Treatment Strategies
Pharmacological Treatments
Integrative and Eclectic Psychotherapy
Conclusion
Outside Resources
Discussion Questions
Vocabulary
References
About Noba
Acknowledgements
Copyright
How to cite a Noba chapter using APA Style