Intro to Psychopathology & Psychotherapy

• Psychotherapy is defined as a relationship among persons where one individual needs special assistance to improve their functioning, and the other individual is able to render such help.
• Psychotherapy is also defined as the informed and intentional application of clinical methods and relationships derived from established psychological principles, for the purposes of assisting people to modify their behaviours, cognitions, emotions and/or other personal characteristics in directions that the participants deem desirable.
• Psychotherapy is a controlled act in Ontario since its delivery implies some risk
• Six regulatory colleges in Ontario are authorized to provide the controlled act of psychotherapy
• Questions as to what constitutes a life worth living have been discussed for centuries, originally belonging to the domains of philosophy and religion.
• In the past century, questions about human existence and how to best and most effectively live life have come to occupy a central place in psychotherapy.
• Each therapeutic approach has its own perspective on these central questions.
• Behaviorism heavily influenced the academic study of psychology; it had limited influence on psychotherapy until the 1960s.
• Carl Rogers’ client-centered therapy was the major alternative to psychoanalytic psychotherapy during the first 2 decades following World War II.
• In the 1950s, Rogers emphasized the therapeutic relationship as necessary and sufficient for facilitating positive change.
• Watson (1878 – 1958) repudiated the study of consciousness and the use of introspection.
• World War II transformed the field of psychology and psychotherapy, with an unprecedented number of traumatized soldiers changing the way psychiatrists understood psychological dysfunction.
• Clinical psychology established itself as a bona fide profession during the 1940s.
• Watson’s behaviorism argued that psychology should be a purely objective experimental branch of natural science focused on the prediction and control of behaviour.
• Rogers emphasized the therapy process over technique in the 1950s.
• Psychotherapy as a clinical method emerged around year 1900.
• Many of the basic principles of psychological treatments today evolved from Sigmund Freud’s (1856 - 1939) writings on psychoanalysis.
• Freud’s psychoanalytic theory emerged in the context of 19th century preoccupation with the development of rationality and science.
• Freud’s psychoanalytic theory focused on explaining the nature and workings of the human mind, and treating psychic ailments through self-analysis (introspection), observation, and case studies.
• Hundreds of empirical studies designed to compare the efficacy of one form of therapy with the efficacy of another showed that most evidence-based therapies demonstrate equivalent benefits.
• Eysenck’s findings were heavily criticized and later proved inaccurate, but contributed to the implementation of RCTs to study the efficacy of psychotherapy.
• Psychotherapy research began to focus heavily on determining which therapy approach was the most effective.
• By the 1980s, it became clear that Eysenck was wrong: psychotherapy has a positive effect for most recipients.
• Competition and rivalry increased among theoretical orientations, all vying to prove their approach was the most effective.
• Assumptions about what constitutes psychopathology frame how clinicians formulate cases and proceed to treat them.
• The 1960s saw incredible growth of psychotherapy and psychotherapy research, with the proliferation of therapy approaches.
• In the 1990s, procedures were established to provide criteria for efficacious treatments for specific disorders.
• Current trend in psychotherapy research recognizes the contributions of specific, common, and other factors to the change process in therapy.
• Most psychotherapists were being trained within three broad clinical approaches: psychodynamic, client centered, and behavioral.
• By the 1950s, there was a call to scientifically evaluate psychotherapy and its effects.
• Hans Eysenck, a prominent behaviorist, was a vocal opponent of traditional psychotherapy, publishing a review of the psychotherapy outcome literature in 1952 and concluding that there was no evidence that psychotherapy works.
• The 1970s marked a critical paradigm shift towards more intensive analyses and methodological pluralism in the study of psychotherapy.
• Psychopathology: the study of psychological dysfunction, including unusual or maladaptive behaviour.
• Each therapy approach contains a theory of psychopathology (i.e., what needs to change in the client).
• The APA began publishing a list of empirically supported treatments but the debate over what is considered “empirical support” continues…