Exam time:  9 am to noonExam day:  Wednesday, December 16Exam room: Jefferson Labs room 250

PLEASE COMPLETE THE ONLINECOURSE EVALUATION (CUE)

Before you leave for break

Psy 18 Final Exam

Last Meeting!!

TreatmentPreventionWrap-Up

Psychotherapy versus Drugs

• advantages of therapeutic relationship• addresses underlying issues• effects last longer• takes longer• dependent on skill of therapist• dependent on motivation of client

• quicker action• effective for biologically- based symptoms• less expensive• possibility of relapse when discontinued• side effects• possibility of dependence• does not address underlying issues

Psychotherapy Drugs

Therapeutic “Common factors”Richards & Richards (2006)

Establishing Positive expectancies: Empathy, warmth and genuineness;HopeNegotiation of goals GuidanceCommitmentTrust in therapistA “safe” placeForming an allianceFlexibility of responsiveness

Is Treatment Always Helpful?

• outcome studies: about 85% of patients are helped • between 5% and 10% deteriorate• OCD• Borderline PD• personality conflicts• sexual attraction• “bad” therapies

Evidence-Based Treatment

Randomized Controlled Trials (RTCs)

• outcome measures• placebos• “blindness”• standardization of treatment

(manualized therapies)• treatment bias• dropout bias

Internet-based Psychotherapy?

afterdeployment.org

Prevention

• emphasis on psychological health rather than disorder

• reduces suffering

• reduces expense

• improves global functioning

• increases self-efficacy in many areas of life

Levels of PreventionUniversal interventions• general population• healthy lifestyle programs• DARESelective interventions• specific subgroups at risk• Head StartIndicated interventions• individuals with subclinical signs and symptoms

Concluding Remarks

• Current state of psychopathology

• What I hope you have learned

Current State of Psychopathology

??

Carson 12

Predispositions to Depression Predispositions to Depression In 21In 21stst-Century-Century

• geneticsgenetics

• dietdiet

• pace of life ofpace of life of children and adultschildren and adults

• noisenoise

• ease of survivalease of survival

• indoor existenceindoor existence

• drug culturedrug culture

• Age of instant gratificationAge of instant gratification

• Age of InformationAge of Information

• de-emphasis on religionde-emphasis on religion

• loss of the extended familyloss of the extended family and the communityand the community

• divorce and loss of nuclear familydivorce and loss of nuclear family

• commercialism and the commercialism and the “ “more” mentalitymore” mentality

Carson 13

“Psychological Immunization” Against Depression

Cognitive Skills Problem-Solving Skills

• realistic optimism• self-acceptance and appreciation

• world view bigger than self

Emotional Regulation Social Skills

• positive coping strategies• stress management

• problem-solving• goal setting

• making good choices

• reflective listening• assertiveness

• empathy

Self-Care Skills

• nutrition• physical exercise

• rest• moderation

What I hope you have learned…