psyc 401 final!! ;_;

effect size in meta analysis

-convert findings of treatment studies into standard deviation units Mean (poster) - mean (pretreat) / (SD1 +SD2)/2 -reflects difference between treatment group and control group .80 = large .50 = moderate .20 small effect

efficacy of psychotherapy treatment

-effect size ~.75

contemporary psychodynamic or psychoanalytic psychotherapy

-focus not on impulse but on interpersonal or attachment styles -attempt to have people become aware of their interpersonal styles + their impact on others and themselves

behaviour and underlying therapy

-focus on changing observable behaviour through systematic applications of learning theory based ¥ underlying models of pathological behaviours emphasize learning > an inherent fault of oneself - ppl feel less stigmatized (client not learned something yet, so they can commit to alter behaviour) ¥ Two large groups ◦ 1. increase # of desirable behaviours (compliments made by spouse) ◦ 2. decrease number of undesirable behaviours (chronic nail biting) ¥ relational or associative learning - conscious and allows us to connect stimuli and behaviour that occur at same time; autobiographical knowledge (info bout our experiences), clinical - provides conscious memories a pt can retrieve and use to guide behaviour ¥ second major principle: link to treatment method to presumed type of learning that may represent etiology of presenting problem ◦ phobias due to classical conditioning ◦ lack of social skills - poor modelling or social avoidance (failure to obtain subsequent positive reinforcement from others with whom person interacts) ¥ modeling + positive reinforcement - ideal tools w/ which to teach new behaviours (building friendship), need to reduce undesirable behaviours is harder ◦ need to consider (ethical acceptability of treatment approach + availability of effective punishing methods and or reinforcers)

what is ethics

1. A system of moral principles; the ethics of a culture. 2. The analysis and determination of how people ought to act toward each other when judged against a set of values. 3. The branch of philosophy dealing with values relating to human conduct, with respect to the rightness and wrongness of certain actions and to the goodness and badness of the motives and ends of such actions.

10 step ethical decision making model

1. Who are the ppl potentially affected by decision 2. What are relevant, ethical issues/laws? Which ethical values & laws are in conflict 3. How do personal biases, stresses, or slef interest affect my choice of action 4. WHAT ARE MY POSSIBLE PLANS of actions a. Could tell parents, or can meet first 5. What are likely short term and long term risk and benefits of each possible actions 6. What is best course of action 7. Act on your first choice decision and assume responsibility for consequences 8. Carefully evaluate outcomes of your chosen course of action 9. Continue to accept responsbility, consider an alternative action if needed and correct any unforeseeable consequences 10. Taking steps to prevent similar problems in future

mature defenses

1. humor: finding comic/ironic elements in difficult situations to reduce unpleasant affect and personal discomfort - allows some distance and objectivity from events so that an imdivid can reflect n what is happening 2. suppression: consciously deciding not to attend to particular feelings, state, or impulse, defense differs from repression, denial in that it is conscious 3. asceticism: attempting to eliminate pleasurable aspects of experience bc internal conflicts produced by pleasure (spiritual goals) 4. alturism: committing onself to needs of others over and aove one's own - service of narcissitic problems too tho 5. anticipation: delaying immediate gratification by planning + thinking about future achievements and accomplishments 6. sublimation: transforming socially objectionable or internally unacceptable aims into socially acceptable ones

list of dysfunctional thinking pattern

1. labeling: using negatively toned word or label that you reflexively attach to certain problematic behaviours (i am such an idiot bc i forgot to update my phone) 2. discounting: selective attention such that you attend to problematic parts of situation 3. catastrophizing: anticipating worst outcome despite lack of evidence to support it 4. black & white thinking: overly categorical in one's thinking 5. fortune telling: making unjustified and untested forecasts 6. must or should statements: very rigid rules bat how other ppl are expected to behaviour + how terrible it is for these expectations to not have met 7. emotional reasoning: convincing yourself that just bc u feel or believe something, it is a fact 8. mind reading: u firmly believe u know what others are thinkingg altho person has not said anything -> non consideration of other possibilities + paralyze ppl

shelter that was then, this is now

1. misconception 2. not one psychoanalysis 3. major features a. unconscious -fundamental aspect of human behaviour b. Conflict -fundamental aspect too, notion that we feel or perceive or behave in competing fashions, we have conflicts -> approach/avoid at same time c. Past influences present - when ur a child u a learning machine d. Transference - u learn more about yourself e. Defense - keep aversive affect from overwhelming us i. Intellectualization (in students) - get information to solve problem f. Psychological causation

vehicles for change

1. obseration, interpretation & confrontation 2. transference 3. resistance

cpa code of ethics as umbrella documents

ethical principles (respect for dignity of persons) -> codes of conduct (informed consent) -> practice guidelines (i.e. speciality guidelines for forensic psyc)

personal conscience

even w/ above ordering of principles, psycs will be faced w/ ethical dilemmas that are difficult to resolve ● In these circumstances, psycs are expected to engage in ethical decision making process that is explicit enough to bear public scrutiny, resolution might be matter of personal conscience

article findings

how effective is psychotherapy in general • effect size - diff b/t treatment and control groups • 1.0 = one SD healthier than normal distribution or bell curve than avg untreated pt • large effect sizes w/ psychodynamic therapy how effective is psychodynamic therapy • consistent trend toward larger effect sizes at follow-up suggests that psychodynamic therapy sets in motion psychological processes that lead to ongoing change even after therapy has ended • 77.8% of reductions in health care utilization that were due to psychodynamic therapy • for pts w/ mixed/moderate pathology , pretreatment to posttreatment effect was 0.78 for general symptom improvement -> 0.94 at long term follow up w/ avg 3-5 yrs posttreatment • intrapsychic changes occurred in pts who received psychodynamic therapy but not in pts who received dialectical behaviour therapy • more outcome studes for CBT • many psychodynamic outcome studies have included pts w/ range of symptoms and conditions > specific diagnostic categories concern: psychotherapy efficacy studies is that they use highly selected and unrepresentative pt samples and consequently • In study of manualized cognitive therapy 4 depression o 1. Working alliance predicted pt improvement on all outcome o 2. Psychodynamic process predicted pt improvement on all outcome measures o 3. Therapist adherence to cognitive treatment predicted poorer outcome - insensitive/ dogmatic ways

well-establish empirically validated treatment

¥ 1. anxiety + stress problems : CBT for panic, GAD, exposure treatment s, stress inoculation training ¥ 2. depression: BT, CT, IT ¥ 3. health problems: BT - headache, multicomponent CBT, CBT for bulinia ¥ 4. childhood problems: behaviour modification for enuresis, parent training programs for those having children w/ oppositional behaviour ¥ 5. marital problems: behavioura material therapy

behaviour therapyy techniques

¥ 1. flooding: ◦ goal - provoke extinction and encourage approach behaviour ◦ for anxiety reduction where phobic client is exposed to highly feared arousing situation and where therapist provides ongoing encouragement to assure that client remains in situation until noticeable habituation set in ¥ 2. systematic desensitization ◦ goal = prvoke extinction and encourage approach behaviour ◦ treat phobias - learn relaxation and uses hierarchy fear producing situation ¥ 3. graduated exposure ◦ goal = provoke extinction and encourage approach behaviour ◦ feared stimulus needs to be stopped - expose client to more and more fear arousing stimuli in previously established hierarchy ¥ 4. contingency contracting: help eliminate an undesirable behaviour ◦ agreement (written) b/t client + pt or possibly two parties outside therapy context that spells out what consequence is for not completing contract ¥ 5. token economy: provide systematic reinforcement for desirable behaviours ◦ reinforcement sys developed tokens to present certain type of reinforces - weekend pass ¥ 5. satiation or overcorrection ◦ goal: help eliminate undesirable behaviour ◦ relatively mild aversive punishment in which somebody is require to engage in activity that may be initially pleasant (smoking cigar) but that needs to continue until subjective quality becomes unpleasant ¥ 6. response cost : reduce undesirable behaviours ◦ punishment procedure where contingent on production of undesirable behaviour, corresponding specified amt of reinforcementt removed (200$ 4 speeding) ¥ 7. time out: stop undesirable behaviour ◦ individ removed from enviro + asked to spend time in less pleasant enviro ¥ 8.shaping: learn a couplex behaviour ◦ sequential learning process where invidious learn through reinforcement procedures to acquire all skills needed for an relatively complex behaviour (giving public speech) ¥ 9. chaining" ◦ ultimate target behaviour can be broken into steps on can learn w/ reinforcement (drive car safely in safe school yard then regular street -> manual) ¥ 10. rehearsal: practice new behaviour ◦ practice new behaviour in initially safe enviro like role play in order to prepare for later performance ¥ 11 modeling- mastery model. provide sample for desirable behaviour ◦ showing how it is done very well ¥ 12. modeling - coping model: " ◦ method helping imdivid acquire new behaviour showing her how can it be done by most ppl ¥ 13. aversion therapy: help eliminate undesired behaviour ◦ unpleasant consequence after an undesirable behaviour was shown

evolution of psychoanalytic theory

¥ classical psychoanalysis - freud based on treatment of hysterical neuroses (conversion disorders that involve symptoms that appear to be neurological but no physiological bases to explain symptoms) ◦ basic biological drives (sexual/aggression) as unconscious motivators of behaviourr -> cause of symptoms ◦ freud proposed model in order to understand personality - ID (entirely unconscious + source of energy for instinctual impulses, produce aversive state of anxeity) , EGO (functions of personality that guide imdivid in real world with emphasis on safety + survival), SUPEREGO (lawful, moral, deal aspirations, subdue or control both impulses + anxiety) ◦ conflicts between these -> neurological symptoms/ personality problems ◦ treatment involves to make unconscious drives conscious through several techniques such as free association (pt talks bat anything), dream interpretation where symbolic nature of features of dream reveal unconscious material, transference responses ◦ important part = therapist not influencing flow of unconscious material in any way, speaks little, attempts not to direct pt

nice core canadian ethics

◦ 1. order to write this code, authors began w critical analysis of other existing codes ◦ 2. social contract: calls for respect for one's own profession -> embedded in a similar contract w/ other profs/popul ◦ 3. code was developed using series of vignettes that were tested on psych + feedback used to revise ethical principles ◦ 4. principles underlying code organized around for major ethical principles ◦ 5. given that ethical dilemma involves not being able to honour principles of ethics alike, decided to assist decision makers it would be helpful to assign differntial weights to importance of 4 major principles (left is more important, and further right are lesser) ◦ 6. code comes w/ explicit 10 steps of ethical decision making ◦ 7.. can psyc see themselves having professional conscience that goes beyond ethical behaviour -> societal good ◦ 8. code embraces idea of minimal standards - do not harm + idealistic + aspiration standards ◦ 9. apa + cpa umbrella documents - authors perceive as good foundation for specific practice guidelines

10 ethical standards

◦ 1. resolving ethical issues ◦ 2. competence ◦ 3. human relations ◦ 4. privacy and confidentiality ◦ 5. advertising and other public statements ◦ 6. record-keeping and fees ◦ 7. education and training ◦ 8. research and publication ◦ 9. assessment ◦ 10. therapy

PA: symptom substitution & genetic principles

◦ symptom substitution - idea that underlying impulses or conflicts are not conscious are manifested as symptoms, symptoms = representations of underlying impulses ◦ genetic principles: suggests prevailing and enduring influence of past on current mental activity; past is represented in present + influences current thoughts behaviours + emotions; can be seen in current relationships whereby patterns of problematic interactions are repeated with others

the flight of the dodo

• everybody has won and all must have prizes • outcomes for diff thearpies are equivalent and no form of psychotherapy proved superior to any other • findings always favored preferred treatment of investigators if there were differences • why fail to show differences o 1. Limitations and unexamined assumptions of current research methods o 2. Symptom oriented outcome measures are common - do not assess inner capacity ♣ SWAP - clinican report that assesses broad range of personality processes, both healthy and pathology ♣ Scored by clinicians of any orientation ; healthy functioning index - mental health as consesually understood by clinical practioners

ethical principles of psyc and code of contact

CPBC Code of Conduct Section 10.5: Solicitation for services: "A registrant must not contact or communicate with or cause or allow any person to directly contact or communicate with potential clients, either in person, by telephone, over the internet, or in any other way in an attempt to solicit business, unless the person contacted represents an organization, firm, corporate entity or community which is the potential client.

Caveats

Caveat 1 -"Ethical awareness is a continuous, active process that involves constant questioning and personal responsibility." Caveat 2 ● Awareness of ethical codes is crucial but formal codes cannot take place of an active, thoughtful, creative approach to our ethical responsibilities Caveat #3 ● " Awareness of relevant legislation, case law, and other legal standards is crucial, but legal standards should not be confused with ethical responsibilities." Caveat 4 ● Overwhelming majority of psycs are conscientiousness, dedicated caring individuals, committed to ethical behaviour - none of us infallible Caveat 5 ● As pycs, we often encoutner ehtical dilemmas without clear and easy answers

vehicles for behaviour change in psychoanalytic treatment (gabbered)

1. observation, interpretation and confrontation A:observation - involves calling attention for behavioural displays in therapy situation that person may not be aware of, therapist may focus on person's nonverbal behaviour, vocal intonations, defences B: interpretation - linking behaviour to unconscious material, childhood experiences or relationship patterns C: confrontation - helping pt face some issues or concern that is being defended against or avoided - gentle point out bat avoidance/difficulties in expressing ideas 2. transference - relating to therapist as though therapist was someone form last A: cognitive representations or schemas of past relationships are evident in therapeutic relationship and there may be desire for corrctive experience in that relationships B: interpersonal styles that usually based on early relationship experiences that may be used excessively and inappropriately and cause difficulty for person, may come to fore in therapeutic relationship. being able to communicate bat interpersonal style, in here and now can provide important vehicle of insight, change 3. resistance - there may be ambivalence regarding to getting better A: disatisfaction lies in pts inability to behave in manner that is adaptive meet goals and so forth due to anxiety B:pt changing his or her behaviour, therapist is helping pt to step into unknown territory , so can resist bc sense of security w/ old familiar patterns of behaviour that may not be adaptive or produce happiness - produce sense of C: concept of resistance is characterized by others bailing pt for not participating in treatment or characterized by obstinane pt and therapist attempting to manipulate pt into talking; resistance is actually view as result of unconscious defensive process that protects pt form anxiety; pt is not obstinate but experiences anxiety related to dealing w/ or discussing certain content , therapist attempts to help pt to get past it by attempting to create safe and secure enviro in which anxiety producing material can be brought out 4. countertransference - important, therapist pays attention to his or her emotional reactions to pt and uses reactions as info bat inner world of pt A: by monitoring self, therapist can have understanding of how others might respond to pt and can see how pt may unconsciously produce feelings in others (making others angry so they are distant)

neurotic defences

¥ 1. introjection: internalizing aspects of significant person as way of dealing w/ loss of that person (i.e.. introject hostile or bad object as way of giving one an illusion of control over object) ◦ occurs in non defensive forms as normal part of development ¥ 2. identification ◦ internalizing qualities of another person by becoming like person; whereas introjection leads to na internalized representation experienced as an other, identification is experienced as part of self, this too can serve non-defensive function in normal development ¥ 3. displacement: shifting feelings assoiciated w/ idea or object to another that resembles original in some way ¥ 4. intellectualization - using excessive and abstract ideation to void difficult feelings ¥ 5. isolation of affect: separating an idea from its associated affect state to avoid emotional turmoil ¥ 6. rationalization: justification of unacceptable attitudes, beliefs, or behaviour to make them tolerable to oneself ¥ 7. sexualization - endowing object w/ sexual significance to turn negative experience -> exciting/stimulating to ward of anxiety associated ¥ 8. reaction formation - turning unacceptable wish/impulse to opposite ¥ 9. repression: expelling unacceptable ideas, impulses, blocking them from entering consciousness this, defense differs from denial bc latter is associated w/ external sensory data whereas this is inner states ¥ 10. undoing: attempting to negate sexual/aggressive/ shameful implications from previous comment or behaviour by elaborating clarifying or doing opposite

phases of classical psychosis

¥ 1. opening phase - determining nature of person's difficulties, to learn as much has possible abt person and his or her current + past life situations, history + development, as well as behaviours related to how person relates his info to therapist; therapist attempts to detect these that are relevant for development of difficulties, conflicts or issues person wishes to understand + change ¥ 2. development of transference phase ◦ pt relate current behaviour to unconscious material from past childhood + wishes regarding past relationships ◦ therapist becomes important component of pts life + pt responds therapist in distorted fashion as if they were some person they knew before and responds in pattern of behaviour similar to behaviour engaged in by pt w/ person of past ◦ help pt distinguish reality + fantasy, understand conscious influences of early experiences + gain more control over automatic behaviours that case/perpetuates them ¥ 3. working through phrase - coincides w/ second phase and involves consistent interpretations of transference responses, recall of early material that relates to early relationships + development+ deepening insight into unconscious influences ¥ 4. resolution of transference phase- termination phase of treatment, typically a mutually agreed upon date of termination is set by therapist + pt , issues pertaining to loss dependency, and abandonment often arise, these issues are dealt with in the same manner and are understood in context of ending important relationship ◦ termination = highly significant element of appropro treatment

guidelines for child custody evals during divorce proceedings

¥ 1. orienting guidelines: purpose of child custody evaluation - assess best psyc interests of child, child interest + wellbeing are paramount, focus on evaluaten is on parenting capacity psych and developmental needs of child and resulting ¥ 2. general guidelines - role of psyc is professional expert striving to maintain objective impartial stance, psyc gains specialized competence, psyc is are of personal and societal biases and engages in non discriminator practice, avoids multiple relationships ¥ 3. procedural guidelines: conducting child custody evaluation ◦ determined by evaluator based on nature of referral question ◦ psyc obtain informed consent from all adult participants + informs childs ◦ psyc informs part bat limits of confidentiality + disclosure of info ◦ uses multiple methods of data gather ◦ neither over interprets/inappro interpret clinical + assessment data ◦ doesn't give any opinion regarding psyc function of any individual who has not been personally evaluated ◦ recommendations are based on what is best psyc interests of child ◦ psyc clarifies financial arrangements

primitive defenses

¥ 1. splitting - compartamentalizing expermients of self and other such that integration isn't possible, when imdivid is confronted w/ the contradictions in behaviour, thoughts or affect regards the differences w/ bland denial or indifference ¥ 2. projective identification - both intrapsychic defense mechanism + interpersonal communication ◦ behaving in such way that subtle interpersonal pressure placed on other person to take characteristics of aspect of self or an internal object that is projected into that person ¥ 3. denial - avoiding awareness of aspects of external reality that are difficult to face by disregarding sensory data ¥ 4. dissociation - disrupting onse sense of continuity in areas of identity, memory, consciousness, perception as way of retaining an illusion of psyc control in face of helplessness and loss of control ◦ extensive cases where alteration of memory of events of disconnection bc disconnection of self from event ¥ 5. idealization: attributing perfect or near-perfect qualities to others as way of avoiding anxiety or negative feelings ¥ 6. acting out: enacting are unconscious wish or fantasy impulsively as way of avoiding painful affect ¥ 7. somatization: converting emotional pain or other affect states into physical symptoms and focusing one's attention on somatic (rather than intraphysic) concerns ¥ 8. regression: earlier phase of functioning/development to avoid conflicts/ tension in present ¥ 9. schizoid fantasy: retreating into ones private internal world to avoid anxiety bat interpersonal situations

confounding observations BT

¥ BT - clear links w/ experimentally derived principles + translation of these —> methods ¥ techniques easy to standardize / write up in manual format and compare with other results, easy to teach ¥ suited for most populations ¥ BT - ca be used for anything, nobel prize, feedback on driving, etc ¥ black box principle: ability of BT to manipulate individuals behaviour w/o his consent or understanding of what is being down ◦ mechanistic and not inhumane , ◦ punishment depends on intensity + potential harmfulness of punishment + consent

alder

¥ alder - founder of individual psyc school ◦ early family influences would lead imdivid developing life plan that guides his or her behaviour without much conscious awareness of this life plans details ◦ early family/ larger social influences may create maladaptive patterns of behaviour (inferiority/ superiority complexes) ◦ argued for equality of genders + democratic approach to family dynamics ◦ therapy - directive than classical PA + geared toward understanding personality in light of early life influences ◦ emphasized prevention - parent training courses to ensure parents have skills + understanding to raise children

functional analysis

¥ behaviour therapy = steps; BT strives to quantify behaviour + collect sufficient info to build etiological model that can form foundation for developing therapy program - functional analyses ◦ entire program should be explained to clint usually ◦ relatively easy to monitor bc overt behaviour

controversies w/ therapy outcome research

¥ constructive tradiiton - psychotherapy outcome researchers routinely write review papers of both qualitative and quantitative nature to document effectiveness of therapy ◦ taking stock useful for advancement of profession + can serve as road map for future research activities on topic ◦ professional organizations/foundations call together regular basis group of researchers to form consensus committees who will publish findings to serve as guides for decision making ¥ d > 1.0 in exposure based, cognitive behavioural therapies for phobias, PTSD ¥ cct produce weaker overall effects than cognitive behavioural or interpersonal therapy ¥ little empirical evidence available for systemic therapy bc is more on outlook on life + social interactions / philosophy than a coherent package of manual driven treatments w/ typical techniques ¥ evidence for clinically psychodynamic oriented treatments (ST tho) ¥ nonspecific effects in psychotherapy account for up to half effect of psychotherapy outcomes ◦ difficult to show that new treatment can lead to benefits that significantly exceed those derived from nonspecific effects ¥ great majority of ppl who receive psychotherapy also benefit from it; more interested in which facotrs maximize therapy process/ matches of treatment to specific application work best ◦ APA created committee on what is referred to as empiricaly validated therapies ▪ purpose: guide prctitioners in choosing right therapy for their clients +assist CP to get funding from insurance companies or obtain support from hospital administrates to use these therapies ▪ list s are long, but certain types of therapies are considered empirically validated for only one specifici application and there may be more than ne for that

goals of psychoanalytic psychotherpay

¥ contemp psyc - eclectic ¥ overall goal - "overcome developmental obstacles and personality patterns that interfere w/ person's ability to function at person's higher possible capacity" , utilization of current relationships to resolve past ones ¥ 1.establish strong therapeutic relationship providing basis for interventions, pt can express goals of treatment + feel safe and accepted ¥ 2. bring change to overall personality + character structure -> normal behaviours + eliminate symptoms + troublesome behaviours + prevent them ¥ 3. aid in bringing unconscious conflicts, patterns, defences and emotions to conciousawareness ◦ being aware of behaviour can give control + what to focus on/alter ◦ classical PA therapy - focus on attempting to make sexual+ aggressive impulses more conscious ◦ ego psych 0 focus mainly on ego + making ego defenses and attendant anxiety more conscious ◦ object relations - issues and concerns w/ separation and individuation that derive from early relationship w/ primary caregiver are made more conscious ; understand presence + purpose of self object functions ¥ 4. psychoanalytic treatments may not induce changes in personality structure but to bolster or strengthen supports, shore up defences, coping styles, current distress reduction, conflict (supportive psychotherapy0 ◦ use of exploratory vs supportivee approaches depends on pts needs and abilities , sometimes not necessary to induce change to personality but deal with past trauma

cost effectiveness of psyc treatments

¥ cost of healthcare would be lower if psyc services are effective/used a lot ¥ hunsley - 90% of studies on cost offset have shown that gains in terms of reduced overall health care costs are greater than cost of psychotherapyy itself -> 20-30% cost offsets ¥ cost offset/benefit should dsecribe how much money treatment has cost relative to other health care expensive + evaluation of benefits to economy (calculating economic gain of early return to work, reduced absenteeism, higher work activityy) ¥ lined heard - dialectic behaviour therapy - type of Ct suited for treatment of PD , ◦ group treated w/ DBT required greater initial cost for active treatment than control group, but when subsequent costs related to additionally needed health care for groups were computer in detail, DBT cost only half as much

what has been learned from existing meta-analyses

¥ d = .85 is large effect , most therapies fall from 0.6 - 1.1 ¥ top: non -ret cognitive therapies, CBT, systematic desensitization, behaviour modification, psychodynamic, RET, gestalt, CCT ¥ large effect 2.38 - relativelyy small # of clinical trials hat were indeed very successful whereas addition of further clinical trails -> regression to mean effect ¥ psychological therapy typically produces large pre-port effect (.93 - 0.85) ◦ CBT effects > dynamic, humanistic approach + minimal treatment ◦ relatively strongest treatment effect = behavioural treatments ◦ humanistic + dynamic = more strong outcomes ¥ more traditional therapies listed earlier typically have large effects with averaged d scores for within pt change: prepost effects ranging from .8 - 1.0 ¥ minimal treatments (tap nonspecific effects) have pre-post effect .3-.5,h alf of all treatment outcomes is counted for by nonspecific factors like quality of alliance, support, normalization ¥ lipsey ◦ published studies overestimate effects of treatment relative to unpublished studies by 20% - harder to publish studies w/ weak results ◦ studies w/ high methodology quality ratings led to neither stronger no weaker outcomes ◦ studies very large samples produced weaker effects than small samples ◦ studies w/ randomized assignments to treatment conditions lead to effects of similar magnitude than did studies w/o RA

short term dynamic psychotherapies

¥ development of PA treatments that are very focused, intensive, time limited + brief duration ◦ use highly select pt groups w/ understanding that several of St treatments are appropro for particular types of pts but not others ¥ ideas dealing w/ unconscious, importance of interpersonal relationships, transference responses, affect, conflict, ¥ overarching goal: similar to Lt treatment but tiring is often different ¥ time limit of treatment + degree to which therapist is active/directive STDPs - focal issue quickly determined upon + emphasized in treatment , depending on STDP focus of treatment uses therapeutic relationship/ transference responses, directly confronting conflicts/issues by challenging + provoking

Qs in meta-analytic reviews

¥ overall Qs : are whether XX is superior to this (stat significant greater effect size than comparison treatment (between group treatment) or alleviates this ((computing effect sizes for within person changes following therapy) ¥ therapy outcome affected by ◦ 1. experience and training of therapist ◦ 2. ethnicity ◦ 3. gender of client ◦ 4. gender of therapist ◦ 5. age of pt ◦ 6.level of distress prior to treatment ◦ 7. quality of alliance between therapist and pt ◦ 8. adherence by therapist to required treatment protocol ◦ 9. length of therapy ◦ 10. delivery form ¥ meta analysis provides overall effect is for given treatment and permits further exploration of mediating factors that explain how good outcome came about ◦ reveal what treatment client is most likely to benefit one

history of therapy outcome

¥ hans eysenck - first major review paper on psychotherapy effects , rate of improved pts who received it was no better than those who didn't receive therapy; no particular treatment 72% remission of problems after 2 yrs, those who received psychoanalysis showed improvement in 44$ and others who received ill defined eclective therapy reported improvement rates of 64% ◦ CRIT: not derived from controlled trials, groups were unlikely to be comparable at point of hospitalization, social class, illness severity/type + belief hospitals kept records/ made clinical decisions in standardized ways ¥ potential value of psychotherapy can be assessed using surveys of type that commercial polling companies use to evaluate voter preference ◦ consumer report 1995 - 4k respondents who had seen mental health professional and ask bout experience ▪ degree to which treatment alleviate presenting problem, how satisfied they are , how they judged overall emotional state ▪ 90% made them feel better, no reported diff in psychotherapy vs psychotherapy w/ meds ▪ social workers/psyc more effective than marriage counsellors ¥ quantitative reviews - meta analysis + box score reviews ¥ dodobird verdict: everybody has won and everyone should win a prize

self psychology theory (heinz kohlt

¥ heinz kohlt -development of self and on how self-caring, self esteem, narcissism, precede caring for others and how development of narcissism reflects normal development ¥ mainly focused on psychopathology - related to deficits in development of coherent sense of self + vulnerable self esteem ¥ self object functions - elicit responses from others to correct deficits in self esteem ¥ emphasizes development deficits > conflicts ◦ lack of empathy + being taught they are not valued/cherished, child goes thru life w/ deficit of someone who isn't lovable -> self disorders ◦ self disorders/traumas derive from child not being seen or affirmed or being regarded as an object for gratification by caregiver/abuse, child goes thru life not sure if she actually exists and experiences little or no self worth ▪ will try to correct unconsciously by trying to get others to respond in a way that makes up for deficit ◦ self disorders ▪ mirror transference - person can look to others for affirming behaviour to be proud of person's accomplishments ▪ idealizing transference - maintain self esteem aby attempting to interact w/ or bask in glow of someone else's ideal or powerful position ▪ alter-ego transference - can imitate an idealized other as a way of being like or margin w/ idealized other ¥ treatment involves identifying deficits in self esteem or self concept and attempting to create therapeutic situation that allows for strong empathic responses by therapist, mirroring behaviour, developing/fostering sense of self

limitations on confidentiality

¥ mandatory reporting requirement for neglect and physical/sexual abuse of children - must report even if it violates confidentiality ¥ limitations on confidentiality ¥ must ask client if they are involved in ongoing or pending court procedure - and should shape how psyc keeps clients records guided by Q is this written material factually correct and complete, constructive, non-offending language ¥ duty to inform motor vehicles when psyc learns clint is operating motor vehicle although client's competence is impaired due to senility or brain injury ◦ may lose drivers license and impact relationship ¥ tarasoff decision - it reveals how far they are expected to go to protect their clients _ guiding future decisions regarding their duty of care

cognitive therapy

¥ natural outgrowth of experimental research on regulation of mood + emotions associated w/ healthy adjustment/psychopathology ¥ identify thinking errors ◦ right and wrong, categorical and dogmatic ◦ goal: direct client to think more function terms + teach new thought patterns that are empowering and opening up new pop ¥ how realistic person views world is important for treatment programs ◦ ie. someon`e YAVIS - relatively quick improvement bc negative self view can be tested for many positive characteristics vs someone 80 yr old widow, diabetic, arthritis, - would therapist point out her depressive thoughts are irrational/unreasonable ¥ therapist needs to make effort to learn bat pts habitual thinking patterns, to look for recurring themes are may be dysfunction or that are open to change + look 4 alternatives

Aaron beck

¥ nature of depression - cognitive triad; overly pessmistic view of self, their enviro, future ◦ automatic thoughts: writing out what u feel everyday in a book; 1st layer ◦ 2nd layer = accidental patterns in our own thinking underlying assumptions - start to recognize idiosyncratic rule-driven and often dysfunctional thought patterns of depression pts ◦ 3rd layer, during childhood years created, deepest = schemas/corebeliefs: ie. experience of world as one in which ppl easily rejected, unsafe, incompetent ◦ at beginning of therapy - thought record tends to use 3 column method, 1st column = salient events during given day, 2nd column - record what they are feeling at time + how strong, 3rd = thoughts ▪ therapists hopes to recognize particularly frequent and recurring thought patterns - when this happens, the theme is referred as hot thought which means they are the ones receiving most attention ¥ just uncovering dysfunctional thought patterns isn't enough, you must test truthfulness of negative expectations by conducting behavioural experiments ◦ first one formulates expectation in form of hypothesis and then tests it through actual behaviour and observation

ethical considerations w/ BT

¥ never harm clients, but we can do punishment to minimize harm/ maximize benefits ¥ 1) punishments teaches person only what not to do; in order to solve problem u have to teach someone the right thing to do ¥ 2) any individual who attempts to control others by reinforcement or punishment affects not only specific behaviour but pre-existing relationship w/ this individual ◦ 1) increase liking if receives reinforcement ◦ 2) dislike/despise who gives out punishment

ego psychology

¥ one major revision with focus on children ¥ emphasized how ego functions in present in both adaptive + maladaptive ways ¥ importance of interaction patterns + developmental stages of person in childhood + adulthood + unconscious/conscious processes that influence behaviour ¥ treatment focus on current relationships + observe = attempt to understand psyc defense and anxiety underlying defences ¥ based on structural model of id, ego, superego - these constant conflict —> anxiety ¥ anxiety + defense result in compromise formation - neurotic symptoms or personality characteristics and disturbances ¥ treatment focus on compromise formations + conflicts that make up one's character + developmental issues ◦ analysis of defenses ▪ 1. primitive defences most pathological ▪ 2. neurotic defences ▪ 3. mature defenses (most healthy) ¥ impact: drawn attention to importance placed on current functioning of ego + defences that imdivid uses to cope w/ anxiety that often form focus of treatment

object relations theory

¥ predominant perspective in contemp PA + treatment ¥ object relations - internal + external world of interpersonal relations; object - refers to person to whom imdivid is relating ¥ based on premise that self + development self = interpersonal, arises from interactions with others ◦ first/predominant is care givers ¥ emphasizes development + stamping in conceptions of self and objects esp relationship b/t self and objects ¥ nature of significant relations + self conceptions internalized in childhood ¥ main focuses - how person views significant relationships either consciously or unconsciously ¥ important concepts ◦ 1. great importance on first + predominant relationship of infant + primary caregiver ▪ separation and individuation ( autonomy) important for establishing patterns of self acceptance, independence, interpersonal warmth etc ◦ 2. nature of early relationships = internalized as relationship schema (script/formula/framework for relationship pattern) + influences development of self + personality + related psychological difficulties ◦ 3. relationship schema activated in current relations and colors these relationships, can't thwart development/mature development ¥ reflects major revisions to trad PA ¥ treatment - demonstrating + making pt aware of how his or her characteristic relationship styles = schemas are problematic -> can shift/change

reinforcement

¥ primary reinforces - effective reinforces such as drink, sex, chemically induced pleasure ◦ cannot any form of sexual pleasure to clients in exchange for desired behaviours ◦ food and drink are essentially and can't be withheld (desserts tho) ¥ secondary reinforcers: govern much of our daily lives ◦ ie employees receive paychecks as thank you,; this money can be traded for pleasures/necessities; parents may use allowances to reinforce children's participation, etc ◦ token economy - facilitate learning of desirable behaviours in exchange for tokens that can be trained in for other reinforces like choco bar ◦ benefit of strengthening positive interpersonal relationships ◦ for autistic children, verbal praises may run out, so create a list for possible praises or possible prizes such as gold stars ◦ clients can engage in contracts with others - go fishing after 6 mo of quitting smoking

APA code of ethics principles

¥ principle A: beneficence and nonmaleficence ◦ psyc strive to benefit those w/ whom they work + take care to do no harm ◦ seek 2 safeguard welfare and rights of those with whom they interact professionally and other affect persons and welfare of animal subjects of research ◦ attempt to resolve conflicts in responsible fashion that avoids or minimizes harm ◦ alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence - strive to be aware of their possible effect own physical and mental health on their ability to help those w/ whom they work ¥ principle B: fidelity and responsibility ◦ establish relationships of trust w/ those w/ whom they work; aware of their professional and scientific responsibilities to society and to specific communities in which they work ◦ seke to manage conflicts of interest -> exploitation / harm, take responsibility for their behaviours , contribute personal time not for personal advantage ◦ consult or cooperate w/ other prof + institutions ¥ principle C: integrity ◦ psyc seek to promote accuracy, honesty, and truthfulness in science, teaching ,practice of psyc ◦ do not steal/cheat/egnage in fraud, subterfuge, and intentional misrepresentation ◦ psyc strive to keep promises avoid unwise/unclear commitments ◦ deception - justifiable, maximize benefits, minimize harm, psych have serious obligation to consider need for possible consequences, their responsibility to correct any resulting mistrust or other harmful effects that arise from use of such techniques ¥ principle D: justice ◦ * psycs recognize that fairness and justice entitle all persons to access and benefit from the contributions of psyc and to equal quality of processes, procedures, and services being conducted by psych ◦ exercise reasonable judgement and take precaution to ensure that their potential biases, boundaries of their competence + limitations of their expertise do not lead or condone unjust practices ¥ principle E: respect for pal's rights and dignity ◦ psyc respect dignity and worth all ppl and rights of individuals to privacy, confidentiality, and self determination ◦ aware of special safeguards necessary to protect rights and welfare of persons or communities whose vulnerabilities impair autonomous decision making ◦ aware of and respect cultural, individual, role differences (age, gender, race, etc) ◦ try to eliminate biases that affect work

psychoanalytic terminology

¥ psychodynamic: broad term that refers to models of normal and maladaptive human behaviour + models of treatment ¥ determinants of behaviours = primary unconscious motives, emotions, or drives that form of main characteristics of personality ◦ interact + conflicts sometimes - dynamic interplay among components of personality in order to understand person and his or her difficulties ◦ focus on inner motors + drives of behaviour -> overt cover behaviour / signs and symptoms of maladjustment ¥ psychoanalysis: one broad, comprehensive psychodynamic theoretical perspective - developed initially by freud but revised ◦ main treatment approach freud developed - classical psychoanalysis ▪ focused on inborn internal biological drives that are unconscious and primarily sexual in nature ▪ aggressive drives important in development both normal/pathological ▪ long term (several years), intensive (several times a week) ¥ psychoanalytic psychotherapies: revised/refined freud's ideas - biological impulses, students emphasized interpersonal needs and motives > biological dries ◦ needs arise from early childhood relationships with parents, family or peers, from process involved in development of self/identity or adaption to enviroo as driving forces ◦ shorter in duration and therapist is more active + directive ◦ some time limited, brief (12 sessions), focused on particular component of behaviour - short term dynamic psychotherapies

sullivan

¥ sullivan - based theory/treatment on interpersonal relatedness + critical roles of various relationships including communal social experiences ◦ interpersonal theory of psychiatry - personality evolved from internal relationships rather than bio/instingual drives ◦ self sys - invidious develop sys of traits, based on interactions w/ others that constitute the self ◦ good me, bad me, not me, childhood self sys based n interactions ◦ personifications: mental representations of relationships ◦ parataxic distorions - pts respond to therapists based on previous relationships they've had

psychoanalysis

• Sigmund Freud • One of the first to believe abnormal behaviour result of psychological rather than physiological problems • Developed own form of treatment called psychanalysis (along with Joseph Breuer) • Based on premise that unconscious impulses will enter the conscious part of a person's mind • Need to obtain insight • Permits a release of tensions and anxieties • Uses: • Free association • Dream analysis • All done to get access to unconscious

CT sessions

• Taught to identify, evaluate, and replace negative thoughts with positive thoughts • Middle Sessions: identify and modify underlying beliefs that lead to negative thoughts • Last Sessions: Solidify gains and broaden evaluation of negative cognitions and attempts to try to forestall future relapse

Use of meta-analytic reviews

¥ value of particular outcomes - aspirin trial (one takes aspirin, one doesn't, aspirin group had 50% reduction in morality which was reflection small effect size ¥ overemphasis on extending life may push aside treatments that alleviate distress and improve QoL as being trite although pts consider it meaningful ¥ third parties (employers/insurance) excited by psyc therapy outcomes that get pts back to work more quickly; reduce duration of disability pensions + reduce # of hospital/doctor visits ¥ reasearchers published meta-analyses to cluster outcomes they are studying into variables like ◦ mortality rates, reoccurrence of critical event , reduced use of meds, biological markers of disease, important behavioural outcomes, self report measures of distress ¥ primary focus in publications of treatment outcome studies is on group means - on variability of change within group ◦ does not tell us about individual patients ¥ butterfly diagram 0 two columnns on far outsides are comparable to each of columns on inside; each butterfly wing represents process of change in one group 0 where group means of treatment group (m4) were significantly superior to group means of control group (m2) ◦ sig improvement occurred only in small group of pt but may suffice to produce stat sig diff b/t group means - successful therapy ◦ important to look at subgroups and individual outcomes ¥ conducting follow-up investigations can be costly and frustrating experience bc pts themselves even if they had benefited greatly from therapyy, may not want to return for follow-up tests bc their heads the study have been completed

punishment

¥ when psychotherapy is provided 1-1, punishment is unheard of, but may be be suitable when pt in question is not able to comprehend, consent, or participate in choosing a therapy, has failed reinforcement procedures + shows problematic behaviours that are dangerous and self injurious in nature (ie. bb girl who kept vomitting after eating, applied mild shocks to be aversive and gradually she stopped) ¥ clients can apply punishment to themselves ◦ 1. aversive drug (disulfirum- antabuse) for alcohol dependency - makes them want to vomit ▪ pt must agree to undergo this treatment + has consequences explained (balancing risk) ◦ 2. little rubber band place around wrist of individual w/ compulsive tendencies like hair pulling, skin picking or nail chewing ▪ when they realize they'er about to do something ¥ punishment as therapy A) not a first choice treatment 2) avoid risk of LT harm 3) preferably conducted w/ permission of client or even better, client themselves

ethical dilemma

• A professional situation in which one or more ethical principles, codes or laws are in conflict; or when we have conflicting obligations to different people or groups.

cognitive therapies

• Assumptions: • How person interprets events predicts how they will respond to those events • Patients use maladaptive information processing strategies • CT helps patients to identify maladaptive beliefs and assess accuracy of those beliefs • Use of "experiments" in the real world to test accuracy of maladaptive information processing • Tends to be highly structured and very active and problem-focused • Provides patients with clear model of how their difficulties (disorder) works • Encourage self-monitoring and assessment of progress • Short-term, time-limited (20 sessions) • Socratic method and comparable to scientific method • Formulate hypotheses • Collect data • Test and revise hypotheses -hw assignments critical

levels of ethical decision making

• Automatic/routine • Choices made easily by referencing the Code or other practice documents • Systematic working through of dilemmas when there is conflict of obligations or principles

to whom do we have ethical responsibilities

• Clients/Patients • Students • Supervisees • Research participants • Colleagues • Employers & employees • Profession at large • Society ...

aaron beck's cognitive therapy

• Developed from his clinical experience with depressed patients • Postulates: • Depressed people have negative view of themselves, the world, and the future. • Distressed people have negative schemas or structures through which they perceive and interpret their experiences • Cognitive Therapy: • Active, directive, time-limited, structured approach to treat various disorders • Based on notion that individual's affect and behavior are determined by way in which he structures the world • Cognitions based on attitudes or assumptions developed from previous experiences • Focuses on identifying and changing maladaptive cognitions which will lead to reduction in distress • Uses "Socratic" method of arguing • May also give behavioral homework assignments, training in problem-solving • First part of therapy is training the person about the emotional theory (i.e., negative cognitions lead to negative emotions)

differential weighting of ethical principles

• Ethical Dilemma: Situations where ethical principles conflict and it is not possible to give them equal weight. Ordering of Principles: 1. Respect for the Dignity of Persons (I) 2. Responsible Caring (II) 3. Integrity in Relationships (III) 4. Responsibility to Society (IV)

albert Ellis' rational emotive therapy

• Negative emotions arise from people's irrational interpretations of experiences • A-B-C Theory of Emotions • A = antecedent or activating event in the environment • B = belief triggered in mind by event • C = emotional consequence of the belief • A B C: • Loss of job -> I'm worthless -> Depression • Loss of job -> My boss is a jerk-> No Depression • Treatment: • Rational arguments regarding the belief that arises • Can be rather boisterous • Some common irrational beliefs: • "I absolutely must have sincere love and approval almost all the time from all the significant people in my life. - I must be thoroughly competent, adequate, and achieving in all respects - Unhappiness is caused by external events over which I have almost no control.

commonalities among psychodynamic therapies

• Psychopathology, signs, and symptoms derive from personality and character. • Psychic Determinism • Early development of relationships • Genetic Principle • Unconscious • Emotion/Affect • Relating to others and self • Transference & Counter-transference

common complaints against psychology

◦ 1. inappropriate assessment procedures (37.3% of all complaints) ◦ 2. lack of professional competence (13.5%) ◦ 3. client relationships - key problems here are confidentiality and boundary violations (13%)

shelder 2010 - seven features

● 1. ​Focus on affect o encourages exploration and discussion of full range of pts emotion o therapist helps pt describe + put into words what pt is feeling esp if troubling, threatening, contradictory that they might not be able to recognize/acknowledge o recognition that intellectual insight not same as emotional insight, which resonates at deep lvl and leads to change ● 2. Exploration of attempts to avoid o ppl do great many things knowingly and unknowingly to avoid aspects of experience that are troubling o avoidance may take coarse forms - missing session, arriving late, being evasive o focus on incidental aspects > psyc meaningful; facts and events, external cirumstances> own's own role in shaping ● 3. Identification of themes and patterns o work to identify + explore recurring themes and patterns in pts thoughts, feelings, self concept, relationships, life experiences o pt may be acutely aware of patterns that are painful or self defeating but unable to escape from them or be unaware until therapists help ○ Skill to have! ● 4. Past experience o identification of themes and patterns -> recognition that past experiences affect our relation to and experience of present (esp attachment figures) o explore early experiences, relation b/t past and present o goal - help pts free themselves from bonds of past experience in order to live more fully in present ● 5. Focus on interpersonal relations o heavy emphasis on pt's relationships and interpersonal experience (object relations + attachment) o both adaptive + nonadaptive aspects of personality and self concept are forged in context of attachment relationships and psyc difficulties often arise when problematic interpersonal patterns interefere w/ person's ability to meet emotional needs ● 6. Focus on therapy relationships o repetitive themes in person's relations that tend to emerge in therapy relationship o provide unique opportunity to explore and rework in vivo o goal : greater flexibility in interpersonal relationships and an enhanced capacity to meet interpersonal needs ● 7. Exploration of fantasy life ○ PERFECTION - seeking acceptance and not be rejected, to try to get a connection with others o in contrast to other therapies in which therapist may actively structure sessions or follow predetermined agenda, psychodynamic therapy encourages pts to speak freely abt whatever is on their minds rich source of info abt how person views self, others, interprets situations/experience, what interferes w/ potential capacity to find greater enjoyment and meaning in life ● Series of meta analysis to provide empirical evidence of psychodynamic

why ethics in psychology

● 1.To help establish a group as a profession ● 2. Act as support and guide to individual professionals ● 3. To help meet responsibilities of being profession ○ Minimum lvl of competence ● 4. To provide a statement of moral principle that helps individual professional to resolve ethical dilemmas ○ What are guiding principles to navigate through difficult situations

goals of psychoanalytic psychotherapy

● 1.​therapeutic relationships ● 2. Change to personality and character structure ● 3. Aid in bringing relevant unconscious material to consciousness ● 4. Supportive or exploratory ● Ppl will feel worse for a while in psychotherapy

cpa code of ethics

● 60s/70s made changes w/ code bc used american ● 80s - had our own ● Improve on APA code ● -establish psyc as formal discipline in canada ● Support and guide canadian psycs in all professional activities ● Unique features ○ Empirically derived (based on 37 ethical dilemmas) ○ Differential weighting of 4 principles ○ Social contract- type of contract based on mutual respect and trust, discipline of psyc should be commited that its members would put ○ Includes both minimal & idealized or aspirational standards ○ Systematic ethical decision-making model

principle III: integrity in relationships

● Accuracy & honesty ● Straightforwardness & openness Dual/Multiple Relationships • Dual or multiple relationships is where the psychologist functions in one professional role as well as another significant role in relation to the same person (e.g., therapist, supervisor, friend). sexual relations ● There are no circumstances in which sexual activity between psyc and client is acceptable

principle IV: responsibility to society

● Advancement of knowledge & understanding ● Promotion of welfare of all human beings ● Respect for society & development of society ● Extended responsibiliy

ethical decision making

● Code of ethics (​aspirational, core values, CPA + APA Code of ethics) -> p​ rofessional standards (​prescriptive for profession, CPBC code of conduct) -> ​legal standards (prescriptive for society, statues and case law)

cpa vs papa ethical principles

● Cpa ○ 1. ​Respect for dignitity of persons ○ 2. Responsible caring ○ 3. Integriy in relationships ○ 4. Responsibility to society ● APA ○ 1. Benefience, non maleficence ○ B. fidelity + responsibility C: integrity D: jsutice E: respect for people's rights and dignity

CPA principle I: respect for dignity of person

● General respect, rights, fairness ● Psycs greatest responsibility to protect rights of those in most vulnerable positions (clients, students, research participants) ● Ethical standards: non-discrimination, fair treatment/due process, informed consent, protection of vulnerable individuals, confidentiality

Principle I: confidentiality

● Professional standard of conduct not to disclose info abt client except under conditions agreed to by client ● An implied promise to keep info disclosed in psyc client relaitonship private Limits of confidentiality ● 1. Imminent risk of harm to self or others (case law, adult guardianship act) ● 2. Harm or risk of harm to child or senior (child, family, community service act) ● 3. Unsafe to drive (motor vehicle ct) - call a cab/COPS ● 4. Court order (ask if there are any legal proceedings) ● 5. Supervision (if applicable, are u ok with me telling supervisor in order to be better)

triangles of adaption & object relations

● Triangle of adaptation ○ Defnse, anxiety, attachment need/ interpersonal style ● Triangle of object relations ○ therapist/group, current, past

principle II: responsible caring

● Welfare of consumers ● Greatest responsibility is to those in most vulnerable position (like I) ● Safeguarding wellbeing (II) rather than rights (I) ● Risk/benefit analysis & minimize harm and maximize benefits ● Need for competence & self knowledge

speaking against lists of empirically validated research

◦ 1. existence of lists reduces momentum in field of creating promising/innovative therapies ◦ 2. there is always possibility that given pt is not likely to respond well to supposedly most efficacious approach or has subjective dislike for it that can lead to poor adherence ◦ 3. graduate training programs must balance need to teach skills required for application of empircally validated treatments _ encourage to be more open minded + consider more than a mere technical match of client's presenting problem ◦ 4. it will be difficult to convince grant review committees to fund new treatment research project when they are alreadyy two+ effective treatments for given problem

milton four major contributions provided by freud

◦ 1. importance of structure + processes of unconscious ◦ 2. role of early childhood experiences in shaping personality development ◦ 3. methodology for psyc treatment of mental disorders ◦ 4. recognition that understanding person is central to understanding person's problem