Psychodynamic Approach

Stigma and Self fulfilling prophecy, What did Harris et al do?
Expectations of behavioural disorder
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What was asked?
Children were told to play with a child who either had ADHD and no ADHD
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What are the target effect?
Lower enjoyment and self credit for task
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What are the alternatives to medical model?
Make no dichotomy between normal and disordered states, consider social and psychological fctors, make the indivdual the focus of treatment, consider non-pharmacological interventions as primary
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What is the dimensional approach?
Mental disorders not categorically different - extremes. BUT: does not address processes causing disorder
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What has the diagnostic label have?
Little impact on type of treatment given
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What is the aim?
Identify processes that led to and maintain problems faced by individuals
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What is the explanatory hypothesis?
Guide the therapist and establish criteria to evaluate intervention
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what is an approach?
Single position regarding theory and practive of psychotherapy
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What is a school?
Grouping of similar approaches
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What did Totton do?
Every therapist works from an idea of what people really are like: a vision of human nature
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What is critical to remember?
Theories dont develop in a vacuum dramatically influenced by context
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What did Freud say about Anna O?
Under hypnosis spoke of past traumas and expressed strong emotions, symptoms cured (cartharsis)
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What are implications?
Behaviour influenced by unconscious mental process, physical symptoms could be removed talk therapy, Reminiscenes, painful, shameful, alarming, banished from consciousness
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What are the three levels of consciousness?
Conscious, preconscious and unconscious
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What is conscious?
Thoughts/feelings that we are aware of
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What is the preconscious?
memories/knowlede that we are unaware of but can easily be brought into awareness that we are aware of
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What is the unconscious?
Indissmissable material that we are unaware of, influences behaviour, auses of neuroses
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What is this called?
Tripatite model of personality made up of three components
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What are the three components?
Id, ego and Superego
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What is this similar to?
Platos earlier model of the soul which is made up of rational, spirited and appetitive parts
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what is Helmholtz theory?
Conservation of Energy: energy neither created nor destroyed but only transforms from one for to another, or transfers from one object to another
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What did Brucke say?
All living things are energy systems
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What did Freud state?
Psychic energy
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What is personality?
Energy systems - transformations and transference of psychic energy from one part to another shape personality
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What are instincts?
Source of energy in behaviour and make up the dynamics of personality
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What are the instincts of Darwin?
Eros preservation of self and species, sexual drive --> libido and Thanatos - self destruction, aggressive drive --> destructive energy
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What is ID?
Original system, present from birth
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What does it consist of?
everything inherited, and is filled with energy from the instinct
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What strives?
Satisfy instinctual needs with immediate gratification ruled by the pleasure principle (tension, avoid pain, gain pleasure)
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What happens if delayed?
primary process thinking, generation of fantasies to gratiy id impulses wish fulfillment
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When does Ego develop?
6 months
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When is intermediary between id and reality?
Ruld by the reality principles
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what is confronted?
secondary process thinking - planning and decision making and repression
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Where is there a battle between?
Three systems for Id's emergy: when one gains control of energy at the loss of others
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What is a state of tension for anxiety?
Which must be reduced
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What is there?
A warning of danger, informing the ego that something must be done
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What is it brought about?
by intra-psychic or psychodynamic conflict between ego and systems it interacts with
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What are the three factors about anxiety?
Realistics, fear of real dangers in the external world, moral: fear of conscience (conflict with super ego), neurotic (fear of strength of IDs instinctual impulses(conflict with Id)
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What are the five developments?
Oral, anal, phallic, latency and genital
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What must happen?
Conflicts at each stage must be resolved to move on successfully
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What is the failure?
To resolve - fixations - impact on personality
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What are personality characteristics are oral?
Dependence, depression, guilt, mistrust
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What are personality characteristics are anal?
focus on tidiness, obsessive behaviours
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What are personality characteristics are phallic?
Antisocial personality, difficulties in romantic relationships
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What are personality characteristics are latency?
Problems with self -control
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What personality characteristics are genital?
Identity diffusion
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What is the Oedipus complex?
SExual attraction to mother, father seen as rival, fear of castration from father, renouncement of attraction to mother, identification with father
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What is the electra complex?
Realisation that she doesnt have a penis, horror and rejection of mother, attraction towards father
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What do instinctual demands from id do?
Place it in danger, neurotic anxiety and defence mechanisms to relieve anxiety
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What do defence mechanisms do?
develop in childhood
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As a result of ?
Struggle against sexuality
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What do they do?
operate unconsciously
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What are the 6 types of ego defence mechanisms?
Repression, reaction formation, regression, denial, projection and sublimation
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What is the ego defence mechanism for Repression?
Preventing unacceptable thoughts from entering consciousness
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What is the ego defence mechanism for reaction formation?
Preventing awareness of unacceptable desires by taking opposite stance
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What is regression?
REverting to earlier developmental lebel
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What is denial?
Refusing to face reality
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What is projection?
Attributing own unacceptable thoughts to another
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What is sublimation?
Channelling fustrated energy into sociall acceptable outlet
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What is repression?
Repressed instinctual drive still exists --> continues to influence behaviour
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What about with other defence mechanisms?
Repression can be normal behaviour
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What can it also give rise to?
Neuroses difference is a matter of degree no kind - dimensional
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What is meant by neuroses?
Originate in childhood, symptoms may be later
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What is it triggered by?
Stress or crisis
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What is normal?
Passing through the stages successfully without major fixations, development of successful ego and super ego and evolving adequate defence mechanisms
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What is neurotic behaviour?
Fustration of sexual impulses or damming up of sexual instincts by ego - repression, transforming fustrated sexual impulses into neurotic symptoms, evolving inadequate defence mechanisms
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Why do neuroses perpetuate?
Because repressions are unconscious --. ego does not have access so conflict cant be resolved
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Why does OCD develop according to freud?
fixation at anal stage
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What occurs?
Battle between opposing forces involves explicit thoughts and actions
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What is depression similar to?
Grieving regression to oral stage,
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What is depression?
An introjection of negative feelings
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When are neuroses acquired? and how are they maintained?
During childhood, but are maintained because the cause of the issues has been repressed - unconscious
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When is the less restricted id?
Freeing of healthy impulses
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What happens with the ego?
Stregnthening of reality based ego functioning, widening its perceptions that it approves more of the id
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What happens when there is a more humane super ego?
altering the contents of the superego so that it represents humane not punitive moral standards
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According to Freud who is suitable for psychoanalysis?
Not individuals with psychosis, not individuals near or above the age of 50, reasonable degree of education, reliable character
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How many sessions a week?
At least 4 sessions a week, 45 minutes each
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What is the first Freudian technique?
Free association - allowing the mind to wander and reporting everything that comes to mind
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What is the second freudian technique?
REsistance - anything that works against the process of therapy
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What is the third freudian technique?
Interpretation - constructions or explanations of material revealed in free association
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What is the fourth freudian techniques?
Transference, the repetition of earlier life situations in relation to the therapist
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What is the final freudian technique?
The interpretation of unconscious material revealed through dreams
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What is the definition of dream analysis?
Royal road to a knowledge of the unconscious activities of the mind
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What are the functions of dreams?
Wish fulfilment, guardians of sleep
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What does this mean?
Disguised hallucinatory fulfilments of repressed sexual infantile wishes
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What two contents are there?
Manifest vs latent content
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What is dream work?
Complex mental process of disguise involving condensation displacement, symbolism
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What did the Wolfman dream?
I dreamt that it was night and that i was lying in my bed. Suddenly the window opened of its own accord, and i was terrified to see that some white wolves were sitting on the big walnut tree in front of the window, there were 6 or 7.
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What are the current symptoms due to?
Unconscious repressed material that must be worked through
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What do dreams do?
Give insight into repressed wishes based on a previous experience
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At age of 11/2, sergei had witnessed what?
the primal scene - his parents having sexual intercourse
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What desires were there?
Sexual gratification from father, castration fears
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What would distortion through dream work do?
Reversals - rest motion, watched/watching, Condensations - white colour, symbolism - tails:castration
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Who is the wolf?
the father
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What is free association?
Christmas tree, wish fulfillment - presents; sexual satisfaction from father
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What did Freud say psychoanalysis was?
A science, hypothesis testing, karl popper
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What other problems were there with psychoanalysis?
Very limited sample. lack of causal explanations, failure to address social, cultural or political factors
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What did Jung say about the levels of consciousness?
Consciousness: known and available to the individual, personal unconscious: memories and experiences that have been forgotten or repressed, Complexes (associations with strong emotional content
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What is collective unconscious?
Images, potentialities, predispositions that have been inherited from our ancestors - never been in consciousness
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What are archetypes?
Innate, identical psychic structures common to all
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What is persona?
The mask work by an actor public personality
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What is a shadow?
The dark side of our personality
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What is anima?
Feminine side within male personality
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what is animus?
Masculine side within female personality
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What is self?
Central archetype, personality as a whole
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What is psychic energy?
Libido and other motivating forces
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What is opposition?
Flow of energy between 2 poles, tension and conflict arise from clash of opposites
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What is compensation?
balance or adjust enrgy distributed through the psyche
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What is transcendent function?
Synthesising process which can remove some of the separation between conscious and unconscious
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What are 2 attitue types based on?
Habitual direction of an individual's interests: Extraversion and introversion
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What are four function types?
Based on an individual's most differentiate function of psychological adaptation: thinking, feeling, sensation, intuition
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Everyone has what?
All functions but 2 are well developed while other 2 remain mostly unconscious in the shadow
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What are humans born with?
A programme for life - incorporated into the self
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What are the four stages of life?
childhood, youth, middle age, extreme old age
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What does the person become?
Differentiated as separate psychological individual, distinct from collective psychology
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What is the inegration of?
Unconscious and conscious into whole self
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What did Jungisan say about the medical model?
Not consistent with medical model, problem is always the whole person, never the symptom alone
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What are hysteria?
Extreme extraversion, away from inner integrity, exaggerted concern with influence in social relationships
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What are schizophrenia?
Extreme introversion, withdrawal of libido from reality world of fantasy
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What did Jung say neurosis?
Conscious and unconscious imbalanced
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What are forms?
Form of adaptation created as part of individuation
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What is shrinking back?
Escape from a challenging life event which individual feels unequipped to meet
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What did Freud say about neurosis development?
Easy childhood, backward looking reductie
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What did Jung say about neurosis?
Any stage in life cycle, forward-looking adaptive
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What is Jungs saying?
Suffering of a soul which has not found its meaning
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What did Goals of therapy suggest?
Attaining specific goals, dealing with complexes strengthening consciousness
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What is the person suppose to understand?
Own inner being and meaning of lives
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When can it occur?
all stages of life
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What are four factors of Jung's therapies?
Individuals, eyetoeye, 2/3 sessions W/k and break after 10 weeks
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What isnt his therapy?
not a cure, better able to deal with life's challenges; better integration of conscious and unconscious
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What are the four stages of therapeutic process?
Confressions - share secrets, elucidations - therapist interprets, education - new and adaptive habits, transformation - individuation, acceptance of self
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What is analysis of transference?
Understand projections that take lace from client to therapist
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What is active imagination?
Get in touch with unconscious material, may use dreams as a starting point
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What is used?
allow unconscious to produce series of images
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Like Freud, what did Jung give?
Importance to dreams
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What did Jung say about dreams?
Dreams express, meaning of dream in manifest content, compensatory function, constructive - makes unconscious potential
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What did Freud say about dreams?
Dreams disguise, meaning of dream in latent content, wish fulfilment, reductive -trace back to infantile experiences
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What is amplification?
Elaboration and clarification of dream images to establish context, directed associations
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What is interpretation?
Keep record of dreams and interpretations
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What is assimilation?
Client and therapist make conscious sense of dreams, clients assent of therapist's interpretation
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Does psychotherapy work?
Eysenck, found that 44% cured by psychoanalysis
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What did Smith and glass suggest?
Average person receiving treatment is better off than 75% of untreated individuals
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What are evidence based treatments?
Assumes we can classify mental disorders categorically, ensures that therapy offered has been shown to work
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What did Leicsenring show?
Meta analysis of 6 RCTs comparing STPP with cognitive behavioural therapy.
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What was shown as a result of STPP?
REdcution in depressive symptoms, reduction in general psychiatric symtpoms, improvement in social functioning
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What was found?
No difference between CBt and STPP, no evidence that psychodynamic approaches more effective in treating specific mental disorders
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What was asked?


Children were told to play with a child who either had ADHD and no ADHD

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What are the target effect?


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What are the alternatives to medical model?


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What is the dimensional approach?


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