PSY1102F

Winter 2025
Treatment (3) & Health(1)
General Announcements
• Study Guide for the final exam is posted on BrightSpace (in the
“Lectures” folder)

• If you don’t see a grade for Test 2, please contact one of our TAs so
that we can initiate a search. You may have to attend an office hour
to identify your scantron sheet.

• Midterm 1 tests are in my office (VNR2016) for review during my

office hours
General Announcements
• Office Hours in VNR2016 (9:30 – 11:30): Mar 28th, April 4th
• No Appointment Necessary
• No TA office hours after April 4th

• For Final Exam →Office Hours on Zoom (9:30-11:30): April 24th

• Click on Zoom tab in BrightSpace to join the meeting; I will talk to
students one at a time (privately)
• I will answer e-mail questions sent before noon on April 24th
(time permitting)
Announcements
• Final Exam is on Friday, April 25th, 2:00 pm – 5:00 pm, at 125 University
Private (GYM in Monpetit)
• NOTE! EXAM DETAILS ARE PROVIDED ON YOUR UOZONE PAGE. PLEASE CHECK
HERE FOR ANY CHANGES BEFORE HEADING TO THE EXAM ROOM.

• Final exam is cumulative; covers everything on the Study

Guide list

• Location is 125 University Private (GYM); in Monpetit Hall (MNT)

• Check time and location the day before!
• Reminder!! You must have your student card with you for this exam.
From Last Class
• Complete the topic of psychopharmacotherapy
➢Anxiolytics
➢Mood stabilizers
• Briefly explain other biological treatments (ECT, TMS, psychosurgery)
• Introduce basic types of psychotherapy
• Explain insight therapy (and the importance of Freudian influences)
• Explain behavioural therapies based on operant conditioning
Today’s Objectives
• Continue explanation of therapies based on learning
• Describe two more important therapy types
➢Humanistic Therapy
➢Cognitive Therapy
• Introduce the topic of stress and health
➢Defining stress
➢Good and bad stress
➢Stressors and stress responses
Applied Behavioural Analysis
• Skinner contributed but became therapy later
• Goals
➢reduce inappropriate behaviours
➢increase effective communication
➢increase adaptive learning
➢increase appropriate social behaviours

• Very useful for children with autism

➢ intensive therapy around 20 hours per week
➢early intervention (before four years of age)
➢large gains; few services required later
Applied Behavioural Analysis
Reducing inappropriate behaviours
• First
➢ conduct a behaviour assessment
➢ record what happens before, during, and after the behaviour
➢ manipulate the consequences to determine the cause
• Then
➢ teach an appropriate response
➢ and, use reinforcers to replace the inappropriate response
• Example (for improving social skills)
➢ ”high five” for every time a teen smiles and shakes hands
when meeting a person
➢ therapist is called a “behaviour analyst”
Other Behavioural Analyst Approaches
• Acceptance and Commitment Therapy (ACT)
• Approach?
➢Change responses to thoughts and feelings
• Examples
➢helping students with public speaking anxiety
➢helping people with obsessive-compulsive disorder
➢helping people with depression
• If the problem is less serious
➢use self-management techniques (record, monitor, and use reinforcers)
➢successful in treating nail biting, over-consumption of coffee, and to
improve math performance
Pavlovian (Classical) Conditioning Therapies
• Associating behaviours with environmental stimuli

• Basic idea is that learned behaviours are sometimes maladaptive

• This type of therapy is utilized to treat fears and phobias

• Therapists often use “counterconditioning”

➢replace undesirable behaviours with more adaptive ones
Systematic Desensitization
• A type of counter conditioning
• Very effective
• Step 1 = guiding patient in relaxation skills (e.g., deep breathing,
muscle relaxation)
• Step 2 = establish a “fear hierarchy”
➢ranking of anxiety-inducing stimuli from least to most
distressing
• Step 3 = rate anxiety-inducing stimuli from 1 to 100 (higher numbers
= more distress)
➢this is the “Subjective Units of Distress Scale (SUDS)
 Systematic Desensitization
• For many patients, just thinking about
stimuli causes anxiety
• Therapist and patient practice
relaxation with a low-SUDS stimulus
• As the patient is more comfortable, the
therapist progresses through the SUDS
hierarchy toward the more anxiety–
inducing stimuli Arachnophobia is a
common fear
Example: Test Anxiety

• Learn relaxation skills

• Rate the fear hierarchy
➢short quiz might be 20 SUDs
➢a midterm might be 75 SUDs
➢a final exam worth most of the course grade might be 100 SUDs
• Student visualizes sitting in class and taking a quiz not worth very much
➢this is “imaginal exposure” and is vivid but safe
➢several examples of this with imagination of stimuli with greater SUDs
• As anxiety reduces, student can take an actual test, replacing the anxiety with
more pleasurable sense of calm
Flooding (Using Extinction)
• Used because systematic desensitization can take months
• Carefully controlled conditions
➢patient placed in the presence of the highest SUD stimulus
➢encouraged to confront; not allowed to escape
• Reaction
➢first reaction of patient is often extreme
➢over minutes to hours, the patient does relax (presumably
because nothing negative happens)
• This method is highly effective for treating phobias; works quickly
Humanistic Therapy
History
• Insight therapies were intensive and not focused on specific problems
• Behavioural therapies were very specific but did not focus on personal
growth
• Humanistic therapy developed to better understand human problems
• Humanism suggests that
➢individuals are unique
➢all can contribute
➢psychological health means reaching full potential
• Main goal is to help patient gain a better sense of self and meaning
Carl Rogers
• Originally trained in psychoanalysis
• But came to place more emphasis on conscious
experience
• Distinguished between the “real self” and the “ideal
self” (in personality development)
• Real self
➢how we view ourselves
• Ideal self
➢how we think we should be (societal expectations)
• Mismatch = psychological maladjustment
 Goals and Applications
• Can be used to treat anxiety, depression,
personality disorders, and substance-related disorders

• Goal is to work with the person’s tendency to “self-actualize”

• Rogers called this “person-centered therapy”

Role of the Therapist
• Unconditional positive regard
➢respectful and caring
➢express that the patient is doing the best they can
• Empathy (not sympathy)
➢understanding of the patient’s problems and emotions
• Congruence
➢body language matches what the therapist is saying

• No hierarchy (patient and therapist are peers)

• Therapy is non-directive (follows the lead of the patient)
• Implication? More effective for self-motivated patients
Gestalt Therapy
• “the whole is more than the sum of its parts”
• Sometimes what is important is hidden (Fritz Perls, 1969)
• Goal
➢uncover hidden elements that were suppressed due to outside
disapproval
➢helping patient express as a whole person
• Therapist challenges patient to “own” these elements
• Focus is on the here and now
• Therapists are direct (less gentle)
Empty Chair Technique
• Patient imagines an individual or a problem
sitting in an empty chair.
• Encouraged to express feelings and thoughts to
the chair.
• Goal is to uncover underlying conflict
• Sometimes patient sits in the chair
• Very intense feelings can arise

Fritz Perls was a controversial figure

Practiced Gestalt Therapy on Vancouver Island in the late 1960s
Cognitive Therapy
Background • Focus is on maladaptive thoughts

• Cognitive therapies
➢teach thought management
techniques
➢goal is to remove negative
thinking patterns
Rational-Emotive Therapy
• Introduced in the 1950s by Albert Ellis
• Influenced by cognitive theory
• Defined an A-B-C approach
➢A = Adverse event: a situation or event that triggers a negative
emotional or behavioral response
➢B = Beliefs: the core beliefs associated with the activating event
➢C = Consequences: the emotional or behavioral outcome caused
by beliefs about the activating event (the psychological problem)

When A happens, B influences the response, and C is the outcome.

Rational-Emotive Therapy
• The problem is irrational or inflexible beliefs (according to Ellis)
➢e.g., “I must be the smartest person in the class”; “If I am not loved, I have
no value”; “I will get an A, no matter what”
• Example
➢person with depression
➢began feeling depression after breaking up with a romantic partner
➢therapist argues that the person has beliefs about the breakup (I am not
loveable; I will not love again)
➢the thoughts are automatic but also irrational (maladaptive)
➢the therapist attacks the thoughts to show that they are irrational
Aaron Beck (Beck’s Model)
• Beck made enormous contributions to the field of psychology
➢Developed scales such as the Beck Depression Inventory (still
used today)
➢Lived to be 100 years old; died in 2021

• A founder of Cognitive Behavioural Therapy (CBT)

➢focus on connection between thoughts and resulting emotions
➢train patients to identify negative thinking
➢patients keep a “thought record”
 Examples of Cognitive Distortions
(Exaggerations or Misperceptions)
• All-or-nothing thinking (black-and-white or dichotomous thinking). There are
only two categories and no continuum.
➢e.g., “If I don’t earn all A’s, I’m a failure.”

• Discounting the positive. The person thinks their own positive attributes don’t
count at all.
➢e.g., “I was only hired for this job because I got lucky.”

• Catastrophizing. The person makes negative predictions without considering

other, more likely possibilities.
➢e.g., “I will never be able to learn all this material before my exam.”
A Little More History
• Behavioural therapies were a radical change from insight therapies
• Therapies like Applied Behavioural Analysis are sometimes referred
to as the “first wave of psychotherapy”
• Cognitive-behavioural therapy (CBT) combines behavioural and
cognitive approaches
➢CBT is sometimes referred to as the “second wave of
psychotherapy”
➢Focuses on how information processing influences behaviour
CBT
• Short-term
• Action-oriented
• Problem-focused
• No reference to the unconscious
or to self-actualization
• Main intention is to treat specific
psychological disorders
 CBT and the Cognitive Triad
• Beck’s “Cognitive Triad”
➢A person’s beliefs about self, the
world, and the future
➢The interaction of these can make
a person more or less vulnerable to
depression
➢Treatment focuses on thoughts in
this system

• An example of therapy
➢cognitive restructuring to identify
cognitive distortions and develop
alternate and more positive
thoughts
Applications of CBT
• Most widely used form of evidence-based psychotherapy
• Not a cure, but effective for the treatment of
➢depression
➢bipolar disorder
➢anxiety disorders
➢eating disorders
➢substance use disorders
➢insomnia
➢chronic pain and fatigue
➢anger and aggression
➢and more....
Third Wave of Psychotherapy
• Emphasizes mindfulness, acceptance, and individual values and
goals

• Includes mindfulness-based cognitive therapy

➢incorporates approaches like meditation
➢shows effectiveness in measurement trials
➢not better than CBT, but patients seem to be more accepting
(stay in treatment)
Stress and Health (New Topic)
What is Stress?
• Difficult to define
• How would you do this?
• People often refer to
➢external stimuli (e.g., jobs, finances, exams)
➢physiological responses (e.g., sweaty palms, increased heart
rate)
➢thoughts (fear of being alone in a dark parking lot)

• There is no precise definition of stress; instead, it might be better to

learn the terminology surrounding what people refer to as stress
Good Stress and Bad Stress
• Good stress
➢beneficial; motivates us; can enhance function
• Bad stress
➢reduces motivation; impairs function
• Early research into stress done by Hans Selye (at McGill University)
➢Eustress – reactions to good stress (e.g., having a baby, work
promotion, moving house)
➢Distress – reactions to bad stress (e.g., death of a loved one,
failing an exam, being victim of a crime)
Stress Models
• Yerkes-Dodson law (1908)
➢relates stress to performance (u-shaped graph)
➢too little or too much stress will impair performance
➢well-known model but not much empirical evidence for it

• Maximal Adaptability Model (recent)

➢humans adapt to stressors
➢high levels of performance even when environment is very demanding (and
presumably stressful)
➢overcoming adversity or working toward a goal inevitably involves stress
Stressors and Stress Response
• Stress and Coping Theory (Lazarus & Folkman, 1984)
➢definitions come from this theory
• Stressors
➢external events and stimuli
➢potential to disturb a person’s balanced state
➢range from mild to severe
• Stress responses
➢internal psychological and biological responses to stressors
➢work to restore a balanced state
➢involves thoughts, emotions, and bodily feedback (e.g., faster heart rate)
Time and Level of Severity
• Acute stressors
➢short-term external circumstances or stimuli
➢lasting minutes to hours
➢e.g., short class presentation; important exam; accidentally
sending a text to the wrong person

• Chronic stressors
➢long-term external circumstances or stimuli
➢lasting weeks to years
➢e.g., living in poverty; caring for an elderly relative; continuous
workplace stress
Time and Level of Severity
• Acute and Chronic stressors exist on a continuum from mild to
moderate to severe
• Traumatic stressors
➢severe and often life-threatening
➢short or long-term
➢e.g., war combat situations; child abuse; natural disasters (fires,
tornadoes, earthquakes, etc.)

A natural question is “why do we need to experience all the negative feelings

and unpleasantness associated with stress?”
Indeed, why do we need a stress response at all?
Timing of Stressors
The Stress Response
• Appears to be an evolutionary development
• Part of a survival set of responses
• Research perspective
➢Minds and bodies are like balanced scales
(homeostasis)
➢Stressors can unbalance the scale
➢Stress response provides “alerts” and
”reactions” to restore balance
• Alerts = thoughts, emotions, and sensations
• Reactions = psychological and biological
responses to restore balance
Stress Response as Adaptation
• Threats and challenges are inevitable in our lives
• The stress response helps us to maintain homeostasis when events
happen
• Evolved to help us deal with predators and attacks from other
humans
• Coordinated responses including energy allowed us to avoid harm
• Anticipating stressors was also useful to prepare us to respond
For Next Class
• Finish reading the “Stress and Health” module
• Have a good weekend!