Source: Psychology 100 Finals Review Packet, The Ohio State University
Difficulty: Introductory. Prerequisites: the Psychological Disorders unit (you need to know the disorders these treatments target) and basic familiarity with classical and operant conditioning from earlier in the course.
This section covers the major approaches to treating mental disorders: behavioural therapies (systematic desensitisation, exposure therapy, token economies), cognitive behavioural therapy, group and family therapy, biomedical treatments (pharmacotherapy, ECT, psychosurgery), and the evidence base behind them. The through-line is that different disorders respond to different treatments, and the field increasingly demands empirical support for what clinicians do.
Psychotherapy helps people resolve emotional and behavioural problems. Behavioural approaches target specific actions (exposure therapy, systematic desensitisation). Cognitive behavioural therapy (CBT) targets irrational thinking. Biomedical treatments include medication (pharmacotherapy), ECT, and psychosurgery. Empirically supported therapies (ESTs) are treatments backed by rigorous evidence.
Psychotherapy
A psychological intervention designed to help people resolve emotional, behavioural, and interpersonal problems and improve quality of life.
Paraprofessional
A person with no professional training who provides mental health services. Research shows paraprofessionals can be surprisingly effective for some conditions.
Behaviour therapists
Therapists who focus on specific problem behaviours and the current variables that maintain them, rather than unconscious conflicts.
Systematic desensitisation
A technique in which patients are taught to relax while being gradually exposed to what they fear, in a stepwise manner. Think of it as climbing a fear ladder one rung at a time.
Exposure therapy
Therapy that confronts patients with what they fear, with the goal of reducing the fear response. More direct than systematic desensitisation.
Dismantling
A research procedure for examining which specific components of a larger treatment are responsible for its effectiveness.
Response prevention
A technique in which therapists prevent patients from performing their typical avoidance behaviours, commonly used alongside exposure for OCD.
Participant modelling
The therapist first models how to cope with a feared situation, then guides the patient through it.
Token economy
A system in which desirable behaviours are rewarded with tokens that can be exchanged for tangible rewards. Based on operant conditioning principles.
Aversion therapy
Treatment that uses punishment to decrease the frequency of undesirable behaviours (e.g. pairing alcohol with a nausea-inducing drug).
Cognitive behavioural therapy (CBT)
Treatment that attempts to replace maladaptive or irrational cognitions with more adaptive, rational ones. The dominant evidence-based therapy for many disorders.
Group therapy
Therapy that treats more than one person at a time, allowing participants to learn from each other's experiences.
Structural family therapy
Treatment in which therapists involve themselves in family activities to change how family members arrange and organise their interactions.
Empirically supported therapies (ESTs)
Treatments for specific disorders that are supported by high-quality scientific evidence. The gold standard for clinical practice.
Pharmacotherapy
The use of medications to treat psychological problems (e.g. antidepressants, antipsychotics, anxiolytics).
Electroconvulsive therapy (ECT)
Patients receive brief electrical pulses to the brain that produce a seizure, used to treat serious depression that has not responded to other treatments.
Psychosurgery
Brain surgery to treat psychological problems. Rare today, but historically includes lobotomy.
Built on learning principles (classical and operant conditioning).
Systematic desensitisation pairs relaxation with gradually increasing exposure to a feared stimulus. Used for phobias.
Exposure therapy is more direct: patients confront the feared stimulus without the relaxation component. The goal is extinction of the fear response.
Response prevention blocks avoidance behaviours, commonly combined with exposure for OCD (the patient is exposed to the trigger and prevented from performing the compulsion).
Participant modelling: the therapist demonstrates coping, then the patient practises.
Token economy: rewards desirable behaviour with tokens redeemable for privileges. Used in institutional settings.
Aversion therapy: pairs an undesirable behaviour with an unpleasant consequence.
Dismantling studies test which ingredients of a treatment package are doing the work.
Targets the link between thoughts and feelings. Maladaptive cognitions ("I'm worthless," "Nothing will ever improve") are identified and replaced with more realistic alternatives.
CBT has strong empirical support for depression, anxiety disorders, and many other conditions.
It is the treatment most closely associated with the cognitive model of depression.
Group therapy offers peer support, normalisation, and the chance to learn from others' experiences.
Structural family therapy treats the family system, not just the identified patient, by restructuring how members interact.
Pharmacotherapy: medication is the first-line treatment for many disorders (SSRIs for depression, antipsychotics for schizophrenia, benzodiazepines for acute anxiety).
ECT: still used for treatment-resistant depression. Modern ECT is safer than its historical reputation suggests.
Psychosurgery: a last resort. Historically associated with lobotomy; modern procedures are far more targeted and rarely performed.
Empirically supported therapies (ESTs) are treatments validated by controlled research.
Paraprofessionals can deliver effective support for some conditions, which has implications for increasing access to mental health care.
Students often confuse systematic desensitisation with exposure therapy. Systematic desensitisation uses relaxation and a gradual hierarchy; exposure therapy is more direct confrontation with the feared stimulus.
ECT is not the crude, painful procedure portrayed in films. Modern ECT uses anaesthesia and muscle relaxants, and it remains effective for severe depression.
Aversion therapy is not the same as punishment in everyday parenting. It is a clinical procedure that deliberately pairs a behaviour with an aversive stimulus.
CBT is not just "thinking positively." It is a structured, evidence-based process of identifying and testing specific irrational beliefs.
⚠️ Know the difference between systematic desensitisation and exposure therapy.
⚠️ Be able to explain response prevention and when it is used (typically with exposure for OCD).
⚠️ ESTs are the standard the field aspires to. Know what makes a therapy empirically supported.
⚠️ Dismantling is a method, not a therapy. It tests which components of a treatment are effective.
⚠️ Know the three biomedical treatments: pharmacotherapy, ECT, psychosurgery.
True or False: Systematic desensitisation involves flooding the patient with their most feared stimulus immediately. Answer: False. It uses a gradual hierarchy paired with relaxation.
Fill in the blank: A treatment that replaces irrational thoughts with more rational ones is called ______. Answer: Cognitive behavioural therapy (CBT).
True or False: Paraprofessionals have no role in effective mental health treatment. Answer: False. Research shows paraprofessionals can be effective for certain conditions.
Fill in the blank: The research procedure that isolates which components of a treatment are effective is called ______. Answer: Dismantling.
Q: A therapist treats a patient with OCD by having them touch a "contaminated" surface and then preventing them from washing their hands. What two techniques are being combined?
A: Exposure therapy (confronting the feared stimulus) and response prevention (blocking the avoidance behaviour, in this case handwashing).
Q: Why might a researcher use a dismantling study rather than simply testing whether a treatment works?
A: Because a treatment may contain multiple components, and not all of them may be necessary. Dismantling identifies which specific elements drive the effect, allowing clinicians to streamline treatment.
Q: Compare pharmacotherapy and CBT as treatments for depression. What are the advantages of each?
A: Pharmacotherapy (e.g. SSRIs) can provide relatively quick symptom relief and is the standard for severe cases. CBT targets the underlying thought patterns that maintain depression and has lower relapse rates after treatment ends. Many clinicians combine both.
Q: What is the token economy, and what learning principle does it draw on?
A: A token economy rewards desirable behaviours with tokens exchangeable for tangible rewards. It draws on operant conditioning, specifically positive reinforcement.
This section connects psychology to physical health. It covers how stress is defined and appraised, how it affects the body (immune system, cardiovascular system), the coping strategies people use, and the biopsychosocial model that ties everything together. Understanding stress also loops back to the Disorders unit, since stress is a trigger in the diathesis-stress model and is central to PTSD.
Stress arises when demands outstrip coping resources. We appraise stressors (primary appraisal) and our ability to handle them (secondary appraisal), then cope through problem-focused or emotion-focused strategies. Chronic stress suppresses the immune system and contributes to cardiovascular disease. Social support, cognitive restructuring, hardiness, and proactive coping are protective factors. Crisis debriefing, once widely used after trauma, has been found ineffective.
Stress
Tension, discomfort, or physical symptoms that arise when a situation (a stressor) strains our ability to cope effectively.
Clinician's illusion
The bias that clinicians only see people who react negatively to stressors, which can skew their perception of how common negative stress reactions are.
Traumatic event
A stressor so severe that it can produce long-term psychological or health consequences.
Stressors as stimuli
The approach of identifying which events produce stress. Focuses on the objective event.
Stress as a transaction
The view that stress is a subjective experience, depending on how the person appraises the situation.
Primary appraisal
The initial evaluation: is this event a stressor? Is it threatening, challenging, or irrelevant?
Secondary appraisal
The follow-up evaluation: can I handle this? Do I have the resources to cope?
Problem-focused coping
Dealing with a stressor by taking action to eliminate or change it. In simple terms, fixing the problem.
Emotion-focused coping
Dealing with a stressor by managing the emotional response it triggers, rather than changing the situation itself.
Stress as a response
People's psychological and physiological reactions to stress, including the fight-or-flight response.
Corticosteroids
Stress hormones (e.g. cortisol) released during the stress response. Chronically elevated levels damage the immune system.
Hassles
Minor daily nuisances that strain our ability to cope. Accumulated hassles can be as damaging as major life events.
Antigens
Foreign particles that trigger an immune response.
Pathogens
Disease-causing organisms (bacteria, viruses, etc.).
Phagocytes and lymphocytes
White blood cells that engulf invaders and coordinate the immune response.
Macrophages
Immune cells that destroy antigens and dead tissue.
T and B cells
Lymphocytes that produce antibodies and coordinate targeted immune responses.
Antibodies
Proteins that mark invading pathogens for destruction by other immune cells.
Autoimmune diseases
Diseases (e.g. rheumatoid arthritis) in which the immune system mistakenly attacks the body's own tissues.
Psychoneuroimmunology
The study of the link between the immune system and the central nervous system. This field investigates how psychological states affect physical health.
Psychosomatic
Psychological problems causing physical symptoms.
Peptic ulcer
A stomach disease historically linked to stress (though bacterial causes are now also recognised).
Psychophysiological
Illnesses that stress can exacerbate or make more likely (e.g. hypertension, tension headaches).
Biopsychosocial perspective
The view that most mental and physical illnesses are caused by biological, psychological, and social influences together.
Coronary heart disease (CHD)
Blockage of the arteries supplying blood to the heart.
Atherosclerosis
Narrowing of coronary arteries caused by cholesterol deposits. The underlying process in CHD.
Social support
The material, emotional, and informational support our social networks provide during times of stress. A strong protective factor.
Cognitive restructuring
Thinking about problems in more adaptive ways. Reframing a stressor as a challenge rather than a threat.
Proactive coping
Anticipating stressful events and taking steps to prevent them from happening.
Catharsis
Feeling of relief after expressing painful emotions.
Crisis debriefing
An intervention designed to decrease the risk of PTSD when administered immediately after a traumatic event. Research has found it is not effective and may even be harmful.
Hardiness
A personality style characterised by viewing stressors as challenges that can be controlled and overcome. Hardy individuals tend to cope better.
Rumination
Dwelling unproductively on one's problems. Associated with prolonged distress and depression.
Stress can be viewed as a stimulus (what events cause stress?), a response (how do body and mind react?), or a transaction (stress depends on the person's appraisal of the situation).
Primary appraisal: "Is this a threat?" Secondary appraisal: "Can I handle it?"
Hassles (daily minor irritants) accumulate and can be as health-damaging as major life events.
Traumatic events are extreme stressors with lasting consequences, potentially triggering PTSD.
Problem-focused coping: address the stressor directly (study harder for the exam, fix the leaky pipe).
Emotion-focused coping: manage the emotional response (talk to a friend, exercise, meditate).
Proactive coping: anticipate and prevent stressors before they hit.
Cognitive restructuring: reframe the situation ("This is a challenge, not a catastrophe").
Hardiness: a personality disposition characterised by commitment, control, and challenge. Hardy individuals cope better.
Rumination is the opposite of adaptive coping: dwelling on problems without taking action, which worsens distress.
The immune system fights pathogens using phagocytes, lymphocytes (T cells, B cells), macrophages, and antibodies.
Psychoneuroimmunology studies how stress and the nervous system affect immune function. Chronic stress suppresses the immune response via elevated corticosteroids.
Autoimmune diseases occur when the immune system attacks the body's own tissue.
Psychosomatic conditions: psychological distress producing real physical symptoms.
Psychophysiological conditions: illnesses worsened by stress (hypertension, tension headaches, possibly peptic ulcers).
Coronary heart disease and atherosclerosis are linked to chronic stress, Type A behaviour patterns, and hostility.
The biopsychosocial perspective holds that most illness is shaped by the interplay of biological, psychological, and social factors.
Social support (emotional, informational, material) is one of the strongest buffers against stress-related illness.
Cognitive restructuring and proactive coping reduce the impact of stressors.
Catharsis can provide temporary relief, but research on whether emotional venting is long-term beneficial is mixed.
Crisis debriefing was widely used after trauma (e.g. natural disasters, workplace incidents) but research has found it is not effective and may interfere with natural recovery.
The clinician's illusion reminds us that professionals see a skewed sample: the people who cope poorly. Most people recover from stress without professional help.
Students often assume that emotion-focused coping is inferior to problem-focused coping. Both are adaptive depending on the situation. When you cannot change the stressor (e.g. bereavement), emotion-focused coping is the appropriate response.
Crisis debriefing sounds like it should work. The evidence says otherwise. Exams test whether you know this.
Psychosomatic does not mean "imaginary." The symptoms are real; the cause is psychological.
Rumination is not the same as reflection or problem-solving. Rumination is repetitive, passive, and stuck on the negative.
⚠️ Know the difference between primary and secondary appraisal.
⚠️ Problem-focused vs. emotion-focused coping: be able to classify examples of each.
⚠️ The biopsychosocial perspective is a frequently tested integrating framework.
⚠️ Crisis debriefing is the surprising finding: it does not work. Expect a question.
⚠️ Know the immune system basics: antigens, pathogens, phagocytes, lymphocytes, T cells, B cells, antibodies.
⚠️ Psychoneuroimmunology is the field linking stress to immune function. Know the term and the basic mechanism (chronic stress → elevated cortisol → suppressed immunity).
True or False: Primary appraisal involves assessing whether you have the resources to cope. Answer: False. That is secondary appraisal. Primary appraisal assesses whether the event is a threat.
Fill in the blank: The study of the link between the immune system and the nervous system is called ______. Answer: Psychoneuroimmunology.
True or False: Crisis debriefing has been shown to effectively prevent PTSD. Answer: False. Research has found it is not effective.
Fill in the blank: A person who views stressors as challenges they can control and overcome demonstrates ______. Answer: Hardiness.
True or False: Rumination is an effective coping strategy for dealing with stress. Answer: False. Rumination involves dwelling unproductively on problems and is associated with worse outcomes.
Q: A student facing a difficult exam decides to create a detailed study schedule and ask a tutor for help. What type of coping is this?
A: Problem-focused coping. The student is taking direct action to address the stressor.
Q: Explain why high levels of corticosteroids are harmful during chronic stress.
A: Corticosteroids (e.g. cortisol) are stress hormones. In the short term, they help mobilise energy. Chronically elevated levels suppress immune function, making the body more vulnerable to illness.
Q: How does the biopsychosocial perspective differ from a purely medical model of illness?
A: The medical model treats illness as a purely physical/biological problem. The biopsychosocial perspective recognises that biological factors, psychological states (stress, beliefs, coping style), and social influences (support networks, socioeconomic status) all interact to affect health.
Q: A fire department requires all firefighters to attend a crisis debriefing session within 24 hours of every major incident. Based on the research, is this a sound policy?
A: No. Research has shown that crisis debriefing is not effective at preventing PTSD and may even interfere with natural recovery. A better approach is to monitor personnel and offer support to those who develop symptoms.
Psychological Treatments connects directly to Psychological Disorders (each therapy was developed for specific disorders: CBT for depression and anxiety, exposure for phobias, pharmacotherapy for schizophrenia). Stress and Health links to Social Psychology (social support is both a social and a health concept), to Psychological Disorders (stress is the "stress" half of the diathesis-stress model; PTSD is both a disorder and a stress outcome), and to Personality (hardiness is a personality disposition that buffers against stress).
Psychotherapy, CBT, cognitive behavioural therapy, systematic desensitisation, exposure therapy, response prevention, participant modelling, token economy, aversion therapy, dismantling, group therapy, structural family therapy, ESTs, empirically supported therapies, pharmacotherapy, ECT, electroconvulsive therapy, psychosurgery, paraprofessional, stress, stressor, primary appraisal, secondary appraisal, problem-focused coping, emotion-focused coping, proactive coping, cognitive restructuring, hardiness, rumination, catharsis, crisis debriefing, corticosteroids, cortisol, immune system, psychoneuroimmunology, psychosomatic, psychophysiological, biopsychosocial, coronary heart disease, atherosclerosis, social support, antigens, pathogens, phagocytes, lymphocytes, T cells, B cells, antibodies, autoimmune, clinician's illusion, Flynn effect, hassles, PTSD