Source: Chapters 13–14, General Psychology (Ohio State University)
Difficulty: Intermediate | Prerequisites: Chapters 5 (conditioning), 10 (personality theories), and 12 (psychological disorders)
Tags: therapy, psychotherapy, CBT, cognitive behavioural therapy, psychodynamic therapy, humanistic therapy, behaviour therapy, systematic desensitisation, antidepressants, antipsychotics, ECT, health psychology, stress, coping, GAS, Selye, stages of change, Type A Type B
Chapter 13 covers how psychological disorders are treated, from talk therapies to medication and brain stimulation. Each therapy approach maps onto a theoretical perspective you have already studied: psychodynamic therapy draws on Freud, humanistic therapy on Rogers, behaviour therapy on conditioning, and cognitive therapy on the idea that distorted thinking maintains distress. Chapter 14 zooms out to the relationship between psychology and physical health, exploring how stress affects the body, how people change health behaviours, and why social support matters. If you are behind, revisit Chapter 5 (classical and operant conditioning) and Chapter 12 (disorders) before tackling these two chapters, because the therapy methods only make sense once you understand what they are treating and the learning principles they rely on.
Therapies fall into two broad camps: psychological (talk-based) and biological (medication, ECT). The main psychological approaches are psychodynamic, humanistic, behavioural, cognitive, and cognitive-behavioural, each targeting a different assumed root cause. Health psychology studies how stress, coping strategies, personality, and social support interact with physical health. The general adaptation syndrome describes the body's three-stage response to prolonged stress, and behaviour-change models outline how people move from not thinking about change to maintaining it.
Psychotherapy
Treatment of mental health issues through psychological techniques (conversation, behavioural exercises) rather than medication. In simple terms, it is structured "talk therapy" delivered by a trained professional.
Psychodynamic therapy
A therapy rooted in Freud's ideas that aims to bring unconscious conflicts and early-childhood experiences into conscious awareness. Techniques include free association and dream analysis.
Client-centred therapy (Rogers)
A humanistic therapy in which the therapist provides unconditional positive regard, empathy, and genuineness to help clients explore their feelings and move toward self-directed growth. The therapist does not interpret or advise; the client leads.
Systematic desensitisation
A behaviour-therapy technique for treating phobias. The client learns relaxation, builds a hierarchy of feared situations (least to most frightening), and gradually works through the hierarchy while staying relaxed. The goal is to replace the fear response with a relaxation response.
Aversion therapy
A behaviour-therapy technique that pairs an unwanted behaviour with an unpleasant stimulus to reduce the behaviour (e.g., applying a bitter-tasting substance to nails to discourage biting).
Token economy
A behaviour-modification system in which desirable behaviours earn tokens that can be exchanged for rewards. Commonly used in institutional and classroom settings.
Cognitive therapy (Beck)
A therapy focused on identifying and restructuring distorted thinking patterns (e.g., "I always fail") that maintain emotional distress. The therapist helps the client test beliefs against evidence.
Cognitive-behavioural therapy (CBT)
An approach that combines cognitive restructuring (changing maladaptive thoughts) with behavioural techniques (exposure, activity scheduling). CBT is one of the most extensively researched and widely used therapies.
Antidepressants
Medications that improve mood by altering neurotransmitter activity, most commonly serotonin. SSRIs (selective serotonin reuptake inhibitors, e.g., fluoxetine/Prozac) are the first-line choice for many depressive and anxiety disorders.
Antipsychotics
Medications that reduce psychotic symptoms such as hallucinations and delusions, primarily by blocking dopamine receptors. Used mainly in the treatment of schizophrenia.
Mood stabilisers
Medications (e.g., lithium) used to even out the mood swings of bipolar disorder, reducing both manic and depressive episodes.
Antianxiety drugs
Medications that reduce tension and anxiety quickly (e.g., benzodiazepines such as diazepam). Effective short-term but carry a risk of dependence.
Electroconvulsive therapy (ECT)
A biological treatment in which a brief electrical current is passed through the brain to induce a controlled seizure. Reserved for severe, treatment-resistant depression. Modern ECT uses anaesthesia and muscle relaxants and is more targeted than its historical reputation suggests.
Health psychology
The subfield that studies how biological, psychological, and social factors influence health, illness, and health-related behaviours.
Stress
The body's response to demands (stressors) that tax or exceed coping resources. It can be acute (short-term) or chronic (ongoing).
General adaptation syndrome (GAS, Selye)
A three-stage model of the body's response to prolonged stress: alarm (fight-or-flight activation), resistance (the body adapts and copes), and exhaustion (resources are depleted, increasing vulnerability to illness).
Problem-focused coping
Coping strategies aimed at directly addressing or changing the source of stress (e.g., making a revision timetable before exams).
Emotion-focused coping
Coping strategies aimed at managing the emotional response to stress rather than the stressor itself (e.g., talking to a friend, journalling).
Avoidant coping
Coping by ignoring or avoiding the stressor (e.g., procrastinating instead of studying). Generally the least effective strategy over time.
Theory of planned behaviour
A model predicting that behavioural intentions, and therefore actual behaviour, are shaped by three factors: your attitude toward the behaviour, subjective norms (what important others think), and perceived behavioural control (whether you believe you can do it).
Stages of change model (Transtheoretical model)
A model describing five stages people move through when changing a health behaviour: precontemplation (not considering change), contemplation (thinking about it), preparation (planning), action (making the change), and maintenance (sustaining it).
Social support
The perception or reality of being cared for, valued, and part of a network. Consistently linked to lower stress, better immune function, and improved health outcomes.
Type A personality
A behavioural pattern characterised by competitiveness, impatience, time urgency, and hostility. The hostility component is the element most strongly linked to heart disease.
Type B personality
A behavioural pattern characterised by a more relaxed, patient, and easy-going approach. Associated with lower cardiovascular risk.
Psychodynamic therapy
Based on: Freud's psychoanalytic theory.
Goal: make unconscious conflicts conscious.
Techniques: free association, dream analysis, exploring transference.
Suitable for: clients interested in deep self-exploration, often longer-term.
Humanistic therapy (client-centred)
Based on: Rogers' humanistic perspective.
Goal: create a supportive environment so clients can grow toward their potential.
Key conditions: unconditional positive regard, empathy, genuineness.
The therapist reflects feelings and avoids directing the conversation.
Behaviour therapy
Based on: classical and operant conditioning principles.
Goal: change maladaptive behaviours directly.
Techniques:
Systematic desensitisation (graduated exposure paired with relaxation).
Aversion therapy (pairing an unwanted behaviour with an unpleasant stimulus).
Token economy (reinforcement-based systems).
Cognitive therapy (Beck)
Based on: the idea that distorted cognitions maintain emotional disorders.
Goal: identify, challenge, and replace irrational or unhelpful thoughts.
Example distortions: catastrophising ("If I fail this exam, my life is over"), all-or-nothing thinking ("I'm either perfect or a failure").
Cognitive-behavioural therapy (CBT)
Combines cognitive restructuring with behavioural techniques.
One of the best-supported therapies across a wide range of disorders (depression, anxiety, OCD, PTSD).
Typically structured, time-limited, and goal-oriented.
Antidepressants (SSRIs): increase available serotonin. First-line for depression and many anxiety disorders.
Antipsychotics: block dopamine receptors. Used for schizophrenia and severe psychotic episodes.
Mood stabilisers (lithium): reduce the severity of manic and depressive episodes in bipolar disorder.
Antianxiety medications (benzodiazepines): fast-acting but risk dependence with prolonged use.
ECT: effective for severe, treatment-resistant depression. Side effects can include short-term memory disruption.
Stressors can be acute (a pop quiz) or chronic (long-term caregiving, ongoing financial pressure).
General adaptation syndrome (GAS):
Alarm – the body's initial fight-or-flight response.
Resistance – the body adapts, hormone levels stabilise but remain elevated.
Exhaustion – prolonged stress depletes resources, immune function drops, risk of illness rises.
Coping strategies:
Problem-focused coping targets the stressor directly and is most effective when the situation is controllable.
Emotion-focused coping manages the emotional fallout and is more appropriate when the situation cannot be changed.
Avoidant coping (ignoring, procrastinating) tends to worsen outcomes over time.
Theory of planned behaviour: intention to change depends on personal attitude, social norms, and perceived control. All three need to align for behaviour change to be likely.
Stages of change model: people rarely leap from inaction to lasting change. The five stages (precontemplation → contemplation → preparation → action → maintenance) describe a progression that often involves setbacks and cycling between stages.
Strong social support is one of the most reliable predictors of both mental and physical health.
Type A personality (especially the hostility component) is associated with higher risk of cardiovascular disease.
Type B personality is associated with lower stress-related health risks.
CBT techniques (thought records, behavioural experiments) are used not only in therapy but also in self-help programmes, workplace stress management, and educational settings.
Understanding the stages of change model helps explain why simply telling someone to "just quit" a bad habit is ineffective: they may be in precontemplation or contemplation and need different support than someone in the action stage.
The GAS model explains why students who are chronically stressed throughout the term often fall ill during or just after finals: they have reached the exhaustion stage.
Social-support research is the scientific backing behind the common-sense advice to maintain close relationships and ask for help when under pressure.
Students sometimes assume psychodynamic therapy is just "lying on a couch talking about your childhood." Modern psychodynamic approaches are more interactive and focused, though they do explore early experiences and unconscious patterns.
CBT is often mistaken for "just thinking positive thoughts." In practice, it involves structured exercises, evidence-testing, and behavioural experiments, not vague optimism.
ECT is frequently misunderstood because of its portrayal in older films. Modern ECT is administered under anaesthesia, uses targeted electrical pulses, and is an effective last-resort treatment for severe depression.
Students sometimes equate Type A personality with being ambitious. The health risk is specifically associated with the hostility dimension, not with competitiveness or drive in general.
⚠️ Be able to match each therapy type to its underlying theory: psychodynamic → Freud, humanistic → Rogers, behaviour → conditioning, cognitive → Beck, CBT → combined.
⚠️ Know the key technique(s) for each therapy: free association, unconditional positive regard, systematic desensitisation, cognitive restructuring.
⚠️ Be able to match drug classes to the disorders they treat: SSRIs → depression/anxiety, antipsychotics → schizophrenia, lithium → bipolar, benzodiazepines → short-term anxiety.
⚠️ Know the three stages of the general adaptation syndrome in order: alarm, resistance, exhaustion.
⚠️ Distinguish problem-focused from emotion-focused coping and give an example of each.
⚠️ Know the five stages of the stages of change model in sequence.
⚠️ Know which component of Type A personality carries the cardiovascular risk (hostility).
The therapy that uses unconditional positive regard, empathy, and genuineness is called __________ therapy.
True or False: Antipsychotic medications primarily work by increasing serotonin.
In the general adaptation syndrome, the stage at which the body's resources are depleted is called __________.
True or False: Problem-focused coping involves managing your emotional response rather than addressing the stressor.
The stages of change model begins with the __________ stage.
Answers: 1. Client-centred (humanistic). 2. False (they primarily block dopamine receptors). 3. Exhaustion. 4. False (that describes emotion-focused coping; problem-focused coping targets the stressor directly). 5. Precontemplation.
Q: A therapist asks a client to describe whatever comes to mind without censoring. Which therapy type is this, and what is the technique called?
A: This is psychodynamic therapy, and the technique is free association. The aim is to access unconscious thoughts and conflicts by bypassing the client's usual filters.
Q: A person with a spider phobia learns relaxation techniques and then gradually works through a list of increasingly scary spider-related situations. What therapy technique is being used?
A: Systematic desensitisation, a behaviour-therapy technique that pairs relaxation with gradual exposure to the feared stimulus.
Q: Explain how CBT would approach a client who believes "If I make one mistake at work, everyone will think I'm incompetent."
A: The therapist would help the client identify this as a cognitive distortion (catastrophising, all-or-nothing thinking). Together, they would examine the evidence for and against the belief, develop a more balanced thought (e.g., "Everyone makes mistakes; one error does not define my competence"), and test the new belief through behavioural experiments (e.g., noticing colleagues' reactions after a minor error).
Q: Name the three stages of Selye's general adaptation syndrome and briefly describe each.
A: (1) Alarm: the body detects the stressor and activates the fight-or-flight response. (2) Resistance: the body adapts to the stressor and attempts to cope, with stress hormones remaining elevated. (3) Exhaustion: prolonged stress depletes the body's resources, weakening the immune system and increasing vulnerability to illness.
Q: According to the theory of planned behaviour, what three factors predict whether a person will follow through on a health-behaviour change such as quitting smoking?
A: (1) Attitude toward the behaviour (does the person believe quitting is a good idea?). (2) Subjective norms (do the people important to them support quitting?). (3) Perceived behavioural control (does the person believe they are capable of quitting?). All three must align to produce a strong intention.
Behaviour therapy techniques (Chapter 13) are direct applications of classical and operant conditioning from Chapter 5. Systematic desensitisation uses counterconditioning; token economies use reinforcement.
Biological therapies tie back to the neurotransmitter basics in Chapter 2: SSRIs target serotonin, antipsychotics target dopamine, and understanding why requires knowing how synaptic transmission works.
The biopsychosocial model from Chapter 12 (disorders) extends into Chapter 14 (health psychology): health and illness are best understood as products of interacting biological, psychological, and social factors.
Stress and coping (Chapter 14) connect to the emotion regulation and self-regulation concepts introduced in Chapter 9 (Motivation and Emotion).
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