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Richard P. Halgin
Susan Krauss Whitbourne
University of Massachusetts at Amherst
slides by Travis Langley
Henderson State University
Abnormal
Psychology
Clinical Perspectives on Psychological Disorders 5e
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Chapter 1
Classification and
Treatment Plans
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The Client:
The person
seeking
psychological
services.
Prevalence of
Psychological
Disorders:
1 in 5 people
during 2007
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Clinical Psychologists (PhD or PsyD)
The Clinician:
Mental health professional.
There are many types taking
many approaches.
Psychiatrists (MD)
An important distinction between psychiatrists and
psychologists is that psychiatrists are licensed to
administer medical treatment and prescribe medications,
and psychologists are not.
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The DSM-IV
The Diagnostic and Statistical Manual
of Mental Disorders
published by the
American Psychiatric Association
The DSM-IV (the fourth edition) or DSM-IV-TR
(fourth edition, text revision) contains
descriptions of all psychological disorders,
alternatively referred to as mental disorders.
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The DSM-IV
The Diagnostic and Statistical Manual
of Mental Disorders
Concerns in Developing the DSM-IV:
Reliability
Validity
Base Rates
Social Context
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The DSM-IV
The Diagnostic and Statistical Manual
of Mental Disorders
1952 DSM (a.k.a. DSM-I)
1968 DSM-II (based on ICD)
1980 DSM-III
(more quantitative, objective)
1987 DSM-III-R
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The DSM-IV
The Diagnostic and Statistical Manual
of Mental Disorders
1952 DSM (a.k.a. DSM-I)
1968 DSM-II (based on ICD)
1980 DSM-III
(more quantitative, objective)
1987 DSM-III-R
1994 DSM-IV
2000 DSM-IV-TR
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Mental Disorder
Clinically significant
behavioral or
psychological
syndrome or pattern
Distress or disability
Significant risk
Not accepted, culturally sanctioned
response to a particular event
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Classification system based on
medical model
Descriptive rather than
explanatory
Atheoretical orientation
Categorical approach
Multiaxial system
Assumptions of the DSM-IV
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Neurosis
Term referring to behavior that involves
distressing, unacceptable symptoms that
are enduring and lack any physical
basis.
Not a modern diagnostic term.
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Psychosis
Term referring to various forms of behavior
involving a loss of contact with reality,
such as delusions (false beliefs) and
hallucinations (false perceptions).
Although not a formal diagnostic category,
psychotic is retained in the DSM-IV-TR
as a descriptive term.
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The Five Axes of the DSM-IV
Axis I: Clinical Disorders
Axis II: Personality Disorders and Mental
Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental
Problems
Axis V: Global Assessment of Functioning
(helps assess prognosis)
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The Diagnostic Process
The Clients Reported and
Observable Symptoms
Diagnostic Criteria and Differential
Diagnosis
Final Diagnosis
Case Formulation
Cultural
Formulation
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decision tree:
A series of simple
yes/no questions in the
DSM-IV-TR about a
clients symptoms that
lead to a possible
diagnosis.
differential diagnosis:
Ruling out all possible
alternative diagnoses.
Cultural Formulation
culture-bound
syndromes:
particular patterns of
behavior in certain
cultures, perhaps
reflecting cultural
themes that date
back for centuries.
Example: Ghost
sickness is a
preoccupation
with death and
the deceased
that is reported
by members of
Native American
tribes.
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Establish Treatment Goals
Immediate Goals
Short-Term Goals
Long-Term Goals
Planning Treatment
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Planning Treatment
Determine Treatment Site
Psychiatric Hospitals
Outpatient Treatment
Halfway Houses and
Day Treatment Programs
Guidance Counselors
Employee Assistance Program
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Treatment Modality
Individual Psychotherapy
Family Therapy
Group Therapy
Milieu Therapy
Evidence-based practice
Clinical decision-making that integrates the
best available research evidence and
clinical expertise in the context of the
clients . . .
cultural background
preferences
characteristics
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Treatment Implementation
The Course of Treatment
The Clinicians Role
The Clients Role
The Outcome of Treatment
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