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  1. 1. Theoretical perspectives in professional psychology Maureen Cameron PSYCH6104_14W_O_F 02/03/2014
  2. 2. Hundreds of unique theoretical orientations exist in the world of professional psychology. → Often competing or conflicting school of thought → No common language for describing human nature and psychological intervention → Multiple ways of understanding personality, psychopathology, and psychotherapy → Growing demand for research and evidence based practice for credibility → Development of ethical standards of practice and best practice guidelines to inform practice across varied orientations → A richly creative and artistic field → An ever expanding knowledge base for understanding human though, behaviour and development
  3. 3. The numerous fields and subfields of psychology are too exhaustive to list, each worthy of a presentation of their own! For the purposes of this presentation, I briefly explore the following perspectives: → → → → Behaviourist Approach Feminist Approach Client-Centered Humanist Approach Biopsychosocial My focus will not be on the history of these perspectives, and instead will outline some of the main principles underlying conceptions of pathology and therapeutic intervention.
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  5. 5. Behavioural approach → Rejects concepts like tendencies, internal traits, defenses, motivations → People are controlled by their environments → Overt behaviours are those we can observe through outward actions → Covert behaviours include thoughts, perceptions, feelings, attributions of causality, etc. → All behaviours are learned through classical conditioning, operant conditioning or vicarious learning → Personality is a group of commonly performed responses
  6. 6. Classical Conditioning (Ivan Pavlov): With repeated paring of an unconditioned stimulus that elicits an unconditioned response and a neutral stimulus, the previously neutral stimulus elicits the same response as the unconditioned stimulus Operant Conditioning (B. F. Skinner): Change a behaviour by changing its consequences; consequences of a behaviour either increase, maintain, or decrease the frequency, duration or intensity of the behaviour Social Learning/Vicarious Learning (Albert Bandura): Through modelling, people observe behaviour and then perform that behaviour later with expectation of similar reinforcement
  7. 7. Behaviourist understanding of human problems: → Problems are determined by environmental contingencies → Negative/pathological behaviours are learned → Sometimes appropriate responses have not been learned or adaptive behaviours punished → If a problem behaviour can be learned then it can be unlearned → Problems are understood in terms of behaviours that need to be increased or decreased or learned/unlearned
  8. 8. Behaviourist Intervention: → The client is an active participant, learning about and changing behaviours → Shaping: problem behaviours are shaped into a desired pattern through reinforcement of successive approximations to desired behaviour → Clinicians, clients, caregivers and other involved parties can assist in making reinforces and punishers available in the environment → Teaching through modelling → Systematic desensitization and flooding for fear/anxiety Behavioural activation for depression
  9. 9. Strengths & Criticisms of Behaviourist Approach: Strengths: → Empirically validated due to rigorous experimentation and research → Hopeful outlook in terms of changing bad habits (learned behaviours) → Individuals are not inherently pathological, look to environmental influence Criticisms: → Limited view of human nature (ignores disposition, cognitive schemas, internal drives, etc.) → Ignores exploration of philosophical/existential aspects of life → Some habituated behaviours are resistant to change → Deterministic
  10. 10. feminist approach The feminist perspective in psychology is extremely diverse in nature with several theories, perspectives and approaches under its umbrella This is reflective of array of feminist ideologies: liberal, socialist, lesbian, radical, womanist, cultural, libertarian, postmodern, etc. It was born out of the social movements of the 1960s, criticisms of traditional concepts of health and wellness, and criticisms of traditional psychoanalysis
  11. 11. Feminist Understanding of Human Problems: “The Personal is Political!” → Problems experienced by both men and women are understood in terms of sex and gender, social and structural constraints, social institutions and social constructions of knowledge → Sex roles, gendered socialization, classism and patriarchy are seen as contributors to problems → Concepts of self are socially constructed and problems have a social location → Problems are not pathological but a result of coping within a patriarchal system and internalization of patriarchal ideologies
  12. 12. Feminist Therapeutic Intervention: → Change occurs within the context of an egalitarian relationship → Embrace strengths; value knowledge and skills; accept and validate feelings → Raises awareness of and challenges gendered expectations and internalized oppression → Depathologize through examination and reframing → Holistic and multilevel, considering all strengths and barriers → Mental health is not improved through individual therapy alone (consider domestic violence for example): need for advocacy and empowerment as well! → Gender role and power analysis, skill development (I e. assertiveness), self –disclosure, reframing/relabeling, social action, group work, encourage self-care and self-acceptance
  13. 13. Strengths & Criticisms of Feminist Approach: Strengths: → Depersonalizes problems and avoids victim blaming → Strengths based and empowering → Support social change → Egalitarian Criticisms: → Too political, non neutral → Minimizes potential problem sources (I e. predispositions)
  14. 14. Carl Rogers’ (1902-1987) client-centered Humanist approach “Existence precedes essence!” (Jean-Paul Sarte): Born out of existentialist philosophy concerned with the meaning of, and social construction of, human existence Rejects deterministic notions in psychoanalysis and behaviourism that suggest behaviour is controlled by unconscious forces or previous experience Through consciousness and action, we create our own existence and self; this occurs in relation to other human beings We are responsible for our own life and self-fulfillment Given the right conditions, all humans have an inherent drive toward fulfillment or self actualization (ability to achieve goals, wishes and desires)
  15. 15. Client-Centered Humanist Understanding of Problems: → An absence of unconditional positive regard from others and lack of positive regard for self leads to an incongruence in self concept and poor self esteem → In this absence we forgo our genuine self to pursue social approval/conditional regard → Problems, pain and distress, are reflective of this incongruence between real and ideal self → Inability to accept oneself leads to stunted growth, possible repression of feelings and experiences, anxiety, rigidity
  16. 16. Client-Centered Humanist Intervention: Good therapy shares the same elements of a good friendship, and does not require specialized knowledge or techniques “Core conditions,” qualities of the therapeutic relationship and type of communication are necessary and sufficient for client to move in line with natural inclination toward self actualization: → Congruence/Genuineness → Unconditional Positive Regard → Empathy If these conditions are met: → Clients come to fully know themselves and become more honest → Heal old wounds → Develop greater authenticity and congruence → Trust their own experiences , accept others as different
  17. 17. Strengths & Limitations of Client-Centered Humanism: Strengths: → View of all people as naturally good, creative, capable → Non-pathological → Critical impact of therapeutic relationship → Individual as a whole not parts to be evaluated/critiqued → Fosters search for spiritual/life purpose and meaning Criticisms: → Core conditions may not be necessary or sufficient → Ethnocentric ideology → May not be able to empirically measure self actualization → Sets client and therapist up for failure
  18. 18. Biopsychosocial approach Proposed by physician George Engel in1977 as response to inadequacy of the biomedical model in understanding and treating physical and psychological illnesses May be referred to as a systems/complexity approach or an ecological approach, conveying need for holistic perspective Complexity of human psychology can only be understood from an integrative perspective, with consideration of biological, sociocultural, and psychological contexts Purpose of psychology: meet behavioural health needs while promoting biopsychosocial functioning “Behavioural health” includes psychiatric disorders, substance abuse, and psychological health
  19. 19. Biopsychosocial understanding of problems: → Problems are located within a complex system → Consideration of risks and strengths across biopsychosocial domains, and may include information from an array of sources • Biological: Health habits and behaviours, general medical history, medications, gender, physical abilities/disabilities, neuropsychological functioning , diet, nutrition, sleep habits, etc. • Psychological: Personality, mental status, substance use, developmental history, sexual orientation, current symptoms and current problems, etc. • Sociocultural: Educational history, race, family history, living situation, financial circumstances, religion, community involvement, hobbies, etc. Problems may be understood according to severity of need and strength of resources across these domains
  20. 20. Biopsychosocial approach to intervention: → Focuses both on meeting behavioural health needs and promoting biopsychosocial functioning → Is holistic: not psychotherapy alone! → Prioritizes to address urgent, current and ongoing needs for optimal functioning → Does not adhere to any one theoretical intervention, but looks for best practices related to various issues, pulling from many frameworks → Is collaborative in nature
  21. 21. Strengths & criticisms of the biopsychosocial approach: Strengths: → Allows for individualized creative interventions → Holistic response to complexity of human nature → Accommodates many empirically supported interventions → Resolves divide amongst theoretical backgrounds → Facilitates collaboration and communication amongst health professions Criticisms: → Too eclectic and theoretical → Still competing dialogues about which approach is most effective → Undisciplined, subjective
  22. 22. My approach Prior to taking this course I understood my own social work practice framework as being “Generalist-Eclectic Approach” Similarities to biopsychosocial model: → Person in environment, informed by ecological systems theory → Use of flexible problem-solving to guide and prioritize interventions → Holistic, multilevel assessments that address strengths, diversity, oppression → Flexible and eclectic use of range of theories and techniques relevant to unique situation → Focus on development of a good helping relationship that fosters empowerment → Values artistic elements in practice as well as empirically sound modalities
  23. 23. Thank-you for joining me!
  24. 24. WORKS CITED Coady, N. & Lehmann, P. (2008). An overview and rationale for a generalist-eclectic approach to direct social work practice. In N. Coady & P. Lehmann (Eds.), Theroetical Perspectives for Direct Social Work Practice (3-39). New York: Springer Publishing Company. Cobb, N. (2008). Cognitive-behavioral theory and treatment. In N. Coady & P. Lehmann (Eds.), Theroetical Perspectives for Direct Social Work Practice (221-248). New York: Springer Publishing Company. Friedman, H. S. & Schustack, M. W. (2012). Personality: Classic theories and modern research (5th Ed.). Toronto: Allyn & Bacon. Ghaemi, S. N. (2011). The biopsychosocial model in psychiatry: A critique. An International Journal in Philosophy, Politics, Religion and the Arts, 6(1), 1-8. Retrieved from Hayes, S. (2012). The choice humanistic psychology faces. Psychotherapy, 49(4), 461-464. doi:10.1037/10027625
  25. 25. WORKS CITED CONTINUED Kensit, D. (2000). Rogerian theory: A critique of the effectiveness of pure client-centered therapy. Counselling Psychology Quarterly, 13(4), 345-351. Melchert, T. (2011). Foundations of professional psychology: The end of theoretical orientations and the emergence of the biopsychosocial approach. Waltham, MA: Elsevier .Munro, S., Baker, J. & Playle, J. (2005). International Journal of Mental Health Nursing, 14, 96-201. doi:10.1111/j.1440-0979.2005.00365.x Rothery, M. & Tutty, L. (2008). Client-centered theory. In N. Coady & P. Lehmann (Eds.), Theroetical Perspectives for Direct Social Work Practice (299-320). New York: Springer Publishing Company. Saulnier, C. F. (2008). Feminist Theories. In N. Coady & P. Lehmann (Eds.), Theroetical Perspectives for Direct Social Work Practice (343-368). New York: Springer Publishing Company.