CLEP Psychology · Lesson 13 of 15
CLEP Psychology

Lesson 13: Treatment of Psychological Disorders


What You'll Learn

Content

Treatment accounts for about 6–7% of the CLEP Psychology exam. The organizing insight: every therapy rests on a theory of what causes psychological suffering, and diagnoses follow DSM-5 terminology and criteria. Learn the theory and the techniques follow. Two big families exist: psychotherapies (talk-and-behavior treatments) and biomedical therapies (treatments acting directly on the brain and body).

Psychoanalytic and psychodynamic therapy

Psychoanalysis (Freud) assumes problems come from unconscious conflicts, usually rooted in childhood and repressed out of awareness. The cure is insight — bringing the buried conflict into the light. The signature technique is free association: the client says whatever comes to mind, uncensored, so unconscious material can surface. The analyst watches for resistance (the client blocking near sensitive topics) and transference (redirecting feelings about an important figure, such as a parent, onto the therapist), and interprets dreams. Modern psychodynamic therapy keeps the core idea — we lack full conscious access to our motives — but is briefer, face-to-face, and focused on current relationship patterns.

Humanistic (client-centered) therapy

Carl Rogers's client-centered (person-centered) therapy assumes people are growth-oriented and that distress comes from the gap between the true self and the conditional approval absorbed from others. The therapist does not interpret or advise; the therapist provides a growth-promoting climate built on unconditional positive regard, genuineness, and empathy, using active listening — reflecting the client's feelings back so the client can find their own direction.

Behavior therapies

Behavior therapies skip insight: the maladaptive behavior is the problem, and conditioning principles can unlearn it.

Technique Conditioning type How it works Typical use
Systematic desensitization (Wolpe) Classical Relaxation is paired step-by-step with a graded anxiety hierarchy (counterconditioning) Phobias, anxiety
Aversion therapy Classical An unwanted behavior is paired with an unpleasant stimulus (e.g., alcohol + a nausea drug) Substance use, habits
Token economy Operant Desired behaviors earn tokens exchangeable for privileges Institutional settings

Systematic desensitization and aversion therapy are mirror images: desensitization removes an unwanted response (fear) by pairing the feared thing with relaxation; aversion therapy creates an unwanted response by pairing a bad habit with something unpleasant.

Cognitive therapies and CBT

Cognitive therapists locate the problem in thinking: it is the interpretation of events, not the events, that produces distress. Aaron Beck's cognitive therapy targets the automatic negative thoughts behind depression (catastrophizing, all-or-nothing thinking), testing them against evidence. Albert Ellis's rational-emotive behavior therapy (REBT) is more confrontational: the therapist vigorously disputes irrational beliefs ("I must be perfect or I am worthless") until the client abandons them. Cognitive-behavioral therapy (CBT) combines cognitive restructuring with behavioral change (including exposure) in one structured, present-focused package; it has the strongest research support of any psychotherapy for depression and anxiety disorders.

Group and family therapy

Group therapy treats several clients together, harnessing peer feedback and the relief of learning you are not alone. Family therapy treats the family as an interacting system: one member's symptoms often reflect dysfunctional patterns in the whole unit, so the therapist works on the system, not just the individual.

Biomedical treatments

Drug class Action Treats
Antidepressants (SSRIs, e.g., fluoxetine) Block serotonin reuptake, raising available serotonin Depression, anxiety disorders
Antipsychotics Block dopamine receptors Schizophrenia, psychotic disorders
Antianxiety drugs (benzodiazepines) Depress central nervous system activity Short-term anxiety relief
Mood stabilizers (lithium) Level mood swings Bipolar disorder

Electroconvulsive therapy (ECT) induces a brief, controlled seizure and — despite its grim reputation — remains a genuinely effective option for severe, treatment-resistant depression.

The introduction of antipsychotic drugs in the 1950s enabled deinstitutionalization: the mass release of patients from long-stay mental hospitals into community-based care. It relieved warehousing but, where community services lagged, contributed to homelessness and undertreatment.

Does therapy work?

Meta-analysis — statistically pooling many studies — shows that psychotherapy clients improve more than untreated controls, and that no single school dominates for every disorder, though specific therapies win for specific conditions (e.g., exposure for phobias). The therapeutic alliance — the trust between therapist and client — predicts success across therapy types. Most practitioners today are eclectic, drawing techniques from several approaches to fit the client, and evidence-based practice integrates research evidence with clinical expertise and client characteristics. For many disorders, medication plus psychotherapy outperforms either alone.

Key Takeaways

Practice Questions

Question 1
A psychoanalyst encourages a client to say whatever comes to mind without censoring anything. The purpose of this free-association technique is to
Question 2
According to Carl Rogers, the most essential contribution a client-centered therapist can make is to
Question 3
Amara has an intense fear of elevators. Her therapist first teaches her deep muscle relaxation, then guides her through a graded series of elevator-related situations — from viewing photographs to riding one floor — while she remains relaxed at each step. This treatment is
Question 4
Marcus tells his therapist, "I must succeed at everything I attempt, or I am a complete failure." The therapist immediately and vigorously challenges this belief as irrational and self-defeating. The therapist's approach is
Question 5
A psychiatrist prescribes a medication that blocks dopamine receptors in order to reduce a patient's hallucinations and delusions. The medication is best classified as
Question 6
On an inpatient psychiatric unit, residents earn points for attending group sessions and completing self-care tasks; the points can be exchanged for privileges such as extra recreation time. This arrangement illustrates
Question 7
Lithium is most commonly prescribed to treat
Question 8
A therapist treating a client with panic disorder helps the client test the accuracy of the thought "a racing heart means I am dying" and also assigns graded practice in situations the client has been avoiding. What distinguishes this treatment as cognitive-behavioral therapy rather than a pure behavior therapy is that it
Question 9
A client who wants to stop drinking takes a medication that produces severe nausea whenever alcohol is consumed. Although this treatment and systematic desensitization both rely on classical conditioning, this technique differs because it
Question 10
A commentator asserts that electroconvulsive therapy is a discredited relic that modern psychiatry has abandoned. Which of the following best evaluates this claim?
Question 11
Beginning in the 1950s, the population of long-stay psychiatric hospitals in the United States fell dramatically. Which of the following best explains a major cause of this deinstitutionalization?
Question 12
A meta-analysis pooling hundreds of therapy-outcome studies finds that clients who receive psychotherapy improve more, on average, than untreated controls, and that no single school of therapy is dramatically superior for every disorder. Which conclusion is best supported by these findings?
Show answer key & explanations

Answer Key

Q1 — D (allow repressed unconscious material to surface). - Correct: Free association exists to bypass censorship so repressed conflicts can leak into awareness — the raw material for psychoanalytic insight. - A) Counterconditioning is the mechanism of behavior therapy, not talk-based uncovering. B) Reinforcement is operant behavior therapy. C) Disputing beliefs is Ellis's REBT, which confronts conscious thoughts, not unconscious ones. E) Unconditional positive regard is the humanistic climate, not an uncovering technique. - Fix rule: Free association = a pipeline to the unconscious; its goal is always insight.

Q2 — B (unconditional positive regard, genuineness, and empathy). - Correct: Rogers held that a climate of total acceptance, authenticity, and empathy lets clients grow toward their own solutions. - A) Interpretation of dreams and resistance is psychoanalytic — Rogers explicitly refused the expert-interpreter role. C) Thought-testing homework is Beck's cognitive therapy. D) Tokens are operant behavior therapy. E) Medication is biomedical, outside the humanistic model entirely. - Fix rule: Rogers = provide the growth climate (UPR + genuineness + empathy); the client finds the path.

Q3 — D (systematic desensitization). - Correct: Relaxation training plus a graded anxiety hierarchy is Wolpe's systematic desensitization — counterconditioning fear with relaxation. - A) Aversion therapy pairs a behavior with something unpleasant; nothing unpleasant is added here. B) REBT disputes beliefs; no relaxation or hierarchy. C) Free association is psychoanalytic uncovering. E) A token economy uses exchangeable reinforcers, absent here. - Fix rule: Relaxation + step-by-step feared-situation ladder = systematic desensitization.

Q4 — B (rational-emotive behavior therapy). - Correct: Vigorous, direct disputation of an irrational "must" belief is the defining move of Ellis's REBT. - A) A client-centered therapist would reflect the feeling, never confront the belief. C) Systematic desensitization treats fear with relaxation, not argument. D) Psychodynamic therapy probes unconscious origins rather than debating the belief itself. E) No medication or physical intervention is involved. - Fix rule: Therapist argues the client out of an irrational "must/should" = Ellis's REBT.

Q5 — C (an antipsychotic). - Correct: Blocking dopamine receptors to reduce hallucinations and delusions defines antipsychotic medication. - A) SSRIs raise serotonin and treat depression/anxiety — wrong transmitter, wrong symptoms. B) Mood stabilizers such as lithium level bipolar mood swings. D) Antianxiety drugs depress CNS activity for anxiety relief. E) Stimulants increase arousal and would worsen, not reduce, psychotic agitation. - Fix rule: Blocks dopamine → treats psychosis = antipsychotic; raises serotonin → treats depression = SSRI.

Q6 — A (a token economy). - Correct: Earning exchangeable secondary reinforcers (points) for target behaviors is a token economy, an operant behavior therapy common in institutions. - B) Systematic desensitization treats fear with relaxation and a hierarchy. C) Cognitive restructuring changes thoughts, not reward contingencies. D) Transference is a psychoanalytic phenomenon. E) The placebo effect is improvement from expectation, not from programmed reinforcement. - Fix rule: Earn tokens/points for target behaviors, trade for privileges = token economy.

Q7 — C (bipolar disorder). - Correct: Lithium is the classic mood stabilizer for bipolar disorder, smoothing swings between mania and depression. - A) Schizophrenia calls for antipsychotics. B) Specific phobia calls for exposure-based behavior therapy. D) OCD is typically treated with CBT/exposure and SSRIs. E) Dissociative identity disorder is not a lithium indication. - Fix rule: Lithium = mood stabilizer = bipolar disorder.

Q8 — E (targets distorted thoughts in addition to changing behavior). - Correct: CBT is defined by the integration — cognitive restructuring plus behavioral change such as exposure. Pure behavior therapy refuses to work on thoughts. - A) Exclusive focus on rewarding behavior describes pure operant therapy, the thing CBT goes beyond. B) Insight into childhood conflict is psychodynamic. C) CBT includes exposure; it does not avoid feared situations. D) Transference is psychoanalytic, irrelevant to CBT's definition. - Fix rule: If thoughts AND behavior are both being changed, it is CBT.

Q9 — E (attaches an unpleasant response to an unwanted behavior). - Correct: Aversion therapy pairs the unwanted behavior (drinking) with an aversive stimulus (nausea) so the behavior itself becomes repellent — the opposite goal of desensitization. - A) Relaxation plus a hierarchy is desensitization itself, not the difference. B) Both techniques are classical, not operant. C) Behavior therapies do not pursue insight. D) Creating a pleasant response to a feared stimulus describes counterconditioning in desensitization, the reverse of aversion. - Fix rule: Desensitization calms a feared stimulus; aversion therapy disgusts an unwanted behavior.

Q10 — A (flawed; ECT remains effective for severe, treatment-resistant depression). - Correct: Despite its reputation, modern ECT is an evidence-supported last-resort treatment when severe depression has not responded to drugs or psychotherapy. - B) ECT is legal and in current use. C) Antidepressants fail for a substantial minority of patients, which is exactly when ECT is considered. D) Overcorrects — ECT is a last resort, never first-line for all mood disorders. E) ECT's established indication is severe depression, not anxiety disorders. - Fix rule: ECT = still used, last resort, severe treatment-resistant depression.

Q11 — D (antipsychotic drugs allowed community treatment). - Correct: The arrival of antipsychotics in the 1950s controlled psychotic symptoms well enough for large numbers of patients to leave hospitals for community care — the engine of deinstitutionalization. - A) The DSM expanded rather than eliminated categories. B) Psychoanalysis never demonstrated quick cures for psychosis. C) ECT predates the exodus and did not empty hospitals. E) No federal law banned inpatient treatment. - Fix rule: Deinstitutionalization = 1950s antipsychotics + community mental health movement.

Q12 — C (therapy works overall, supporting an eclectic approach). - Correct: Improvement over untreated controls plus no across-the-board winner is precisely the evidence base for drawing techniques from multiple approaches to fit the client and disorder. - A) Contradicts the stated finding that treated clients improve more. B) The data show no school is superior for everything. D) The meta-analysis is about psychotherapy producing improvement. E) "Fully accounts" overreaches — treated clients outperformed untreated controls beyond expectation effects. - Fix rule: Meta-analysis: therapy > no therapy; no universal winner → match the tool to the problem (eclectic).

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