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Psy 573 psychopathologyweek 1 study guide readings

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Week 1 Study Guide
You’ll be tested on the following points in Exam #1. While you won't be tested on ALL this
material, you will not be tested on anything additional outside what is in these weekly Study
Guides.
The history of community mental health treatment and rehabilitation for persons with severe
mental illness (Drake, Green, Mueser, & Goldman, 2003)
Treatment paradigms over time (p. 428)
- Psychosocial model (parental and intrapsychic influences) to Biopsychosocial model
(interplay between biological and psychosocial factors)
- In the 1960s and 1970s, the focus of community treatment was on symptom control
and the goal was to help people remain stable and stay out of the hospital. In the
1980s-attention turned to rehabilitation, and the goal became to help people function
in adult societal roles, such as worker, student, parent, or spouse. And in the 1990s
the ideology of community mental health shifted to the theme of recovery with the
goal to help people pursue independence, self-management, personally meaningful
activities, and better quality of life.
Pharmacological evolution (p. 430-432)
Chlorpromazine (1950s) to help treated severe mental illnesses
First generation antipsychotic
Prior to this: medications only sedated and reduced agitation
Chlorpromazine led to many patients becoming symptom-free and
successfully living in society again.
Clozapine (1980s, used 30 years prior briefly)
Second generation antipsychotic
used to treat refractory patients with schizophrenia
Helped with symptoms, negative side effects for some
Other second-gen antipsychotics introduced since 90s
Work well, but can have negative side effects
Gave clinicians and patients more options
Issues
Clinicians often hasty to prescribe meds without sufficient clinic evidence
of need
Availability of new medications
Hard to balance development of new meds, educating
practitioners on use, and assessing efficiency and effectiveness
Treatment facility evolution
- By the 1990s, psychiatric rehabilitation became the dominant method in
community mental health.
- First, rehabilitation continues to emphasize patient-centered services, such as
empowering the client to make choices regarding goals and interventions, to
direct services, and to be as independent as possible. Second, rehabilitation
continues to focus on the skills and supports needed for participation in routine
community life. People with mental illnesses generally want to be integrated in

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their communities, rather than segregated in mental health settings, work
enclaves, group homes, or special programs. Thus, current approaches recognize
that clients’ goals include normalization, inclusion, quality of life, and recovery
(Carling, 1995; Torrey and Wyzik, 2001). Third, rehabilitation approaches range
from experiential learning to specific training sessions, but research and clinical
experience have led to a greater emphasis on specificity: specific skills for
particular tasks and individual settings
Integrated treatment
- Sixth, rehabilitation services are most effective when they are integrated with
clinical services (Bond et al., 2001). The individual client cannot be divided up
into different aspects, directed to visit several clinics or programs, and required to
synthesize multiple disparate messages. Practitioners must therefore work
together, typically in multidisciplinary teams, to insure that services are
comprehensive, integrated, and continuous (Liberman et al., 2002).
The strange absence of things in the ‘culture’ of the DSM-5 (Ecks, 2016)
How DSM-5 conceptualizes culture
“cultural issues”, “Cultural formulation”, “cultural Formulation interviews”. Said
to be the totality of norms and values held by individuals, families, social
systems, and practices. Into 3 sections:
“Cultural Issues” – first mentioned in intro
“cultural formulation” – chapter, extends discussion of culture and
outlines “cultural formulation interview”
“glossary of cultural concepts of distress” - well-documented syndromes
such as ataque de nervios, dhat, susto
Echoes definition from cultural anthropology “culture” is totality of norms and
values held by individuals, families, social systems and institutions
Ex. Language, religion, spirituality, kinship, rituals, laws -> all part of
culture
Lists where things differ according to cultural norms and expectations
Previous concept of “culture-bound syndromes” is rejected and replaced by
“cultural syndromes”, “cultural idioms of distress”, “cultural
explanation/perceived causes”
Acknowledges all forms of distress to be locally shaped, even DSM disorders
Main critiques of culture in DSM-5

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Week 1 Study Guide You’ll be tested on the following points in Exam #1. While you won't be tested on ALL this material, you will not be tested on anything additional outside what is in these weekly Study Guides. The history of community mental health treatment and rehabilitation for persons with severe mental illness (Drake, Green, Mueser, & Goldman, 2003) • Treatment paradigms over time (p. 428) - Psychosocial model (parental and intrapsychic influences) to Biopsychosocial model (interplay between biological and psychosocial factors) - • • In the 1960s and 1970s, the focus of community treatment was on symptom control and the goal was to help people remain stable and stay out of the hospital. In the 1980s-attention turned to rehabilitation, and the goal became to help people function in adult societal roles, such as worker, student, parent, or spouse. And in the 1990s the i ...
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