Understanding Psychology (10th Ed)

FIGURE 1 
Estimates of the eff ective-
ness of diff erent types of treatment, 
in comparison to control groups of 
untreated people. The percentile score 
shows how much more eff ective a 
specifi c type of treatment is for the 
average patient rather than is no 
treatment. For example, people given 
psychodynamic treatment score, on 
average, more positively on outcome 
measures than about three-quarters of 
untreated people. 
(Source: Adapted from 
Smith, Glass, & Miller, 1980).
60 
50 80 
90 
70 
Success rate (percentage) 
Cognitive behavioral 
Behavior modification 
Systematic desensitization 
Person- or client-centered 
Gestalt 
Psychodynamic
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562 Chapter 
16 
Treatment of Psychological Disorders
determine the most effective treatment for a specifi c disorder (APA Presidential Task 
Force, 2006; Brownlee, 2007; Kazdin, 2008). 
Because no single type of psychotherapy is invariably effective for every indi-
vidual, some therapists use an eclectic approach to therapy. In an eclectic approach to 
therapy, therapists use a variety of techniques, thus integrating several perspectives, 
to treat a person’s problems. By employing more than one approach, therapists can 
choose the appropriate mix of evidence-based treatments to match the individual’s 
specifi c needs. Furthermore, therapists with certain personal characteristics may 
work better with particular individuals and types of treatments, and—as we consider 
next—even racial and ethnic factors may be related to the success of treatment 
(Cheston, 2000; Chambless et al., 2006; Hayes, 2008).
Consider the following case report written by a school counselor 
about Jimmy Jones, a 12-year-old student who was referred to a 
counselor because of his lack of interest in schoolwork: 
Jimmy does not pay attention, daydreams often, and frequently falls 
asleep during class. There is a strong possibility that Jimmy is 
harboring repressed rage that needs to be ventilated and dealt with. 
His inability to directly express his anger had led him to adopt 
passive-aggressive means of expressing hostility, i.e., inattentiveness, daydreaming, 
falling asleep. It is recommended that Jimmy be seen for intensive counseling to 
discover the basis of the anger. (Sue & Sue, 1990, p. 44)
The counselor was wrong, however. Rather than suffering from “repressed rage,” 
Jimmy lived in a poverty stricken and disorganized home. Because of overcrowding at 
his house, he did not get enough sleep and consequently was tired the next day. 
Frequently, he was also hungry. In short, the stresses arising from his environment and 
not any deep-seated psychological disturbances caused his problems. 
This incident underscores the importance of taking people’s environmental and 
cultural backgrounds into account during treatment for psychological disorders. In 
particular, members of racial and ethnic minority groups, especially those who are also 
poor, may behave in ways that help them deal with a society that discriminates against 
them. As a consequence, behavior that may signal psychological disorder in middle-
class and upper-class whites may simply be adaptive in people from other racial and 
socioeconomic groups. For instance, characteristically suspicious and distrustful 
people may be displaying a survival strategy to protect themselves from psychological 
and physical injury rather than suffering from a psychological disturbance (Paniagua, 
2000; Tseng, 2003; Pottick et al., 2007). 
In fact, therapists must question some basic assumptions of psychotherapy when 
dealing with racial, ethnic, and cultural minority group members. For example, 
compared with the dominant culture, Asian and Latino cultures typically place much 
greater emphasis on the group, family, and society. When an Asian or Latino faces a 
critical decision, the family helps make it—a cultural practice suggesting that family 
members should also play a role in psychological treatment. Similarly, the traditional 
Chinese recommendation for dealing with depression or anxiety is to urge people who 
experience such problems to avoid thinking about whatever is upsetting them. Consider 
how this advice contrasts with treatment approaches that emphasize the value of insight 
(Ponterotto, Gretchen, & Chauhan, 2001; McCarthy, 2005; Leitner, 2007). 
Clearly, therapists cannot be “colorblind.” Instead, they must take into account the 
racial, ethnic, cultural, and social class backgrounds of their clients in determining the 
nature of a psychological disorder and the course of treatment (Aponte & Wohl, 2000; 
Pedersen et al., 2002; Hayes, 2008).
Exploring