Solution Manual for Essentials of Abnormal Psychology

Third Canadian Edition Canadian 3rd Edition by Nevid

Greene Johnson Taylor and Macnab ISBN 0132968606
9780132968607
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Chapter 2 Assessment, Classification, and Treatment of Abnormal

Behaviour

Chapter Overview:

Methods of Assessment

The Clinical Interview

The most widely used method of assessment, the clinical interview, involves the
use of a set of questions designed to elicit relevant information from people
seeking treatment. Clinicians generally use a structured interview, which consists
of a fairly standard series of questions to gather a wide range of information
concerning presenting problems or complaints, present circumstances, and
history.

Psychological Tests

Psychological tests are structured methods of assessment that are used to

evaluate reasonably stable traits such as intelligence and personality.

Intelligence Tests

Tests of intelligence, like the Stanford-Binet and the Wechsler scales, are used
for various purposes in clinical assessment, including determining evidence of
mental retardation or cognitive impairment, and assessing strengths and
weaknesses. Intelligence is expressed in the form of an intelligence quotient (IQ).
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Personality Tests

Self-report personality inventories, like the MMPI, use structured items to

measure various personality traits, such as anxiety, depression, and masculinity-
femininity. These tests are considered objective in the sense that they make use
of a limited range of possible responses to items and an empirical, or objective,
method of test construction.

Projective personality tests such as the Rorschach and TAT, ask subjects to
interpret ambiguous stimuli in the belief that their answers may shed light on the
unconscious processes. Concerns persist about the validity of these tests,
however.

Neuropsychological Assessment

Methods of neuropsychological assessment help determine organic bases for

impaired behaviour and psychological functioning. For example, the Luria
Nebraska Test Battery is a sophisticated batteries of tests measuring various
perceptual, intellectual, and motor skills and performance.

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Behavioural Assessment

In behavioural assessment, test responses are taken as samples of behaviour

rather than as signs of underlying traits or dispositions. The behavioural
examiner may conduct a functional assessment, which relates the problem
behaviour to its antecedents and consequences. Methods of behavioural
assessment include behavioural interviewing, self-monitoring, use of analogue or
contrived measures, direct observation, and behavioural rating scales.

Cognitive Assessment

Cognitive assessment focuses on the measurement of thoughts, beliefs, and

attitudes in order to help identity distorted thinking patterns. Specific methods of
assessment include the use of a thought record or diary and the use of rating
scales such as the Automatic Thoughts Questionnaire (ATQ).

Physiological Measurement

Measures of physiological function include heart rate, blood pressure, galvanic

skin response (GSR), muscle tension, and brain wave activity. Brain-imaging
techniques such as EEG, CAT scans, PET scans, MRI, fMRI , BEAM, and MEG
probe the inner workings and structures of the brain.

Classification of Abnormal Behaviour

The Diagnostic and Statistical Manual of Mental Disorders (DSM), is the most
widely accepted diagnostic system, now in its fourth edition. Another widely used
system is the International Classification of Diseases (ICD) published by the
World Health Organization. Now, in its tenth edition, and with Canadian
enhancements and modifications, the system is known as the ICD-10-CA, which
has been adopted as the Canadian standard for coding, reporting, and tracking
health information.

The DSM uses specific diagnostic criteria to group patterns of abnormal

behaviours that share common clinical features and a multiaxial system of’
evaluation. Strengths of the DSM include its use of specified diagnostic criteria
and a multiaxial system to provide a comprehensive picture of the person’s
functioning. Weaknesses include questions about reliability and validity, and
about the medical model framework.

Methods of Treatment

Psychotherapy involves a systematic interaction between therapists and clients

that incorporates psychological principles to help clients overcome abnormal
behaviour, solve problems in living, or develop as individuals. The various
approaches to psychotherapy employ theory-based specific treatment factors
and nonspecific factors such as the quality of the therapeutic relationship and the
installation of hope.

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Biological Therapies
Biological approaches include drug therapy, electroconvulsive shock therapy
(Ed), and psychosurgery. Minor tranquilizers such as Valium may relieve short-
term anxiety but do not directly help people solve their problems. Neuroleptics
help relieve flagrant psychotic features, but regular use of most antipsychotic
drugs has been associated with a risk of disabling side effects. Antidepressants
have been shown to be effective in treating depressive disorders, and lithium has
been shown to be effective in treating bipolar disorder. ECT is often associated
with dramatic relief from severe depression, but questions remain about side
effects. Psychosurgery is conducted only rarely because of adverse
consequences. Deep brain stimulation involves implanting electrodes within the
part of the brain that affects mood.

Psychodynamic Therapies

Psychodynamic therapies originated with psychoanalysis, the approach to

treatment developed by Freud. Psychoanalysts use techniques such as free
association and dream analysis to help people gain insight into their unconscious
conflicts and work them through in the light of theft adult personalities. More
recent psychoanalytic therapies are generally briefer and less intensive.

Behaviour Therapy

Behaviour therapy applies principles of learning to help people make adaptive

behavioural changes. Behaviour therapy techniques include systematic
desensitization, gradual exposure, modeling, aversive conditioning, operant
conditioning approaches, social skills training, and self-control techniques.

Humanistic-Existential Therapies

Humanistic approaches focus on the client’s subjective, conscious experience in

the here and now. Rogers’s person-centered therapy helps people increase theft
awareness and acceptance of inner feelings that had met with social
condemnation and been disowned. The effective person-centered therapist
possesses the qualities of unconditional positive regard, empathic understanding,
genuineness and congruence.

Cognitive-Behavioural Therapies

Cognitive therapies focus on modifying the maladaptive cognitions that are

believed to underlie emotional problems and self-defeating behaviour. Ellis’s
rational-emotive therapy focuses on disputing the irrational beliefs that occasion
emotional distress and substituting adaptive behaviour for maladaptive
behaviour. Beck’s cognitive therapy focuses on helping clients identify,
challenge, and replace distorted cognitions, such as tendencies to magnify
negative events and minimize personal accomplishments. Meichenbaum’s
cognitive-behavioural therapy attempts to integrate behavioural principles and

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cognitive techniques in a way that reduces or eliminates problematic behaviours
and changes dysfunctional thoughts and cognitions.

Eclectic Therapy

Eclectic therapists make use of multiple models of psychotherapy. In technical

eclecticism, therapists use techniques from different approaches without
necessarily adopting the theoretical models on which they were based. In
integrative eclecticism, therapists attempt to synthesize and integrate diverse
theoretical models.

Group, Family, and Marital Therapy

Group therapy has several advantages over individual treatment, such as

reduced costs, opportunities for shared learning experiences and mutual support,
and increased utilization of scarce therapist resources. The particular approach
to group therapy depends on the orientation of the therapist.

Family therapists work with conflicted families to help them resolve their
differences. Family therapists focus on clarifying family communications,
resolving role conflicts, guarding against scapegoating individual members, and
helping members develop greater autonomy. Marital therapists focus on helping
couples improve their communications and resolve their differences.

Computer-Assisted Therapy

Computer-based interventions and therapy come in all forms, from online

cognitive-behavioural therapy with a live therapist using a video-chat service to
self-guided behaviour therapy for children with anxiety. Computer-based
interventions for various disorders have the potential to dramatically expand and
alter the landscape of treatment.

Does Psychotherapy Work?

Psychotherapy researchers have generated encouraging evidence of the

effectiveness of psychotherapy. Although there are few well-designed head-to-
head comparative treatment studies, the results of meta-analyses of research
studies that compare psychotherapy with control groups support the efficacy of
various approaches to psychotherapy.

Multicultural Issues in Psychotherapy

Therapists need to take cultural factors into account in determining the

appropriateness of Western forms of psychotherapy for different cultural groups.
Some groups may, for example, have different views of the importance of the
autonomy of the individual, or may place more value on spiritual than
psychotherapeutic interventions.

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Abnormal Psychology and Society

Psychiatric Commitment and Patient’s Rights

The legal process by which people are placed in psychiatric institutions against
their will is called psychiatric or civil commitment. Psychiatric commitment is
intended to provide treatment to people who are deemed to suffer from mental
disorders and to pose a threat to themselves or others. Legal or criminal
commitment, by comparison, involves the placement of a person in a psychiatric
institution for treatment who has been acquitted of a crime by reason of insanity.
In voluntary hospitalization, people voluntarily seek treatment in a psychiatric
facility, and can leave of their own accord, unless a court rules otherwise.

Predicting Dangerousness

Although people must be judged dangerous to be placed involuntarily in a

psychiatric facility, mental health professionals have not demonstrated any
special ability to predict dangerousness

Mental Illness and Criminal Responsibility

The Insanity Defence

Three court cases established legal precedents for the insanity defence. In 1834,
a court in Ohio applied a principle of irresistible impulse as the basis of an
insanity defense. The M’Naughten rule, based on a case in England in 1843,
treated the failure to appreciate the wrongfulness of one’s action as the basis of
legal insanity. People who are criminally committed may be hospitalized for an
indefinite period of time, with their eventual release dependent on a
determination of their mental status.

Competency to Stand Trial

People who are accused of crimes but are incapable of understanding the
charges against them or assisting in their own defence can be found incompetent
to stand trial and remanded to a psychiatric facility.

The Duty to Warn

Although information disclosed by a client to a therapist generally carries a right

to confidentiality, the California Tarasoff ruling held that therapists have a duty or
obligation to warn third parties of threats made against them by their clients.

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Chapter Outline:

Systems of Classification 41

Methods of Assessment 41
The Clinical Interview 41
Psychological Tests of Intelligence and
Personality 43
Neuropsychological Assessment 51
Behavioural Assessment 52
Cognitive Assessment 54
Physiological Measurement 56
Probing the Workings of the Brain 56
REVIEW IT Methods of Assessment 58

Classification of Abnormal Behaviour: The DSM System 59

Features of the DSM 60
Evaluation of the DSM System 63
Advantages and Disadvantages of the
DSM System 63
REVIEW IT Classification of Abnormal Behaviour 66

Methods of Treatment 66
Types of Mental Health Professionals in Canada 67
Biological Therapies 68
Deep Brain Stimulation 72
Psychodynamic Therapies 72
Behaviour Therapy 75
Humanistic-Existential Therapies 76
Cognitive-Behaviour Therapies 78
Eclectic Therapy 81
Group, Family, and Marital Therapy 81
Computer-Assisted Therapy 82
Does Psychotherapy Work? 83
REVIEW IT Methods of Treatment 87

Abnormal Psychology and Society 87

Psychiatric Commitment and Patients’ Rights 87
Mental Illness and Criminal Responsibility 91
REVIEW IT Mental Illness and Criminal
Responsibility 94

CONCEPT MAP 96

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Students Should Be Able to:

1. Discuss sociocultural and ethnic factors in the assessment of abnormal

behaviour.

2. Describe different types of interviewing techniques, explaining their

strengths and weaknesses.

3. Describe the features of tests of intelligence and personality.

4. Describe the use of psychological tests in the assessment of

neuropsychological functioning.

5. Discuss the advantages and limitations of behavioural assessment, and

describe the following behavioural techniques: the behavioural interview,
self-monitoring, use of contrived measures, direct observation, and
behavioural rating scales.

6. Discuss cognitive methods of assessment.

7. Discuss the use of physiological measurement in assessment, including

the use of brain-imaging techniques.

8. Discuss historical origins of modern diagnostic systems and the

development of the DSM system.

9. Describe the features of the DSM system and evaluate its strengths and
weaknesses.

10. Identify and describe various culture-bound syndromes.

11. Describe the legal procedures for psychiatric commitment and the
safeguards to prevent abuses of psychiatric commitment.

12. Discuss the controversy concerning psychiatric commitment.

13. Discuss the problem faced by psychologists and other professionals who
are given the task of attempting to predict dangerousness.

14. Discuss the legal basis of the right to treatment and right to refuse
treatment.

15. Discuss landmark cases that establish the legal precedents for the
insanity plea.

16. Distinguish between the “not-guilty-by-reason-of-insanity” verdict and the

“guilty but mentally ill” verdict.

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 17. Distinguish between the insanity plea and the principle of competency to
stand trial.

18. Discuss the “duty to warn” obligation for therapists and describe the
landmark case on which it is based.

Lecture and Discussion Suggestions:

1. Psychological assessment. Essentially, assessment is the process of

collecting and processing information from a client as a basis for determining the
person’s problems as well as the goals and strategies used in treatment. Ideally,
this involves a variety of measures that will lead to a balanced assessment of the
individual. In actual practice, however, clinicians tend to be highly selective in
theft choice of methods, depending partly on the particular client and her or his
problem. For instance, when a client expresses paranoid ideas, the clinician
might include the MMPI-2 to identify specific patterns of abnormality. In another
instance, when a client is intensely fearful of mingling with others in public
places, the clinician may want to do a functional or behavioural analysis of the
phobic behaviour, identifying the conditions in which this behaviour occurs.
Finally, a psychological assessment should include the client’s overall strengths
and weaknesses, not simply what’s wrong with the person.

2. Clinical versus statistical prediction. Can machines do better at making

accurate diagnoses? In this research area clinical judgment is pitted against
statistical formulas—the same set of psychological test scores about patients is
given to clinicians to think about, and is also plugged into statistical prediction
formulas. Since the early 1950s, studies have shown that the formulas do at least
as well as the clinicians. In fact, in recent research statistical techniques have
actually been found to predict how the clinicians reach their decisions. It is
possible to read this research and reach three general conclusions:

A. Clinicians rarely do better than statistical formulas.

B. The formulas in many cases are more accurate than the clinicians.

C. Clinicians should be replaced by the statistical formulas.

Needless to say, such conclusions have not sat well with clinicians. The
clinicians have argued that there is more to understanding a client than just his or
her test scores—formulas cannot make behaviour observations.

A more moderate conclusion is that while some clinical tasks can clearly be
automated, it is probably best in most cases to combine clinical and statistical
methods. Statistics are not a replacement for a clinician, but a tool the clinician
can use.

Murphy, K. R., & Davidshofer, C. 0. (1994). Psychological Testing: Principles and

Applications, 3rd Ed. Englewood Cliffs, N. J.: Prentice-Hall.

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3. The clinical interview. This continues to be the oldest and most widely-used
method of assessment for good reasons. First, a face-to-face setting allows
clients to describe their presenting complaints in their own words. Second, the
clinician may observe a variety of nonverbal behaviours, which also provide clues
as to the client’s personality and problems. And third, the interviewer may orient
the interview to the person rather than vice versa. At the same time, a major
disadvantage of the interview is that the data may be distorted by the particular
questions asked as well as the interviewer’s personal and cultural biases.

Furthermore, each clinician may interpret the same data in different ways.
Therefore, it is often advisable to supplement the clinical interview with personal
and family data, as well as other methods of assessment, such as standardized
personality tests.

4. Classifying abnormal behaviours. Have students discuss the pros and cons of
classifying abnormal behaviours. You might point out the advantages of the
DSM-IV over earlier approaches, especially the shift away from the
psychodynamic assumptions of causality to a more descriptive and cause-neutral
approach. Yet critics point out that any system of classification greatly restricts
the amount of information included about the person, overlooks the individual’s
uniqueness, and results in social stigmas. You might begin this discussion by
simply asking “Why do we need a system for classifying abnormal behaviours?”
and move the discussion from there to the various pros and cons of such a
system.

5. Intelligence tests. Ask students for their opinions about intelligence tests,
including theft usefulness and limitations. Because of the controversy
surrounding intelligence testing, clinicians now use these tests more selectively,
preferably along with other measures. Intelligence tests may be useful in a
number of ways, including the high correlation between measures of intelligence
and standardized achievement test scores. Yet, such tests also may be culturally
biased and might be misinterpreted, especially in the case of individuals from
culturally diverse or disadvantaged backgrounds.

6. Personality tests. Discuss the usefulness of personality tests from the client’s
perspective. Ask volunteers to share their experiences in getting results of a
personality or career inventory. A common misunderstanding of career
inventories such as the Strong-Campbell Interest Inventory (SCII) is that this
instrument tells us which careers we should choose. But in reality, the results
indicate which clusters of careers tend to be most compatible with our interests,
and thus those in which we are most likely to persist, but not the ones that we
should choose.

7. On Being Sane in Insane Places. Rosenhan’s article, On Being Sane in Insane

Places (Science, 1973, 179, pp. 250-258) is engaging for students to read and
can be counted onto provide material for classroom discussion. Replies to the
article (Science, 1973, 180, pp. 1116-1122) are also particularly valuable to

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assign, as they present a wide variety of viewpoints on the study. A few
questions such as: Was Rosenhan setting up the psychiatrists? Is insanity in the
eye of the beholder? What are the effects of the label “insane?” Can medicine
detect liars? There should be sufficient information to sustain discussion on that
controversial piece of research.

8. Personality tests and job screening. A somewhat disturbing trend that appears
to be increasing in recent years is the tendency of companies to use personality
tests, such as the MMPI in their applicant screening process for new hires. Ask
students to discuss the pros and cons of using personality tests in this situation.
In discussing the cons, you might point out that tests like the MMPI were not
really designed to be administered on a massive scale to a “normal” population
and might pose a significant problem of “false positives” when used this way.
Also, there is the related issue of personnel departments not always having
employees who are properly trained to interpret the subtleties that are often
involved in understanding the meaning of the scores provided by many of these
tests. Should these tests be used in these situations to begin with? What are the
dangers in having tests like these administered and interpreted by employees
with often minimal training in the meaning of the scores?

9. Distinguish between a psychological disorder and an illness. A common

misunderstanding of the DSM system of assessment stems from our greater
familiarity with the medical model, in which symptoms are necessarily linked with
causes in the course of diagnosing and treating an illness. However, in the DSM-
IV, abnormal behaviours are viewed as signs of mental disorders, which are
clinically significant clusters of features that may be identified and treated without
necessarily knowing the underlying causes. In fact, for most mental disorders,
the etiology is unknown. Thus, the DSM-IV is a theoretical with regard to etiology
or causal factors, except in regard to those disorders for which this is well
established, as in many of the cognitive disorders with organic origins. The major
justification for this approach is that the inclusion of etiological theories would be
an obstacle for the use of the manual by clinicians of varying theoretical
orientations, including psychologists. Also, it would not be possible to present all
the reasonable theoretical orientations.

10. The disadvantages of the DSM approach. As your text notes, not everyone
has been happy with the multiaxial approach and the philosophy introduced with
the DSM-III in 1980. One such critic has been George Valliant, who found five
problems with this DSM approach:

A. The DSM ignores other cultures and is too anchored in American ideas.

B. The DSM ignores the fact that most diagnoses reflect dimensions and not
categories. He states “pregnancy is a black-and-white diagnosis,
schizophrenia is not.”

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 C. DSM pays too much attention to surface phenomena and too little
attention to the longitudinal course of problems.

D. DSM does not pay enough attention to the underlying psychological

causes of problems.

E. DSM sacrifices validity for the sake of reliability. Valiant likens the DSM’s
emphasis on being objective to drafting all seven footers for pro
basketball—it is a very reliable method, but ignores the more crucial skill
of ball handling.

In particular, you might discuss with the class Valiant’s second objection. Many
others have criticized DSM for pigeon-holing people into categories when many
problems and behaviours are on a continuum. Ask the class how they would
design DSM-V?

Valliant, G. E. (1984). The disadvantages of DSM-III outweigh its advantages.

Ainerkan Journal of Psychiatry, 141, 542-545.

11. The fundamental attribution error. Social scientists tend to regard human
behaviour as resulting from the interaction between the individual’s dispositional
tendencies (intentions, traits, etc.) and his or her situational influences or
immediate environment. However, when it comes to explaining behaviour, social
scientists are well aware of the biases in the way we interpret behaviour,
depending mainly on whether it’s our own or someone else’s behaviour.
According to the fundamental attribution error, we tend to overemphasize
personal, or dispositional, causes in accounting for other people’s behaviour, but
underemphasize these causes for our own behaviour. Expressed differently, we
readily excuse our behaviour because of unfavorable circumstances, while
jumping to unwarranted conclusions about other people’s motives in similar
behaviours and circumstances. Thus, when speaking about ourselves, we use
words that denote our actions and reactions to a situation, such as “I get angry
when” and I become violent wi-zen.” But when talking about someone else, we
generally use words that describe that person’s traits or personality, such as “He
has such a bad temper” or “She is a violent person” (McGuire and McGuire,
Journal of Personality and Social Psychology, 1986, 51, pp. 1135-1143). The risk
of the fundamental attribution error occurs when jury members must decide
whether an act of violence such as an assault or shooting was malicious (due to
dispositional factors) or in self-defense (situational influences).

12. The impact of malpractice litigation. The exorbitant rise in insurance rates in
the 1980s and 1990s and the increased frequency of malpractice cases brought
against professionals have had a mixed impact on mental health care. On the
one hand, these changes have alerted mental-health professionals to become
more conscientious about making risk assessments in their clients, to balance
confidentiality with the need to warn, and to assure continuation of care. All these
changes are in the best interest of the client as well as the professional.

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However, malpractice litigation has also spurred various negative, defensive
practices among professionals. For instance, some professionals tend to engage
in excessive risk-avoidance, such as refusing to treat clients who are viewed as
potentially violent. Or they may avoid asking questions that could yield
information about the likelihood of violent behaviours. While certain defensive
practices may protect professionals against litigation, as well as further rises in
insurance rates, they are not in the best interests of clients.

13. Mutual-help groups. Today, more than 12 million people participate in an

estimated 500,000 mutual-help or self-help groups—groups whose members
share a common problem and meet regularly to share their concerns without the
guidance of professionals. Although these groups often have multiple functions,
such as fostering self-help and lobbying for reform, most have the same
underlying purpose, namely, to provide practical help as well as social support in
dealing with a problem common to all members. A major assumption is that no
one understands you or may help you better than someone who has the same
problems, whether its alcoholism, obesity, or bereavement. In an atmosphere
that is friendly and compassionate, new members soon realize that participation
is voluntary with no strings attached. There is usually an unwritten code of
confidentiality within the group. Even when there is a specified path to recovery,
as in the various “anonymous” groups, members can proceed at their own pace.
Groups that deal with addictive behaviours or emotional disorders often use a
“buddy” system so that new members can count on a familiar person for
encouragement and support. In an atmosphere of acceptance and mutual
support, members can communicate more openly, view their problems more
objectively, and find more effective coping strategies.

14. Predicting violence. Discuss the problems of predicting violence. Because

incidents of violence in the community by mentally ill persons tend to get a high
degree of media coverage, there tends to be an impression that people who are
mentally ill are much more violent than others. Students might be interested to
know that people with abnormal behaviours without prior history of violent
behaviour are no more likely than the general population to engage in violence.
What pressures are therapists under and what factors do they have to consider
when they attempt to make predictions about potential violent behaviour from a
patient being considered for release into the community?

15. The insanity plea. Discuss the insanity plea. How do students feel about a
person accused of a vicious crime being declared “not guilty by reason of
insanity?” What are the pros and cons of the alternative “guilty but mentally ill”
verdict? What would be the pros and cons of scrapping the insanity defence
entirely?

Do students feel that most people accused of crimes get off on the insanity
defence? They don’t! Only a small percentage of criminals use the defence, and
only a small percentage of them use the defence successfully. Do students feel
that people who are found not guilty by reason of insanity spend less time in

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confinement than those found guilty of the same crime? Again, they don’t! The
average person found not guilty by reason of insanity spends more time in a
mental hospital than the person found guilty of the same crime spends in prison
(when parole, probation, and early release programs are taken into account).

In discussing this, you might consider that recently one state legislature passed a
bill requiring that psychiatrists and psychologists giving testimony in court cases
wear a tall conical hat and wave a “magic” wand during their testimony.
Fortunately the bill was vetoed by the governor. What do actions like this say
about the public’s perception of the “expertise” of psychologists and psychiatrists
giving “expert” testimony in court? How has the insanity plea contributed to these
perceptions?

Student Activities:

1. Reflective listening. Instruct students to pair up in dyads. One person is to

select a concern or problem he or she feels comfortable sharing. Then the
person is to share this problem with his or her partner for about five minutes or
so. The partner is to listen with empathy, giving only nonjudgmental feedback,
without adding to or analyzing what is being expressed. Then have the partners
switch roles. After the dyads have completed their role playing, ask the
participants how it feels to be listened to. How does active or reflective listening
differ from everyday conversation? It’s been said that social conversation is often
a competitive exercise in which the first person to thaw a breath is declared the
listener. But we might add---a reluctant, frustrated listener, who doesn’t listen at
all, but merely awaits his or her turn to speak.

2. Selecting a therapist. Ask students how they would go about selecting a

therapist for themselves. You might have students share their suggestions orally
or jot them down and then share them. In selecting a therapist, psychiatrist J.
Ingram Walker ( Eve rybo d y’ s Gu i de to Emo ti o n al We l l -Being, Harbor
Publishing,
1982) suggests that we consider two key questions: (1) Is the therapist
professionally trained and certified or licensed? (2) Do I feel comfortable with this
person? Ordinarily people must be qualified to list themselves as a psychologist,
psychiatrist, or social worker in the telephone book. Also, professionals usually
display their state license or other certificates in a prominent place in their offices.
But you also want to know whether you’ll feel comfortable talking to the therapist.
Does this person really listen to you? Is he or she warm or empathic without
being condescending? Once you’ve selected a therapist, in the initial session it’s
appropriate to discuss such matters as the person’s approach to therapy, the
length of treatment, and the fees.

3. Locating therapists. Assign students to prepare a list of therapists in your area,

with regard to degrees, areas of specialization, forms of treatment, and other
factors. They might call some therapists for such information, consult a local
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mental health association, check the Internet, and consult phone book listings as
ways of gathering this information. They can compare availability of the many
types of treatment discussed in this chapter.

4. Design an outcome study. Break the class into groups and give them the task
of designing a research study to evaluate a psychotherapy technique. They are
to consider therapist and technique variables, control groups, measures of
outcome, and follow-ups. Let the group report their designs and use this to
discuss some of the complexities of research the text authors describe.

5. Self-help resources. Not everyone goes to a therapist for help. Millions of

Americans turn to self-help sections in their libraries and bookstores. Have
students collect examples of various self-help manuals, guides, and books. Ask
them to critically evaluate these with regard to evidence presented for their
effectiveness.

6. The MMPI-2. Ask students to jot down their true or false responses to the
following statements: “I never read the comics,” “I am an important person,” “1
usually get nervous before an important exam.” Then ask how many students
answered “true” to the statement “I am an important person.” Originally, this item
was designed as a measure of self-importance and grandiosity in the earlier
versions of the MMPI, with fewer than 1 out of 10 respondents in a normal
sample endorsing it over 50 years ago. However, the connotations of this
statement have changed with the times, especially due to social changes and the
human potential movement of the past two decades. Today, S out of 10 males
and 7 out of 10 females endorse this statement. As a result, people’s responses
to such test items were reexamined in the re-standardization project that
produced the revised MMPI or MMPI-2.

7. Projective techniques. Get students’ responses to a TAT card or some

ambiguous scene in a magazine involving one or more people. Then display the
picture and ask students to write a paragraph or so in response to the following
questions: What are the people in this picture doing? What are they saying to
each other? And how do you think this situation will turn out? Now ask volunteers
to share their responses. You’ll usually find that responses vary considerably
from one person to another, illustrating how each of us tends to project our own
motives and feelings into the figures shown. You might point out that it is the
common themes in a person’s responses to a series of pictures that provide
important clues to his or her personality, not simply the responses to a given
picture.

8. Designing an assessment program. Break students into groups. Then tell them
that they have been chosen to design an assessment program for a community
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1154. Shimnu seems to be the Buddhist word for “devil.” Cf.
Neander, Ch. Hist. vol. II. p. 181. Prof. von Le Coq (J.R.A.S.
1911, p. 300) says it is of Soghdian origin. Chavannes et
Pelliot, op. cit. 1ère ptie, p. 523, n. 3, seek to show that it is the
equivalent of Ahriman.

1155. On this word see p. 323 supra; cf. Chavannes et Pelliot, op.
cit. 1ère ptie, p. 542, n. 2, which seems to summarize all that
there is to be said about it, and p. 342 infra.

1156. This was of course the exact statement of Zervanism, which

the Khuastuanift implicitly condemns. Cf. Mihr Nerses’
proclamation in 450 A.D. quoted on p. 285 supra.

1157. This was the name of the owner, which was Raimast Parzind
in the Tun-huang text of Sir Marc Stein.

1158. This was the name given to the incarnate, as distinguished

from the spiritual, messengers of the God of Light to man.
Thus Zoroaster is always spoken of in Manichaean literature
as a Burkhan, and doubtless the historical Buddha and Jesus
were included in the same category. Cf. Chavannes et Pelliot,
op. cit. 1ère ptie, p. 572, n. 2.

1159. Obviously the authors of the Khuastuanift knew nothing of the

doctrine put forth by the Manichaeans in Christian lands that
the First Man offered himself as a sacrifice to destroy the sons
of Darkness. Cf. n. 2, p. 294 supra.

1160. Because by so doing the existence of the diabolic creation

would be prolonged.

1161. The words “of the Messenger” [God] are not in Prof. von Le
Coq’s version.

1162. Cf. Chavannes et Pelliot, op. cit. 1ère ptie, pp. 503, n. 1. On
this being mentioned in a paper in the J.R.A.S. 1913, Dr F.
Denison Ross said that he thought the date should be put 300
 years later, J. cit. p. 81. He has since withdrawn this (J.R.A.S.
1913, pp. 434-436).

1163. See the luminous historical study by M. Henri Cordier, “Les

Fouilles en Asie Centrale,” Journal des Savans., Paris, 1910,
pp. 219 sqq., especially pp. 249, 250.

1164. Chavannes et Pelliot, op. cit. 1ère ptie, p. 513, n. 1. Müller,

Handschriften-Reste, pp. 20, 22. Von Le Coq, J.R.A.S. 1911,
p. 301.

1165. Ormuzd, “the whole circuit of the sky,” although he calls him,
more Graecorum, Zeus, “the sun and moon, the earth, fire,
water and the winds,” were “the only gods whose worship had
come down to the Persians from ancient times” in the days of
Herodotus. Cf. Herodotus, Bk I. c. 131.

1166. Faustus (Aug. v. Faust. Bk II. c. 4) distinctly says “Jesus Christ

is the son of the First Man.” Cf. also c. 5.

1167. It is very doubtful whether it is referred to or not in the Tun-

huang treatise. Cf. Chavannes et Pelliot, op. cit. 1ère ptie, pp.
515, n. 2, and p. 516, n. 3.
1168. The Power whom Faustus (Aug. c. Faust. Bk XX. c. 2) calls
“God the Son.”

1169. Evidently the incarnate or human messengers, Zoroaster,

Buddha, Jesus, and Manes. The heavenly “legates” are never
depicted as “preaching” to men.

1170. The Past, Present and Future, called the “Three Moments” in
the Tun-huang treatise. See Chavannes et Pelliot, op. cit. 11me
ptie, pp. 114, 116.

1171. Probably the strong or mighty Srôsh or Tertius Legatus.

1172. This may be compared to the Ophite Diagram in which Agape

or Love is made the summit of the Pantheon. See Chap. VIII
p. 68 supra. See also the same dogma in Valentinus, Chap.
IX p. 123 supra.

1173. Flügel, op. cit. pp. 95, 96.

1174. As to these, see En Nadîm in Flügel, op. cit. pp. 97-100.

1175. Chavannes et Pelliot, op. cit. 1ère ptie, p. 543, n. 2.

1176. Augustine, de Moribus Manichaeorum, c. X. Cf. Baur, Das

Manichäische Religionssystem, pp. 248 sqq. Chavannes et
Pelliot, op. cit. 1ère ptie, p. 547, n. 1, examine the question
whether these are borrowed from Buddhism as F. W. K. Müller
and Cumont assert, and incline to the view that Manes took
them from Zoroastrianism.

1177. The word vusanti does not seem to be explained by Prof. von
Le Coq. Has it any connection with the Sanskrit vasanta
“spring”? In that case, the 50 days fast may have been
continuous like the Christian Lent and the Mahommedan
Ramadan. But it seems more likely that it refers to the weekly
fast on Sunday which, the Fihrist notwithstanding, seems to
 have been incumbent on all the Manichaeans, Elect and
Hearers alike. So Chavannes et Pelliot, op. cit. 2me ptie, p.
111, n. 2. See n. 4, p. 349 infra.

1178. Prof. von Le Coq says (J.R.A.S. 1911, p. 307) that this word is
as yet unexplained and may belong to another language than
Turkish. One is almost tempted to see in it a corruption of the
Yom Kippur or Day of Atonement of the Jews. Judaism is the
last religion from which the Manichaeans would have
consciously borrowed; but the Jews have always taken their
goods where they found them, and it may well be that both
Jews and Manichaeans were here drawing from a common
source.

1179. Is this the Tertius Legatus or another?

1180. Augustine, c. Faust. Bk II. c. 5. Cf. Chavannes et Pelliot, op.

cit. 1ère ptie, p. 539, and n. 1.

1181. Chavannes et Pelliot, op. cit. 1ère ptie, p. 573, n. 3.

1182. So Baur, op. cit. This was doubtless true in the West and in
lands where they were exposed to severe persecution.

1183. This explains its translation from its original Pahlavi into the
language of the converts and each copy bearing the name of
the owner.

1184. See Cumont, Cosmog. Manich. p. 56, for authorities. Cf. also
de Stoop, op. cit. p. 22. As has been many times said above,
every religion and sect at the time accused the others of these
filthy practices, without our being able to discern any proof of
the justice of the accusation in one case more than in another.
In any case, St Augustine, here the chief authority, could not
have known of it at first hand, as he had never been more
than a Hearer, and he himself says (contra Fortunatum, Bk I.
App.) that while he had heard that the Elect celebrated the
 Eucharist, he knew nothing of the mode of celebration. Cf.
Neander, Ch. Hist. II. p. 193.

1185. All contemporary authorities are agreed that they were

forbidden to drink wine.

1186. Neander, op. cit. II. p. 170.

1187. Le Coq, Chotscho, Vol. I. Pl. I. and IV.

1188. Aug. c. Ep. Fundamenti, c. 8.

1189. Augustine, c. Faust. Bk XVIII. c. 5, whom he quotes, does not

say however that they kept Sunday as a festival, but merely
that they then worshipped the Sun: Vos in die, quem dicunt
solis, solem colitis.

1190. Aug. c. Ep. Fundamenti, c. 8 and de Stoop, op. cit. p. 27.

1191. Al-Bîrûnî, Chronology, p. 27.

1192. Ib. pp. 121, 190.

1193. A few other undoubted extracts from the Shapurakhan are to

be found in Müller, Handschriften-Reste, passim, and others
quoted at second hand from Mahommedan writers in Kessler,
op. cit., as to which see ib. pp. 180-191.

1194. Al-Bîrûnî, op. cit. p. 225.

1195. See Kessler, op. cit. p. 191 sqq.

1196. Aug. c. Faust. Bk XXXII. c. 7.

1197. See Albert Dufourcq, De Manichaeismo apud Latinos, Paris,

1900, where all these apocrypha are carefully examined. The
Quo vadis story appears on p. 40.

1198. Chavannes et Pelliot, op. cit. p. 508, and n. 1.

1199. Hegemonius, Acta, c. XIII. p. 22, Beeson.
ère
1200.
Chavannes et Pelliot, op. cit. 1 ptie, pp. 399, 400.
ère
1201.
Op. cit. 1 ptie, pp. 509, n. 5, 510, n. 2, 533, nn. 2 and 4.

1202.
Nowhere is this curious theory, which forms the base of most
Mediaeval Cabala and magic, more clearly stated. Thus the
Tun-huang treatise says in describing the fashioning of the
body of man by the devils (as in the Μέρος τευχῶν Σωτῆρος),
“there is not a single formation of the universe (or cosmos)
which they did not imitate in the carnal body” (Chavannes et
Pelliot, op. cit. 1ère ptie, p. 527); and in the next page “The
demon ... shut up the five natures of Light in the carnal body
of which he made a little universe (microcosm).”
ère
1203.
Chavannes et Pelliot, op. cit. 1 ptie, p. 514.

1204.
Op. cit. pp. 528, 529.

1205.
Their Chinese names are discussed by MM. Chavannes and
Pelliot (op. cit. 1ère ptie, pp. 521, n. 1, 542, n. 1, 543, nn. 1, 2,
and 544, n. 1), wherein are gathered nearly all that can be
said about them. The learned commentators decide that their
functions still remain mysterious. But see next note infra.

1206.
W. Radloff, Chuastuanift, das Bussgebet der Manichäer, St
Petersburg, 1909, pt I. pp. 19, 20. Von Le Coq, J.R.A.S. 1911,
p. 294: “when the Gods Kroshtag and Padwakhtag, the
Appellant and Respondent, should have brought to us that
part of the light of the Fivefold God that, going to God, is there
 to be purified.” One is inclined to compare this with Jeû and
Melchizidek receiving and purifying the light won from this
world, or with Gabriel and Michael in the Pistis Sophia bearing
the heroine upward out of Chaos; but the parallel may be
accidental and is easily pushed too far.

1207.
Like the “Twin Saviours” of the Pistis Sophia, whose functions
are never even alluded to in that document.

1208.
See notes 2 and 3, p. 327 supra.

1209.
M. de Stoop’s Essai sur la Diffusion du Manichéisme is most
informing on this head. See also A. Dufourcq’s Thesis quoted
in n. 2, p. 351 supra. A very brief summary of the history of
the sect was given by the present writer in J.R.A.S. 1913, pp.
69-94.

1210.
For the enquiry by Strategius, afterwards called Musonianus,
and Prefect of the East under Constantius, see Ammianus
Marcellinus, Bk XV. c. 13. Cf. Neander, Ch. Hist. IV. 488 sqq.
That the persecution instituted against them by Diocletian
slackened under Constantine and Constantius, see de Stoop,
op. cit. pp. 40, 41.

1211. See the Laws of Theodosius and Valentinian II, quoted by de

Stoop, op. cit. pp. 41, 42.

1212.
Gibbon, Decline and Fall, III. p. 153. Justinian put to death not
only convicted Manichaeans, but those who being acquainted
with members of the sect, did not denounce them. See de
Stoop, op. cit. p. 43.
1213.
The Manichaeans seem always to have been favoured by the
better classes and high officials of the Empire who maintained
for some time a secret leaning towards Paganism. See de
Stoop, op. cit. p. 84. The case of Barsymès, the banker or
money-changer whom Theodora made Praetorian Prefect,
and who was allowed according to Procopius (Anecdota, c.
XXII. 7) to profess Manichaeism openly, was doubtless only
one of many. It is apparently this Barsymès who is invoked in
the Turfan texts as “the Lord Bar Simus,” see Müller,
Handschriften-Reste, pp. 45, 59.

1214.
That this was the professed policy of the sect seems plain
from the words they attributed to Manes himself: “I am not
inhuman like Christ who said: Whoso denieth me, him will I
deny. I say unto you: Whoso denieth me before man and
saves himself by this falsehood, him will I receive with joy, as
if he had not denied me.” Cf. de Stoop, op. cit. p. 46, quoting
Cedrenus; Al Bîrûnî, Chronology, p. 191.

1215.
Von Le Coq, Exploration Archéologique à Tourfan, Confces
au Musée Guimet (Bibl. de Vulg. t. XXXV.), 1910, p. 278.

1216.
de Stoop, op. cit. pp. 86, 144.

1217.
Neander, Ch. Hist. III. pp. 34, 35.

1218.
Op. cit. III. p. 46.

1219.
Sozomen, Hist. Eccl. Bk V. c. 5, for instances. Cf. Neander,
op. cit. III. pp. 66, 67.
1220.
Neander, op. cit. III. p. 96.

1221.
Op. cit. III. p. 100.

1222.
S. Dill, Roman Society in the Last Century of the Western
Empire, pp. 143-166.

1223.
Eusebius, Vita Constantini, Bk III. cc. 64, 65.

1224.
Op. cit. c. 66.
Transcriber’s Notes:
Footnotes have been collected at the end of the text, and are
linked for ease of reference.
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