(b) Classical conditioning

Systematic desensitisation (developed by Wolpe) pairs relaxation responses with anxiety-producing stimuli, using the principle of counter-conditioning (a form of classical conditioning) to gradually extinguish the fear response.

(b) Beliefs

In the ABC model: A = Activating event, B = Beliefs (rational or irrational), C = Consequences (emotional/behavioural). Ellis argued that irrational beliefs about events (not the events themselves) cause emotional distress.

(c) Free association

Free association is a technique from Freud’s psychoanalytic therapy, not Rogers’s client-centred therapy. Rogers emphasised empathy, unconditional positive regard, and congruence (genuineness).

(b) Behaviour therapy

Token economy is based on operant conditioning — desired behaviours are rewarded with tokens that can be exchanged for privileges.

(c) Financial profit

Ethical principles in psychotherapy include confidentiality, informed consent, competence, avoidance of harm, and appropriate professional boundaries. Financial profit is not an ethical principle.

Albert Ellis proposed the ABC model in REBT:

• A – Activating Event: The external event or situation that triggers a response (e.g., failing a test)
• B – Beliefs: The individual’s interpretation of the event — either rational (“I’ll study harder next time”) or irrational (“I’m a complete failure”)
• C – Consequences: The emotional and behavioural outcomes resulting from the beliefs (e.g., sadness or determination)

Key principle: It is not the event (A) that causes emotional distress (C), but the beliefs (B) about the event. By identifying and challenging irrational beliefs, the therapist helps the client develop more rational, adaptive thinking.

Rogers identified three core conditions essential for therapeutic change:

1. Empathy — the therapist makes a genuine effort to understand the client’s feelings and experiences from the client’s own perspective

2. Unconditional Positive Regard — the therapist accepts and values the client completely, without judgement or conditions, regardless of what the client says or does

3. Congruence (Genuineness) — the therapist is authentic, transparent, and honest in the relationship, without putting up a professional façade

According to Rogers, when these conditions are present, the client feels safe to explore their feelings and move toward self-actualisation.

Both approaches are often combined as Cognitive-Behavioural Therapy (CBT).

1. Behaviour Therapy:

Based on learning principles (classical and operant conditioning). It focuses on changing maladaptive behaviours rather than exploring unconscious conflicts.

• Systematic desensitisation — gradually pairs relaxation with feared stimuli to extinguish phobias
• Token economy — rewards desired behaviours with tokens exchangeable for privileges
• Aversion therapy — pairs unwanted behaviour with unpleasant stimuli
• Effective for phobias, OCD, addictions, and behavioural problems

2. Cognitive Therapy:

Based on the idea that distorted thinking causes emotional and behavioural problems.

• Beck’s Cognitive Therapy — identifies and challenges cognitive distortions (overgeneralisation, catastrophising, selective abstraction) common in depression
• Ellis’s REBT — uses the ABC model to challenge irrational beliefs and replace them with rational ones
• Effective for depression, anxiety, and stress-related disorders

3. Humanistic-Existential Therapy:

Emphasises personal growth, self-awareness, and the search for meaning.

• Rogers’s Client-Centred Therapy — creates a safe environment through empathy, unconditional positive regard, and congruence, enabling the client to explore feelings and move toward self-actualisation
• Existential Therapy — helps clients confront issues of meaning, freedom, and mortality
• Gestalt Therapy — focuses on present experience and unresolved feelings
• Effective for personal growth, self-esteem issues, and existential concerns

Each type has strengths — behaviour therapy is most effective for specific behavioural problems, cognitive therapy for thought-related disorders, and humanistic therapy for personal development and self-exploration.

Rehabilitation is the process of helping individuals with mental disorders reintegrate into society and lead meaningful, productive lives. It goes beyond symptom reduction to focus on restoring dignity, independence, and quality of life.

Key components:

1. Occupational therapy — trains individuals in work-related skills, improving self-sufficiency and providing a sense of purpose

2. Social skills training — teaches communication, assertiveness, and interpersonal skills necessary for daily social interactions

3. Supported housing — provides structured living environments (e.g., halfway houses) for individuals transitioning from hospitals back into the community

4. Community mental health services — includes outpatient treatment centres, crisis intervention teams, day-care centres, and prevention programmes accessible to all

5. Family education and support — educates family members about the disorder, reduces stigma, and teaches them how to provide a supportive environment

6. Vocational rehabilitation — helps individuals find and maintain employment through job training, supported employment, and skill development

Importance: Rehabilitation recognises that recovery from mental illness is not just about medical treatment — it requires a supportive social environment, meaningful activity, and restoration of the person’s role in their family and community.

(a) Both A and R are true and R is the correct explanation of A

Aaron Beck’s research showed that depression is characterised by specific cognitive distortions — automatic negative thoughts about the self, the world, and the future. Cognitive therapy targets these distorted thinking patterns, helping clients identify and replace them with more realistic thoughts. This is why cognitive therapy is especially effective for depression.

(i) Systematic desensitisation is a behaviour therapy technique developed by Joseph Wolpe.

(ii) Three steps:

1. Relaxation training: The therapist teaches Meera deep muscle relaxation, deep breathing, or guided imagery techniques
2. Anxiety hierarchy construction: Meera and the therapist create a graded list of dog-related stimuli from least to most anxiety-provoking (e.g., hearing the word “dog” → seeing a picture → seeing a dog from a distance → being near a dog → touching a dog)
3. Gradual exposure with relaxation: Meera practises relaxation while being exposed to each item on the hierarchy, starting from the least anxiety-provoking. She moves to the next level only when she can remain relaxed at the current level. Eventually, she can remain calm even in the presence of a real dog.

(iii) This technique is based on classical conditioning, specifically the principle of counter-conditioning — pairing the feared stimulus (dog) with a response (relaxation) that is incompatible with anxiety. Through repeated pairing, the fear response is extinguished.

(iv) The therapist might also use cognitive restructuring to address Meera’s irrational beliefs about dogs (e.g., “All dogs are dangerous and will attack me”). By challenging and replacing this belief with a more realistic one (“Most dogs are friendly; the incident was with one specific dog in unusual circumstances”), Meera’s anxiety can be further reduced, making the desensitisation process more effective.

(i) A halfway house is a supervised, community-based residential facility that provides transitional living for individuals recovering from mental illness. It serves as a bridge between hospitalisation and full independent living in society.

(ii) Halfway houses contribute to rehabilitation by:

• Providing a structured, supportive environment where residents can practise daily living skills (cooking, cleaning, managing finances) in a safe setting
• Offering ongoing counselling, social skills training, and vocational guidance to help residents develop the skills and confidence needed for independent living
• Reducing social isolation — living with others in a similar situation provides peer support and a sense of community
• Facilitating gradual reintegration into society rather than an abrupt transition from hospital to independent living, which can be overwhelming

(iii) Two other components of rehabilitation:

1. Community mental health services — outpatient clinics, day-care centres, and crisis intervention teams that provide accessible treatment and support
2. Vocational rehabilitation — job training, supported employment, and career counselling to help individuals gain and maintain meaningful employment