(a) Compare directional and non-directional therapies with reference to their effectiveness. (10 marks) (b) Give a comparative…

(a) Directional and non-directional therapies: effectiveness

Directional (directive) therapies are therapist-led and structured: the therapist sets goals, chooses techniques and gives tasks, as in cognitive-behaviour therapy, exposure and behaviour therapy. Non-directional therapies, such as Rogers's client-centred therapy, leave the agenda to the client; the therapist offers empathy, unconditional positive regard and genuineness so that the client finds his or her own direction. Focus: directional therapy targets symptoms and skills, and non-directional therapy targets self-understanding and growth. Effectiveness: for specific problems such as phobias, panic, OCD and depression, directional methods have the strongest trial evidence and usually act faster. Non-directive supportive therapy also helps, though meta-analyses (Cuijpers et al., 2012) find it slightly less effective for depression. For self-esteem, identity and relationship problems, non-directive work is useful. Common factors, especially a good therapeutic alliance, explain much of the outcome in both (Wampold), so differences in overall effect are often modest. Practice is often integrative: directive for acute symptoms and non-directive for adjustment, matched to the client's needs.

(b) Positive and negative symptoms of schizophrenia: a comparison

Positive symptoms are additions to normal experience: hallucinations (often auditory), delusions, disorganised speech and grossly disorganised or catatonic behaviour. Negative symptoms are losses of normal function: blunted affect, alogia, avolition, anhedonia and social withdrawal (asociality). Onset and course: positive symptoms often begin acutely and fluctuate with relapses; negative symptoms are insidious and persistent, and are often present before the first episode. Neurobiology: positive symptoms are linked to excess dopamine activity in mesolimbic pathways, and negative symptoms to reduced prefrontal (hypofrontal) function and low dopamine there, with enlarged ventricles. Treatment: antipsychotics (D2 blockade) reduce positive symptoms well; negative symptoms respond poorly and need psychosocial rehabilitation, social-skills training and sometimes newer drugs. Prognosis: negative symptoms and cognitive deficits predict poor social and occupational function more strongly than positive ones. Crow's (1980) Type I and Type II distinction and Andreasen's scales (SAPS, SANS) are used in assessment.

(c) Nature and significance of biofeedback therapy

Biofeedback gives a person real-time information about a body process that is normally not noticed, such as muscle tension (EMG), skin temperature, skin conductance, heart-rate variability, breathing or brain waves (EEG, called neurofeedback), usually as a tone or a display. Nature: it works on operant-conditioning and learning principles. By watching the signal and trying relaxation, breathing or imagery, the person learns to bring the response under voluntary control, until he or she can do it without the device. Significance: it makes stress responses visible, and it builds self-efficacy and self-regulation without drugs. It has good evidence for tension headache and migraine, and also helps in anxiety and stress disorders, chronic pain, incontinence and Raynaud's disease. Evidence is mixed for conditions such as ADHD and hypertension, where it is only an adjunct. It is non-invasive, safe and complements other therapy. Limits are cost, the training time needed and the need for a trained therapist.

(d) Nature and diagnosis of dyslexia

Dyslexia is a specific learning disorder with impairment in reading, a neurodevelopmental condition marked by difficulty in accurate and fluent word recognition, decoding and spelling, in a child with adequate intelligence, vision, hearing, schooling and motivation. DSM-5 classes it as specific learning disorder with impairment in reading, and ICD-11 as developmental learning disorder with impairment in reading. Its core is usually a phonological deficit: trouble in sound-letter mapping, with slow rapid naming and weak verbal working memory. It is recognised as a specific learning disability under the Rights of Persons with Disabilities Act, 2016. Diagnosis: a team (clinical psychologist, special educator, paediatrician or psychiatrist) takes the developmental, family and school history; checks vision and hearing to exclude them; assesses intelligence; and uses standardised tests of reading, spelling, phonological awareness, rapid naming and memory, such as the NIMHANS index for specific learning disabilities. A screening test may precede it. Performance must be well below what is expected for age and must have persisted despite instruction.

(e) Appreciating diversity as a core value for community psychologists in India

Community psychology works with communities in their own contexts, and respect for diversity is one of its defining values, together with empowerment and social justice. In India the claim is especially strong, for these reasons. Plural society: caste, tribe, religion, region, gender, class and 22 scheduled languages shape how distress is understood, expressed and treated. Interventions that ignore this fail. Cultural validity: a psychologist working with tribal communities has to respect local healing practices and decision-making, and seek partnership instead of imposing a model. Equity and inclusion: marginalised groups (Dalits, tribal people, women, persons with disabilities) face stigma and unequal access, so services must reach them without discrimination, as the Mental Healthcare Act 2017 requires. Participation and trust: programmes such as the District Mental Health Programme succeed when local people take part, and diversity-sensitive work builds trust and empowerment. So the value is a practical and ethical requirement, not an optional courtesy.