Chapter 2: Relevant Theories and Therapies for Nursing Practice

Question 1

______ theories help us to explain behavior. Psychological therapies are tx based on these theories.

Answer 1

Psychological

Question 2

The “tip of the iceberg.” Contains all the material a person is aware of at any one time, including perceptions, memories, thoughts, fantasies, and feelings.

Answer 2

Conscious

Question 3

Just below the surface of awareness. Contains material that can be retrieved rather easily through conscious effort.

Answer 3

Preconscious

Question 4

Includes all repressed memories, passions, and unacceptable urges lying deep below the surface. Exerts a powerful yet unseen effect on the conscious thoughts and feelings of the individual. Usually unable to retrieve this material without the help of a trained therapist.

Answer 4

Unconscious.

Question 5

At birth. Source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond, as well as the wishes that motivate us. Cannot tolerate frustration and seeks to discharge tension and return to a more comfortable level of every. Lacks the ability to problem solve. Not logical and operates according to the pleasure principle.

Answer 5

Id

Question 6

Problem solver, reality tester. Able to differentiate subjective experiences, memory images, and objective reality and attempts to negotiate with the outside world.

Answer 6

Ego

Question 7

The last portion of the personality to develop. Represents the moral component of the personality. Consists of the conscience (“should nots” and the ego ideal (all the “shoulds”). Represents the ideal rather than the real. Seeks perfection, as opposed to seeking pleasure or engaging reason.

Answer 7

Superego

Question 8

Operate on the unconscious level. Deny, falsify, or history reality to make it less threatening. Ward off anxiety by preventing conscious awareness of threatening feelings. Can distort reality to such a degree that we experience difficulty with healthy adjustment and personal growth.

Answer 8

Defense mechanisms

Question 9

Freudian Theory and Nursing

Answer 9

Importance of individual talk sessions. Attentive listening. Transference. Countertransference.

Question 10

Erikson’s Ego Theory

Answer 10

Eight stages of development. Personality continues to develop through old age. Developmental model is important part of nursing assessment. Helps determine what types of interventions are most likely to be effective.
Trust vs. mistrust. Autonomy vs shame and doubt. Initiative vs guilt. Industry vs inferiority. Identity vs role confusion. Intimacy vs isolation. Generatively vs self-absorption. Integrity vs despair.

Question 11

Purpose of all behavior is to get needs met through interpersonal interactions and to decrease or avoid anxiety (any painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied). Security operations- measures the individual employs to reduce anxiety and enhance security. Collectively, all of the security operations an individual uses to defend against anxiety and ensure self-esteem make up the self-system.

Answer 11

Sullivan’s interpersonal theory

Question 12

Therapy should educate pts and assist them in gaining personal insight. Nurse should interact with the pt as an authentic human being.

Answer 12

Sullivan

Question 13

Participant observer

Answer 13

Mutuality, respect for the pt, unconditional acceptance, empathy

Question 14

Diagnosis targeted, time limited, present focused. Treatment alliance and empathy. Two foci: illness, not flaw. Mood and life situations are related.
Psychiatric disorders are influenced by interpersonal interactions and the social context. The goal is to reduce or eliminate psychiatric sx by improving interpersonal functioning and satisfaction with social relationships.

Answer 14

Interpersonal psychotherapy

Question 15

Peplau and the Therapeutic relationship

Answer 15

Levels of anxiety, interventions to lower anxiety, aim to improve pt’s ability to think and function.

Question 16

Implications of behavior theories for nursing

Answer 16

Modifying or replacing behaviors. Behavior management

Question 17

Behavior therapy

Answer 17

Modeling. Operant conditioning. Systematic desensitization. Aversion therapy. Biofeedback

Question 18

Voluntary behaviors are learned through consequences and behavioral responses are elicited through reinforcement, which causes a behavior to occur more frequently

Answer 18

Operant conditioning

Question 19

Based on the assumption that changes in maladaptive behavior can occur without insight to the underlying cause. Approach works best when it is directed at specific problems and the goals are well defined.

Answer 19

Behavior therapy

Question 20

Therapist provides a role model for specific identified behaviors, and the patient learns through imitation.

Answer 20

Modeling

Question 21

The basis for behavior modification and uses positive reinforcement to increase desired behaviors

Answer 21

Operant conditioning

Question 22

Another form of behavior modification therapy that involves the development of behavior tasks customized to the pt’s specific fears; these tasks are presented to the pt while using learned relaxation techniques.

Answer 22

Systematic desensitization

Question 23

Used widely to treat behaviors such as alcoholism, sexual deviation, shoplifting, hallucinations, violent and aggressive behavior, and self-mutilation. Sometimes the tx of choice when other less drastic measures have failed to produce the desired effects. Pairing of a maladaptive behavior with a noxious stimulus so that anxiety or fear becomes associated with the once-pleasurable stimulus. Punishment. Avoidance training.

Answer 23

Aversion therapy