Chapter 2: Theories and Therapies Flashcards
who is the mother of psychiatric nursing
Hildegard peplau
psychological theories…
help us to explain behavior
treatments based on theories
who was the beginning of mental health issues
Freud
what did freud believe that mental illness come from
unresolved childhood trauma
Freud developed what theory
psychoanalytic (analyzing psych)
Freuds levels of awareness
conscious
preconscious
unconscious
Freuds level of awareness
conscious
contains all the material a person is aware of at any one time
Freuds level of awareness
preconscious
material that can be retrieved rather easily through conscious effort
Freuds level of awareness
unconsious
all repressed memories, passions, unacceptable urges lying deep below surface
what method of therapy was developed based on Freuds psychoanalytical
Cathartic
Cathartic method
talk therapy viewed today as getting things off our chest
what is included in cathartic method
free association
free association
talk about what ever comes to mind, requires full and honest disclosure
Frueds Personality structure componets
Id
ego
superego
Frueds Personality structure
id
pleasure principle
reflex action
primary process
Id wants…
to be comfortable/having needs met
Frueds Personality structure
ego
problem solver
reality tester
navigate outside world
Ego wants…
differentiate between subjective experience and objective reality
Frueds Personality structure
superego
moral component
superego wants….
perfection
what one of the personality structures is in the conscious
ego
superego
what one of the personality structures is in the preconscious
ego
superego
what one of the personality structures is in the unconsious
id
ego
superego
Id cannot tolerate
frustration
Id seeks to discharge
tension
Id lacks the ability to
problem solve
Id operates according to
pleasure principle
example of Id
hungry screaming baby
Ego is developed
first few years of life as the child intereacts with others
Ego saying
THINK PLAN DO
superego develops
between 3-5
super ego represents what component of personality
moral
superego consist of
conscience
ego ideal
superego
conscience
should nots from parents and society
superego
ego ideal
shoulds from parents and society
if the superego falls short of perfection it may induce feelings of
guilt
defense mechanisms are to ward off _________ and prevent ____________ awareness of threatening feelings
anxiety, conscious
defense mechanisms operate on what level
unconsious
Frueds psychosexual stages of development
oral
anal
phasic
latency
genital
(more in book deck)
transference
unconsious feelings that the patient has toward a healthcare worker that were originally felt in childhood for a significant other
countertransference
unconsious feelings that the health worker has toward the patients
how do we eliminate transference and countertransference
maintain boundaries
self awareness
classic psychoanalysis has 3 key factors
free association
dream analysis
defense mechanism recognition
psychodynamic therapy
how it works
back and forth with patient,
dynamic: both engaged
psychodynamic focuses on
here and now
who are the best candidates for psychodynamic therapy
worried well
- clear area of difficulty
- are intelligent and well motivated for change
interpersonal theory definition
purpose of all behavior is to get needs met through interpersonal interactions and to reduce avoid anxiety
who developed interpersonal theory
sullivan
Sullivan defined personality as
behavior observed within interpersonal relationships
interpersonal theory
anxiety
painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied
interpersonal theory
security operations
measures the individual employs to reduce anxiety and enhance security
interpersonal theory
self system
all of the security operations an individual uses to defend against anxiety and ensure self esteem
what is interpersonal therapy effective in treating
grief and loss
interpersonal disputes
role transition
interpersonal theory is one person working on self to better understand
their role
who implicated interpersonal theory into nursing
Hildegard peplau
Peplau thought that the nurse was both the
participant and observer
Peplau thought that self awareness helps keep focus on
patient
What are the main points of Peplau
self awareness (patient focused)
mutuality
respect for the patient
unconditional acceptance
empathy
Peplau empathy vs sympathy
sympathy is not good
empathy: understanding what you are going through is hard
Peplau took __________ theory of anxiety to nursing practice
Sullivan
what does it mean that the nurse is both the participant and observer
interactions with patient as an authentic human being
Peplau had two parts of nursing
art
science
Peplau art of nursing
care, compassion, advocacy, comfort and well being
what we DO with patients
Peplau science of nursing
understand human problems, psychosocial phenomena, relieve patients suffering
who are behavior scientists
Pavlov
watson
skinner
behavior theories all involve
conditioning
what is conditioning
paring a behavior with a condition that reinforces or diminished a behaviors consequence
behavior theories believe that
personality is learned behaviors and can become synonymous with behavior
if behavior changes
so does personality
Pavlov conditioning
classical
Pavlov experiment
dogs
neutral stimulus= bell
- will not produce response by it self
non neutral stimulis= food
- will produce an unconditioned response
pairing neutral stimulus with non neutral stimulus (uncontrolled stimulus) will cause uncontrolled response
eventually you will not need the uncontrolled stimulus to elicit a uncontrolled response
Watson type of condition
classical
Watson believed that personality traits and responses (maladaptive and adaptive) were socially learned through
classical conditioning
Watson experiment
little Albert experiment
conditioned previous unafraid baby to become afraid of a rat
rat= neutral stimulis became conditioned stimulus
Albert elicited a emotional response (conditioned response) similar to the distrsss (unconditioned response) originally given to the noise (unconditioned stimulus)
skinner type of conditioning
operant
operant conditioning
method of learning that occurs through rewards and punishment for voluntary behavior
in operant conditioning behavioral responses are elicited through
reinforcement
skinner believed that idea of learning is a function of change in
overt behavior
skinner believe that changes in behavior are the result of an individual’s
response to events that occur in environment
Skinner box
give food for pressing lever (pos)
turn on shock for pressing lever (neg)
4 main types of behavioral therapy
modeling
operant
systematic desensitization
aversion
modeling behavior therapy
therapist provides a role model for a behavior, patient learns through imitation and role play
operant conditioning behavior therapy
uses positive reinforcement for behavior modification
systematic desensitization behavior therapy
uses customized behavioral tasks based on the patients own fears
patient also learns relaxation techniques
systemic desensitization therapy is also called
exposure therapy
aversion behavior therapy
paring a target behavior with negative stimulus
biofeedback back is used for controlling
bodys physiological response to stress and anxiety, power to use your thoughts to control your body
cognitive theory states that
thoughts become feelings
feelings become behavior
behavior reinforces thoughts
cognitive theory states that ________ comes before _______ and __________
thoughts
feelings
actions
behaviorists focusing on increasing, decreasing, eliminating measurable….
behaviors
cognitive theorists believe there is a dynamic interplay between individuals and ____________. believe thoughts come before __________ and ____________-
enviornment
feelings
actions
Cognitive theories
rational emotive therapy scientist
ellis
Rational emotive therapy aims to eradicate _____________ beliefs
irrational
Rational emotive therapy believe that what thoughts are not accurate
should, ought, must
negative thinking process
who developed cognitive behavioral therapy
beck
types of cognitive therapies
Rational emotive therapy
cognitive behavioral therapy
trauma focused cognitive behavioral therapy
dialectical behavior therapy
cognitive therapy is aimed at
identfy and test distorted beliefs and change way of thinking; reduce symtoms
cognitive behvaioral therapy believes
changing negative thoughts impacts behaviors
patient is taught to challenge own negative thinking
trauma focused cognitive behavioral therapy is mainly used in
children who experienced trauma
dialectical behavior therapy main focus is
integration of oppisites
(BPD, bipolar)
middle ground, not all black and white
humanistic theories believe
psychology must go beyond experiences of hate, pain and misery and to include love, compassion, happiness, and well being
main humanistic scientist
maslow
Maslow is the father of
humanistic psychology
maslows hierarchy of needs explain
when lower needs are met we can accomplish higher ups
how does Maslow help us prioritize
what is most important in the sequencing of nursing action
levels of maslows heirchy
physciological needs
safety
belonging and love
esteem
self actualization
biological theories and therapies focus on
neuro
chemical
bio
genetic
developmental theories
cognitive development
theory of psychosocial development
theory of object relations
cognitive development scientist
Piaget
what are the steps to cognitive development
sensorimotor
preoperational
concrete operational
formal operation
sensorimotor age
birth to 2
sensorimotor
infant builds understanding of themself and reality through interactions
able to differentiate between itself and other objects
learns via assilmilation and accommodation
assimilation
organization of information and absorbing it into existing schema
accomodation
when an object cannot be assimilated and the schemata have to be modified to include the object
pre operational age
2-4
pre operational
child is not able to conceptualize abstractly
needs concrete physical situation
concerete operations age
7-11
concerete operations
think abstractly and. conceptualize, creating logical structures
formal operations age
11-15
formal operations
cognition reaches final form
no longer requires concrete objects to make rational judgements
deductive and hypothetical reasoning
who created theory of psychosocial developmetn
Erickson
Erikson states that
if you fail at one stage you are not stuck there and personality develops through old age
trust vs mistrust age
0-1.5
autonomy vs shame-doubt age
1.5-3
initiative vs guilt age
3-6
industry vs inferiority age
6-12
identify vs role confusion age
12-20
intimacy vs isolation age
20-35
generatively vs self absorption age
35-65
integrity vs dispair age
65+
how do developmental theories impact nursing
helps determine what interventions are most likely to be most effective
also how we communicate to patient
who developed theory of object relations
Mahler
mahler stated regarding mother and child
early in development the child does not have a concept of object constancy for mother, when the mother disappears she does not exist
mahler developed separation individuation
psychological birth of infant
child separates from mother and begins to indiciduate
theories of moral development
stages of moral development
ethics of care theory
who created stages of moral development
kohlberg
preconvectional level
stage 1 obedience and punishment
stage 2 individualism and exchange
conventional level
stage 3 good interpersonal relationships
stage 4 maintaining social order
post convectional level
stage 5 social contact and idividual rights
stage 6 universal and ethical principles
stage 1
obedience and punishments
stage 2
individualism and exchange
stage 3
good interpersonal relationships
stage 4
maintaining social order
stage 5
social contact and idividual rights
stage 6
universal and ethical principles
who developed ethics of care theory
gilligan
what did Gilligan propose
women come to prioritize an “ethics of care” as their sense of morality evolves along with their sense of self
while men prioritize “ethics of justice”
to gain a conscious memory we need
something to trigger it
more than likely a therapist
your boss is in the cafe and you select the salad instead of the burger you wanted, id ego or sego
sego because you want perfections
child had a baby brother born and started sucking finger and wanting milk what psychosexual stage
oral, based on description not age
the child regressed or went backwards
phallic is when _________ identity develops
sexual
latency is when _______ develops
sego
what therapy session is targeted to worried well
psychodynamic
interpersonally believes that what relationship influences personality development
early
in behavior theory, what drives personality
behavior
cognitive theory
thoughts
feelings
behaviors
CBT believes
change thinking and we can change behaviors
patient has a panic attack and goes to the track and runs bleachers until dehydration and blisters, what will you dress first
dehydration
adress physiological issue even if mental illness drove it
sensiomotor
physical interactions
preoperational
bigger vs smaller
concerete operational
problem solving
formal operations
rank pain 0-10
abstract thinking
preconventional level
I love me
selfish
pregnant mother
conventional level
I love you
self sacrificing
newborn baby
post conventional level
l love me and you
mother after newborn, cares about family whole
