Chapter 3 Psychosocial Theories & Therapy Flashcards

Question

Displacement

Answer 1

Shifting feelings related to an object, person, or situation to another less threatening object, person or situation Adaptive Use: A student who is angry about his grade on a paper goes to a batting cage & swings hard at every ball Maladaptive Use: A woman who just got in an argument w/ her boyfriend yells at her mother over the phone

Answer 2

Pretending the truth is not reality to manage unpleasant, anxiety-causing thoughts or feelings Adaptive Use: A patient whose breast cancer caused an open wound on her chest says, “it’s just a few cells” Maladaptive Use: A person who just got their third DUI emphatically says, “I don’t have a drinking problem!”

Answer 3

1) Oral (Birth-8 months): Major site of tension and gratification is the mouth, lips, and tongue - Includes biting and sucking activities. - Id is present at birth. Ego develops gradually from rudimentary structure present at birth. 2) Anal (18-36 months): Anus and surrounding area are major source of interest -Potty training (voluntary sphincter control is acquired) 3) Phallic/oedipal (3-5 years): Genital is the focus of interest, stimulation, and excitement - Discovering one's genitals, aligning with the parent of the opposite sex 4) Latency (5-11 or 13 years): Resolution of oedipal complex - Sexual drive channeled into socially appropriate activities such as school work and sports - Formation of the superego - Final stage of psychosexual development 5) Genital (11-13 years): Begins with puberty and the biologic capacity for orgasm - Involves the capacity for true intimacy.

Answer 4

Unconscious process of displaying feelings for significant people in the past onto a healthcare provider in the present

Answer 5

Emotional reaction by a healthcare provider to a patient based on feelings the provider had for significant people in the past

Answer 6

Focus on discovering causes of client’s unconscious, repressed thoughts, feelings, conflicts related to anxiety Skills Utilized: Free association, dream analysis, interpretation of behavior used to gain insight into and resolve these conflicts, anxieties Lengthy, expensive, practiced on limited basis today

Answer 7

Trust vs Mistrust (Infant): Viewing the world as safe & reliable - Virtue: HOPE Autonomy vs Shame & Doubt (Toddler 18 months-3 years of age): Achieving a sense of control & free will - Virtue: WILL Initiative vs Guilt (Preschool): Beginning development of conscience - Virtue: PURPOSE Industry vs Inferiority (School Age): Emerging confidence in own abilities - Taking pleasure in accomplishments - Virtue: COMPETENCE Identity vs. Role Confusion (adolescence): Formulating a sense of self and belonging - Virtue: Fidelity Intimacy vs. Isolation (young adult): Forming adult, loving relationships, and meaningful attachments to others - Virtue: LOVE Generativity vs. stagnation (middle adult): Being creative and productive; establishing the next generation - Virtue: CARE Ego integrity vs. despair (maturity): Accepting responsibility for oneself and life - Virtue: Wisdom

Answer 8

Sensorimotor (Birth--2 years old): Sense self as separate from the environment, object permanence Preoperational (2 years old--7 years old): Express self w/language , understand symbolic gestures, classify objects Concrete Operations (7-11 years old): Apply logic to thinking - Understand spatiality & reversibility - Increase sociability - Apply rules - Still think concretely Formal Operations (11-15 y.o. +): Think & reason in abstract terms - Expand & refine logical thinking & reasoning - Achieve cognitive maturity

Answer 9

1) Physiological Needs: Oxygen, food, water, sleep, shelter, sex, freedom from pain 2) Safety & Security: Protection, security, & freedom from harm or threatened deprivation 3) Love & Belonging: Enduring intimacy, friendship, & acceptance 4) Self-Actualization (Highest Level): Need for beauty, truth, & justice

Answer 10

Sullivan: Significance of interpersonal relationships - Therapeutic milieu: Patients participating in groups Peplau: Therapeutic Nurse--Client Relationships - 4 Phases: Orientation, identification, exploitation, resolution - Nurses' roles - Mild Phase of Anxiety - Moderate Phase of Anxiety - Severe Phase of Anxiety - Panic Anxiety: Distorted perceptions, fight-flight-freeze

Answer 11

1) Orientation Phase: Directed by the nurse & involves engaging the patient in treatment, providing explanations and information, and answering questions. 2) Identification Phase: Begins when the patient works interdependently w/ the nurse, expresses feelings, and begins to feel stronger 3) Exploitation Phase: The patient makes full use of the services offered 4) Resolution Phase: The patient no longer needs professional services & gives up dependent behavior - The relationship ends

Answer 12

Focuses on a person’s positive qualities, their capacity to change (human potential), and the promotion of self-esteem

Answer 13

Begin to focus on the positive aspects of the patient (what tools can be given to help improve mental health) Abraham Maslow: Hierarchy of Needs - Basic physiological, safety and security, love and belonging, esteem, self-actualization Carl Rogers: Client-centered therapy (focus on client’s role) - Unconditional positive regard, genuineness, empathetic understanding

Answer 14

Stranger: Offering the patient the same acceptance and courtesy that the nurse would to any stranger Resource person: Providing specific answers to questions w/in a larger context Teacher: Helping the patient learn either formally or informally Leader: Offering direction to the patient or group Surrogate: Serving as a substitute for another, such as a parent or sibling Counselor: Promoting experiences leading to health for the patient, such as expression of feelings

Answer 15

Focuses on the role of the client, rather than the therapist, as the key to the healing process Rogers believed that each person experiences the world differently and knows their own experience best

Answer 16

Focuses on observable behaviors & behavior changes Does NOT focus on how the mind works Ivan Pavlov: Classical conditioning B.F. Skinner: Operant Conditioning

Answer 17

A positive state of heightened awareness & sharpened senses, allowing the person to learn new behaviors and solve problems -The person can take in all available stimuli (perceptual field) Signs & Symptoms: - Sharpened senses - Increased motivation - Alert - Enlarged perceptual field - Can solve problems - Learning is effective - Restless - Gastrointestinal “butterflies” - Sleepless - Irritable - Hypersensitive to noise

Answer 18

Involves a decreased perceptual field (focus on immediate task only) - The person can learn new behavior or solve problems only with assistance - Another person can redirect the person to the task Signs & Symptoms: - Selectively attentive - Perceptual field limited to the immediate task - Can be redirected - Cannot connect thoughts or events independently - Muscle tension - Diaphoresis - Pounding pulse - Headache - Dry mouth - Higher voice pitch - Increased rate of speech - GI upset - Frequent urination - Increased automatisms (nervous mannerisms)

Answer 19

Involves feelings of dread or terror - The person cannot be redirected to a task; they focus only on scattered details and have physiologic symptoms of tachycardia, diaphoresis, and chest pain. - A person with severe anxiety may go to an emergency department, believing they are having a heart attack Signs & Symptoms: - Perceptual field reduced to one detail or scattered details - Cannot complete tasks - Cannot solve problems or learn effectively - Behavior geared toward anxiety relief and is usually ineffective - Feels awe, dread, or horror - Doesn’t respond to redirection - Severe headache - N/V, diarrhea - Trembling - Rigid stance - Vertigo - Pale - Tachycardia - Chest pain - Crying - Ritualistic (purposeless, repetitive) behavior

Answer 20

Can involve loss of rational thought, delusions, hallucinations, and complete physical immobility and muteness The person may bolt and run aimlessly, often exposing themself to injury Signs & Symptoms: - Perceptual field reduced to focus on self - Cannot process environmental stimuli - Distorted perceptions - Loss of rational thought - Personality disorganization - Doesn’t recognize danger - Possibly suicidal - Delusions or hallucination possible - Can’t communicate verbally - Either cannot sit (may bolt and run) or is totally mute and immobile

Answer 21

A turning point in an individual’s life that produces an overwhelming emotional response Individuals experience a crisis when they confront some life circumstance or stressor that they cannot effectively manage through the use of their customary coping skills

Answer 22

1) The person is exposed to a stressor, experiences anxiety, and tries to cope in a customary manner 2) Anxiety increases when customary coping skills are ineffective 3) The person makes all possible efforts to deal with the stressor, including attempts at new methods of coping 4) When coping attempts fail, the person experiences disequilibrium and significant distress

Answer 23

Sometimes called Developmental Crisis Predictable events in the normal course of life, such as leaving home for the first time, getting married, having a baby, and beginning a career

Answer 24

Unanticipated or sudden events that threaten the individual’s integrity, such as the death of a loved one, loss of a job, and physical or emotional illness in the individual or family member.

Answer 25

AKA Social Crisis Include natural disasters like floods, earthquakes, or hurricanes; war; terrorist attacks; riots; and violent crimes such as rape or murder

Answer 26

FALSE Events like marriage, childbirth, & retirement are often desirable to the individual but may still present overwhelming challenges

Answer 27

1) Perception of the event 2) Availability of emotional support 3) Availability of adequate coping mechanisms

Answer 28

Usually self-limiting: Lasts usually 4-6 weeks Can be resolved in (3) ways: 1) Return to precrisis level of functioning 2) Begins to function at a higher level 3) Stabilizes at level lower than precrisis level of functioning Positive outcomes are more likely to occur when: - The problem (precipitating event & response) is clearly & thoroughly defined - Early intervention

Answer 29

Includes a variety of techniques based on the assessment of the individual

Answer 30

Designed to assess the person’s health status & promote problem-solving, such as: - Offering the person new information, knowledge, or meaning - Raising the person’s self-awareness by providing feedback about behavior - Directing the person’s behavior by offering suggestions or courses of action

Answer 31

Aim at dealing with the person’s needs for empathetic understanding, such as: - Encouraging the person to identify and discuss feelings - Serving as a sounding board for the person - Affirming the person’s self-worth.

Answer 32

Behavior modification Positive reinforcement Negative reinforcement Token economy Systematic desensitization Aversion therapy Meditation Biofeedback

Answer 33

A method of attempting to strengthen a desired behavior or response by reinforcement, either positive or negative

Answer 34

A reward immediately following a behavior to increase the likelihood that the behavior will be repeated

Answer 35

Involves removing a stimulus immediately after a behavior occurs so that the behavior is more likely to occur again

Answer 36

Behavioral technique used to help overcome irrational fears & anxiety associated w/ a phobia 1) Client is asked to make a list of situations involving the phobic object, from the least to the most anxiety-provoking - Learns and practices relaxation techniques to decrease and manage anxiety 2) Exposed to the least anxiety-provoking situation and use the relaxation techniques to manage the resulting anxiety - Gradually exposed to more and more anxiety-provoking situations until they can manage the most anxiety-provoking situation

Answer 37

Inpatient treatment Current treatment reflects the belief that it is more beneficial and certainly more cost-effective for clients to remain in the community and receive outpatient treatment whenever possible The client can often continue to work and can stay connected to family, friends, and other support systems while participating in therapy

Answer 38

1) When the person is severely depressed and suicidal 2) Severely psychotic 3) Experiencing alcohol or drug withdrawal 4) Exhibiting behaviors that require close supervision in a safe, supportive environment.

Answer 39

A method of bringing about change in a person by exploring their feelings, attitudes, thinking, and behavior Involves a one-to-one relationship between the therapist and the client People generally seek this kind of therapy based on: - Their desire to understand themselves and their behavior - To make personal changes - To improve interpersonal relationships - To get relief from emotional pain or unhappiness

Answer 40

The therapist-client relationship Both the client and the therapist must be compatible for therapy to be effective. - Therapists vary in their formal credentials, experience, and model of practice Selecting a therapist is extremely important in terms of successful outcomes for the client - The client must select a therapist whose theoretical beliefs and style of therapy are congruent with the client’s needs and expectations of therapy The client may also have to try different therapists to find a good match

Answer 41

A therapist’s theoretical beliefs

Answer 42

A # of persons who gather in a face-to-face setting to accomplish tasks that require cooperation, collaboration, or working together Each person in a group is in a position to influence and to be influenced by other group members

Answer 43

Refers to what is said in the context of the group, including educational material, feelings and emotions, or discussions of the project to be completed

Answer 44

Refers to the behavior of the group & its individual members, including seating arrangements, tone of voice, who speaks to whom, who is quiet, and so forth.

Answer 45

Formal leader usually for therapy groups & education groups Informal leader may emerge in support groups & self-help groups. Effective leaders focus on group process & group content

Answer 46

Commences as soon as the group begins to meet Members introduce themselves, a leader can be selected (if not done previously), the group purpose is discussed, and rules and expectations for group participation are reviewed Group members begin to “check out” one another and the leader as they determine their levels of comfort in the group setting

Answer 47

Begins as members begin to focus their attention on the purpose or task the group is trying to accomplish This may happen relatively quickly in a work group with a specific assigned project but may take two or three sessions in a therapy group because members must develop some level of trust before sharing personal feelings or difficult situations During this phase, several group characteristics may be seen - Group cohesiveness: The degree to which members work together cooperatively to accomplish the purpose Cohesiveness is a desirable group characteristic and is associated with positive group outcomes - It is evidenced when members value one another’s contributions to the group; members think of themselves as “we” and share responsibility for the work of the group. When a group is cohesive, members feel free to express all opinions, positive and negative, with little fear of rejection or retribution. - If a group is “overly cohesive,” in that uniformity and agreement become the group’s implicit goals, there may be a negative effect on the group outcome. In a therapy group, members do not give one another needed feedback if the group is overly cohesive. In a work group, critical thinking and creative problem-solving are unlikely, which may make the work of the group less meaningful.

Answer 48

Occurs before the group disbands The work of the group is reviewed, with the focus on group accomplishments or growth of group members or both, depending on the purpose of the group

Answer 49

A group member who makes excessive verbal contributions -> prevent equal participation of other members Decide if, how, and when to intervene Ex) Politely interrupt by acknowledging contribution then redirect the discussion May choose to limit discussion time per member

Answer 50

Avoid problem-solving Encourage person to develop own solutions

Answer 51

Show respect for the disliked member Acknowledge contribution Stay neutral Avoid displaying negative verbal / nonverbal behaviors

Answer 52

Respect the person's silent manner Understand the meaning of the member's silence before encouraging interaction

Answer 53

Determine if the conflict is a natural part of group process or whether the group needs to address issues With leader-to-member conflict, be sensitive to the power differential - If necessary, handle conflict through conflict resolution

Answer 54

Gaining new information, or learning Gaining inspiration or hope Interacting with others Feeling acceptance and belonging Becoming aware that one is not alone and that others share the same problems Gaining insight into one’s problems and behaviors and how they affect others Giving of oneself for the benefit of others (altruism)

Answer 55

Goal: For members to learn their behavior & make positive changes via interacting & communicating w/others May be organized around a specific medical diagnosis (ex: depression) or a particular issue (ex: improving interpersonal relationships) Often formal in structure 1 or 2 leaders that are therapists - One task of the group leader or the entire group is to establish the rules for the group - Rules deal w/ confidentiality, punctuality, attendance, and social contact between members outside group time.

Answer 56

Ongoing and run indefinitely, allowing members to join or leave the group as they need to

Answer 57

Structured to keep the same members in the group for a specified number of sessions If the group is closed, the members decide how to handle members who wish to leave the group and the possible addition of new group members

Answer 58

A form of group therapy in which the client and their family members participate

Answer 59

Include: - Understanding how family dynamics contribute to the client’s psychopathology - Mobilizing the family’s inherent strengths and functional resources - Restructuring maladaptive family behavioral styles - Strengthening family problem-solving behaviors

Answer 60

Communication Management Boundaries Socialization Emotions & Support

Answer 61

Clear, understandable messages between family members Each member is encouraged to express thoughts and feelings

Answer 62

Blaming: Members blame others to shift the focus away from their own inadequacies Manipulating: Members use dishonesty to support their own agendas Placating: One member takes responsibility for problems to keep peace at all costs Distracting: A member inserts irrelevant information during attempts at problem-solving

Answer 63

Adults of a family agree on important issues, such as rule making, finances, and plans for the future

Answer 64

Management may be chaotic, with a child making management decisions at times

Answer 65

Boundaries are distinguishable between family roles Clear boundaries define roles of each member and are understood by all Each member functions appropriately

Answer 66

Enmeshed boundaries: Thoughts, roles, and feelings blend so much that individual roles are unclear Rigid boundaries: These families tend to have members that isolate themselves

Answer 67

All members interact, plan, and adopt healthy ways of coping Children learn to function as family members, as well as members of society Members are able to change as the family grows and matures

Answer 68

Children do not learn healthy socialization skills w/in the family and have difficulty adapting to socialization roles of society

Answer 69

Emotional needs of family members are met most of the time, and members have concerns about each other Conflict and anger do not dominate

Answer 70

Negative emotions predominate most of the time Members are isolated and afraid and do not show concern for each other

Answer 71

Provide info to members about a specific issue Ex) stress management, med management, or assertive training

Answer 72

Organized to help members who share a common problem how to cope w/it

Answer 73

Members share a common experience but, not in a formal/structured therapy group

Answer 74

Includes therapies used w/ conventional medicine practices

Answer 75

Therapies used in place of conventional treatment

Answer 76

Combines conventional & CAM (complementary & alternative med) therapy that have scientific evidence supporting their safety & efficacy

Answer 77

Include homeopathic & naturopathic medicine - Herbal & nutritional therapy - Restorative physical exercises (yoga & tai chi) - Meditation - Acupuncture - Remedial massage

Answer 78

Uses herbs, foods, & medicines

Answer 79

Therapeutic massage, chiropractic manipulation

Answer 80

Therapeutic touch, qi-gong, pulsed fields, magnetic fields

Answer 81

Involves providing services to people w/ severe & persistent mental illness to help them live w/in the community Focuses on client's strengths Often called "support services" or programs Activities involve: - Med management - Transportation - Shopping - Hygiene - Finances - Social support