Psychosocial Theories Flashcards
Adjunctive Therapies Used w/ Psychopharmacology
CBT
Family Therapy
Psychotherapy
Freud
Personality components:
- ID: primitive instincts
- Ego: conscious part of the personality
- Superego: conscience
Dream analysis
Ego defense mechanisms
Psychosexual stages of development
Defense Mechanisms
Ego protecting from anxiety
Denial Intellectualization Projection Rationalization Regression Reaction Formation Splitting Humor Altruism
Psychoanalysis
Focuses on discovering causes of client’s unconscious, repressed thoughts, feelings, and conflicts related to anxiety
Free association:
- clarification
- confrontation
- defense interpretation
- transference interpretation
Denial
Pretending the truth is not reality to manage the anxiety or acknowledgement of what is real
Failure to acknowledge an unbearable condition
Projection
Blaming of unacceptable thoughts onto an external object
Ex: saying someone you are angry with dislikes you
Intellectualization
Talks about one’s feelings in a way that is emotionless, avoid the negative feelings by excessive use of intellectual functions.
Ex: doctor dying of chronic disease explains pathophysiology of disease in detail to family
Regression
Resorting to an earlier more comfortable way of functioning
Ex: child who slides back to prior maturational stage when tired or hungry
-adult that throws tantrum when they don’t get their way
Rationalization
Creating reasonable and acceptable explanations for unacceptable behavior
Ex: student blames failure on teacher being mean
Reaction Formation
Turning something into its opposite to make it less threatening (reacting the opposite)
Ex: woman who never wanted children becomes a supermom
-person who dislikes their boss tells everyone how great their boss is
Splitting
Labeling people as all good or all bad
May be seen w/ borderline personality disorder
Ex: pt tells nurse that they are the only staff member to understand them and that all other staff are mean
Humor/Altruism
Mature defenses
-humor: maximizes our capacity to tolerate psychological pain
Transference
Client displaces onto the therapist feelings that the client originally experienced in other relationships
Countertransference
Therapist displaces onto the client attitudes or feelings relating to the therapist’s past
-self-reflection is important!
Erickson
Expanded Freud’s work across the lifespan while focusing on social and psychological development in life stages.
According to Erikson, psychosocial growth occurs in sequential phases and each stage is dependent on completion of previous stage and life task.
Behavior Therapy
Unlearning unacceptable behaviors and relearning:
- desensitization
- classical conditioning (Pavlov)
- operant conditioning (Skinner)
- behavior modification (behavioral principles that reward or reinforce behaviors)
- token economy (form of contingency management)
- thought stopping
A school of psychology that focuses on observable human behaviors and what one can do externally to bring about behavior change but does not attempt to analyze or explain how the mind works. Focused on purely behavior
Existential Theories
Goal: return to (or discover) authentic self through emphasizing personal responsibility
- rational emotive therapy
- logotherapy
- Gestalt therapy
- reality therapy
Hildegard Peplau
Promotion of the therapeutic nurse-patient relationship to build trust
Phases:
- orientation phase
- working phase
- termination phase
Four Levels of Anxiety
Peplau described four levels of anxiety:
- Mild = positive state of heightened awareness or sharpened senses (allows person to learn new behaviors and solve problems)
- baseline motivation to get things done
- Moderate = involves more decreased perceptual field (maybe you can only focus on the immediate task), person can learn new behaviors and solve problems only with assistance
- Severe = can involve feelings of dread or terror, person cannot be redirected, might have physiological symptoms of anxiety (increased HR, sweating, chest pain, may go to ER)
- Panic = most extreme level of anxiety
Hierarchy of Needs
Maslow developed pyramid of basic needs and drives that motivate people.
Bottom = physiologic needs (food, water, shelter, sex, freedom from pain), must be met first before we can move up in pyramid
Humanistic Model
Carl Rogers
Developed client-centered therapy
Focuses on role of “client” rather than therapist as key to healing process.
Therapist takes on person-centered approach, rather than directive role, b/c Rogers viewed the client as the expert.
Unconditional positive regard, genuineness, and empathetic understanding.
Basic nature of humans is to become self-actualized or move towards self-improvement and constructive change.
First one to use “client” instead of patient.
Types of Therapy
- Individual Psychotherapy
- Group/Psychotherapy groups (ex = 12 step meetings)
- Family Education/ Education Groups
- Family Therapy
- Support Groups/Self-Help Groups
Group Roles
Productive Roles: information seeker, opinion seeker, information giver, energizer coordinator, harmonizer, encourager, elaborator
Inhibiting Roles: monopolize, aggressor, dominator, critic, recognition seeker, passive follower
Milieu Therapy
Harry Stack Sullivan credit w/ development of first therapeutic community/milieu.
Involved clients interactions with one another, including practicing interpersonal relationship skills, giving another person feedback about behavior, and working cooperatively as group to solve day to day problems.
Primary modes of treatment we see on inpatient mental health unit. See clients coming into milieu (day area, Tv room, dining room area) and they are developing meaningful relationships with each other in those settings.
Creates an environment that is safe, supportive, and therapeutic.
Psychiatric Rehabilitation
Provides services to help people with mental illness live in the community
Help the client live successfully in the community while helping manage illness and symptoms
Often called community support services or community support programs.
Staff often assist clients with ADLs (transportation to appointments, shopping, community meals, food prep, helping with money management, organizing meds for week or supervised meds distributed to clients)
Alternative Therapies
Reiki Acupuncture Meditation Art Therapy Nutrition Exercise Music Therapy Supplements (important to know about supplements as nurse b/c of things like St. John’s Wort)
