Theories and Models Flashcards
4 Models and Approaches Relevant to Mental Health
- Harm Reduction Model
- Recovery-Based Model
- Strength-Based Approach vs. Deficit-based
- Trauma Informed Care
What is harm reduction
Refers to policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop
What are the origins of harm reduction?
began to be discussed frequently after the threat of HIV spreading among and from injecting drug users was first recognized; early 1980s.
similar approaches have long been used in many other contexts for a wide range of drugs.
Harm Reduction Principles and Examples
based on a strong commitment to public health and human rights.
examples: smoking patches, condoms, needle exchange
Traditional Model of Mental Health Care
Focuses on diagnosis, compliance, the eradication of symptoms and illnesses, and reducing risk
Recovery Model of Mental Health Care
Focuses on the person’s lived experience, choices and self-management, on achieving hopes and dreams and on encouraging positive risk-taking.
Clinical relationship moves from one patient to one of collaborative shared decision-making,
- Understanding that patients’ lived experiences make patients the experts in their own care
Recovery Approach does not mean:
Everyone needs to be hopeful or naively unrealistic about what is possible
Strength Based Approach
Concentrate on the inherent strengths of individuals, families, groups and organisations, deploying personal strengths to aid recovery and empowerment.
Deficit-based Approach
Focus is on the disorder, problems, signs and symptoms, high risk statistics
See Aboriginal populations as having barriers to good health as opposed to identifying strengths
Person Centred Approach
Focuses services on individuals’ strengths in terms of resources, abilities, skills, and capacities to maintain a positive perspective that encourages further positive developments.
Trauma Informed Care Approach
Can help health care providers to tailor care and establish a safe environment of understanding for Aboriginal clients who are impacted by historical violence such as residential schooling
Four Assumptions of Trauma Informed Care
Realization: of the widespread impact of trauma on individuals, groups, families, and individuals
Recognize: the signs of trauma
Respond: by integrating knowledge about trauma on all areas of functioning (e.g., policies, procedures and practices)
Resist Re-traumatization: of clients and of staff and prevent triggering painful memories
Florence Nightingale
1820-1910
Founder of Modern Nursing
Imporving Environmental Conditions
2 Theorists of Interpersonal Relations
- Hildegard Peplau
- Ida Jean Orlando
Hildegard Peplau
Interpersonal Relations
Nurse/Patient Relationship
Concepts in model
- interpersonal relations
- self system
- need
- anxiety
Ida Jean Orlanda
Interpersonal Relations
Dynamic Nurse–Patient Relationship Model (1961)
Studied the factors that enhanced or impeded the integration of mental health principles in the basic nursing curriculum
Existential/Humanistic Theoretic Perspectives
Joyce Travelbee
Rosemarie Rizzo Parse
Joyce Travelbee
Seeking Life Meaning
Provided an existential perspective on nursing
Believed that humans seek meaning in their life and experiences
Rosemarie Rizzo Parse
Human-becoming
Quality of life as perceived by a person and their family is focus of model
The individual is perceived as open and free to ascribe meaning to life and to bear responsibility for choices
Three Principles of Parse Human Becoming Model
Meaning: structuring meaning is the imaging and valuing of language
Rhythmicity: configuring rhythmical patterns of relation is the revealing-concealing and enabling-limiting and connecting-separating
Transcendence: co-transcending with possible is the powering and originating of transforming
Four Postulates of Parse Human Becoming Model
Illimitability: indivisible, unbounded knowing extending to infinity
Paradox: rhythm expressed as pattern preference
Freedom: contextually construed liberation
Mystery: the unexplainable
Caring Models
Patricia Benner
Jean Watson
Philip Parker’s Tidal Model
Patricia Benner
Caring Model
Developed a particular notion of nursing as a caring relationship
Nursing practice is based upon “the lived experience of health and illness
Novice to expert model
Philip Barker
Caring Model - Tidal Model
Emphasizes the centrality of the lived experience and is based on assumption that people are their life stories and generate meaning through such stories
Change (i.e., becoming different) is a core element in this model; hence the metaphor of the tide
Systems Models
McGill Model of Nursing
Imogene N King
Betty Neuman
Dorothea Oren
Callista Roy
Martha Rogers
McGill Model of Nursing
Systems Model
Strength-based perspective
Four major concepts: health, family/person, collaboration, learning
Imogene M King
Systems Model
Goal Attainment
Betty Neuman
Systems Model
Systems and Stress
Guide the actions of the professional caregiver through the assessment and intervention processed by focusing on two major components
> Relationship between nurse and patient
> Relationship between patient and patient response to stressors
Dorothea Orem
Systems Theory
Self Care
Callista Roy
Systems Theory
Adaptation
Describes humans as living adaptive systems with two coping mechanisms: the regulator and the cognator
Martha Rogers
Systems Theory
Main Concept: energy fields as open systems
Biologic Theories
Important in understanding the manifestations of mental disorders and caring for people with these illnesses.
Importance is growing, as knowledge of the brain grows.
4 Psychodynamic Theories and Definition
Explain human development processes especially in early childhood, and their effects on thought and behaviour
- Psychoanalytic
- Jung
- Adler
- Horney
Main Concepts of Psychoanalytic Theory
- Study of the unconscious: awareness of events
- Personality and its development: id (unconscious), ego (logic), and superego (moral)
- Object relations and identification: the psychological attachment to persons/objects
- Anxiety and defence mechanisms: a specific state of unpleasantness accompanied by motor discharge along definite pathways
- Sexuality: libido; resides in the id
- Psychoanalysis: therapeutic process of assessing the unconscious and with the mature adult mind resolving the conflicts that originated in childhood.
- Transference and countertransference
Adler
Neofreudian Model
Focused on social aspects of human existence
Motivating force in human life is striving for superiority
Avoiding inferiority complex
Jung
Neofreudian Model
Humans were not only influenced not only by their past but also by their hopes and futures
Two psychological types
Extrovert: finds meaning in the world
Introvert: finds meaning within
Horney
Neofreudian Model
Primary concept was that of basic anxiety
Humanistic Theories
- Rogers
- Gestalt
- Maslow’s Hierarchy of Needs
Roger’s
Humanistic
client-centred theory
Empathy; unconditional positive regard
Gestalt
Humanistic
modern civilization inevitably produces neurotic anxiety because it forces people to repress natural desires
Exercises aimed to enhance a person’s awareness of emotions, physical state, and repressed needs as well as physical and psychological stimuli in the here-and-now environment
Maslow
Humanistic
Physiological and survival
Safety and security
Love and belonging
Esteem
Self-actualization
Behavioural Theories
2 Types
- Early Stimulus-Response
- Pavlov
- Watson - Reinforcement
- Thorndike
- Skinner
Pavlov
Early Stimulus Response Behavioural Theory
unconditioned stimulus (not dependent on previous training) that elicits an unconditioned (i.e., specific) response
Classical conditioning: if the conditioned stimulus was repeatedly presented before the meat, eventually salivation was elicited by the conditioned stimulus
Watson
Early Stimulus Response Behavioural Theory
Frequency: the more often a given response is made to a given stimulus, the more likely the response to that stimulus will be repeated
Recency: the more recently a given response to a particular stimulus is made, the more likely it will be repeated
Thorndike
Reinforcement Behavioural Theory
o Tried to determine whether animals solved problems by reasoning or instinct
o Stamping-in: gradually learning correct response via stimulus-response connection
o Believed in the importance of the effects that followed the response or the reinforcement of the behaviour
Skinner
Reinforcement Behavioural Theory
classical conditioning vs. operant conditioning
Respondent behaviour: end result of classical conditioning; elicited by specific stimulus
Given the stimulus the response occurs automatically
Operant behaviour: distinctive characteristic is the consequence of a particular behavioural response not a specific stimulus
Example: child learns to clean up his toys in his play area because he gets a reward, like a piece of candy, from his parents. The reward reinforces the child’s behavior and makes it more likely that he will clean up the toys in the future, thus, creating positive behavior.
Cognitive Theories
Bandura
Aaron Beck
Bandura
Social cognitive theory
o modelling: pervasive imitation
o self-efficacy: person’s sense of their ability to deal effectively with the environment which he develops in his work
o elicitation: no desire present, but when one person starts an activity, others want to do the same
Aaron Beck
Cognitive Theory
Thinking and feeling
o Depressed people had faulty information-processing systems that led to biased cognitions causing errors in judgement that become habitual errors in thinking
Developmental Theories
- erikson: psychosocial
- piaget: learning
- gilligan: gender differentiation
Cultural Theories
Madeleine Leininger: Transcultural Health Care
Applicability of Sociocultural Theories to PMH Nursing
o Used concepts from anthropology and nursing (from such theorists as Henderson [1966], Rogers [1970], and Watson [1979]) to depict universal and diverse dimensions of human caring
o Directed toward holistic, congruent, and beneficent care.
Spiritual Theories
- Frankl’s Logotherapy
- Yalom’s Existential
Frankl
Spiritual Theory
Logotherapy
o Focused on helping a person find meaning in life
o based on the assumptions of freedom of will, will to meaning, and meaning of life
Yalom
Spiritual Theory
Existential Psychotherapy
o Considers central life concerns as death, freedom, isolation, and meaninglessness
