Transcript Chapter_02

Chapter 2
Relevant Theories and
Therapies for Nursing Practice
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
F
The mind as an iceberg
(Fig. 2-1)
Slide 2-2
B
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F
Freud
Personality Structure
Developmental Stages

Id

Oral

Ego

Anal

Superego

Phallic

Latency

Genital
Levels of Awareness

Conscious

Preconscious

Unconscious
B
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F
Erikson vs. Freud
Erikson
Freud
• stressed ego
• stressed id
• psychosocial aspects of
development
• psychosexual aspects of
development
• considers life span
development
• personality formed by age
of 5
• studied healthy people
• studied neurotic people
B
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F
Sullivan
Needs
Self System

Satisfactions

Good-me

Security

Bad-me

Not-me
Anxiety



Empathetic between
child and mother
Can be described;
observable behaviors
Security Operations

Selective inattention

Dissociation
Individuals strive for
anxiety reduction
B
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F
Peplau
4 Phases of Interpersonal Process

Orientation

Identification

Working

Resolution
Described 4 Levels of Anxiety
B
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F
Peplau, cont.
Ideas about Nursing

Focus is on client

Nurse is participant observer

Nurse has awareness of role

Nursing is investigative

Nurses use theory

Developed process recording
B
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F
Piaget
Stages of Cognitive Development

Sensorimotor

Preoperational

Concrete operations

Formal operations
Schema

Developed to organize and understand the world
Processes Used to Develop Schemata

Assimilation

Adaptation
B
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F
Maslow
Needs Hierarchy

Physiological needs

Psychological needs

Meta-needs
Beliefs about Humankind

Needs are fulfilled by and through other humans

A person does the best he/she can at the time

With adequate understandable information, a person will
make good decisions

Man has a higher nature
B
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F
Kohlberg
Level I Preconventional (ages 4-10)

Emphasis on external control, avoiding punishment
Level II Conventional Role Conformity (ages 10-13)

Want to please other and be considered “good”

Develop social concern and conscience
Level III Autonomous Moral Principles (after age 13,
if ever)

Acknowledges the possibility of conflict between 2
accepted standards and tries to decide between them

Acts in accord with internalized standards
B
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F
Psychotherapies
Psychodynamic/Psychoanalytic


Focus:
- internal experience
- defense mechanisms
- transference and past relationships
Therapist: more non-directive
Cognitive Therapy


Focus:
- thoughts/cognitions
- correcting cognitive distortions
Therapist: active and directive
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B
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F
Psychotherapies, cont.
Interpersonal Therapy

Focus: interpersonal relationships

Problems:
- Grief
- Role disputes
- Role transition
- Interpersonal deficit

Therapist: active and directive
B
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F
Psychotherapies, cont.
Behavioral Therapy

Focus: learning more adaptive behavior

Applications: - Operant conditioning
- Modeling
- Systematic desensitization
- Aversion therapy
- Relaxation
- Assertiveness

Therapist: active and directive
B
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