Chapter 3 MH

psychoanalytic (Freud)
development (Erikson, Piaget)
Interpersonal (Sullivan, Peplau)
Humanistic (Maslow, Rogers)
Behavioral (Pavlov, Skinner)
Existential (Beck, Ellis, Frankl, Perls, Glasser)

all human behavior is caused and explainable
repressed sexual impulses, desires as motivation for behavior (debunked)
personality components: Id, Ego, Superego

Moving back to a previous developmental stage to feel safe or have needs met
ex: Adult pouts like a 4-year-old if they are not the center of their partner’s attention

Failure to acknowledge an unbearable condition; failure to admit the reality of a situation or how one enables the problem to continue
ex: Person with diabetes eating chocolate candy
ex: Spending money freely when broke

Unconscious blaming of unacceptable inclinations or thoughts on an external object
ex: Man who has thought about same-gender sexual relationship but never had one beats a man who is gay
ex: Person with many prejudices loudly identifies others as bigots

oral
anal
phallic / oedipal
latency
genital

occurs when client displaces onto therapist attitudes and feelings the client originally experiened in other relationships

occurs when the therapist diplaces onto the client attitudes and feelings from their own past

eight psychosocial stages of development
achievement of life's virtues

cognitive, intellectual development
four stages: sensorimotor, preoperational, concrete operations, formal operations

Significant of interpersonal relationships
therapeutic milieu or community

Sullivan

therapeutic nurse-patient relationship
four phases: orientation, identification, exploitation, resolution
nurses roles to meet client's needs: stranger, resource person, teacher, leader, surrogate, counselor
four levels of anxiety: mild, moderate, severe, panic

directed by the nurse and invovles engaging the patient in treatment, providing explanations and information, and answering questions

begins when the patient works interdependently with the nurse, expresses feelings, and begins to feel stronger

the patient makes full use of the services offered

developed the levels and interventions at each stage

hierarcy of needs
basic physiological (bottom), safety and security, loving and belonging, esteem, and self actualization (top)

client-centered therapy (focus on client's role)
unconditional positive regard, empathetic understanding

SAFETY!!!
pick answer that would keep the patient safe

focus on observable behaviors and behavior changes, not how mind works

classical conditioning

operant conditioning
all behavior is learned
behavior has consequences (reward or punishment)

behavior modification -> autism therapy, smoking cessation, have to be careful with treatment
positive reinforcement
negative reinforcement
token economy
systematic desensitization

focuson immediate thought process
used by most existential therapists

exposure to stressor
increased anxiety when usual coping ineffective
increased efforts to deal with stressor
disequilibrium, significant distress

maturational -> puberty, having baby, getting married
situational -> death of loved one, loss of job
adventitious / social -> floods, earthquakes, war

directive interventions: assess health status, promote problem-solving
supportive interventions: deal with person's needs for empathetic understanding

assumtions of White
born in Europe or United States
seldom treated outside their coultural populations
"normal" or "typical" may not apply equally well to different racial, ethnic, or cultural backgrounds

bringing about change in a person by exploring their feelings, attitudes, thinking, behavior
one-to-one relationship between the therapist and the client
progression through stages and relationship as key to success
therapist's theoretical beliefs strongly influence style of therapy

new information or learning
inspiration or hope
interaction with others
feeling acceptance, belonging
awareness of not being alone; others share same problems
insight into problems and behaviors, how they affect others
altruism

psychotherapy groups
family therapy
family education
education groups
support groups
self-help groups

used in conjunction with traditional western medicine

services to people with persistant, severe mental illness to help them live in the community
often called community support services or programs
focus on client's strength
activties involving medication management, transportation, shopping, food preparation, hygiene, finances, social support

nurisng activties that enhance clients' social and psychiological functioning and promote social skills, interpersonal relationships and communication
skills used in mental health and other practice areas

no one theory or treatment approach is effective for all clients
using variety of psychoscoial approaches increases nurse's effectiveness
client's feelings and preceptions are most influential in determining their response