NUR 448 Psychiatric Mental Health Nursing

Relevant Theories For Psychiatric Mental Health Nursing

2-22-2

The mind as an iceberg

(Fig. 2-1)(Fig. 2-1)

Menu FB

Freud

Personality Structure Id Ego Superego

Levels of Awareness Conscious Preconscious Unconscious

Developmental Stages

Oral

Anal

Phallic

Latency

Genital

Developmental Stages

Oral

Anal

Phallic

Latency

Genital

Menu FB

Erikson

Trust v. mistrust Autonomy v. shame and doubt Initiative v. guilt Industry v. inferiority Identity v. role confusion Intimacy v. isolation Generativity v. stagnation Wisdom v. despair

Erikson

• stressed ego

• psychosocial aspects of development

• considers life span development

• studied healthy people

Freud

• stressed id

• psychosexual aspects of development

• personality formed by age of 5

• studied neurotic people

Erikson vs. Freud

Menu FB

Sullivan

Needs Satisfactions Security

Anxiety Empathetic between child and mother Can be described; observable behaviors Individuals strive for anxiety reduction

Self System Good-me

Bad-me

Not-me

Security Operations Selective

inattention

Dissociation

Self System Good-me

Bad-me

Not-me

Security Operations Selective

inattention

Dissociation

Menu FB

Peplau

4 Phases of Interpersonal Process Orientation Identification Working Resolution

Described 4 Levels of Anxiety Mild-Moderate-Severe-Panic

Menu FB

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

Menu FB

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

Menu FB

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

Menu FB

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

Menu FB

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

Menu FB

Psychotherapies, cont.

Interpersonal Therapy Focus: interpersonal relationships Problems:

- Grief- Role disputes- Role transition- Interpersonal deficit

Therapist: active and directive

Menu FB

Psychotherapies, cont.

Behavioral Therapy Focus: learning more adaptive behavior Applications: - Operant conditioning

Positive reinforcement Negative reinforcement Punishment

MenuB

Methods for Behavior Modification

ModelingSystematic DesensitizationImplosions (Imagery)Flooding

Aversion therapy Relaxation Assertiveness