Psychosocial Theories

Question 1

Adjunctive Therapies Used w/ Psychopharmacology

Answer 1

CBT
Family Therapy
Psychotherapy

Question 2

Freud

Answer 2

Personality components:

• ID: primitive instincts
• Ego: conscious part of the personality
• Superego: conscience

Dream analysis

Ego defense mechanisms

Psychosexual stages of development

Question 3

Defense Mechanisms

Answer 3

Ego protecting from anxiety

Denial
Intellectualization
Projection
Rationalization
Regression
Reaction Formation
Splitting
Humor
Altruism

Question 4

Psychoanalysis

Answer 4

Focuses on discovering causes of client’s unconscious, repressed thoughts, feelings, and conflicts related to anxiety

Free association:

• clarification
• confrontation
• defense interpretation
• transference interpretation

Question 5

Denial

Answer 5

Pretending the truth is not reality to manage the anxiety or acknowledgement of what is real

Failure to acknowledge an unbearable condition

Question 6

Projection

Answer 6

Blaming of unacceptable thoughts onto an external object

Ex: saying someone you are angry with dislikes you

Question 7

Intellectualization

Answer 7

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

Question 8

Regression

Answer 8

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

Question 9

Rationalization

Answer 9

Creating reasonable and acceptable explanations for unacceptable behavior

Ex: student blames failure on teacher being mean

Question 10

Reaction Formation

Answer 10

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

Question 11

Splitting

Answer 11

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

Question 12

Humor/Altruism

Answer 12

Mature defenses

-humor: maximizes our capacity to tolerate psychological pain

Question 13

Transference

Answer 13

Client displaces onto the therapist feelings that the client originally experienced in other relationships

Question 14

Countertransference

Answer 14

Therapist displaces onto the client attitudes or feelings relating to the therapist’s past
-self-reflection is important!

Question 15

Erickson

Answer 15

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.

Question 16

Behavior Therapy

Answer 16

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

Question 17

Existential Theories

Answer 17

Goal: return to (or discover) authentic self through emphasizing personal responsibility

• rational emotive therapy
• logotherapy
• Gestalt therapy
• reality therapy

Question 18

Hildegard Peplau

Answer 18

Promotion of the therapeutic nurse-patient relationship to build trust

Phases:

• orientation phase
• working phase
• termination phase

Question 19

Four Levels of Anxiety

Answer 19

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

Question 20

Hierarchy of Needs

Answer 20

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

Question 21

Carl Rogers

Answer 21

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.

Question 22

Types of Therapy

Answer 22

• Individual Psychotherapy
• Group/Psychotherapy groups (ex = 12 step meetings)
• Family Education/ Education Groups
• Family Therapy
• Support Groups/Self-Help Groups

Question 23

Group Roles

Answer 23

Productive Roles: information seeker, opinion seeker, information giver, energizer coordinator, harmonizer, encourager, elaborator

Inhibiting Roles: monopolize, aggressor, dominator, critic, recognition seeker, passive follower

Question 24

Milieu Therapy

Answer 24

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.

Question 25

Psychiatric Rehabilitation

Answer 25

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)

Question 26

Alternative Therapies

Answer 26

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)