A Text Book of Psychology for Nurses – Unit VII

UNIT-VII. MENTAL HYGIENE & MENTAL HEALTH
Concepts of mental hygiene & mental health
Characteristics of mentally healthy person, Warning sign
of poor mental health , Promotive & preventive mental
health- strategies & services , Ego defence mechanisms &
implications , Personal & social adjustments, Guidance &
counseling , Role of nurse
MENTAL HEALTH AND MENTAL HYGIENE
CONCEPT OF MENTAL HEALTH:
From the above discussion we can easily distinguish
between the mentally healthy and unhealthy person in the
following ways –Mental health is not merely the absence of
mental illness. On the other hand, it is a positive, active
quality of the individual daily life. A positive mental health
shows an individual’s ability to cope with the present and to
adjust satisfactorily in future. mental health is a balance
between the body, mind, spirit and the environment in which
a person lives.

CHARACTERISTIC OF MENTALLY HEALTHY

Mental health is often spoken of as a state of well
PERSON:
being associated with happiness, satisfaction, achievement,
and hope. Mental health is a dynamic or ever changing state, Solve his problems by his own efforts.
which is considered as an important aspect of one’s total Able to take decision in any situation.
health status. Maintain daily routine of good healthy practices related
to nutrition, rest and hygiene.
Burmham who emphasizes the importance of
Positive attitude towards self.
integration or wholeness of personality said “a mentally
Give love and accept love.
healthy person is one who has a balanced personality, free
Develop a philosophy of life that gives meaning and
from schism and inconsistencies, emotional and nervous
purpose to his daily activities.
tension, discords and conflicts. a well adjusted person can
Lives in a world of reality rather than fantasy or day
deal with his potentialities as well as he can accept his
dreaming.
limitations.”
Integration with others.

Harry stack sullivaa says that a mentally healthy Accept criticism.

individual would place a major value on efiicient social Appreciate respect others.
functioning. Assumes responsibility based on his capacities.
Enjoy leisure time.
Freudians lay emphasis on an awareness of one’s
unconsciousness motivation and subsequent self control, WARNING SIGN OF POOR HEALTH:

based on the awareness.

Symptoms of mental illness vary depending on the type and

Mental health is, thus, a condition of psychological severity of the condition. Some general symptoms that may

maturity. It is a condition of personal and social functioning suggest a mental illness include:

with a maximum of effectiveness and satisfaction. A mentally

• Poor concentration
healthy person is responsible, self reliant and has a true sense
• Being easily distracted
of individuality. He has a realistic life goal as well as
• Worrying more
philosophy of life and values. He can differentiate between
• Difficulty to take decisions
the right and the wrong.
• Feeling less interested in day-to-day activities
• Low mood
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
 A Text Book of Psychology for Nurses – Unit VII
• Feeling overwhelmed by things It care for the purpose of the preservation and improvement
• Excessive anxiety, fear and worries of mental health of the individual and community.
• Tiredness and lack of energy It is the meant for prevention and cure of minor and major

• Sleeping more or less mental disease and defect of mental, educational and social

• Talking less and avoiding social activities maladjustment.

• Talking more or talking very fast, jumping between topics Definition: It is concerned with the principle and practice in

and ideas promotion, maintenance of the mental health and the

• Finding it difficult to control your emotions prevention of mental disorders. J.A. HADFIELD
Definition: Mental hygiene is defined as the science and arts
• Drinking more
of preserving and maximizing the mental health. English &
• Irritability and short temper
English
• Aggression
PROMOTIVE & PREVENTIVE MENTAL HEALTH
• Isolation
STRATEGIES & SERVICES: WHO’s comprehensive
• Suicidal thoughts
mental health action plan 2013-2020 was adopted by the 66th

CONCEPT OF MENTAL HYGIENE World Health Assembly. Dr Margaret Chan, the WHO
Director-General, described the new Comprehensive Mental
Mental hygiene is a Science which deals with the Health Action Plan 2013–2020 as a landmark achievement: it
process of attaining mental health and preserving mental focuses international attention on a long-neglected problem
health in the society. The term mental health is closely related and is firmly rooted in the principles of human rights. The
with the term mental hygiene as the main objective of mental action plan calls for changes. It calls for a change in the
hygiene is to attain mental health. In other words, mental attitudes that perpetuate stigma and discrimination that have
hygiene is a means of mental health. That is why we can say isolated people since ancient times, and it calls for an
that mental hygiene is the means and mental health is the end. expansion of services in order to promote greater efficiency
in the use of resources.
Mental hygiene deals with the principle of living which
The four major objectives of the action plan are to:
serve as a guide to human adjustments. It is a branch of
• Strengthen effective leadership and governance for
science specially designed to suggest measures for ensuring
mental health.
mental health.
• Provide comprehensive, integrated and responsive mental

Mental hygiene is the sciences of promoting mental health and social care services in community-based

health and preventing mental illness through the application settings.

psychiatric and psychology principal. It is an art which • Implement strategies for promotion and prevention in
includes healthy practice for the promotion, preservation and mental health.

maintenance of mental health. • Strengthen information systems, evidence and research

for mental health.
According to Rivillin, mental hygiene –
Each of the four objectives is accompanied by one or two
means the application of a body of hygiene information and
specific targets, which provide the basis for measurable
techniques
collective action and achievement by Member States
it is taken from the sciences of psychology.
towards global goals. A set of core indicators relating to

Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
A Text Book of Psychology for Nurses – Unit VII
these targets as well as other actions have been developed
and are being collected via the Mental Health Atlas
project on a periodic basis.
PREVENTING SERVICES OF MENTAL HEALTH
The potential and possibilities for prevention of
mental and behavioural disorders have increased substantially
in recent years. This paper provides a brief review of the
place of prevention within the overall public health strategy
for mental and behavioural disorders.
Universal, selective and indicated preventive interventions
are
01. Primary prevention: prevention targets the general
public or a whole population group that has not been
identified on the basis of increased risk. Selective
prevention targets individuals or subgroups of the
population whose risk of developing a mental disorder is
significantly higher than average, as evidenced by
biological, psychological or social risk factors. Indicated
prevention targets high-risk people who are identified as
having minimal but detectable signs or symptoms
foreshadowing mental disorder or biological markers
indicating predisposition for mental disorder, but who do
not meet diagnostic criteria for disorder at that time.
02. Secondary prevention: seeks to lower the rate of
established cases of the disorder or illness in the
population through early detection and treatment of
diagnosable diseases.
03. Tertiary prevention: interventions that reduce disability
enhance rehabilitation and prevent relapses
recurrences of the illness. This paper focuses on primary
prevention of mental disorders.
The distinction between mental health promotion and mental
disorder prevention lies in their targeted outcomes. Mental
health promotion aims to promote positive mental health by
increasing psychological well-being, competence
resilience, and by creating supporting living conditions and
environments. Mental disorder prevention has as its target the
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
reduction of symptoms and ultimately of mental disorders. It
uses mental health promotion strategies as one of the means
to achieve these goals. Mental health promotion, when
aiming to enhance positive mental health in the community,
may also have the secondary outcome of decreasing the
incidence of mental disorders. Positive mental health serves
as a powerful protective factor against mental illness.
components of a single concept of mental health.
ROLE OF NURSE IN IMPROVING MENTAL
HEALTH :
Mental health nurses are responsible for planning and
providing support and medical and nursing care to
people who have a range of mental health issues.
Mental health nurses support people with issues ranging
from anxiety and depression to personality and
eating disorders or addiction to drugs or alcohol.
Mental helath nurse Dealing with the specific symptoms
of mental illness, de-escalating stressful situations and
helping patients overcome challenges.
Interacting with patients' families and other care staff -
offering advice and information on patients' conditions.
Assessment and evaluation of the patient’s mental health
Development of treatment care plan
Consultation with other health professionals about
treatment plan
Provision of care and psychotherapy treatment
Maintenance of medical records
Support and education to the patients and their family
DEFENCE MECHANISM/MENTAL MECHANISM
and
Definition: when an individual is faced with problem,
difficulties or failure, he employs certain way or device to
achieve health, happiness and success. These are called
defence mechanism. Defence mechanism enables a person to
resolve conflict and reduce the stress and anxiety.
and
Defence mechanism can be divided into successful and
unsuccessful mechanisms as given below:
A Text Book of Psychology for Nurses – Unit VII
Successful unsuccessful
Repression Suppression
Rationalization Reaction Formation
Intellectualization Displacement
Compensation Denial
Substitution Isolation
Sublimation Projection
Regression
Conversion
Fixation
Fantasy
Introjections
Identification
01. Repression
According to Freud, repression is basic to all other forms
of defence mechanism. Repression refer to the process by
which an individual strives to keep unacceptable, painful and
anxiety provoking need, urges and feelings associated with
them in the unconscious layer of the mind. When we cast a
discomforting idea deliberately out of our mind, we called it
suppression. Suppressed material is easily recalled and it
available in the conscious mind. When this process takes
places unconsciously, we call it repression.
Example: a child may feel angry with his mother because
she had punished him. When he feel too guilty about his
anger, he may repress it and may still be unconsciously
angry. It will be happened when the accidentally breaking
of his mother favourite thing or bed wetting by the child..
02. Rationalization
In this defence mechanism we make excuses giving a
reason different from the real one for what we are doing. it is
a defence mechanism in which person justified his failure by
using the socially unacceptable behaviour by providing
socially approved reasons.
There are generally two types of rationalization. These are:
a. Sour Grapes : When an individual fails to attain his goals
after repeated efforts, he may say that he did not want it any
way. He adjusts to the frustration by denying the existence of
any desire in him to attain the original goals. examples: A fox
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
which could not reach the grapes and out of sheer
frustration declares that grapes are sour. Or a boy when he
fails to qualify himself in the school football team
rationalizes his failure by saying that he does not want to
play
B. Sweet Lemon: When an individual is not satisfied with
his achievement or the situation he is in, then he uses this
form of rationalization. The individual who uses this method
tries to convince himself that what he has is exactly what he
wants. Examples: A teacher before joining the teaching
profession tried his best to get a better job than teaching but
when he fails, he accepts teaching as a very good profession
and thus rationalizes himself.
03. Intellectualization
It is related to rationalization, it is the far from an
emotional or threatening situation by talking or thinking
about it in intellectual term. A nurse, doctor and paramedical
worker cannot afford to become emotionally attached to each
patient. So the employed the defence or free from the
emotional attachment by giving brief statement regarding the
situation.
Examples a patient who is serious ill, calmly tell the family
member rather than saying I am so sorry.
This is helpful a defence mechanism to separate yourself
from professional crises and anxiety
Another examples: when a person who has just been
diagnosed with a terminal ill might focus on the disease
information in order to avoid distress and remain distant from
the reality of the situation.
04. Compensation
When we replace a loss or to make up for a defect. Just
as nature compensate for disease in our bodies when a blind
person develops extraordinarily keen hearing. So we develop
personality traits to compensate for various inadequacies.
When people are frustrated in their desires in one direction,
they compensate for it by attaining success in other direction.
Example: A student who fails in his studies may
compensate by becoming the college champion in athletics.
A plain girl who cannot compete with her more beautiful
A Text Book of Psychology for Nurses – Unit VII
sisters may compensate by studying hard and come first in
her class.
05. Substitution
A mechanism in which original goals are substituted by
others. For example, a student who has not been accepted
for admission in a medical college may satisfy herself by
admission in nursing courses.
06. Sublimation
It is the channeling of a strong and socially unacceptable
drive into a form that is acceptable to society. In the
sublimation sexual desire are very important.
For example: An unmarried women show repressed
sexual desires, by working as a nursery school teacher.
A young person who has fail in love may start write
poetry about love.
Unsuccessful defence mechanism
1. Suppression
It is a intentional pushing away from awareness of
certain unwelcome idea, memories and feelings. We push
backward according to our wish and remember these ideas
we required.
For example: a student worry about study so that that
They postponed weakened programme.
2. Reaction formation: it is a strongly rejected or oppose to
other. Such a tendency is called as reaction formation.
Example: the mother of an unwanted child may feel guilty
and so become over-indulgent or over protective of the child
to assure herself that she is a good mother
People who extreme friendly, over polite have
unconscious feeling of anger and hatred towards many
people.
3. Displacement
Means to replace the actual object of feelings which are
often aggression, with another object.
Examples: A person who is angry with his boss, but cannot
show it for fear of losing the job may fight his wife and
children on return from the office or kick his dog.
4. Denial
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
Denial is the unaccepted of real thing, we use denial when
death in the family, serious illness or life threatening
situation. A people often practice denial, at least for a period
of time, when he knows he has a fatal illness but cannot
accept his death.
Examples : very old people will not easily accept that their
mental and physical powers are on the decline as they
advance in age.
, backward students do not find any reliability in the
intelligent tests.
Denial is quite harmful if practiced in moderation, but can
lead to serious difficulties in health and life style if
practiced to excess.
5. Isolation
Separation of the idea of an unconscious impulse from its
appropriate affect, thus allowing only the idea and not the
associated affect to enter awareness, as in the ability to
express traumatic experience without the associated
disturbing emotion, with passage of time.
For example, a solider humorously describes how he was
seriously wounded in the war.
6. Projection:
Projection relives tension and anxiety by transferring the
responsibility for unacceptable idea, impulses, wishes or
thoughts to another person.
For example: student who believe that everybody cheat in
examinations may also cheat in a same way.
The surgeon who did the mistake in operation theatre may
a insist that it happened because the theatre nurse and ward
boy did their task badly.
7. Regression
Some people do not meet the problem of life, its strains
and stress, in a mature way. They revert and retreat to an
infantile or childish level of behaviour, and thus avoid the
painfulness of suffering a conflict or tension. This mode of
behaviour is called regression. It always implies a form of
behaviour which is less mature then what is expected of the
individual
A Text Book of Psychology for Nurses – Unit VII
Example, a student may fall ill just to avoid such frustrating We use defense mechanisms to protect ourselves from
situations as an examination or appearance before a group. feelings of anxiety or guilt, which arise because we feel
He may suffer from stomach trouble or vague aches or threatened, or because our id or superego becomes too
headache. These modes of behaviour save the student from demanding.
facing the real problems We all have thoughts, feelings, and memories that can be
8. Conversion difficult to deal with. In some cases, people deal with
A mental mechanism in which an emotional conflict is such feelings by utilizing what are known as defense
expressed as a physical symptom for which there is no mechanisms.
demonstrable organic basic. These defense mechanisms are unconscious
Example: A student very anxious about his exams may psychological responses that protect people from threats
develop a headache. and things that they don't want to think about or deal
9. Fantasy or Daydreaming with.
Normally everyone uses imagination in some form to
fulfill the shortcoming of his life. Thus fantasy is a common PERSONAL & SOCIAL ADJUSTMENTS:

method of adjustment that reduces conflict and tension. Day
dreaming is another frequently used form of fantasy.
Example: Teenagers fantasize about adventure, romance
and being successful in future while old people relive their
youth in their fantasies. Excessive daydreaming may result
in the loss of contact with fact of life and may lead to a
psychotic disorder called schizophrenia
10. Identification
It is an adjustment mechanism which enables one to
achieve satisfaction from the successes of other people,
groups or organization.
Example: Boys often identify themselves with their father,
and girls with their mothers. Student often identify
themselves with their favourite teachers and try to modify
their behaviour accordingly.
Implication of Ego Defence Mechanism:
Adjustment means the modification to compensate
for or meet special conditions. Webster-1951
Adjustment is the interaction between a person and
his environment. How one adjusts in a particular situation
depends upon one’s personal characteristics and the
circumstances of the situations. Arkoff-1968
An adjustment is a small change that is made to
something such as a machine or a way of doing something.
AREA OF ADJUSTMENT: Adjustment in the case of
individual consisted of personal as well as environmental
components. These two aspects of adjustment can be further
subdivided into smaller aspects of personal and
environmental factors.
Broadly speaking there are three areas where an individual
need to be adjusted to live a balance life. These are: Family
and home, School, and Society.

The defense mechanism has a profound impact on the Here we will discuss two areas: (1) Family and home, and (2)

development of personality. school.

The idea of a defense mechanism is a psychological 01. Adjustment at Family and Home:

approach to coping with a particular problem or An individual is not born adjusted or maladjusted, it is

situation. his physical, mental and emotional potentialities that are

It is a construct of the conscious in dealing with an issue influenced and directed by the factors of environment in

that potentially resides in the sub-consciousness. which he found himself that adjustment or
maladjustment gradually develop.
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
A Text Book of Psychology for Nurses – Unit VII
The family is the oldest and the most important of all the It is the interaction of the child's personal characteristics
institutions that man has devised to regulate and integrate and their experiences that ultimately determines how a
his behavior as he strives to satisfy his basic needs. child adjusts to school (Margetts, 2002).
if family relationship has been good, not only during
childhood but also during adolescence, the person will CHARACTERISTICS OF ADJUSTMENT
MECHANISM
develop into a well adjusted individual. One of the
important roles of family is presumed to be the
Adjustment mechanism is almost used by all people.
socialization of the child.
They are ideas which are inferred from the behavior of
Home is first social institution where a child needs to be
the individuals.
adjusted. When a child becomes aware of other
All mechanisms are used to protect or enhance the
individuals who comprise his social environment at
persons self esteemed against dangers.
home he tends to regard them as a mean through which
They increase satisfaction and help in the process of
he may attain personal satisfaction.
adjustment if used within limit.
From the very beginning he imitates the speaking and
The danger is always within the person. He fears his own
eating habits of his family and gradually reflects attitudes
motives.
learned in the home toward elders.
The fear and danger are manifested in adjustment
02. Adjustment at school
mechanism.
As the children start school they face many challenges.
The overall effect of adjustment mechanism is to cripple
Personal challenges occur as children take new identity
the individual's functioning and development through
at school. Children face the challenges to adjust to the
falsifying some aspects of his impulses so that he is
strange building, new teachers, new academic
deprived of accurate self knowledge as a basis for action.
activities, and they need to mix with the new and more
diverse group of children. Characteristics of a well adjusted person:
At school, daily schedule is more structured, with more
formal rules. Children are faced with large groups of A well-adjusted person is supposed to possess the

children of different ages and size especially during following characteristics:

assembly and playtime, and they are confronted with the Awareness of his own strengths and limitations. A well

challenges of making new friends. Successful adjustment adjusted person knows his own strengths and weaknesses. He

to school largely depends on past experiences at home tries to make capital out of his assets in some areas by

and on children skills and knowledge. accepting his limitation.

When children exhibit a range of social skills associated Respecting himself and others. The dislike of one-self is a

with cooperation, initiating interactions or assertion, and typical symptom of maladjustment. An adjusted individual

self control, they are more likely to adjust easily to has respect for himself as well as for others.

school. Difficulties are likely to arise when children are: An adequate level of aspiration. His level of aspiration is

non compliant; disorganized; distractible; or when they neither too low nor too high in terms of his own strengths and

are anti social and have difficulty considering the rights abilities. He does not try to reach for the stars and also does

of others (Margetts, 2002). not repent over selecting an easier course for his

Adjustment to schooling is influenced by a variety of advancement.

personal and family Characteristics, and societal trend.

Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
 A Text Book of Psychology for Nurses – Unit VII
Satisfaction of basic needs. His basic organic, emotional and
social needs are full satisfied or in the process of being
satisfied. He does not suffer from emotional cravings and
social isolation. He feels reasonably secure and maintains his
self-esteem.
Absence of critical or fault-finding attitude. He appreciates
the goodness in objects, persons or activities. His observation
is scientific rather than critical or punitive. He likes people,
admires their good qualities, and wins their affection.
Flexibility in behavior. He is not rigid in his attitude or way
of life. He can easily accommodate or adapt himself to
changed circumstances by making necessary changes in his
behavior.
The capacity to deal with adverse circumstances. He is not
easily overwhelmed by adverse circumstances and has the
will and the courage to resist and fight odds. He has an
inherent drive to master his environment rather than to
passively accept it.
A realistic perception of the word. He holds a realistic vision
and is not given to flights of fancy. He always plans, thinks
and acts grammatically.
A feeling of ease with his surroundings. A well-adjusted
individual feels satisfied with his surroundings. He fits in
well in his home, family, neighbourhood and other social
surroundings. If a student, he likes his school, school-mates,
teachers, and feels satisfied with his daily routine. When he
enters a profession, he has a love for it and maintains his zeal
and enthusiasm despite all odds.
A balanced philosophy of life. A well-adjusted person has a
philosophy which gives direction to his life while keeping in
view the demands of changed situations and circumstances.
This philosophy is centredaround the demands of his society,
culture, and his own self so that he does not clash with his
environment or with himself (Mangal, 2006).
Methods of Adjustment: methods of adjustment can be
divided into two main categories.
01. Direct methods: These types of methods employed by the
individual intentionally at the conscious level.
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
Increasing trial or improving efforts: They are help in
getting permanent solution of the problem in a particular
situation.
Adopting compromising means: For maintain harmony
between his self and the environment one may adopt
following posture
He may altogether change his direction of efforts by
changing the original goal.
He may seek partial substitution of goal like selection
for the provincial civil services in place of the IAS.
He may satisfy himself by an apparent substitute for
the real thing.
Withdrawal and submission: one may learn to manage
with one’s environment by just accepting defeat and
surrendering oneself to the powerful forces of
environment and circumstances.
02. Indirect methods: In which a person tries to seek
temporary adjustment to protect him for the time being
against a psychological danger. These are purely psychic or
mental device-way of perceiving situation as he wants to see
them and imaging that thing would happen according to his
wishes. A few important defence mechanism includes:
repression, regression, compensation , rationalization,
projection etc
PERSONAL ADJUSTMENT:
Process of harmony between the individual and his
environment. Applies energy and effort to accommodate
perfectly within the society and the environment
Tries to fulfil his needs and lead a happy social life.
SOCIAL ADJUSTMENT:
Human being is a social being
As social beings we live in a society
Everyone needs acceptance and recognition from and
within the society.
Try to behave according to the norms of the society, so
that we can adjust with others.
Social adjustment is a psychological process.
A Text Book of Psychology for Nurses – Unit VII
It frequently involves coping with new standards and
values in the society.
Social adjustment is getting along with the members of
the individual as one can.
GUIDANCE & COUNSELING:
Guidance is based upon a philosophy of human
uniqueness, goodness, worth and dignity all of which can be
nurtured. The guidance processes are based on the belief that
given certain conditions, an individual’s potential to make a
choice and make a decision can be utilized for maximum
benefit to the individual and society.
MEANING OF GUIDANCE
To guide means to indicate, to point out, and to
show the way. It means more than to assist. A man falls on
the street; we assist him to get up but we do not guide him
unless we help him to go in a certain direction.
The synonyms of ‘to guide’ are – to lead, to conduct, to
regulate, to direct, to steer, to show, to channel, to point.
DEFINITION OF GUIDANCE
Guidance involves the difficult art of helping boys and girls
to plan their own future wisely in the full light of all the
factors that can be mastered about themselves and about the
world in which they are to live and work.” Secondary
Education Commission, 1952.
“Guidance is assistance made available by personally and
adequately trained men or women to an individual of any age
to help him manage his own life activities, develop his own
points of view, make his own decisions and carry his own
burdens.” Crow and Crow.
“Guidance helps an individual to develop his personality and
enables him to serve the society to the best of his capabilities
and talents.” Woodworth.
PRINCIPLES OF GUIDANCE
01. Principle of all-round development of the
individual: Guidance must take into account the all-
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
round development of the individual when bringing
about desirable adjustment in any particular area of his
personality.
02. The principle of human uniqueness: No two
individuals are alike or same. Person differs in their
physical, mental, social, emotional and behaviour
development. Though guidance we can recognize these
differences and provide help according to their specific
need.
03. Principle of holistic development: The child grows
as a whole and even if one aspect of personality is in
focus, the other areas of development which are
indirectly influencing the personality have also to be
kept in mind.
04. The principle of cooperation: No individual can be
forced into guidance. The consent and cooperation of
the individual is a pre-requisite for providing guidance.
05. The principle of extension: Guidance service should
not be limited to a few persons, who give observable
evidence of its need, but it should be extended to all
persons of all ages, who can benefit from it directly or
indirectly.
06. The principle of adjustment: principal of adjustment
related to an individual whole life span. it is chiefly
concerned with an individual’s physical or mental
health, with his adjustment at home, school, society
and vocational area.
07. Principle of individual needs: The individual and his
needs are of utmost significance. Recognition of
individual freedom, worth, respect and dignity is the
hallmark of guidance. Freedom to make a choice and
take a decision needs to be respected and encouraged.
08. The principle of responsibility: Parents and teachers
have great responsibility in the execution of the work
of guidance. guidance should be centred on a qualified
person.
09. The principle of expert opinion: serious guidance
problems should be referred to persons who are trained
A Text Book of Psychology for Nurses – Unit VII
to deal with particular area of adjustment for their
expert opinion.
10. The principle of evaluation: The guidance
programme should be evaluated in terms of its
effectiveness and improvement. Evaluation is essential
for the formulation of new goals or re-drafting the
existing goals.
AREA OF GUIDANCE
01. Educational guidance: In education guidance plays the
role of helping the individual in planning suitable
programs and making progress. It involves helping
students to develop;
Good study habits and note taking skills.
Habits that lead to adequate preparation so as to develop
confidence to sit for examinations
Skills to deal with crisis situations
Improved concentration in order to uplift grades.
Skills in subject choice
Methods of developing realistic goals based on values,
ability and interests
Guidance also plays preventive, remedial
developmental roles.
02. Vocational guidance: This is the process of helping
individuals to choose an occupation or profession. These
guidance provided in following manner :
Informing About jobs available.
Types of duties to be performed and wages according to
performance.
Working hours and conditions.
Qualifications and requirements for entry.
Preparation for entry
Students can be exposed to information through the
following channels;
Reading from library sources
Guests from various career fields can be invited to give
speeches about their work.
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
Students can be shown films or videotapes that show
people in different professional fields at work for
example, a surgeon at work.
Students are assisted to make choices of an occupation
by taking relevant courses. Students are also informed of
the changes taking place in the occupational outlets.
03. Personal guidance: The individual is helped to deal
with adjustment problems from various sources, for
example family, change of school, learning problems,
boy/girl relationships, decision making, problem solving
and goal setting. Personal counseling helps the
individual to deal with anxieties and stress, drug abuse,
and suicidal tendencies.
04. Guidance for Leisure Time : This involves helping
students with information about;
What to do during out of class sessions, weekends and
holidays
Selection of hobbies, co-curricular activities e.g. games,
athletics, cultural and work experiences.
Students need to be helped to make the time out of class
a time to develop certain interests. During this time
and activities should be arranged to promote interpersonal
behaviour.
05. Social guidance: This refers to guidance on social
behavior and relationships. Sometimes students have
problems relating with peers and as a result they do not
win peer acceptance. These students need training in
social skills so that they learn how to make and keep
friends. They should be trained how to communicate
their needs, feelings and aspirations as well as how to be
sensitive to the needs and feelings of other people. This
will make them better functioning and more adaptive in
social environments.
06. Moral guidance: Moral guidance aims at helping
students to practice morality. It helps students to be able
to distinguish right from wrong and to make the right
moral decisions. Moral guidance will train students the
benefits of being truthful so that they avoid telling lies. It
will also keep them from anti social behavior so that they
A Text Book of Psychology for Nurses – Unit VII
observe the set rules and regulations; learn to respect
Goals of Counselling:
authority as well as conforming to societal norms
governing moral behavior. Listening carefully to the patient is the main goal.
07. Health guidance: should help the students to acquire
healthy habits in the following areas. To make the patient to ventilate his emotions properly

Good feeding habits. Each student should know the and help him to be aware of his own emotions and

benefits of a balanced diet. Students should avoid encourage him to be independent.

harmful eating habits for example over-reliance on junk Identify the need of the patient. E.g., parents need

foods, anorexic and bulimic habits, drugs and risk taking counselling for their children’s behaviour problems.

sexual behaviour. Main problem should be focused so that the sub-

Exercise and rest, which help to improve the individual’s problems should be identified by the patient himself.

physique and body strength. Unhealthy person may Make the patient to accept himself with his problem and

develop a various types of illness. help him to adjust with it till it gets over

08. Marital guidance: The person is helped to make the To focus on his strengths by studying the case and

right choice of partners, how to live with a spouse and produce positive attitude in him and ultimately help him

how to make decisions in marriage. Marital guidance to reduce his negativity.

helps for married couples who have problems in their

PRINCIPLES OF COUNSELLING:
relationship.
09. Finances guidance: the person is trained how to manage 01. Principle of acceptance: Accept the patient without
his money, how to look for scholarships and help in any differences. For example: allow the patient
order to ease the burden of financing education. physical, psychological, social, economical and
cultural conditions.
Definition of counseling 02. Principle of authenticity: Counsellor should have
genuineness, honesty and simplicity.
:Ccounselling is an accepting, trusting and safe relationship
03. Principle of communication: Communication
in which client learn to discuss openly what worries and
should be verbal as well as non-verbal and should be
upsets them, to define precise behaviours goals to acquire
skilful.
essential social skills and to develop the courage and self
04. Principle of empathy: Instead of showing
confidence to implement the desire new behaviours. Merle
sympathy put yourself in patient’s shoes and then
M Ohlsen-1977
give reflections accordingly.
“Counseliing is a process through which an 05. Principle of non-judge: Counsellor should be non-
individual is able to solve their problem and pursue a path judgmental about his condition. Mental attitude-do
suited to their abilities and aspirations. – JM Brewer not criticizes or comments negatively regarding
patient’s complaints.
Professional counselling is a safe and confidential*
06. Principle of confidentiality: All personal
collaboration between qualified counsellors and clients to
information should be maintained confidential.
promote mental health and wellbeing, enhance self-
Always keep the patient’s name, and the problem
understanding, and resolve identified concerns. Clients are
strictly secretes and assures the patient about the
active participants in the counselling process at every stage.
same.

Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
A Text Book of Psychology for Nurses – Unit VII
07. Principle of individuality: Counsellor should Treat
each and every patient as unique and respect his
problem as well.
08. Principles of non-emotional involvement:
Counsellor should not getting emotionally involved
with the patient and avoid getting carried away with
his feelings.
TECHNIQUES/APPROACHES TO COUNSELLING:
Approaches of counseling based on the
counselling process and role of the counsellor.
Three types of counseling techniques
01. Directive or counsellor centered: the counsellor is active
and direct the individual in making decision and finding
solutions to problems. The counselor does not force the
individual but directs the process of thinking of
counselee by informing, explaining, interpreting and
through advising. Final decision has to be taken by the
counselee
02. Non-directive or client centered counselling: In the
directive counselling, counselee is guided to use his own
inner resources to solve the problem. In this approach,
the counselee plays an important role.
03. Eclectic counselling: In this counselling, the strategy
arises out of the appropriate knowledge of individual
behaviour and a combination of directive and other
approaches.
Characteristics of eclectic counselling
Objective types and coordinating methods are use in
eclectic counselling
At the beginning client-active methods are used.
Principle of low expenditure is emphasized.
Make them possible to client himself find out solution of
a problem.
AREA OF COUNSELLING:
Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur
Emotional Abuse: allows one person to gain power and
control over another through words and gestures which
gradually undermine the other’s self respect.
Relationship Issues: Some relationships are unable to
contain some of life’s pressures and stresses; illness,
redundancy, retirement or debt all take their toll.
Trauma: A traumatic event involves an experience or
enduring event(s) that overwhelm our ability to cope or
understand the ideas and emotions involved with that
experience.
Stress: Too much stress can put your health at risk and
leave you unable to function. It is the second major cause
of illness at work, after back problems.
Terminal Illness: Counselling can be a valuable
resource for everyone close to the individual, and for the
individual themselves.
Work related issues: Counselling can help unravel
patterns of relating to people, and show us how to
examine our own issues, helping towards a more
fulfilling career.
Anger Management: Understanding what the trigger
points are and re-examining our thoughts around them
can be among the first steps to managing anger.
Anxiety: Anxiety is a problem which feeds on itself and
is often covered up and dealt with in isolation. Anxiety
can take many forms including phobias, social anxiety,
panic attacks, and insomnia.
Depression: Depression is a state of low mood and
aversion to activity that can affect a person’s thoughts,
behaviour, feelings and physical well-being. Depressed
people may feel sad, anxious, empty, hopeless, helpless,
worthless, guilty, irritable, or restless.
Bereavement Counselling: This focus on working
through the stage of grief. In this counselling talking
about the loss and is usually helpful and allows a person
to adjust to their new life with all its changes, good and
bad. However keeping things bottled up, or denying the
sadness can prolong the pain.
A Text Book of Psychology for Nurses – Unit VII
Low self-esteem: Counselling can often help those development and personality.
suffering from low self-esteem and help develop a sense Guidance helps a person It has been used by individuals,
of self, to ensure a more fulfilling life. discover and develop his institutions, families,
psychological, vocational and rehabilitation agencies and other
educational potential in order to organizations. It utilizes
be happier and more useful in psychological methods in the
society. Each person is
collection of case
responsible for his decisions but
history data through personal
when he is young he
interview, testing and aptitude.
will need some one to guide him
through life.
It assists clients towards an A counselor’s basic concern
appropriate course of action. It should go beyond treating
may be used as therapeutic aid dysfunction. It should deal with
in the treatment of minor a client’s self awareness which
emotional disturbances and should help him towards
disorders.
personal growth & development.
Advice or instructions given by Advice given by a counselor
someone more experienced or based on personal or psychology
qualified related problems of the
individuals.
Anyone who has good Need to be done with a
experience and knowledge can professional counselor with a
give guidance to others recognized license to practice as
a counselor.
Deals with education and career Deals with personal and socio-
relater issue psychological issues
Has a broader scope such as Essentially covers personal and
educational guidance, career psychological assistance
guidance, financial guidance,
Difference between guidance and counseling:
health guidance, etc
Guidance Counseling
*************************************
Guidance is defined as the act of Counseling is a psychological
guiding, giving leadership, specialty that deals with research
supervision, direction or and applied work in supervision,
professional guidance for future training, career development,
actions. It is usually provided to prevention, and health. It focuses
students in preparation for a
on a person’s strengths, assets,
vocation.
environmental interactions,
educational background, career

Omprakash Swami (Author) - Associate Professor, Mahatma Gandhi Nursing College, Jaipur