Chapter 2

Relevant Theories and

Therapies for Nursing Practice

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The mind as an iceberg

Slide 2-2 (Fig. 2-1)

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Freud

Personality Structure Developmental

● Id Stages
● Ego
● Oral
● Superego
● Anal
● Phallic
Levels of Awareness
● Latency
● Conscious
● Genital
● Preconscious
● Unconscious

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Erikson vs. Freud

Erikson Freud
• stressed ego • stressed id
• psychosocial aspects • psychosexual aspects
of development of development
• considers life span • personality formed by
development age of 5
• studied healthy people • studied neurotic
people

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Sullivan

Needs Self System

● Satisfactions ● Good-me
● Security ● Bad-me
Anxiety ● Not-me
● Empathetic Security Operations
between
child and mother
● Selective
inattention
● Can be described;
observable
● Dissociation
behaviors
● Individuals strive
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Peplau

4 Phases of Interpersonal Process

● Orientation
● Identification
● Working
● Resolution
Described 4 Levels of Anxiety

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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

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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 Menu F
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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
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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 decideB between
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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 B Menu F
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Psychotherapies, cont.

Interpersonal Therapy
● Focus: interpersonal relationships
● Problems:
- Grief
- Role disputes
- Role transition
- Interpersonal deficit
● Therapist: active and directive

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Psychotherapies, cont.

Behavioral Therapy
● Focus: learning more adaptive behavior
● Applications: - Operant conditioning
- Modeling
- Systematic desensitization
- Aversion therapy
- Relaxation
- Assertiveness
● Therapist: active and directive
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