Nurs 260 - Pmh - Chapter 2: Relevant Theories And Therapies For Nursing Practice

Humans are ACTIVE rather than passive participants in life, striving for self-actualization (p. 20).

SIGMUN FREUD is often referred to as the "father of psychoanalysis" (p. 16). ABRAHAM MASLOW is considered the father of humanistic psychology (p. 20).

A positive ransference is developed when the client experiences feelings toward the nurse of therapist that were originally held toward significant others in his or her life. When this occurs, these feelings need to be explored with the client. Such exploration helps the client to better understand his/her own feelings and behaviours (p. 25).

Countertransference is the health care worker's unconscious and personal response to the client. For instance, if the client reminds you of someone that you do not like, you may unconsciously react to the client "as if" the client where the other individual (p. 25).

Freud used the image of an iceberg to describe THREE levels of awareness (CONSCIOUS, PRECONSCIOUS, and UNCONSCIOUS) (p. 16).

ABRAHAM MASLOW, considered the father of humanistic psychology, introduced the concept of "self-actualized personality," associated with high productivity and enjoyment of life (p. 20).

John B. Watson... developed the school of thought referred to as BEHAVIOURISM. He was strongly influenced by Pavlov's conditioning principles and began to apply these principles to human beings. Watson placed a strong emphasis on the role of the SOCIAL ENVIRONMENT in shaping behaviour (p. 22)

The id lacks the ability to problem solve; it is not logical and operates according to the pleasure principle. The pleasure principle works to discharge tension through one of two mechanisms: reflex action and primary process (p. 16).

False. Pavlov formalized his observations of behaviours in dogs in a theory of CLASSICAL CONDITIONING. Pavlov found that when a neutral stimulus (a bell) was repeatedly paired with another stimulus (food that triggered salivation), eventually the sound of the bell alone could elicit salivation in dogs (p. 21).

Operant conditioning is the basis for behaviour modification and uses POSITIVE REINFORCEMENT to increase desired behaviours. For example, when desired goals are achieved or behaviours are performed, clients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges. This reward system is known as TOKEN ECONOMY (p. 28). SYSTEMATIC DESENSITIZATION is a form of behaviour modification therapy that involves the development of behavioural tasks customized to the client's specific fears; this involves incrementally expsoing the cleint to the fear (p. 29).

Modeling is a form of behavioural therapy (p. 27).

B.F. Skinner had a theory of operant conditioning, which refers to the manipulation of selected reinforcers to elicit and strengthen desired behavioural responses. REINFORCERS (e.g. positive/negative reinforcers) refers to the consequence of behaviour and is defined as anything that increase the occurrence of a behaviour. The value of a reinforcer lies in its meaning to a particular individual (p. 22).

President George H. Bush declared the 1990s to be the Decade of the Brain, where vast amounts of research monies and effort were directed at study of the structure and functions of the brain (p. 22).

Four types of behavioural therapy are discussed in the text: modeling, operant conditioning, systematic desensitization, and aversion therapy (p. 27). Biofeedback (under the subcategory of aversion therapy) is also a form of behavioural therapy is is successfully used today, especially for controlling the body's psyiological response to stress and anxiety (p. 30).

The EGO develops because the needs, wishes, and demands of the id cannot be satisfactorily met through primary processes and reflex action. The ego, which emerges sometime in the fourth or fifth month of life, is the PROBLEM SOLVER and REALITY TESTER. The ego... attempts to NEGOTIATE A SOLUTION with the outside world. The ego uses SECONDARY PROCESSES to plan a course of action and to test this action in an effort to validate the plan (p. 17).

Freud initially used HYPNOSIS, but this provided mixed therapeutic results. He then changed his approach to TALK THERAPY, known as the CATHARTIC METHOD. Today we refer to catharsis as "getting things off our chests." Talk therapy EVOLVED to include "FREE ASSOCIATION," which requires full and honest disclosure of thoughts and feelings as they come to mind. Freud concluded that talking about difficult emotional issues had the potential to health the wounds of mental illness (p. 16).

The ID lacks the ability to problem solve; it is not logical and operates according to the pleasure principle. The pleasure principle works to DISCHARGE TENSION through one of two mechanisms: reflex action and primary process. REFLEX ACTION is inherent and automatic. We are equipped with many reflexes, including GAGGING, CRYING, and LAUGHING. Each of these successfully ALLEVIATES certain forms of TENSION (p. 16).

PSYCHODYNAMIC PSYCHOTHERAPY is oriented more to the here and now, and less of an attempt is made to reconstruct the developmental origins of conflict (p. 25). Also the focus of psychodymanic psychotherapy is to uncover unconscious material that appears in the form of symptoms or unsatisfactory life patterns (p. 26). CLASSICAL PSYCHOANALYSIS is seldom used today because it is too expensive and takes too long (p. 25). CONDITIONING involves pairing a behaviour with a condition that reinforces or diminishes the behaviour's occurrence (p. 21).

The therapist intervenes constantly to keep the therapy on track, either by redirecting the client's attention or by interpreting deviations from the focus to the client (p. 26).

These are all true. Bruno Bettelheim coined the term milieu therapy to describe his use of the total ENVIRONMENT to treat disturbed children. A milieu is an all-inclusive term that recognizes the people, setting, structure, and emotional climate as all important to healing (p. 30). Milieu therapy, or THERAPEUTIC COMMUNITY, has at its focus a living, learning, or working environment (p. 31).

The EGO uses SECONDARY PROCESSES to PLAN A COURSE OF ACTION AND TO TEST THIS ACTION IN AN EFFORT TO VALIDATE THE PLAN. This process is known as REALITY TESTING because the individual is factoring in reality to implement a plan to decrease tension. It is the ego that coordinates expression of self and is the mediator of various demands from the id, superego, and reality (p. 17).

The superego, the last portion of the personality to develop, represents the MORAL COMPONENT of personality. The superego consists of the CONSCIENCE, which is all the "should nots" internalized from parents, and the ego idea, which is all the "shoulds" internalized from parents. The superego represents the IDEAL rather than the real; it seeks perfection as opposed to seeking pleasure of engaging reason (p. 17).

SCHEMATA are attitudes or assumptions. COGNITIONS are verbal or pictorial events in one's stream of consciousness. Cognitions are based on schemata developed from previous experiences. COGNITIVE THERAPY is an active, directive, time-limited, structured approached used to treat a variety of psychiatric disorders. It is based on the underlying theoretical principle that how people feel and behave is largely determined by the way in which they think about the world and their place in the world. It involves work by Aaron Beck and Albert Ellis (p. 26). Cognitive therapists helps clients to change the way they think and therefore reduce symptoms. Clients are taught to callenge their own negative thinking to substitute positive thoguhts (p. 27).

AVOIDANCE TRAINING - e.g. the patient avoids punishment by pushing a glass of alcohol away within a certain time limit. Is a form of AVERSION THERAPY. Aversion therapy (which is akin to PUNISHMENT) is sometimes the treatment of choice when other less drastic measures have failed to produce desired effects (p. 29).

There are many parallels between Sullivan’s notion of security operations and Freud's concept of defense mechanisms. Both are processes of which we are unaware, and both are ways in which we reduce anxiety. However, Freud's defense mechanism of repression is an intrapsychic activity, whereas Sullivan's security operations are interpersonal relationship activities that can be OBSERVED(p. 18).

Maslow described BASIC NEEDS as "D-motives" or "deficiency needs" meaning that they are so basic to existence that they must be resolved to reduce the tension associated with them (p. 20).