THEORIES AND THERAPIES

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psychoanalytic theory

states that human behavior is based on interactions composed of three parts of personality: id, superego, and ego. freud proposed that conflicts among the three components help determine an individual’s personality and how they behave or interact in the world.

id

component known for instant gratification, which can be physical needs or desires. includes, for example, behaviors influenced by hunger, like a child crying or an adult cooking.

superego

part that is concerned with morals and following rules so the individual can achieve an idealized self. develops based on an individual’s cult and what they are taught as right and wrong. ex: a person contemplates stealing an item from a store because they need it but can’t afford it.

ego

thought of as the rational element of an individual’s personality and can be viewed as both conscious (things they are aware of) and unconscious (outside of the individual’s awareness). the decision maker.

behavioral therapy

focuses on modifying a client’s maladaptive behaviors, patterns, and responses, and instead encouraging adaptive behaviors. follows the concept that behaviors are learned and can have negative consequences. in order to change these behaviors, client must adjust the behavior to an adaptive response. used with clients who have phobias or substance use disorders. nurse should collect data related to client behaviors, encourage them to identify maladaptive behaviors and adaptive coping skills, and provide education related to the use of these skills.

cognitive therapy

based on the concept that problems can stem from an individual’s past but are guided and maintained by what is going on in the present. to treat and deal with the problem, one must address the current issues, as a current crisis or problematic situation can lead an individual to have a negative thought process. therapist will often identify the thoughts an individual has that enhance or contribute to one’s anxiety. nurse should encourage the client to have a positive thought process that is focused on reality. client should understand that therapy involves using an individual’s past to understand current problems and how they affect mental health.

cognitive behavioral therapy (CBT)

based on the premise that the client’s mental health problem is based in part on faulty thinking or unhealthy thoughts, related feelings, and learned behaviors. the learned behaviors have resulted in unhealthy ways of living or behaving. the person must now learn better ways of coping (new ways of thinking) that will lead to better patterns of living (behaviors).nurse should provide psychoeducation and acknowledge the patient’s feelings related to their illness. nurse helps the individual recognize the thought patterns that created their current situation and helps them apply new behaviors.

biological therapy

alters the individual’s psychological functioning via drugs or from other therapies such as brain-stimulating therapies. can be used in conjunction with other forms of therapy.

individual therapy

involves a client and therapist working 1 on 1 through talk therapy. is geared towards clients of all ages with a variety of mental illnesses. key factors are establishing trust and building a therapeutic relationship. reduces or eliminates client’s manifestations to promote well-being so they can continue with daily life. nurse should act as the client’s advocate, assist them in finding a therapist, and provide education about possible benefits.

group therapy

psychosocial therapy in which multiple clients meet together w/ a therapist, where ideas and insights are shared for the purpose of improving one’s coping skills. groups are formed based on a specific dx to best assist group members. in children, often the therapy is a form of play. with adolescents, the value of peer relationships is key. in older adults, the key features are socialization and sharing memories to which others can relate. nurse can lead these sessions; nurse should encourage participation amongst the group and provide education related to specific group topics (positive coping skills, ways to decrease stress, etc.)

family therapy

involves those who have a relationship in which members are engaged with one another. focus is to work as a unity, focusing on all members of the family rather than just one individual. improving communication is key. nurse should be aware of different family functions and recognize when there is a dysfunction or problem.

milieu therapy

a form of psychotherapy in which the environment is controlled to assist the client in preventing self-destructive or maladaptive behaviors. can occur in an inpatient or outpatient setting. nurse should support and validate patients while promoting safety and communicating with the client.

telehealth

clients meet with therapist virtually. can be in the form of a virtual video conference, telephone, or even online chat. popular for those who do no have the ability to leave home, live in areas where therapy is not close, or those who cannot meet the schedule of most therapists. can reduce delays in care, decrease stigma, and prevent emergency room visits by having the ability to contact the therapist off-hours. some may find this service impersonal or come with hesitations related to patient privacy. nurse should assist clients with setting up these appointments and educate them on the issues of privacy, benefits, and goals of this form.

psychoanalytic therapy

examines how the unconscious mind can influence individual thoughts, behaviors, and feelings. purpose is to bring about the unconscious material (from the ego) into the conscious mind. can be applied to all ages and a variety of diagnoses. nurse should plan interventions that are geared toward helping the client make a change when desired and to explain that the purpose is to express any repressed emotions and learn adaptive coping skills.