Chapter 2: Theories and Therapy

what is interpersonal therapy?

an effective short term therapy and are used for 3 specific problems:

• grief and loss

• interpersonal disputes

• role transition

what is Patricia Benner’s focus of theory?

caring as foundation for nursing

what is Patricia Benner’s contribution to Psychiatric-Mental Health Nursing?

• encourages caring and comforting interventions

• emphasized nurse-patient relationship

• importance of teaching and coaching patient as well as being present for them during their pain and suffering

what is Dorothea Orem’s focus of theory?

helping patients become capable of self-care when they are unable to do so independently

what is Dorothea Orem’s contribution to Psychiatric-Mental Health Nursing?

• promoting self-care activities of the patient

what is Sister Callista Roy’s focus of theory?

continual need for people to adapt physically, psychologically, and socially

what is Sister Callista Roy’s contribution to Psychiatric-Mental Health Nursing?

• emphasizes assisting patients to adapt so they can cope better with change

what is Betty Neuman’s focus of theory?

impact of internal and external stressors on equilibrium of the system

what is Betty Neuman’s contribution to Psychiatric-Mental Health Nursing?

• emphasizes role of assisting patients to discover and use stress-reducing strategies

what is Joyce Travelbee’s focus of theory?

meaning in the nurse-patient relationship and importance of communication

what is Joyce Travelbee’s contribution to Psychiatric-Mental Health Nursing?

• acknowledging patient suffering and alleviating through communication skills through stages of the nurse-patient relationship

what is the all-or-nothing thinking distortion?

thinking in black and white, reducing complex outcomes into absolutes

what is the overgeneralization distortion?

using a bad outcome (or a few bad outcomes) as evidence that nothing will ever go right again

what is the labeling distortion?

a form of generalization in which a characteristic or event becomes definitive and results in an overly harsh label for self or others

what is the mental filter distortion?

focusing on maintaining a negative detail or bad event and allowing it to taint everything else

what is the disqualifying the positive distortion?

maintaining a negative view by rejecting information that supports a positive view as being irrelevant, inaccurate, or accidental

what is the jumping to conclusions distortion?

making a negative interpretation despite the fact that there is little or no evidence

what is the jumping to conclusions (mind reading) distortion?

inferring negative thoughts, responses, and motive of others

what is the jumping to conclusions (fortune-telling error) distortion?

anticipating that things will turn out badly as an established fact

what is the magnification or minimization distortion?

exaggerating the importance of something or reducing the importance of something

what is the magnification or minimization (catastrophizing) distortion?

an extreme form of magnification in which the very worst is assumed to be a probable outcome

what is the emotional reasoning distortion?

drawing a conclusion based on an emotional state

what is the “should” and “must” statements distortion?

rigid self-directives that presume an unrealistic amount of control over external events

what is the personalization distortion?

assuming responsibility for an external event or situation that was likely outside personal control

what are the primary disorders treated with Psychodynamic therapy and the length of therapy?

• Anxiety, depression, personality disorder

• 20+ sessions

what are the primary disorders treated with interpersonal therapy and the lengths of therapy?

• depression

• short term (12-20 sessions)

what are the primary disorders treated with cognitive behavioral therapy and the length of therapy?

• depression, anxiety/panic, eating disorders

• short term (2-20 sessions)

what are the primary disorders treated with behavioral therapy and the length of therapy?

• PTSD, OCD, panic disorder

• fever than 10 sessions

what is the treatment focus of psychodynamic therapy?

unresolved past relationships and core conflicts

what is the treatment focus of interpersonal therapy?

current interpersonal relationships and social supports

what is the treatment focus of cognitive behavioral therapy?

thoughts and cognitions

what is the treatment focus of behavioral therapy?

learned maladaptive behavior

what is the role of the therapist and technique used in psychodynamic therapy?

• significant other, transference object

• therapeutic alliance, free association, understanding transference, challenging defense mechanisms

what is the role of the therapist and technique used in interpersonal therapy?

• problem solver

• creates new patterns of communication and expectations for relationships

what is the role of the therapist and technique used in cognitive behavioral therapy?

• active, directive, challenging

• evaluating thoughts and behaviors, modifying dysfunctional thoughts and behaviors

what is the role of the therapist and technique used in behavioral therapy?

• active, directive, teacher

• relaxation, thought stopping, self-reassurance, seeking social support

what disorders are treated with Electroconvulsive therapy (ECT)?

depression, mania, catatonia

what disorders are treated with Repetitive transcranial magnetic stimulation (rTMS)?

depression

what disorders are treated with Vagus nerve stimulation (VNS)?

depression

what disorders are treated with Deep brain stimulation (DBS)?

depression, OCD

what is the site for Electroconvulsive therapy (ECT) and is it convulsive?

cortical; yes

what is the site for Repetitive transcranial magnetic stimulation (rTMS) and is it convulsive?

cortical, no

what is the site for Vagus nerve stimulation (VNS) and is it convulsive?

cervical cranial nerve; no

what is the site for Deep brain stimulation (DBS) and is it convulsive?

subcortical; no

Who developed the person-centered model of psychotherapy within humanism?

Carl Rogers

What are the three core concepts emphasized in Carl Rogers' person-centered therapy?

• congruence (authenticity)

• unconditional positive regard

• empathetic understanding

How does Carl Rogers' theory apply to nursing?

It encourages nurses to view each patient as a unique individual and use attitudes of unconditional positive regard, empathy, and genuineness in care

Give an example of how a nurse might apply Rogers' humanistic approach in a clinical setting

By asking, “What can I do to help you regain control over your anxiety?”—showing empathy, support, and patient-centered care.

Who developed the theory of cognitive development?

Jean Piaget

What are Piaget’s four stages of cognitive development?

• Sensorimotor (0–2 years)

• Preoperational (2–7 years)

• Concrete operational (7–11 years)

• Formal operational (11 years–adulthood)

What does "congruence" mean in Carl Rogers’ therapy?

the therapist’s authenticity and genuineness in interactions with the patient

What is meant by “unconditional positive regard” in Rogers' therapy?

acceptance and support of a person regardless of what they say or do, creating a nonjudgemental and accepting environment

Define “empathetic understanding” in Rogers’ person-centered approach

the ability to understand the client’s feelings and experiences as if they were the therapists own, without losing their own sense of self

What occurs in the sensorimotor stage (0–2 years) of Piaget’s theory?

cognition develops through physical interaction with the environment; infants learn through reflexes and senses

What characterizes the preoperational stage (2–7 years)?

children begin to use language and symbols, but their thinking is still egocentric and not yet logical

What defines the concrete operational stage (7–11 years)?

children start to think logically about concrete events and understand concepts like conversation and reversibility

What happens in the formal operational stage (11 years–adulthood)?

individuals can think abstractly, logically, and hypothetically

How does Piaget’s theory support cognitive interventions in nursing?

It helps nurses tailor communication and education to the patient’s developmental stage, especially with those who have negative self-views

Give an example of how a nurse might apply Piaget’s theory in practice.

A nurse explains and shows an 8-year-old child (concrete operational stage) all the equipment for starting an IV before surgery

Who developed a six-stage theory of moral development?

Lawrence Kohlberg

What does Kohlberg’s theory help nurses evaluate?

it provides a framework for evaluating moral decisions and understanding patients’ levels of moral reasoning

Which therapy approach did Albert Ellis develop?

Rational Emotive Behavioral Therapy (REBT), which is active, cognitive, and confrontational

What is the goal of Rational Emotive Behavioral Therapy (REBT)?

To help patients assume responsibility for their behavior, accept themselves, take risks, and adopt new behaviors.

How does Ellis’s approach relate to existentialism?

It focuses on helping patients live fully in the present and look forward to the future.

How can nurses apply Ellis’s approach in practice?

By encouraging patients to engage in meaningful present-focused activities.

ex: going on vacation with family

Which theory did Albert Bandura develop?

Social Learning Theory

What are the two main concepts Bandura is known for?

Modeling and self-efficacy

What is self-efficacy according to Bandura?

A person’s belief that they can achieve a desired outcome through their own efforts

How does Bandura’s theory benefit nursing practice?

It combines cognitive functioning and environmental factors to give nurses a broad understanding of how people learn.

How might a nurse apply Bandura’s theory?

By helping a teenager identify three negative outcomes of tobacco use, promoting self-reflection and behavior change.

Who developed logotherapy and what does it emphasize?

Viktor Frankl; logotherapy emphasizes finding meaning and value in life, especially during suffering.

What is the focus of logotherapy?

Helping individuals find self-respect and purpose through discovering life’s meaning.

How is Frankl’s existentialist approach used in nursing?

It encourages nurses to understand the personal meaning behind a patient’s behaviors and emotions.

Give an example of applying Frankl’s theory in nursing care.

A nurse listens attentively as a patient talks about the emotional impact of her daughter’s death.

What are the most basic needs in Maslow’s hierarchy?

physiological needs (food oxygen, water, sleep, sex, and body temperature regulation)

What needs emerge once physiological needs are satisfied?

safety needs (security, protection, freedom from fear and anxiety, law, order, and stability)

What needs follow safety in Maslow’s hierarchy?

belonging and love needs (intimate relationship, affection, family, and social groups)

What comes after love and belonging in the hierarchy?

esteem needs (self regard and recognition from others)

What is the highest level of Maslow’s hierarchy?

self-actualization (becoming everything one is capable of being)

What is the individual's role in achieving self-actualization?

choosing a personal path to inner peace and fulfillment