Theories and Therapies

Author: Ashley Amrol, MSN-ED, RN, PMH-BC
Copyright: © 2023 by Elsevier, Inc. All rights reserved.

Darwin’s Theory
  - Emphasizes the survival of the fittest organisms through natural selection.
  - Creates a belief that individuals who are impaired or unsuccessful are positioned lower on the evolutionary scale.
    - Categories affected include poverty, disease, alcoholism, mental illness.

Sigmund Freud
  - Believed unconscious thoughts and emotions significantly influence behavior.
  - His method of therapeutic psychoanalysis explores the unconscious mind.
  - Developed theories regarding:
    - The development of personality.
    - The structure and dynamics of the personality.
  - Proposed that the mind consists of three interacting structures:
    1. Id
    2. Ego
    3. Superego
Personality Development
  - Emotional disturbances arise from five sources that impede personal change.
  - Defense Mechanisms:
    - Psychological strategies employed by individuals to mitigate negative states such as conflict, frustration, anxiety, and stress.
    - Common defense mechanisms include:
        - Denial
        - Fantasy
        - Projection
        - Repression
  - Psychoanalysis was the primary form of therapy utilized by Freud and many of his followers.

Carl Jung
  - Conceptualized the mind as divided into three levels:
    1. Conscious Ego
    2. Personal Unconscious
    3. Collective Unconscious
  - Coined the terms extroversion and introversion to categorize personalities:
    - Extroversion: Outward-going personalities.
    - Introversion: Inward-focused personalities.

Individual Psychotherapy
  - Alfred Adler
    - Views individuals as holistic organisms interacting within their environment.
    - Emphasizes the need for therapists to understand a patient by actively engaging—“must see with his eyes and listen with his ears.”
Interpersonal Psychotherapy
- Harry Stack Sullivan
- Focuses on the social nature of individuals and the vital role anxiety plays in personality formation.

Psychosocial Development
  - Erik Erikson
    - Proposed eight stages of human life, each marked by a core developmental task.
    - Resolution of each task contributes to the individual's total personality.

Foundational Assumptions
- All behavior is learned.
Ivan Pavlov
- Researched dog responses to various stimuli.
- Established the principles of conditioning, leading to the development of the American behavioral movement.
John B. Watson
- Advocated that psychology is an objective science, specifically the science of behavior.
B.F. Skinner
- Promoted objective psychology, stating all organisms are inclined toward pleasure and away from pain.

Significance
- Humanistic theories are integral to contemporary therapies due to their focus on the whole individual.
Fredrick Perls
- Developed Gestalt therapy, emphasizing unresolved past conflicts and stressing the importance of the present, freedom, responsibility, and personal wholeness.

Abraham Maslow
  - Advocated for a holistic approach in psychology, integrating personality, motivation, self-actualization, and human nature.
  - Central thesis: Human nature is fundamentally good and has an inherent potential for self-fulfillment.
  - Introduced Maslow’s Hierarchy of Needs:
    - A framework for prioritizing human needs and guiding client care.

Carl Rogers
- Focused on the constructive aspects of human nature, promoting acceptance.
- Contributions have positively influenced nursing, pastoral counseling, and education.

Joseph Cautela
- Introduced Covert Modeling: Mental rehearsal of challenging performances before execution.
Training Areas for Coping Skills:
  - Anxiety management
  - Assertiveness training
  - Progressive relaxation
  - Techniques to alleviate physical stress responses.

Cognitive Therapy Goals:
- Aim to replace dysfunctional beliefs with constructive thoughts, altering personal viewpoints.
Cognitive Therapeutic Techniques Categorized into:
  1. Cognitive Restructuring
  2. Coping Skills
  3. Problem-Solving Skills

Problem-Solving Therapy:
- Teaches clients methods for resolving issues in constructive ways, leading to more satisfaction.
Reality Therapy:
- Assists clients in assessing the effectiveness of their behaviors and developing better strategies to meet their needs.

George Mead
- Believed social context is crucial in shaping self-concept.
Thomas Szasz:
- Asserted that mental illness is a myth and that individuals are responsible for their behaviors.
Community Psychology:
- Focuses on societal changes at the community level.

Homeostasis:
- Defined as the body's ability to achieve and maintain a stable internal environment.
- Introduced by Walter Cannon, who observed physiological changes during emotional responses, noting the body’s tendency to stabilize.

Hans Selye
  - Investigated physical and biochemical changes related to stress.
  - Described the body’s responses to stress as part of his General Adaptation Syndrome, consisting of three stages:
    1. Alarm
    2. Resistance
    3. Exhaustion

Definition:
- The investigation of the biochemical underpinnings of thought, mood, emotion, and behavior.
- Ongoing research leads to new theories and treatment approaches.
Psychobiological Theories:
  - Causative aspects of mental illness include:
    - Genetics
    - Neurotransmitter function
    - Viral factors
    - Fetal development
    - Immune system impairment.

Field examining interactions between the central nervous system, immune system, and personality dimensions.
Neurotransmitter research has revealed the existence of neuropeptides, and findings suggest that various interventions positively influence immune responses.

Florence Nightingale's Perspective:
- Seen illness as a natural process of the body attempting self-repair.
- The focus of nursing therapy is to help clients reach their optimal level of wellness.

The trend toward somatic treatment of mental health issues is increasing, bolstered by advancements in biochemical and physiological research.
Examples of Somatic Therapies:
  - Drug treatment therapy
  - Electroconvulsive therapy
  - Biofeedback
  - Phototherapy
  - Acupuncture
  - Pharmacotherapy

Feminist and Women’s Therapy:
- Emerged from the feminist movement of the 1970s.
Creative Aggression Therapy:
- Focuses on teaching clients how to redirect aggression productively and to engage in “fair fighting.”
Movement Therapy:
- Seeks to align the body with itself to restore balance.