Chapter 3: Psychosocial Theories and Therapy
1. Explain the basic beliefs and approaches of the following psychosocial theories:
psychoanalytic, developmental, interpersonal, humanistic, behavioral, existential and
crisis intervention
 Psychoanalytic: Sigmund Freud
o All human behavior is caused and can be explained (deterministic
theory).
o Believed that repressed (driven from conscious awareness) sexual
impulses and desires motivate much human behavior
o Dream analysis: involves discussing a client’s dreams to discover their
true meaning and significance
o Free association: therapist tries to uncover the client’s true thoughts
and feelings by saying a word and asking the client to respond quickly
with the first thing that comes to mind
o Transference: occurs when the client displaces onto the therapist
attitudes and feelings that the client originally experienced in other
relationships
o Countertransference: occurs when the therapist displaces onto the
client attitudes or feelings from his or her past
 Developmental: Erik Erikson
o Described 8 psychosocial stages of development
o In each stage, the person must complete a life task that is essential to
his or her well-being and mental health
o Jean Piaget: Cognitive stages of development
 Believed that human intelligence progresses through a series of
stages based on age, with the child at each successive stage
demonstrating a higher level of functioning than a previous stages
 Interpersonal: Harry Stack Sullivan—Interpersonal and Milieu therapy
o Believed that one’s personality involves more than individual
characteristics, particularly how one interacts with others
o Established 5 life stages of development—infancy, childhood, juvenile,
preadolescence, and adolescence, each focusing on various
interpersonal relationships
o Milieu therapy: involved clients’ interactions with one another,
including practicing interpersonal relationship skills, giving one another
feedback about behavior, and working cooperatively as a group to solve
day-to-day problems
 Humanistic theories: Maslow
o Hierarchy of needs: the basic drives or needs that motivate people
o Self-actualization: a person who has achieved all the needs of the
hierarchy and has developed his or her fullest potential in life
o Carl Rogers: Client-centered therapy
 Focuses on the role of the client, rather than the therapist, as the
key to the healing process
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Behavioral theories: behaviorists believe that behavior can be changed through
a system of rewards and punishments
o Ivan Pavlov: Classical conditioning
 Behavior can be changed through conditioning with external or
environmental conditions or stimuli
o B.F. Skinner: Operant conditioning
 People learn their behaviors from their history or past
experiences, particularly those experiences that were repeatedly
reinforced *Believed that changing the behavior was what was
important
Existential theories: believe that behavioral deviations result when a person is
out of touch with him or herself or the environment. *The person who is selfalienated is lonely and sad and feels hopeless
o Cognitive therapy: focuses on the immediate thought processing—how
a person perceives or interprets his or her experience and determines
how he or she feels or behaves.
o Albert Ellis: Rational emotive therapy
 Identified 11 “irrational beliefs” that peoples use to make
themselves unhappy
o Viktor Frankl: Logotherapy
 Based his beliefs in his observations of people in Nazi
concentration camps during World War II
 His curiosity about why some survived and others did not led him
to conclude that survivors were able to find meaning in their lives
even under miserable conditions.
 Used in spirituality and grief counseling
o Gestalt therapy: emphasizes identifying the person’s feelings and
thoughts in the here and now. Believed that self-awareness leads to
self-acceptance and responsibility for one’s own thoughts and feelings
o Reality therapy: focuses on the person’s behavior and how that
behavior keeps him or her from achieving life goals
Crisis intervention: includes a variety of techniques based on the assessment of
the individual.
o Directive interventions: are designed to assess the person’s health
status and promote problem-solving, such as offering the person new
information, knowledge, or meaning
o Supportive interventions: aim at dealing with the person’s needs for
empathetic understanding, such as encouraging the person to identify
and discuss feelings, serving as a sounding board for the person, and
affirming the person’s self-worth.
2. Describe the following psychosocial treatment modalities: individual psychotherapy,
group psychotherapy, family therapy, behavior modification, systemic desensitization,
token economy, self-help groups, support groups, education groups, cognitive therapy,
milieu therapy, and psychiatric rehabilitation
 Individual psychotherapy: is a method of bringing about change in a person by
exploring his or her feelings, attitudes, thinking, and behavior
 Group psychotherapy: the goal is for members to learn about their behavior and
to make positive changes in their behavior by interacting and communicating
with other as a member of a group
 Family therapy: is a form of group therapy in which the client and his or her
family members participate
 Education groups: goal is to provide information to members on a specific
issue—for instance, stress management, medication management, or
assertiveness training
 Support groups: are organized to help members who share a common problem
cope with it
 Self help groups: members share a common experience, but the group is not a
formal or structured therapy group
 Psychiatric rehabilitation: involves providing services to people with severe and
persistent mental illness to help them to live in the community
 Systematic desensitization: can be used to help clients overcome irrational fear
and anxiety associated with phobias
 Behavior modification: is a method of attempting to strengthen a desired
behavior or response by reinforcement, either positive or negative
 Milieu therapy: involved clients’ interactions with one another, including
practicing interpersonal relationship skills, giving one another feedback about
behavior, and working cooperatively as a group to solve day-to-day problems
3. Identify the psychosocial theory on which each treatment strategy is based
 See answer 1 and 2
4. Identify how several of the theoretical perspectives have influenced current nursing
practice
 An understanding of psychosocial theories and treatment modalities can help
the nurse select the appropriate and effective intervention strategies to use with
clients