Therapeutic Models & Its Relevance To Nursing
Practice
PSYCHOANALYTICAL MODEL (or Psychodynamic Theory)
By Sigmund Freud;
 Emphasizes unconscious processes or psychodynamic
factors as the basis for motivation and behavior;
He believed that repressed (driven from conscious
awareness) sexual impulses and desires motivate much
human behavior.
 Personality is developed by early childhood;
Personality Components/Processes
Id: Instincts
Ego: Reality
Superego: Morality
Conscious Level (EGO)
Executive mediating between id impulses and superego
inhibitions; testing reality; rational. Operates mainly at
conscious level but also at preconscious level.
Preconscious Level (SUPEREGO)
Ideals and morals; striving for perfection; incorporated
from parents; becoming a person’s conscience.
Operates mostly at preconscious level.
Unconscious Level (ID)
Basic impulses (sex and aggression); seeking immediate
gratification; irritational and impulsive. Operates at
unconscious level.
LEVELS OF CONSCIOUSNESS
Conscious Level – Thoughts Perception
Subconscious Level – Memories Stored Knowledge
Unconscious Level – Fears, Violent Motives,
Unacceptable Sexual Desires, Irritational wishes,
Immoral urges, Shameful experiences, Selfish needs
Defense Mechanisms
 Psychological strategies that are unconsciously
used to protect a person from anxiety arising
from unacceptable thoughts or feelings.
 Involves a distortion of reality in wome way so
that we are better able to cope with a situation.
DEFENSE MECHANISMS
REPRESSION
 Unconscious and involuntary forgetting of
painful ideas, events and conflicts.
A nursing student who failed the recent board exam,
can’t remember any of the questions asked
DENIAL
 Unconscious refusal to admit an unacceptable
idea or behavior.
 Sometimes mistaken for rationalization.
“I’m not drunk… I can still drive…”
Alcoholics
Battered wives
Anorexia nervosa DENIAL
Drug dependents
RATIONALIZATION
 Attempts to make or prove that one’s feelings
or behaviors are justifiable.
A student states, “I failed the recent board exam
because there was a leakage and it doesn’t had any
credibility
IDENTIFICATION
 A conscious or unconscious attempt to model
oneself after a respected person.
“I want to be just like you… a very good reviewer ……
nurse….”
INTROJECTION
 Unconsciously incorporating wishes, values,
attitudes of others as if they were your own.
While her mother is gone, a young girl disciplines her
brother just like her mother would.
COMPENSATION
 Covering up for a weakness by overemphasizing
or making up a desirable trait.
An academically weak high school student was sworn
as the new president of the supreme SC.
REACTION FORMATION
 A conscious behavior that is the exact opposite PSYCHOSOCIAL MODEL
of an unconscious feeling.
 or Developmental Model;
An older brother who dislikes his younger brother sends
him gifts for every holiday.  Spans the total life cycle from birth to death;

SUBLIMATION  Each stage of development is an emotional crisis

 Channeling instinctual drives into acceptable
activities.
A former NPA hitman, talks about the importance of
life, democracy, justice, and following laws of the land.”
DISPLACEMENT
 Discharging pent-up feelings to a less
threatening object.
After the board exam, Andy went directly to his room
and smashed his reading table.
UNDOING
involving positive and negative experiences;
INTERPERSONAL THEORY
 Interpersonal theory systems for the work of
Harry Stack Suvillan, who believed that “we
come to treat ourselves as we have been
treated by our parents”
 Early relationships can encounter with others ,
interpersonal transactions, shape our view of
ourselves and create behavioral tendencies that
persist over the life span.
STAGES OF PSYCHOSOCIAL DEVELOPMENT

 Doing something to counteract or make up for a

transgression or wrongdoing.
After hitting his wife, Venicio offered jewelries and
money to her.
PROJECTION
 Blaming someone else for one’s difficulties or
placing one’s unethical desires on someone
else.
 Involves in the development of DELUSIONS;
A nursing graduate
blamed a dean of a
nursing school in Recto
for not passing the
nursing exam.
REGRESSION
 Return to earlier
and more
comfortable
developmental
level.
An examinee went
directly to her room and
sleeps in fetal position
and thumb sucks after
knowing she failed the
board exam……..…… for
physicians.
Interpersonal Theory
- Stems from the work of Harry Stack Sulivan, Hildegard Peplau Interpersonal Relations
who believed that “we come to treat ourselves
PEPLAU’S STAGES AND TASKS OR RELATIONSHIPS
as we have been treated by parents”
- Early relationships and encounters with others, (STAGE) ORIENTATION
interpersonal transactions, shapes our view of
ourselves and create behavioral tendencies that TASKS:
persist over the life span. - Patient’s problems and needs are clarified
Harry Stack Sullivan’s Interpersonal Psychodynamic - Patient asks questions
Theory - Hospital routines and expectations are explained
- Patient harnesses energy toward meeting problems
Hildegard Peplau’s Interpersonal Relations Theory - Patient’s full participation is elicited
IDENTIFICATION
 Emphasized the nurse-client relationship as the
- Patient responds to persons he or she perceives as
foundation of nursing practice. It emphasized the give-
helpful
and-take of nurse-client relationships that was seen by
- Patient feels stronger
many as revolutionary.
- Patient expresses feelings
 Peplau went on to form an interpersonal model - Interdependent work with the nurse occurs.
emphasizing the need for a partnership between nurse - Roles of both patient and nurse are clarified
and client as opposed to the client passively receiving
treatment and the nurse passively acting out doctor’s
orders.

Exploitation
STAGES OF DEVELOPMENT
- Patient makes full use of available services
- Goals such as going home and returning to work
emerge.
NURSES PATIENT - Patient’s behavior fluctuate between dependence
Values Values and interdependence
NURSE -
Culture race Culture race RESOLUTION
PATIENT
Beliefs Beliefs - Patient give up dependent behavior
RELATIO
Past experiences - Services are no longer needed by patient
NSHIP Past experiences
Expectations - Patient’s assumes power to meet own needs, set
expectations
new goals and so forth.
Preconceived
ideas
Jean Piaget's Theory of Cognitive Development
Suggests that children move through four different
stages of mental development.
Focuses not only on understanding how children
acquire knowledge, but also on understanding the
nature of intelligence.
PIAGET’S STAGES OF OGNITIVE DEVELOPMENT
Sensorimotor Stage
- Birth to 2 years
Preoperational Stage
- 2 to 7 years
Concrete Operational Stage
- 7 to 11 years
Formal Operational Stage
- 12 and up