Care of Mother, Child and 08 LEC

Adolescents (Well clients) 06

YNA MANUALES, RN 21 O3
THEORIES OF DEVELOPMENT

OUTLINE
REFERENCES
I Psychosexual Theory
A. Phallic Phase “PROF’S PPT ON QUIPPER AND LECTURE”
B. Latency Phase
C. Genital Phase
II Psychosocial Development Adult
A. Erik Erikson Phase Age Characteristics
Characteristics
a) 8 stages of development in a lifetime
b) Summary • Castration ►Difficulties
c) Application to Nursing Practice Anxiety (fear of with sexual
III Developmental Task Theory losing the penis) identity and
A. Robert Havighurst seen in boys with authority
a) Havighurst’s age period (male figures
IV Stages of Psychological Development preschoolers)
A. Robert Peck •Masturbation/fo
a) Four Adjustments of Middle ndling of genitals
Adulthood is common as a
b) Three Developmental Tasks during way of exploring
Late Adulthood identity
V Adult Development Theory  the
A. Roger Gould preschoolers
a) 7 stages of Adult Development are now
aware that
they have
PSYCHOSEXUAL THEORY 3-6 yrs certain
Phallic (Preschool genitals. That
Adult Age) their genitals
Phase Age Characteristics
Characteristics are different
•Erogenous ►Females: from other
zone: Genitals They seek children’s
Penis>organ of boyfriends/par genitals.
interest for tners who are  In the phallic
both sexes like their stage, it is
• Penis Envy father / exactly common for
(wish to opposite of children to
possess penis) their fathers do
3-6 yrs seen in girls exhibitionism
Phallic (Preschool  According ►Males: They because they
Age) to Freud, seek are
penis is girlfriends/ compared
the organ partners who with others.
of interest are like their
for both mother /
sexes. exactly
opposite of
their mother

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 Adult  Nursing Implication:
Phase Age Characteristics Characte  Accept sexual interests such as fondling own
ristics genitals, as a normal area of exploration. Do
• Critical not condemn the child for this behavior.
Experience –
Oedipal/Electra  Help parents answer questions about birth
complex and sexual differences because until now
(attachment with sexuality is still a taboo topic among families
opposite-sex parent with younger children. As a nurse, help the
and be rid of the parents to talk to their children about
same-sex parent) sexuality.
 Oedipal
Complex - for Adult
Phase Age Characteristics
boys, stronger Characteristics
attachment to •No erogenous • Fixations can
their mothers, zone because result in
and hatred to sexual drive has difficulty in
their fathers been repressed. identifying with
 Electra •Sexual drive others and
Complex - for channeled into developing
girls, stronger socially social skills
3-6 yrs attachment to appropriate
Phallic (Preschool their fathers activities such as • Results to
Age) and hatred school work and sense of
towards their sports inadequacy and
mothers.  This time, inferiority
•Developmental the
Task – Establishing superego is
sexual identity, very
beginning dominant.
socialization Instead of
•There is having
differentiation pleasure
between sexes, centers, the
6-12 yrs
superego becomes school age
Latency (School
more internalized child would
Age)
 Ex. Male divert
Preschoolers sexual
already know energy to
that he is a other
male because activities in
of his genitals. school like
sports.
 Brief Overview (Origin of Oedipal complex): • CRITICAL
Oedipus was taken away from his family at a EXPERIENCE –
young age. His parents are king and queen of Peer Group
Thebes. When Oedipus grew older, he defeated experience &
his father in the war and he took the kingdom intellectual
and married his mother (Queen Jocasta) without growth
knowing that they were his parents. When they  A peer
discovered the truth, Queen Jocasta killed herself group that a
and Oedipus put a pin into his eyes for him to be school age
blind. child would
choose are
groups with
same sex.

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 Adult sexually attracted
Phase Age Characteristics
Characteristics to other people.
•Development
al Task – • CRITICAL
Group EXPERIENCE –
Identification establishment of
Heterosexual
6-12 yrs
•Superego relationship &
Latency (School
influences in Sexual maturity
Age)
erotic interests
• Developmental
•Immense Task –
intellectual Developing social
development control over
instincts;
 Nursing Implication: Resolving
 Help child to have positive experiences to be dependence-
able to develop self-esteem that will help independence
the child prepare for the conflicts of conflict.
adolescence. It is also the reason why the
school age children would have a peer
group that could identify him.  Nursing Implication:
 Provide appropriate opportunities for the
Adult
Phase Age Characteristics Characteristic child to relate with opposite sex/all sexes.
s  Allow to verbalize feelings about new
•Erogenous zone: • Difficulty in relationships. Be open in answering
Genitals becoming questions.
 This is during emotionally
the onset of and financially PSYCHOSOCIAL DEVELOPMENT THEORY
puberty independent
when the  Erik Erikson
genitals or • Lack of
 born in Frankfurt, Germany
the strong
reproductive personal  he began studying at the Vienna
organs start identity and Psychoanalytic Institute, where he
to mature. future goals specialized in child psychoanalysis with Anna
•Adolescent Freud’s encouragement
begins to love • Inability to
others for form  developed the concept of the “identity
12 – genuine motives; satisfying crisis,” an inevitable conflict that
Genital adult •Becomes intimate accompanies the growth of a sense of
yrs sexually attracted relationship identity in late adolescence
to other people
 Contributed the Psychosocial theory
• Note: In the
phallic phase, the  Psychosocial Development
genitals are used  refers to the development of personality.
for identity. In
the genital phase,  Relates to your self-esteem, self-
the genitals are concept.
used for sexual  Ability to interact with others
activities or  Ability to adapt to life changes
sexual pleasure
because the
adolescence are
now becoming

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 Personality
 can be considered as the outward expression
of the inner self
 expression of the temperament
8 STAGES OF DEVELOPMENT
Note: The Psychosocial theory is the most commonly
used theory by health professionals because it
explains well enough of each lifestage.
1. Trust vs. Mistrust (infancy) 0 – 18 mos.
 Task: Attachment to the caregiver
 In this stage:
 the infant learns to love and be loved.
 The infant views the world as safe and
reliable.
 The infant will determine if the relationship
with his/her caregiver is nurturing, stable,
and dependable. The infants would expect
their caregiver to attend their every need
because they cannot do it themselves. When
the infant cries and the caregiver is there
immediately to attend to the infant’s needs,
the infant would develop trust in the
caregiver. The attention given to the infant
should be consistent. If the infant cannot
rely to the consistency of the caregiver then
the infant tends to develop mistrust.
 Virtue: Hope
 hope that the caregiver will be there
immediately when the infant needs her.
Note:
 Success during trust vs mistrust results to trust in
persons. When the child grows older, they will
establish trust in people. There is faith and hope
not only in people but also in the environment
and also in the future.
 But if there is failure in trust vs mistrust there will
be general difficulties related to other people
effectively. In short, there will be trust issues.
Also, failure during trust vs mistrust would lead
to suspicion. There is also fear in the future and
mistrust in the environment.
 Adult Behaviour Reflecting Mastery:
 Realistic trust of self and others
 Confidence in others
 Optimism and hope
 Shares openly with others
 Relates to others effectively
 Behaviors Reflecting Developmental Problems:
 Suspiciousness/testing of others
 Fear of criticism and affection
 Dissatisfaction & hostility
 Projection of blame & feelings
 Withdrawal from others
OR
 Overly trusting of others
 Naïve and gullible
 Shares too quickly and easily
 NURSING IMPLICATION
1. Provide a primary caregiver
2. Provide experiences that add to security such as
soft sounds and touch. Let the child know that we are
there. Tell the caregiver to let the child know that
they are there.
3. Provide visual stimulation for active child
involvement.
Also, in this stage, if the child overly develops trust in
the caregiver and if the caregiver will leave the child
for a while. This is also the stage where separation
anxiety will develop. The child is over attached to the
parent.
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2. Autonomy vs. Shame & Doubt (Toddlerhood) 18
mos. – 3 y.o.
 Autonomy - independence or self-government
 Task: Gaining some basic control over self and
environment In this stage:
 the toddler now would strive to do things on
their own. Achieving some sense of control
and free will.
 Let the toddler choose for themselves or
give options.
 If the caregiver is impatient with the child
and would do all the things for the toddler,
the toddler might feel shameful and
doubtful with his choices.
 Virtue: Will
Note:
 If there is success in autonomy vs shame and
doubt, the toddler would feel a sense of self-
control and adequacy to themselves. The
toddler will also feel willpower.
 If there is failure, the toddler would feel
shame and doubt.
 Adult Behaviour Reflecting Mastery:
 Self-control & willpower
 Realistic self-concept & self esteem
 Pride and sense of goodwill
 Simple cooperativeness
 Delayed gratification when necessary
 Behaviors Reflecting Developmental Problems:
 Self doubt/self-consciousness
 Dependence on others for approval
 Sense of being out of control of the self and
one’s life
 Obsessive-Compulsive behaviors
OR
 Excessive independence of defiance,
grandiosity
 Denial of problems
 Unwillingness to ask for help
 Impulsiveness & inability to wait
 Reckless disregard for safety of self and
others
 NURSING IMPLICATION
1. Provide opportunities for decisionmaking, such as
offering choices of clothes to wear
2. Praise for ability to make decisions rather than
judging correctness of any one decision. Do not tell
the child that his/her choice is wrong instead give
some options or other choices.
3. Initiative vs. Guilt (Preschool Age) 3 - 6 y.o.
 Task: Becoming purposeful and directive
 At this stage, preschoolers want to assert
themselves through initiating activities. It can be
basic problem solving or it can be small activities
among their peers.
 Initiative is enforced when the child is given a
freebound to initiate problem solving. The child
could initiate the activities that he wants to do or
he wants to learn. Also, the child could give
initiative in terms of cognition. Preschoolers ask a
lot of questions. When the parents/caregivers
would answer a child's questions they would feel
a sense of initiative in terms of their cognition or
intelligence. It is important to answer or respond
to a child's question on this stage.
 Virtue: Purpose
Note:
 Success during initiative vs guilt means ability to
initiate one's own activities and have a sense of
purpose.
 Failure during initiative vs guilt would lead to
aggression and a sense of inadequacy or guilt.
 Adult Behaviour Reflecting Mastery:
 Adequate conscience
 Initiative balanced with restraint
 Appropriate social behaviors
 Curiosity and exploration
 Healthy competitiveness
 Sense of direction
 Original and purposeful activities
 Behaviors Reflecting Developmental Problems:
 Excessive guilt/embarrassment
 Passivity and apathy
 Avoidance of activities/pleasures
 Self-pity
 Reluctance to show emotions
 Underachievement of potential
OR
 Lack of follow-through on plans
 Little sense of guilt for actions
 Excessive expression of emotion
 Labile emotion (not stable, change of emotions)
 Excessive competitiveness
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 NURSING IMPLICATION
1 Provide opportunities for exploring new places or
activities.
2. Allow play to include activities involving clay, water
or finger paint. Just simple any activities that the child
is interested in learning.
4. Industry vs. Inferiority (School age) 6 – 12 y.o
 Task: Developing social, physical, and learning
skills
 the schooler is developing various skills,
there would be emerging confidence in their
own abilities.
 At this age, the schooler takes pleasure in
accomplishment. They are sure that they are
doing things well. During this age, the new
authoritative figure is the teacher.
 To achieve the sense of industry, the school
age child must feel that they are doing things
well.
 At this stage, the schooler gives effort in
tasks for praise and rewards. It is the teacher
who will give rewards and praises to school
age children.
 Virtue: Competence
Note:
 Success in this stage is pride and
accomplishment. Also, ability to cooperate
well with others.
 Failure in this stage means inferiority and
unworthiness.
 Adult Behaviour Reflecting Mastery:
 Sense of competence
 Completion of projects
 Pleasure in efforts and effectiveness
 Ability to cooperate and compromise
 Identification with admired others
 When the child has idols or people they
look up, the child could see that they
can be like them.
 Balance of work and play
 Joy of involvement in the world
 Behaviors Reflecting Developmental Problems:
 Feeling unworthy & inadequate
 Poor work history
 Inadequate problem-solving skills
 Manipulation of others
 Lack of friends of same sex
OR
 Overly high-achieving/perfectionist
 Fear of failing Feeling unable to gain love or
affection unless totally successful
 Being a workaholic
 NURSING IMPLICATION
1.Provide opportunities such as allowing child to
assemble and complete short projects so that the
child feels rewarded for accomplishment. It is
important that the teachers give activities to the child
at their own capacity so that the child would complete
the activities well and if they do so, they will feel a
sense of accomplishment.
5. Identity vs. Role confusion (Adolescence) 12 – 18
y.o.
 Task: Developing sense of identity
 formulating a sense of self-belongingness.
 In this stage, the adolescent would combine all
their current roles and they will identify
themselves into one role.
 But in this stage, some adolescents would seek a
negative identity whether than not having an
identity at all.
 Virtue: Fidelity
Note:
 If you are successful in this stage, you would
have a sense of personal identity
 If you are unsuccessful, you would be
confused who you really are or who you
want to become.
 Adult Behaviour Reflecting Mastery:
 Confident
 Emotional stability
 Commitment to career planning and realistic
long term goals
 Sense of having a place in the society
 Establishing relationships with opposite sex
 Fidelity to friends
 Development of personal values
 Behaviors Reflecting Developmental Problems:
 Lack of /giving up of goals, beliefs, values
 Feelings of confusion, indecision
 Superficial, short term relationships with
opposite sex
OR
 Dramatic overconfidence •Acting –out
behaviors (alcohol & drug use)
 NURSING IMPLICATION
1. Provide opportunities to discuss feelings about
events important to the adolescent. Once you give the
adolescent to talk about his feelings or experiences
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then they might have realizations of who they want to
become or who they really are.
2. Offer support and praise for decision making
6. Intimacy vs. Isolation (Young Adulthood) 18 –
35/40y.o.
 Task: Establishing intimate bonds of love and
friendship
 forming adult love relationships and
meaningful attachments to others.
 At this age, friendships and relationships are
meaningful
 Virtue: Love
NOTE:
 Success in this stage means that the young
adult has the ability to love deeply and
commit oneself. Not only in romantic
relationships but also meaningful really
within the family and among friends
 Failure during this stage, means that there
could be emotional isolation or egocentricity.
 Adult Behaviour Reflecting Mastery:
 Ability to give and receive love
 Commitments and mutuality with others
 Collaboration in work and affiliations
 Sacrificing for others
 Responsible sexual behaviors
 Behaviors Reflecting Developmental Problems:
 Persistent isolation
 Emotional distance in all relationships
 Prejudices against others
 Many career changes
 Seeking intimacy through casual sexual
encounters
OR
 Possessiveness & jealousy •Dependency of
parents and or partner
 Abusiveness toward loved ones
7. Generativity vs. Stagnation (Middle Adulthood)
35/40 – 65 y.o.
 Task: Fulfilling life goals that involve family,
career, and society
 At this stage, you could be creative and
productive enough to establish the next
generation.
 Middle adults will be active to the
community.
 Virtue: Care
NOTE:
 Success in this life stage would warrant the
ability to give them care for others
 Failure in this life stage would mean self-
absorption and inability to cope with
changes. They would not take any various
roles.
 Adult Behaviour Reflecting Mastery:
 Productive, constructive, creative
 Personal and professional growth
 Parental and societal responsibilities
 Behaviors Reflecting Developmental Problems:
 Self-centeredness
 Exaggerated concern for appearance and
possessions
 Lack of interest in the welfare of others
 Lack of civic and professional activities
 Loss of interest in marriage and/or
extramarital affairs
OR
 Too many professional or community
activities to the detriment of family/self
(they might neglect other such as family or
self)
8. Integrity vs. despair (maturity or older adult) 65
y.o. to death
 Task: Looking back over one’s life and accepting
it
 accepting responsibility for one's own self or
one’s own life. Older adults reminiscences in
their life.
 Virtue: Wisdom
NOTE:
 Success in this life stage would mean a sense
of integrity and fulfillment. The older adult
would feel good about the choices that they
made in life.
 Failure in this life stage would mean
dissatisfaction in life or the desire to begin
life all over again just to change their choices
or just things would turned out differently.
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 Adult Behaviour Reflecting Mastery:
 Feelings of self acceptance
 Sense of dignity, worth and importance
 Adaptation to life according to limitations
 Valuing one’s life
 Sharing of wisdom
 Exploration of philosophy of life and death
 Behaviors Reflecting Developmental Problems:
 Sense of helplessness, hopelessness,
worthlessness, uselessness
 Withdrawal and loneliness
 Regression
 Focusing on past mistakes, failures
 Suicidal ideas or apathy
OR
 Inability to reduce activities
 Overtaxing strength and abilities
 Denial of death as inevitable
SUMMARY
 Application to Nursing Practice
❑ The nurse assesses a client’s psychosocial
development according to expected norms for specific
age
 the nurse should know which developmental
stage where child is in terms of psychosocial
development
❑ The nurse can use knowledge of development
tasks in selecting appropriate interventions for the
client
 the nurse could use his/her knowledge on
how to reinforce behaviors to achieve the
appropriate developmental task for each
lifestage
❑ The nurse fosters healthy behaviors & encourages
hope that relearning is possible
 If ever there are some delays in achieving
the developmental task that are associated
with each stage then the nurse would
encourage the client/child that they can still
learn even if there are some delays.
 Robert Havighurst (Developmental Task Theory)
 There are different developmental tasks in
different stages of life
 Havighurst made the said theory before 1991
 Qualities: straightforward, unchangeable
DEVELOPMENTAL TASK THEORY
 Robert Havighurst
 There are different developmental
tasks in different stages of life.
 Havighurst made the said theory
before 1991.
 Qualities: straightforward,
unchangeable
6 STAGES
1. Infancy and early childhood (0-6 yo)
o Havighurst compressed infancy,
toddlerhood, and preschool age
o 7 developmental tasks
 Learning to control
elimination of body waste =
potty training
 Learning languages = learning
how to talk
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 2. Middle childhood (6-12 yo)
o School age
o 9 developmental tasks
 Age-mates = same-age peers
 Masculine and feminine roles
are NOT socially acceptable
(sexist, per se)
 Masculine = assertive,
strong, more freedom,
gentlemen (law-
enforcers, politicians)
 Feminine = caring,
understanding,
nurturing (home-
makers, do chores,
caregivers, social
workers)
3. Adolescence (12-18 yo)
o Adolescence
o 9 developmental tasks
 Achieving desired social role
(not about shaping oneself
based on sex)
4. Early adulthood (18-30 yo)
o Young adulthood
o 8 developmental tasks
 Congenial social group = peer
with similar interests,
compatible
 This stage entails cutting your
ties with one’s old peers
because of differences in
personal interests
 You find your matchy peers
with similar likes
5. Middle age (30-60 yo)
o 7 developmental tasks
6. Later maturity (60 yo – above)
o 6 developmental tasks
STAGES OF PSYCHOLOGICAL
DEVELOPMENT/STAGES OF ADULT
 Robert Peck
 Expansion of Erikson’s last two stages (middle
and older adulthoods) in psychosocial theory
 ↓physical, ↑mental, social
FOUR ADJUSTMENTS OF MIDDLE
ADULTHOOD
1. Valuing wisdom vs. valuing physical
powers
 “attractiveness” = perceived
attractiveness
 Middle adults have the choice
between valuing their physical
characteristics and their wisdom
2. Socializing vs. sexualizing in human
relationships
 Middle adults can either value
people as individual and make
meaningful relationships with
them or value them as pleasure
(sex) objects
3. Emotional flexibility vs. emotional
impoverishment
 Points the middle adult’s longing
for their loved one’s absence (e.g.
their children have their own
families, peers are away)
4. Mental flexibility vs. metal rigidity
 Points the middle adult’s mental
flexibility to overcome challenges
using their experiences
THREE DEVELOPMENTAL TASKS DURING LATE
ADULTHOOD
1. Ego differentiation vs. work-role
preoccupation
 Points about the retiree’s
retirement problem
 ↓professional/worker identity
after retirement
 SOLN: find affirmation in other
aspects of life (e.g. community
work, medical missions)
2. Body transcendence vs. body
preoccupation
 Talks bout the late adult’s physical
limitations
 SOLN: older adult should cope
with his/her physical changes
3. Ego transcendence vs. ego
preoccupation
 Older adult explores his/her
worth to the society
 SOLN: instead of being stuck in
their regrets and despair, they
should have ego transcendence =
focus their efforts and time in
doing more worthy activities for
future generations, since they
already accepted the
unchangeable past
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 ADULT DEVELOPMENTAL THEORY
 Roger Gould
 “To transform, there must be a dismantling
of the illusions of safety developed in
childhood” = To transform, one must break
free of one’s comfort zone. This is to achieve
higher form of consciousness.
 Focuses on adult development
 Ages designated in each stage are specific
since Gould’s cross-sectional study involved
524 men and women of stated age range (16-
60 yo). He then dissected his subjects into
specified age range, forming the said stages.

7 STAGES OF ADULT DEVELOPMENT

1. Stage 1 (16-18 yo)

 HOW TO BREAK FREE FROM
COMFORT ZONES: breaking
free from the comfort of your
parents
2. Stage 2 (18-22 yo)
 HOW TO BREAK FREE FROM
COMFORT ZONES: leaving the
comforts of family and home
(not common in PH)
3. Stage 3 (22-28 yo)
 HOW TO BREAK FREE FROM
COMFORT ZONES: breaking
free from family dependence,
committing to career and
children
4. Stage 4 (28-34 yo)
 HOW TO BREAK FREE FROM
COMFORT ZONES:
establishing careers, building
life and marriage
5. Stage 5 (34-43 yo)
6. Stage 6 (43-50 yo)
7. Stage 7 (50-60 yo)

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