BIOLOGICAL MEDICAL MODEL
response. It relies on keeping infections (e.g.
The Biological Model of Abnormality (the only
model not based on psychological principles)
is based on the assumptions that if
the brain,neuroanatomy and
related biochemicals are all physical entities
and work together to mediate psychological
processes, then treating any mental
abnormality must be physical/biological.
The model also suggests that psychological
illness could and should be treated like any
physical illness (being caused
by chemical imbalance, microbes or physical
stress) and hence can be treated
with surgery ordrugs.
There is also evidence for a genetic factor in
causing psychological illness.
The main cures for psychological illness
under this model: electroconvulsive therapy,
drugs and surgery at times can have very
good results in restoring "normality"
as biology has been shown to play some sort
of role in psychological illness.
mental illnesses resemble physical illnesses
and can therefore be diagnosed and treated
in a similar way. Just as physical illnesses are
caused by disease producing germs, genetic
factors, biochemical imbalances or changes
to the nervous system, it is assumed that
this is also true of mental illnesses. Because
it assumes that mental disorders arise from
such physical causes, the medical model is
therefore a biological model.
Possible Biological Causes of Abnormality
Factor Explanation
Genetics The genes we inherit from our
parents provide the blueprint for our bodies
and brains. A slight
abnormality in the genes could result in
abnormalities in a persons brain functioning
with the consequence
that their behaviour becomes abnormal.
Infection The brain itself has no immune
bacteria or viruses) out with a
barrier. Infections that get into the brain can
cause widespread damage, and if the brain is
damaged then a
person may start to have abnormal
experiences or to behave in abnormal ways.
Chemicals To operate properly, the brain
relies on hundreds of different chemicals all
being in the correct balance.
These chemicals (neurotransmitters and
hormones) are used to send messages round
the brain and
nervous system, so too much or too little of
any of them can cause the brain to function
abnormally.
Environmental
factors
Although the medical model focuses on
internal, biological processes, it does not
ignore the possibility that
the environment can have a role to play in
abnormality. On the one hand, a persons
experiences, such as
high levels of stress, can cause biological
reactions that have a knock-on effect on the
brains functioning.
On the other hand, there are some toxins
and pollutants in the environment that affect
brain functioning
directly, such as mercury, which can cause
irrational behaviour and lead, which can
affect childrens
development.
An Example: Depression
Depression is a severe psychological illness
characterised by periods of very low mood
and feelings of helplessness
and guilt. People with depression find it
difficult to motivate themselves to do their
normal activities and often
become socially withdrawn. They may also
have disturbed sleep and appetite, amongst
other physical symptoms.
People who have depression run a
substantially increased risk of suicide.
Depression seems to run in families.
People who are closely related to a
depressed person are two to three
times more likely to develop depression
themselves, compared to people with no
depressed relatives.
People who have depression appear to
have abnormal levels of serotonin compared
with non-depressed
people. A depressed person given a from the literature (e.g., Stein, 2004; Jacobi,
serotonin-boosting drug produces less 1973; Spoto, 1995).
serotonin and more slowly than
a non-depressed person. Drugs that There is not sufficient scope in this particular
increase serotonin activity are often effective
study to fully explore Jungs concept of the
in treating depression.
People who are carrying the Borna Disease psyche, so the following is a brief description
Virus (usually found in livestock such as of the key features and an explanation of
horses or sheep) run a how they can add to the exploration of
higher risk of developing depression than the psychological type. To describe the use of the
general population. One study found that Myers-Briggs theory of psychological type set
30% of a sample of into the Jungian context, the term Jung-
depressed patients were carrying Borna
Virus, compared to 8% carriers in a sample of Myers model will be used, as suggested by
people suffering from Quenk (2002).
another type of disorder.
Stress and depression seem to be related.
Prolonged stress causes the body to release
cortisol. Cortisol The ego is particularly important in
has an inhibitory effect on serotonin, and
depression can be a consequence of long-
term stress.
Exposure to certain chemicals, such as
organophosphates, also seems to increase
the risk of depression.
Occupational groups who use such chemicals
in their work are frequently found to have a
higher risk of
depression than the general population.

PYSCHODYNAMIC MODEL

The psyche, according to Jungian

psychology, is the total personality through
which psychic energy flows continuously in
various directionsinner to outer, conscious
to unconscious. The dynamic movement of
this energy is an outcome of conflicts and
tensions present within the psyche. The
psyche, although not a rigid structure, has
several key components: the ego,
the persona, the shadow, the self, and the relation to type as it is the source of our
conscious and unconscious areas, including conscious identity: who we are, what we like
the collective unconscious. Psychological and dislike, how we prefer to be. Therefore,
type, per se, only represents a small part of this is the area of the psyche that we refer to
the total psyche; however, the other parts of when we assess an individuals preferences.
the psyche will have an influence on type in Jacobi (1973) points out that, although most
terms of its development, dynamics, and of the ego is in the conscious area, some of it
tensions. The diagram below (figure 1) is a is unconscious and is in the shadow. The
representation of Jungs map of the psyche, shadow represents the undeveloped,
compiled from a range of available diagrams unconscious, and inferior part of our
psyches. This would account for the parts of
ourselves or personality characteristics we
may have that we are not always aware of
but which we are judgmental and critical of
when we see them in others (projection).
Typically, when type practitioners work with
clients they are only addressing part of the
conscious ego and the positive aspects of the
preferences. The shadow aspects of the
preferences are rarely addressed. The non-
preferred functions theoretically lie on the
periphery of the unconscious ego, with the
inferior (least preferred) function being more
embedded in the unconscious (Jacobi, 1973;
Spoto, 1995). It is well accepted by most
users of the Myers-Briggs model that the
inferior function can precipitate an eruption
of unconscious material during times of
stress or when the individual has been
overusing the dominant function, as per
Quenks stress model (2002). However, what
practitioners are not often aware of is that
the inferior function, even when not making
an active appearance, influences our
perceptions of others and can give rise to
negative projections. The identification of
these projections can be essential in working
with individuals on their personal
development. It could be argued that
exploring relevant aspects of the shadow
should be part of any developmental work
involving type. In fact, Jung states:
Unfortunately there can be no
doubt that man is, on the whole,
less good than he imagines
himself or wants to be. Everyone
carries a shadow, and the less it
is embodied in the individuals
conscious life, the blacker and
denser it is. If an inferiority is
conscious, one always has a
chance to correct it (1970, p.14).
Part of the ego, and the part that faces the
outer world, is the persona. The
word persona was used by Jung to describe
the mask we wear in order to interact with
others according to expectations, social
convention, and inner motivations. The
persona is an essential part of the
personality for the individuals integration
with society as it will help the individual to
adapt his or her personality to suit different
environments. Thus a healthy persona will be
an adaptation of the individuals real
personality. Too little persona may result in
a person being seen as a rebel or social
misfit, and too much can result in falseness,
inauthenticity, poor personality
development, and, ultimately, inner psychic
conflict. Jacobi (1973) defines the interaction
of the ego and persona as a compromise
between the demands of the environment
and the inner structural necessity of the
individual (p. 28), and the persona itself as
a cloak around the ego. From the point of
view of type, a healthy persona should be
representative of the individuals preferences
plus his or her individual personality traits.
However, some people can be over-identified
with the persona and experience
inauthenticity. This identification with the
persona can be due to habituation, social
pressures, influences from childhood,
defensiveness, or anything that has given
the individual a message indicating that the
character of the persona is a preferable way
to be.
Returning to the concept of the shadow, the
aspects of the personal unconscious that
contribute to the shadow are rejected
experiences or impulses, our non-preferred
functions, and the negative aspects of our
ego and persona. In relation to Jungs theory,
Stein (2004) states that every ego has a
shadow, and that this shadow is opposite to
the persona in that it contains aspects of the
personality that the individual would not like
to be associated with or have seen by others,
or that the individual may deny to him or
herself. The contents of the egos shadow,
being unconscious, are not experienced by
the ego but are projected onto others by the
ego. Sharp (1987) adds that:
[T]he shadow and the persona
function in a compensatory way:
 the brighter the light, the darker
the shadow. The more one
identifies with the persona
which in effect is to deny that one
has a shadowthe more trouble
one will have with the
unacknowledged other side of
the personality (p. 95).
When working with psychological type,
knowledge of the shadow and the tensions
that can be created between the preferred
and non-preferred styles can be essential in
helping individuals to gain insight and self-
awareness. Additionally, becoming aware of
ones projections can help personal
development.
As well as the personal unconscious, Jung
suggested that we also have a collective
unconscious, which, according to Jung,
resides in the deep unconscious and is a
store of memories and attitudes from our
existence as humans. It consists of inherited
instincts and archetypes that can often affect
our beliefs, expectations, and behaviors.
Jung describes it as a deposit of world
processes embedded in the structure of the
brain and the sympathetic nervous system
[which] constitutes, in its totality, a sort of
timeless and eternal world-image which
counterbalances our conscious momentary
picture of the world (1981, p. 376). Some
aspects of the collective unconscious may
affect an individuals personality and use of
type, in that it contains archetypal images
that can influence the development of the
persona. So in a coaching situation, for
example, a person who becomes a manager
in a business may draw on his archetypal
image of a business manager (e.g., direct,
efficient, emotionally detached, decisive,
uncompromising, etc.) and create a persona
based on this which may be unlike his or her
true self. Our archetypal images may also
cause us to predict others behaviors on the
basis of very little information about them, or
to stereotype people.
As well as the dark negative shadow, Jung
also believed that individuals can suppress or
repress potentially positive aspects of
themselves. Therefore, exploration of the
shadow is not all about acknowledging ones
negative aspects but is also about releasing
potential. Jung does not seem to have given
a separate name to this light shadow but he
acknowledges its existence:
If it has been believed hitherto
that the human shadow was the
source of all evil, it can now be
ascertained on closer
investigation that the
unconscious man, that is, his
shadow, does not consist only of
morally reprehensible tendencies,
but also displays a number of
good qualities, such as normal
instincts, appropriate reactions,
realistic insights, creative
impulses, etc. (Jung, 1978, par.
423).
This unconscious potential is partly made up
of aspects of ourselves that do not fit with
our ego image, i.e., aspects that go against
our type preferences and conscious ego.
In summary, most of the aspects of the
psyche are important in getting a deeper
understanding of ones psychological type
and putting type into context. The workings
of the psyche as a whole, the dynamics of
the energies, the striving for balance and the
effect of entropy can help us to explore the
problem of opposites within the individual
as well as the problem of differences
between individuals as a key part of working
with type, as emphasized by Spoto. Being
aware of the Jung-Myers model of type adds
more to the understanding of type dynamics,
moving it further than merely the
acknowledgement of a hierarchy of
preferences; it enables one to explore the
dynamic tensions between the individuals
psychological type and other aspects of the
psyche. Standard use of psychological type
theory focuses mainly on the conscious ego
part of the psyche and on identifying an
individuals preferences. While this is a
valuable first step to self-understanding and
in certain circumstances a valid stopping
point, there is a lot further that one can go in
working with type, particularly in
psychodynamic coaching.
Nature of intelligence: operative and
figurative intelligence
Piaget believed that reality is a dynamic
system of continuous change, and as such is
defined in reference to the two conditions
that define dynamic systems. Specifically, he
argued that reality involves transformations
and states. Transformations refer to all
manners of changes that a thing or person
can undergo. States refer to the conditions or
the appearances in which things or persons
can be found between transformations. For
example, there might be changes in shape or
form (for instance, liquids are reshaped as
they are transferred from one vessel to
another, humans change in their
characteristics as they grow older), in size
(e.g., a series of coins on a table might be
placed close to each other or far apart) in
placement or location in space and time
(e.g., various objects or persons might be
found at one place at one time and at a
different place at another time). Thus, Piaget
argued, that if human intelligence is to be
adaptive, it must have functions to represent
both the transformational and the static
aspects of reality. He proposed that operative
intelligence is responsible for the
representation and manipulation of the
dynamic or transformational aspects of
reality and that figurative intelligence is
responsible for the representation of the
static aspects of reality.[1]
Operative intelligence is the active aspect of
intelligence. It involves all actions, overt or
covert, undertaken in order to follow,
recover, or anticipate the transformations of
the objects or persons of interest. Figurative
intelligence is the more or less static aspect
of intelligence, involving all means of
representation used to retain in mind the
states (i.e., successive forms, shapes, or
locations) that intervene between
transformations. That is, it involves
perception, imitation, mental imagery,
drawing, and language. Therefore, the
figurative aspects of intelligence derive their
meaning from the operative aspects of
intelligence, because states cannot exist
independently of the transformations that
interconnect them. Piaget believed that the
figurative or the representational aspects of
intelligence are subservient to its operative
and dynamic aspects, and therefore, that
understanding essentially derives from the
operative aspect of intelligence.
At any time, operative intelligence frames
how the world is understood and it changes if
understanding is not successful. Piaget
believed that this process of understanding
and change involves two basic functions:
Assimilation and accommodation.
[edit]Assimilation and accommodation
Through studying the field of education
Piaget focused on accommodation and
assimilation. Assimilation, one of two
processes coined by Jean Piaget, describes
how humans perceive and adapt to new
information. It is the process of taking ones
environment and new information and fitting
it into pre-existing cognitive schemas.
Assimilation occurs when humans are faced
with new or unfamiliar information and refer
to previously learned information in order to
make sense of it. Accommodation, unlike
assimilation is the process of taking one's
environment and new information, and
altering one's pre-existing schemas in order
to fit in the new information.
Through a series of stages, Piaget explains
the ways in which characteristics are
constructed that lead to specific types of
thinking; this chart is called Cognitive
Development. To Piaget, assimilation is
integrating external elements into structures
of lives or environments or those we could
have through experience. It is through
assimilation that accommodation is derived.
Accommodation is imperative because it is
how people will continue to interpret new
concepts, schemas, frameworks, etc.
[2]
Assimilation is different from
accommodation because of how it relates to
the inner organism due to the environment.
Piaget believes that the human brain has
been programmed through evolution to bring
equilibrium, and to move upwards in a
process to equilibriate what is not. The
equilibrium is what Piaget believes ultimately
influences structures because of the internal
and external processes through assimilation
and accommodation.
Piaget's understanding is that these two
functions cannot exist without the other. To
assimilate an object into an existing mental
schema, one first needs to take into account
or accommodate to the particularities of this
object to a certain extent; for instance, to
recognize (assimilate) an apple as an apple
one needs first to focus (accommodate) on
the contour of this object. To do this one
needs to roughly recognize the size of the
object. Development increases the balance
or equilibration between these two functions.
When in balance with each other,
assimilation and accommodation generate
mental schemas of the operative
intelligence. When one function dominates
over the other, they generate
representations which belong to figurative
intelligence.
[edit]Sensorimotor stage
The sensorimotor stage is the first of the
four stages in cognitive development which
"extends from birth to the acquisition of
language".[3] "In this stage, infants construct
an understanding of the world by
coordinating experiences (such as seeing
and hearing) with physical, motoric actions.
Infants gain knowledge of the world from the
physical actions they perform on it. An infant
progresses from reflexive, instinctual action
at birth to the beginning of symbolic thought
toward the end of the stage. Piaget divided
the sensorimotor stage into six sub-
stages"[4]:02 years, Infants just have senses-
vision, hearing, and motor skills, such as
grasping, sucking, and stepping.---from
Psychology Study Guide by Bernstein,
Penner, Clarke-Stewart, Roy
The first stage is called the Sensorimotor
stage (birth to about age 2). In this stage
knowledge of the world is limited (but
developing) because its based on physical
interactions/experiences. The child learns
that he is separate from his environment and
that aspects of his environment continue to
exist even though they may be outside the
reach of his senses. Behaviors are limited to
simple motor responses caused by sensory
stimuli. In this stage according to Piaget, the
development of object permanence is one of
the most important accomplishments at the
sensorimotor stage. (Object permanence is a
childs understanding that objects continue
to exist even though they cannot be seen or
heard).
Sub-
Age Description
Stage
1 Simple Birth- "Coordination of sensation
Reflexes 6 wee and action through
ks reflexive behaviors".
[4]
Three primary reflexes
are described by
Piaget: sucking of objects
in the mouth, following
moving or interesting
objects with the eyes, and
closing of the hand when
an object makes contact
with the palm (palmar
grasp). Over the first six
weeks of life, these
 reflexes begin to become
voluntary actions; for
example, the palmar reflex
becomes intentional
grasping.[5]).
"Coordination of sensation
and two types of schemes:
habits (reflex) and primary
circular reactions
(reproduction of an event
2 First that initially occurred by
habits chance). Main focus is still
6 wee
and on the infant's body."[4] As
ks-4
primary an example of this type of
mont
circular reaction, an infant might
hs
reaction repeat the motion of
s phase passing their hand before
their face. Also at this
phase, passive reactions,
caused
by classical or operant
conditioning, can begin.[5]
3 Secon 48 m Development of habits.
dary onths "Infants become more
circular object-oriented, moving
reaction beyond self-preoccupation;
s phase repeat actions that bring
interesting or pleasurable
results."[4] This stage is
associated primarily with
the development
of coordination between vis
ion and prehension. Three
new abilities occur at this
stage: intentional grasping
for a desired object,
secondary circular
reactions, and
differentiations between
ends and means. At this
stage, infants will
intentionally grasp the air
in the direction of a desired
object, often to the
amusement of friends and
family. Secondary circular
reactions, or the repetition
of an action involving an
external object begin; for
example, moving a switch
to turn on a light
repeatedly. The
differentiation between
means and ends also
occurs. This is perhaps one
of the most important
stages of a child's growth
as it signifies the dawn
of logic.[5]
"Coordination of vision and
touch--hand-eye
coordination; coordination
of schemes and
intentionality."[4]This stage
is associated primarily with
4Coordi the development of logic
nation of and the coordination
seconda 812 between means and ends.
ry mont This is an extremely
circular hs important stage of
reaction development, holding what
s stages Piaget calls the "first
proper intelligence." Also,
this stage marks the
beginning of goal
orientation, the deliberate
planning of steps to meet
an objective.[5]
5 Tertiar 1218 "Infants become intrigued
y mont by the many properties of
circular hs objects and by the many
reaction things they can make
s, happen to objects; they
novelty, experiment with new
and behavior."[4] This stage is
curiosity associated primarily with
the discovery of new
means to meet goals.

Piaget describes the child
at this juncture as the
"young scientist,"
conducting pseudo-
experiments to discover
new methods of meeting
challenges.[5]
"Infants develop the ability
to use primitive symbols
and form enduring mental
6Interna
representations."[4] This
lization 1824
stage is associated
of mont
primarily with the
Scheme hs
beginnings of insight, or
s
true creativity. This marks
the passage into the
preoperational stage.
By the end of the sensorimotor period,
objects are both separate from the self and
permanent. Object permanence is the
understanding that objects continue to exist
even when they cannot be seen, heard, or
touched. Acquiring the sense of object
permanence is one of the infant's most
important accomplishments, according to
Piaget.[4]
[edit]Preoperational stage
The Cognitive Development Approaches. By
observing sequences of play, Jean Piaget was
able to demonstrate that towards the end of
the second year, a qualitatively new kind of
psychological functioning occurs.[6]
(Pre)Operatory Thought is any procedure
for mentally acting on objects. The hallmark
of the preoperational stage is sparse and
logically inadequate mental operations.
During this stage, the child learns to use and
to represent objects by images, words, and
drawings.The child is able to form stable
concepts as well as mental reasoning and
magical beliefs. The child however is still not
able to perform operations; tasks that the
child can do mentally rather than physically.
Thinking is still egocentric. The child has
difficulty taking the viewpoint of others. Two
substages can be formed from preoperative
thought.[6]
The Symbolic Function Substage
Occurs between about the ages of 2
and 7. At 2-4 years of age, kids cannot
yet manipulate and transform
information in logical ways, but they
now can think in images and symbols.
The child is able to formulate designs
of objects that are not present. Other
examples of mental abilities are
language and pretend play. Although
there is an advance in progress, there
are still limitations such as
egocentrism and animism.
Egocentrism occurs when a child is
unable to distinguish between their
own perspective and that of another
person's. Children tend to pick their
own view of what they see rather than
the actual view shown to others. An
example is an experiment performed
by Piaget and Barbel Inhelder. Three
views of a mountain are shown and
the child is asked what a traveling doll
would see at the various angles; the
child picks their own view compared to
the actual view of the doll. Animism is
the belief that inanimate objects are
capable of actions and have lifelike
qualities. An example is a child
believing that the sidewalk was mad
and made them fall down.[6]
The Intuitive Thought Substage
Occurs between about the ages of 4 and 7.
Children tend to become very curious and
ask many questions; begin the use of
primitive reasoning. There is an emergence
in the interest of reasoning and wanting to
know why things are the way they are.
Piaget called it the intuitive substage
because children realize they have a vast
amount of knowledge but they are unaware
of how they know it.'Centration' and
'conservation' are both involved in
preoperative thought. Centration is the act
of focusing all attention on one
characteristic compared to the others.
Centration is noticed in conservation; the
awareness that altering a substance's
appearance does not change its basic
properties. Children at this stage are
unaware of conservation.Example, In
Piaget's most famous task, a child is
presented with two identical beakers
containing the same amount of liquid. The
child usually notes that the beakers have
the same amount of liquid.When one of the
beakers is poured into a taller and thinner
container, children who are younger than 7
or 8 years old typically say that the two
beakers no longer contain the same amount
of liquid, and the taller container holds the
larger quantity. The child simply focuses on
the height and width of the container
compared to the general concept.[6]
The second stage is called Pre-
operational stage (begins about the
time the child starts to talk at about
the age of 2). Intelligence is
demonstrated through the use of
symbols, language use matures, and
memory and imaginations are
developed. The childs thinking is
influenced by fantasy (the way the
child would like things to be) and the
child assumes that others see
situations from his viewpoint. The
child takes in informations and then
changes it in his mind to fit his idea.
Piaget noted that children in this
stage do not yet understand concrete
logic, cannot mentally manipulate
information. Childrens increase in
playing and pretending takes place in
the pre-operational stage.
[edit]Concrete operational stage
The concrete operational stage is
the third of four stages of cognitive
development in Piaget's theory. This
stage, which follows the
preoperational stage, occurs between
the ages of 7 and 11 years[7] and is
characterized by the appropriate use
of logic. Important processes during
this stage are:
Seriationthe ability to sort objects
in an order according to size, shape,
or any other characteristic. For
example, if given different-shaded
objects they may make a color
gradient.
Transitivity- Transitivity, which refers
to the ability to recognize
relationships among various things in
a serial order. For example, when told
to put away his books according to
height, the child recognizes that he
starts with placing the tallest one on
one end of the bookshelf and the
shortest one ends up at the other end.
Classificationthe ability to name
and identify sets of objects according
to appearance, size or other
characteristic, including the idea that
one set of objects can include
another.
Decenteringwhere the child takes
into account multiple aspects of a
 problem to solve it. For example, the
child will no longer perceive an
exceptionally wide but short cup to
contain less than a normally wide,
taller cup.
Reversibilitythe child understands
that numbers or objects can be
changed, then returned to their
original state. For example, during
this stage, a child understands that a
favorite ball that deflates is not gone
but can be filled with air again and
put back into play.
Conservationunderstanding that
quantity, length or number of items is
unrelated to the arrangement or
appearance of the object or items.
Elimination of Egocentrismthe ability to
view things from another's perspective (even
if they think incorrectly). For instance, show
a child a comic in which Jane puts a doll
under a box, leaves the room, and then
Melissa moves the doll to a drawer, and Jane
comes back. A child in the concrete
operations stage will say that Jane will still
think it's under the box even though the
child knows it is in the drawer. (See
also False-belief task).
Children in this stage can, however,
only solve problems that apply to
actual (concrete) objects or events,
and not abstract concepts or
hypothetical tasks.
The third stage is known as Concrete
operational stage (First grade to early
adolescence): Intelligence is demonstrated
through logical and systematic manipulation
of symbols related to concrete objects. The
child develops an ability to think abstractly
and to make rational judgements about
concrete or observable phenomena, which in
the past he needed to manipulate physically
to understand. Logic: Piaget determined that
children in the concrete operational stage
were able to incorporate inductive logic. On
the other hand, children at this age have
difficulty using deductive logic, which
involves using a general principle to predict
the outcome of a specific event. Reversibility:
An example of this is being able to reverse
the order of relationships between mental
categories. For example, a child might be
able to recognize that his or her dog is a
Labrador, that a Labrador is a dog, and that
a dog is an animal, and draw conclusions
from the information available, as well as
apply all these processes to hypothetical
situations.[8] The abstract quality of the
adolescent's thought at the formal
operational level is evident in the
adolescent's verbal problem solving ability.
[8]
The logical quality of the adolescent's
thought is when children are more likely to
solve problems in a trial-and-error fashion.
[8]
Adolescents begin to think more as a
scientist thinks, devising plans to solve
problems and systematically testing
solutions.[8] They use hypothetical-deductive
reasoning, which means that they develop
hypotheses or best guesses, and
systematically deduce, or conclude, which is
the best path to follow in solving the
problem.[8] During this stage the adolescent
is able to understand such things as love,
"shades of gray", logical proofs and values.
During this stage the young person begins to
entertain possibilities for the future and is
fascinated with what they can be.
[8]
Adolescents are changing cognitively also
by the way that they think about social
matters.[8] Adolescent Egocentrism governs
the way that adolescents think about social
matters and is the heightened self-
consciousness in them as they are which is
reflected in their sense of personal
uniqueness and invincibility. [8] Adolescent
egocentrism can be dissected into two types
of social thinking, imaginary audience that
involves attention getting behavior,
and personal fable which involves an
adolescent's sense of personal uniqueness
and invincibility.[8]
[edit]Formal operational stage
The final stage is known as Formal
operational stage (adolescence and into
adulthood): Intelligence is demonstrated
through the logical use of symbols related to
abstract concepts. At this point, the person is
capable of hypothetical and deductive
reasoning. During this time, people develop
the ability to think about abstract concepts.
Logic: Piaget believed that deductive logic
becomes important during the formal
operational stage. This type of thinking
involves hypothetical situations and is often
required in science and mathematics.
Abstract thought emerges during the formal
operational stage. Children tend to think very
concretely and specifically in earlier stages.
Children begin to consider possible outcomes
and consequences of actions. Problem-
Solving is demonstrated when children use
trial-and-error to solve problems. The ability
to systematically solve a problem in a logical
and methodical way emerges.
[edit]The stages and causation
Piaget sees childrens conception of
causation as a march from "primitive"
conceptions of cause to those of a more
scientific, rigorous, and mechanical nature.
These primitive concepts are characterized
as magical, with a decidedly nonnatural or
nonmechanical tone. Piaget attributes this to
his most basic assumption: that babies
are phenomenists. That is, their knowledge
"consists of assimilating things to schemas"
from their own action such that they appear,
from the childs point of view, "to have
qualities which in fact stem from the
organism." Consequently, these "subjective
conceptions," so prevalent during Piagets
first stage of development, are dashed upon
discovering deeper empirical truths. Piaget
gives the example of a child believing the
moon and stars follow him on a night walk;
upon learning that such is the case for his
friends, he must separate his self from the
object, resulting in a theory that the moon is
immobile, or moves independently of
other agents. The second stage, from around
three to eight years of age, is characterized
by a mix of this type of magical, animistic, or
nonnatural conceptions of causation and
mechanical or "naturalisitic" causation. This
conjunction of natural and nonnatural causal
explanations supposedly stems from
experience itself, though Piaget does not
make much of an attempt to describe the
nature of the differences in conception; in his
interviews with children, he asked
specifically about natural phenomena: what
makes clouds move? What makes the stars
move? Why do rivers flow? The nature of all
the answers given, Piaget says, are such that
these objects must perform their actions to
"fulfill their obligations towards men." He
calls this "moral explanation."[9]
BEHAVIORAL MODEL
Before conditioning, ringing the bell
caused no response from the dog.
Placing food in front of the dog
initiated salivation.
During conditioning, the bell was rung
a few seconds before the dog was
presented with food.
After conditioning, the ringing of the
bell alone produced salivation
Other Observations Made by Pavlov
Stimulus Generalization: Once the dog
has learned to salivate at the sound of
the bell, it will salivate at other similar
sounds.
Extinction: If you stop pairing the bell
with the food, salivation will eventually
cease in response to the bell.
Spontaneous Recovery: Extinguished
responses can be "recovered" after an
elapsed time, but will soon extinguish
again if the dog is not presented with
food.
Discrimination: The dog could learn to
discriminate between similar bells
(stimuli) and discern which bell would
result in the presentation of food and
which would not.
 Higher-Order Conditioning: Once the
dog has been conditioned to associate
the bell with food, another
unconditioned stimulus, such as a light
may be flashed at the same time that
the bell is rung. Eventually the dog will
salivate at the flash of the light
without the sound of the bell.
Like Pavlov, Watson and Thorndike,
Skinner believed in the stimulus-
response pattern of conditioned
behavior. His theory dealt with
changes in observable behavior,
ignoring the possibility of any
processes occurring in the mind.
Skinner's 1948 book, Walden Two , is
about a utopian society based on
operant conditioning. He also
wrote,Science and Human
Behavior, (1953) in which he pointed
out how the principles of operant
conditioning function in social
institutions such as government, law,
religion, economics and education
(Dembo, 1994).
Skinner's work differs from that of his
predecessors (classical conditioning),
in that he studied operant behavior
(voluntary behaviors used in operating
on the environment).
Skinner's Operant Conditioning
Mechanisms
Positive Reinforcement or reward:
Responses that are rewarded are likely
to be repeated. (Good grades reinforce
careful study.)
Negative Reinforcement: Responses
that allow escape from painful or
undesirable situations are likely to be
repeated. (Being excused from writing
a final because of good term work.)
Extinction or Non-Reinforcement :
Responses that are not reinforced are
not likely to be repeated. (Ignoring
student misbehavior should extinguish
that behavior.)
Punishment: Responses that bring
painful or undesirable consequences
will be suppressed, but may reappear
if reinforcement contingencies change.
(Penalizing late students by
withdrawing privileges should stop
their lateness.)
(Good & Brophy, 1990)
Skinner and Behavioral Shaping
If placed in a cage an animal may take a very
long time to figure out that pressing a lever
will produce food. To accomplish such
behavior successive approximations of the
behavior are rewarded until the animal
learns the association between the lever and
the food reward. To begin shaping, the
animal may be rewarded for simply turning
in the direction of the lever, then for moving
toward the lever, for brushing against the
lever, and finally for pawing the lever.
Behavioral chaining occurs when a
succession of steps need to be learned. The
animal would master each step in sequence
until the entire sequence is learned.
Reinforcement Schedules
Once the desired behavioral response is
accomplished, reinforcement does not have
to be 100%; in fact it can be maintained
more successfully through what Skinner
referred to as partial reinforcement
schedules. Partial reinforcement schedules
include interval schedules and ratio
schedules.
Fixed Interval Schedules: the target
response is reinforced after a fixed
amount of time has passed since the
last reinforcement.
Variable Interval Schedules: similar to
fixed interval schedules, but the
amount of time that must pass
between reinforcement varies.
Fixed Ratio Schedules: a fixed number
of correct responses must occur before
reinforcement may
recur.
 Variable Ratio Schedules: the number
of correct repetitions of the correct
response for reinforcement varies.
Variable interval and especially, variable
ratio schedules produce steadier and more
persistent rates of response because the
learners cannot predict when the
reinforcement will come although they know
that they will eventually succeed.
The theory explains the purpose of
nursing is to help others identify their
felt difficulties.
Nurses should apply principles of
human relations to the problems that
arise at all levels of experience.
Peplau's theory explains the phases of
interpersonal process, roles in nursing
situations and methods for studying
nursing as an interpersonal process.
Nursing is therapeutic in that it is a
healing art, assisting an individual who
is sick or in need of health care.
Nursing is an interpersonal process
because it involves interaction
between two or more individuals with
a common goal.
The attainment of goal is achieved
through the use of a series of steps
following a series of pattern.
The nurse and patient work together
so both become mature and
knowledgeable in the process.
D e fi n i t i o n s
Person: A developing organism that
tries to reduce anxiety caused by
needs.
Environment: Existing forces outside
the organism and in the context of
culture
Health: A word symbol that
implies forward movement of
personality and other ongoing human
processes in the direction
of creative, constructive, productive, p
ersonal andcommunity living.
Nursing: A significant therapeutic
interpersonal process. It functions
cooperatively with other human
process that make health possible for
individuals in communities.
Roles of nurse
Stranger: receives the client in the
same way one meets a stranger in
other life situations provides an
accepting climate that builds trust.
Teacher: who imparts knowledge in
reference to a need or interest
Resource Person : one who provides
a specific needed information that aids
in the understanding of a problem or
new situation
Counselors : helps to understand and
integrate the meaning of current life
circumstances ,provides guidance and
encouragement to make changes
Surrogate: helps to clarify domains
of dependence interdependence and
independence and acts on clients
behalf as an advocate.
Leader : helps client assume
maximum responsibility for meeting
treatment goals in a mutually
satisfying way
Additional Roles include:
1. Technical expert
2. Consultant
3. Health teacher
4. Tutor
5. Socializing agent
6. Safety agent
7. Manager of environment
8. Mediator
9. Administrator
10. Recorder observer
11. Researcher
Phases of interpersonal Individual feels as an integral part of
the helping environment
relationship
They may make minor requests or
Identified four sequential phases in the
attention getting techniques
interpersonal relationship:
The principles of interview techniques
1. Orientation
must be used in order to explore,
2. Identification
understand and adequately deal with
3. Exploitation
the underlying problem
4. Resolution
Patient may fluctuates on
Orientation phase
independence
Problem defining phase
Nurse must be aware about the
various phases of communication
Starts when client meets nurse as
stranger
Nurse aids the patient in exploiting all
avenues of help and progress is made
Defining problem and deciding type of
towards the final step
service needed
Resolution phase
Client seeks assistance ,conveys
needs ,asks questions, shares
Termination of professional
preconceptions and expectations of
relationship
past experiences
The patients needs have already been
Nurse responds, explains roles to
met by the collaborative effect of
client, helps to identify problems and
patient and nurse
to use available resources and
services
Now they need to terminate their
therapeutic relationship and dissolve
Factors influencing orientation phase
the links between them.

Sometimes may be difficult for both as

Identification phase
psychological dependence persists
Selection of appropriate professional
Patient drifts away and breaks bond
assistance
with nurse and healthier emotional
balance is demonstrated and both
Patient begins to have a feeling of
becomes mature individuals
belonging and a capability of dealing
with the problem which decreases the
Interpersonal theory and
feeling of helplessness and
nursing process
hopelessness
Both are sequential and focus on
Exploitation phase
therapeutic relationship
Use of professional assistance for
Both use problem solving techniques
problem solving alternatives
for the nurse and patient to
collaborate on, with the end purpose
Advantages of services are used is
of meeting the patients needs
based on the needs and interests of
the patients
 Both use observation communication
and recording as basic tools utilized by new plans
nursing

Peplaus work and

Assessment Orientation characteristics of a theory
Data Non continuous Interrelation of concepts
collection data collection
and analysis
o Four phases interrelate the
[continuous] Felt need
different components of each
phase.
May not be a Define needs
felt need
Applicability

o The nurse patient interaction

Nursing Identification can apply to the concepts of
diagnosis human being, health,
Planning Interdependent environment and nursing.
goal setting
Mutually set Theories must be logical in nature -
goals
o This theory provides a logical
systematic way of viewing
nursing situations
Implementation Exploitation
o Key concepts such as anxiety,
Plans Patient actively
tension, goals, and frustration
initiated seeking and
are indicated with explicit
towards drawing help
relationships among them and
achievement
progressive phases
of mutually Patient initiated
set goals
Generalizability
May be
accomplishe o This theory provides simplicity
d by in regard to the natural
patient , progression of the NP
nurse or relationship.
family
Theories can be the bases for
hypothesis that can be tested

Evaluation Resolution o Peplau's theory has generated

testable hypotheses.
Based on Occurs after
mutually other phases are Theories can be utilized by
expected completed practitioners to guide and improve
behaviors successfully their practice.

May led to Leads to o Peplaus anxiety continuum is

termination termination a still used in anxiety patients
and
initiation of
 Theories must be consistent with other
validated theories, laws, and principles
but will leave open unanswered
questions that need to be
investigated.
o Peplau's theory is consistent
with various theories
Limitations
Personal space considerations and
community social service resources
are considered less.
Health promotion and maintenance
were less emphasized
Cannot be used in a patient who
doesnt have a felt need eg. With
drawn patients, unconscious patients
Some areas are not specific enough to
generate hypothesis
Research Based on Peplaus
Theory
Freud (1936) saw a persons innate anxiety as the
stimulus for behavior. He described defense
mechanisms
as the humans attempt to control awareness of
and to reduce anxiety (see Chap. 3). Defense
mechanisms
are cognitive distortions that a person uses
unconsciously to maintain a sense of being in
control
of a situation, to lessen discomfort, and to deal
with
stress. Because defense mechanisms arise from
the
unconscious, the person is unaware of using
them.
Some people overuse defense mechanisms,
which
stops them from learning a variety of appropriate
methods to resolve anxiety-producing situations.
The
dependence on one or two defense mechanisms
also
can inhibit emotional growth, lead to poor
problemsolving
skills, and create difficulty with relationships