BHOPAL (M.P.

Assignment
On
PSYCHOsocial THERapY

SUBMITTED TO: SUBMITTED BY:

Mrs. C. Gomthi Mrs. Geeta Choudhary
Professor M.Sc. Nursing Ist yr
hod of psychiatric nursing

PSYCHOSOCIAL THERAPY
1. INTRODUCTION

In treatment modalities of psychiatric patients the approaches used are;

psychopharmacology, psychotherapies or psychological treatments and physical treatment .
Psychotheraoy is a the treatment used for a patient with emotional and personality problems.The
basic principal in psychotherapy is the therapist-patient relationship.Use psychotherapy by
nursing personnel is an indioendant role where nurse use an appropriate psychotherapy approach
to help her patient.

2. DEFINITION
Wolberg define psychotherapy as, “ a form of treatment for problems of an emotional
nature in which a traines person deliberately establishes a professional relationship with
the objective of removing, modifying or retarding existing symptoms, of mediating
disturbed patterns of behavior and of promoting positive personality growth and
development.

Lego S. defines psychotherapy as , “A method of treatment based on the development of

intimate relationship between patient and therapisfor the purpose of exploring and
modifying the patient behavior in a satisfying direction.

GOALS OF PSYCHOSOCIAL THERAPY

1. Changing maladaptive behaviour patterns.
2. Reducing or eliminating envioronmenal conditions that may be causing such a
behaviour.
3. Improving interpersonal and other competencies.
4. Helping the patient to resolve inner conflict and overcome fellings of handicap(such
as the patients feels he cannot socialize or take decision or communicate
effectively.)
5. Helping him to develop a sence of selfidentity.
 TYPES 0F PSYCHOSOCIAL THERAPY

INDIVIDUA BEHAVI INTERPER

L OURAL SONAL
PSYCHOTH THERAP PSYCHO
ERAPY Y THERAPY

•BEHAVIOUR • MARITA
•PSYCHOAN MODIFICATI
ON L
ALYSIS THERAPY
•SYSTEMETIC
•HYPNOSIS DESENTRALI OTHER
ZATION • FAMILY PSYCHOSOC
THERAPY IAL
•ABREACTI •AVERSION THERAPY
ON THERAPY • TRANAC
TIONAL THERAPEU
•ASSERTIVEN THERAPY TIC
•REALITY
ESS COMMUNI
THERAPY TRAINING TY
•UNCOVERI MILIEU
•COGNITIVE
NG BEHAVIOUR THERAPY
THERAPY GROUP
PSYCHOT ATTITUDE
•SUPPORTIV
E HERAPY THERAPY
THERAPY •IMPLOSIVE
THERAPY OCCUPATIO
NAL
•POSITIIVE THERAPY
REENFORCE
MENT RECERATI
ONAL
THERAP
Y PLAY
THERAPY
MUSIC
THERAPY
LIGHT
THERAPY
COLOR
THERAPY
AROMA
THERAPY
 INDIVIDUAL PSYCHOTHERAPY

Psychotherapy conducted on a one to one basis.The therapist treats one person at

a time, The effectiveness of such a therapy depends on the patient-therapist relationship.

Types :

 Psychoanalysis
 Hypnosis
 Abreaction
 Reality therapy
 Uncovering
 Supportive therapy

 Psychoanalysis
Psychoanalytical therapy was developed by freud.the therapeutic technique
focuses primarialy on the influence of unconscious forces such as repressed impulses
and memories, internal conflicts and childhood traumas on the mental life and
adjustment of the individual.
Psychoanalysis as a form of therapy is used primarily in psychoneurosis by
briniging modification in the personality.This is done by establishing a constructive
therapeutic relationship.
The specificmethods used to achive the effect on therapy are: free association ,
dream interpretation, analysis of resistance and defences used by the patient , working
through the fellings and experiences releved by the patient during transference.

Every interaction lasts for 45 minutes, four to five days a week for approximately three or five
years . It is ana expensive form of therapy in term of money and time.

 Hypnosis and Hypnotherapy

Hypnosis is a superficial or deep trance resembling sleep. It is induced in a patient
by suggestions of relaxation and concentrationtrsting attention on a singal object.

The client becomes highly suggestible submissive and abandos control and
response to therapist influence.

He can be induced to recall forgotten events becomes intenssitive to pain, gains

relief from tention, anxity and other psychological symptoms.It affects behavioural
change and control of attitudes.

Hypnosis is considered effective in obesity, hypertention, asthama, smoking ,

peptic ulcer, over eating and other addictive disorders.

 Abreaction
 It is a therapeutic technique in which the patient talks about repressed emotion by
reviving and reliving painful experiences that have been buried in the
unconscious.When the psychiatrist that it could be helpful, he may use an intravenous
injection of a drug such as pentothal.

 Reality Therapy
This is a psychotherapeutic technique which focouses on the present behaviour and
development of a patients ability to cope with the stresses of reality and take a greater
responsibility fpor the fulfillment of his needs.
To achieve these purposes the therapist becomes involved in an active relationship
with the patient, rejects his unrealistic behaviour and teaches better ways to meet his
needs in real worls.
The patients need to be stressed on, that the past cannot be changed;so he must
take responsibility of right or wrong action of present.

 Uncovering
This technique is used to break the patient repressed conflict and traumatic
experience to the surface. It helps te patient in gaining an insight. The patient explores
different methods to cope with the problem,once he gains an insight into his conflict or
problem.

3. Supportive therapy
It is form of “surface therapy”. The therapist helps client or patient to relive
emotional distress and symptoms without probing into the past or attemoting to change the
basic personalityof the individual.

4. Technique of supportive therapy:

1. Ventilation
2. Environmental modification
3. Persuasion
4. Reeducation
5. Reassurance
 Ventilation
It is free expression of feeling emotions. The patient is allowed to talk frerely
whatever comes to his mind. It is also described as mental ventilation.
The therapist will note that during free talking the patient
avoids certain events or mentions them superficially.
The client is encouraged to talk about them more freely until they no longer cause
emotional disturbance in patient.It helps the client to unburden his feeling by sharing and
revealing himself which makes the patient less tense.

 Environmental modification
 A method of improving the wellbeing of mental patients by changing their leaving
condition. If there is a restless patient in the ward due to whom the other patient is not
able to sleep, the former may be transferred to cubicle where no other patient is allowed for
a day or two.

 Persuasion
Persuasion psychotherapy used in which the therapist attempts to induce the
patient to modify his faculty behaviour by using his power of reasoning will and self
criticism.

 Reeducation
The patient learns more effective ways of dealing with
problems and relationship through therapist-patient relationship.

 Reassurance
It is supportive approach that encourages the patient to believe that there are
possibilities of improvement.
It is also used to diminish anxity.

 GOALS OF INDIVIDUAL PASYCHOTHERAPY

A. Establish a therapeutic therapist-patient relationship.
B. Providing an opportunity for the patient to release tension as problems are
discussed.
C. Assisting the patient in gaining an insight into the problem.
D. Providing an opportunity to practice new skills.
E. Reinforcing an appropriate

BEHAVIOURAL THERAPY
Definition
It is form of psychotherapy which focuses on modifying faulty behaviour
rather than basic changes in personality.
Behaviour therapist tries to eliminate the symptoms and modify ineffective or
maladaptive patterns by applying basic learning techniques.
 It is used in followed condition:
i. For behaviour modification
ii. Any anxiety disorders related to behaviour disorders
iii. To control any unwanted impulses
 Behaviour therapy is more useful in :
 Anxiety disorders
 Phobia
 Nocturnal enuresis
 Tics
 Anorexia nervosa
  Tension headache
 Obesity
Techniques of behaviour therapy:
1. Behaviour modification
2. Systematic decentralization
3. Aversion therapy
4. Assertiveness therapy
5. Implosive therapy
6. Positive reinforcement therapy
Behaviour modification
It is also called “simple extinction”. To eliminate a maladaptive behaviour
one has to remove the reinforcement for it. It is effective when reinforcement is being
used without the knowledge of the affected individual.

Systemic decentralization
Systemic decentralization is a form of behaviour therapy developed by j.wolpe
and others.
The objective of the therapy is to reduce or eliminate fear or anxiety in which:
1) The patient is trained in deep muscle relaxation ,
2) He has various anxity provoking situation or special phobia such as fear of death , fear
of animal. These problems are placed from the strongest to the weakest order.i.e the client
is anxious about which one is causing anxiety the least.
3) Each of these situations is presented in imagination or in reality beginning with
the weakest. Once thepatient relaxes while imagining
that means the anxiety is getting reduced gradually. Therapy is very useful in for patient
who have developed certain fears specially to domestic animal like dog.

Aversion therapy
It is a form of behaviour therapy in which the patient is conditioned to avoid an
undesirable behaviour or symptoms by associating them with painful or unpleasant
experience.such as putting a bitter taste on nails or toungue for nail biting.

Aversion therapyhas been used for alcoholism and coumpulsive

unacceptable social behaviour like homosexuality.

Asservativeness training
It is behaviour therapy technique in which the patients is given training to
bring about changes in emotional and other behaviour pattern by assessing
himself.
In other words , one is encouraged not
BIBLIOGRAPHY:

1. R SREEVANI, A GUIDE TO MENTAL HEALTH AND PSYCHIATRC

NURSING, THIRF EDITION, JAYPEE PUBLICATIONS LTD. PAGE NO. 95-
105.
2. NEERAJ AHUJA, A SHORT TEXT BOOK OF PSYCHIATRIC, 7TH EDITION,
JAYPEE [PUBLICATIONS. PAGE NO.:- 213-225.
3. SHEILA L. VIDEBECK, PSYCHIATRIC MENTAL HEALTH NURSING, 5 TH
EDITION, WOLTER KLUWER & LIPPINCOTT WILLIAMS & WIKINS, PAGE
NO. 235-268.
4. MARRY C. TOWNSEND, ESSENTIALS OF PSYCHIATRIC MENTAL
HEALTH NURSING, 5TH EDITION, DEWIS PLUS , PAGE NO. 330-338.

5. K P NEERAJA., “ESSENTIALS OF MENTAL HEALTH AND PSYCHIATRIC

NURSING”., VOULME ONE., JAYPEE PUBLICATION.

6. DR. K. LALITHA, “MENTAL HEALTH AND PSYCHIATRIC NURSING”., VMG BOOK

HOUSE PUBLISHERS.

7. WWW.MEDHUB.NET./
8. WWW.PSYCHIATRIC.ENCYCLOPEDIA./