Harry Stack Sullivan – Interpersonal Theory

 Henry Stack-Sullivan, who is considered the father of interpersonal psychiatry,

developed the Interpersonal Theory of Nursing.
 This theory explained the role of interpersonal relationships and social experiences in
regards to the shaping of personalities, as well as the importance of life events to
psychopathology.
 Stack-Sullivan’s theory states that the purpose of behavior is for the patient to have his
or her needs met through interpersonal interactions, as well as decrease or avoid
anxiety.
 The Interpersonal Theory explains six developmental stages, which Stack-Sullivan calls
“epochs” or heuristic stages in development.
 The first stage, called Infancy, occurs from birth to eighteen months. The main
characteristic of this stage is the gratification of needs.
 The second stage begins at eighteen months and runs until six years of age. This
stage, Childhood, is characterized by delayed gratification.
 The Juvenile Era, which occurs between six and nine years of age, is
characterized by the formation of a peer group.
 The fourth stage, Preadolescence, is between nine and twelve years of age. It is
characterized by the development of relationships within the same gender.
 Early adolescence occurs from twelve to fourteen years. During this stage, the
adolescent develops an identity.
 The sixth stage, late adolescence, runs from fourteen to twenty-one years of age.
This final stage in Stack-Sullivan’s model of nursing is characterized by the
formation of lasting, intimate relationships.
 The Interpersonal Theory explains three types of self: the good me, bad me, and not me.
The “good me” versus the “bad me” based on social appraisal and the anxiety that
results from negative feedback. The “not me” refers to the unknown, repressed
component of the self.
 Stack-Sullivan’s theory also explains anxiety, self-system, and self-esteem. It states that
security operations are those measures that the individual employs to reduce anxiety
and enhance security. A self-system is all of the security operations an individual use to
defend against anxiety and ensure self-esteem.
 This model of nursing provides the basis for interpersonal psychotherapy to specifically
address patients with depression and schizophrenia. The theory proposes that
depression most often develops in the context of adverse events, especially loss.

Hildegard Peplau – Interpersonal Relations Theory

 Hildegard Peplau’s Interpersonal Relations Theory emphasized the nurse-client

relationship as the foundation of nursing practice. It emphasized the give-and-take of
nurse-client relationships that was seen by many as revolutionary.
 Hildegard E. Peplau’s theory defined Nursing as “An interpersonal process of
 therapeutic interactions between an individual who is sick or in need of health services
and a nurse especially educated to recognize, respond to the need for help.” It is
a “maturing force and an educative instrument” involving an interaction between two or
more individuals with a common goal.
 The nursing model identifies four sequential phases in the interpersonal
relationship: orientation, identification, exploitation, and resolution.
 Four Phases of the therapeutic nurse-patient relationship:
 Orientation Phase – The nurse’s orientation phase involves engaging the client
in treatment, providing explanations and information, and answering questions.
 Identification Phase – The identification phase begins when the client works
interdependently with the nurse, expresses feelings, and begins to feel stronger.
 Exploitation Phase – In the exploitation phase, the client makes full use of the
services offered.
 Resolution Phase – In the resolution phase, the client no longer needs
professional services and gives up dependent behavior. The relationship ends.
 The following are the roles of the Nurse in the Therapeutic relationship identified by Peplau:
 Stranger: offering the client the same acceptance and courtesy that the nurse would
respond to any stranger
 Resource person: providing specific answers to questions within a larger context
 Teacher: helping the client to learn formally or informally
 Leader: offering direction to the client or group
 Surrogate: serving as a substitute for another such as a parent or a sibling
 Counselor: promoting experiences leading to health for the client such as expression
of feelings
 Technical Expert: providing physical care for the patient and operates equipment