GOOD

AFTERNOON
CONCEPTUAL MODELS
AND THE ROLE OF
NURSE

Mr.Harikrishna.G.L
 PSYCHO ANALYTICAL MODEL

 PSYCHOSOCIAL MODEL

 BEHAVIORAL MODEL

 INTER PERSONAL MODEL

 PSYCHO ANALYTICAL
MODEL
• Proponent –Sigmund Freud.

Assumptions:
a) All human behavior is caused
and thus is capable of
explanation.
eg:slips of tongue, dreams
b)All human behavior from birth
to old age is driven by an energy
called ‘libido’.

c)Human behavior that channels

pleasure seeking behavior into
socially approved form and
develop ability to delay pleasure
is referred to as “reality seeking
principle”.
d)Personality of human being is
structured into id, ego and
superego.

Id-(It),original source of
personality.
- selfish
- immediate gratification
- primary process thinking
- pleasure seeking principle
Ego- (I) self
-executive of personality
-mediator or balance between
id and superego
-secondary process thinking
-reality principle

Superego-(Higher self)
-judges whether an action
is right or wrong according to
standards of society
 Contd….
e) Human personality function on
3 levels of awareness;

a) Conscious
b) Pre conscious
c) Unconscious
Freud compared the human mind
with an iceburg.
 Contd….
f)Id –always at unconscious level

Ego- more at conscious and pre

conscious level and less at
unconscious level.

Superego-little at conscious level

and pre conscious level and more at
unconscious level
 Contd….
g)Human personality development
passes through 5 ‘psycho sexual’
stages.
-oral
-anal
-phallic
-latency
-genital
 Freud’s stages of psychosexual
development
AGE STAGE DESCRIPTION
BIRTH TO 18 MONTHS ORAL Management of anxiety
by using mouth and
tongue

18 months -3 years ANAL Control of

muscles(urination &
defecation)
3-6 years PHALLIC(OEDIPAL) Awareness of sex &
genitalia

6-12 years LATENCY Exhibition of latent

sexual development &
energy
12 years to adulthood GENITAL Sexual interest &
development of partners
 Contd….
h)This theory assumes that
human personality and behavior
are flexible and that allows the
change.
 THEORIES OF
DEVELOPMENT

ERIKSON’S STAGES OF
PSYCHOSOCIAL
DEVELOPMENT
AGE STAGE TASK TO BE ACHIEVED

BIRTH TO TRUST VS Develop a sense of trust

18MONTHS MISTRUST In others
18 months to AUTONOMY VS Learn self control
3 years SHAME AND
DOUBT
3-6 years INITIATIVE VS Initiate spontaneous
GUILT activities
6-12 years INDUSTRY VS Develop necessary
INFERIOTY social skills
12-20 years IDENTITY VS Integrate childhood
ROLE Experiences into a
DIFFUSION Personal identity
20-30 years INTIMACY VS Develop commitments to
ISOLATION Others & to a lifework
(career)
30-65 years GENERATIVITY Establish a family & become
VS productive
STAGNATION
65+ years INTEGRITY VS View one’s life as meaningful &
DESPAIR fulfilling
 BEHAVIORAL MODEL
Proponents: Ivan Pavlov , Watson
and Skinner.

• Concerned with observable behavior,

rather than with unconscious
processes or the personality itself.
 Assumptions:

a) All human behavior is a response to

a stimulus or to stimuli from the
environment.
b) Human beings can control or
determine the behavior of others.
c) Human personality is a mere
pattern of stimulus-response chains
or habits.
 Contd…
d) Both adaptive and maladaptive
behaviors are learned and strengthened
through reinforcements.

e) Maladaptive behavior can be replaced

by adaptive behavior if the person
receives exposure to specific stimuli
and reinforcements for the desired
adaptive behavior.
 Therapeutic process in
Behavioral model and role of
Nurse

1.Reciprocal inhibition:
- observable behavior is a
learned response to anxiety.
eg: Desensitization,
relaxation therapy.
 Contd….
2.Assertive training:
Assertiveness implies the ability
to stand up for own’s own rights
without hurting the rights of others.

- Through role play and practice

patient modifies his behavior toward
increased assertiveness. This
increases self-esteem & sense of self
control
 Contd….
3.Aversion therapy:
- Here patient is conditioned to
avoid an undesirable behavior by
associating them with painful or
unpleasant experiences.
eg: -putting bitter taste on nails to
avoid nail biting.
-giving drugs like apo morphine
which cause nausea or
vomiting for alcoholics
 Contd…
4.Token Economy Systems:
-positive reinforcement
programs.
-patient is rewarded with a
token when the desirable behavior
occurs.
-patient is penalized by
removing the tokens when
undesirable behavior takes place.
 Contd…
- Use of this system is to
encourage the socially
acceptable behavior in
chronically hospitalized patients.

- The reward must be highly

desirable to the patient.
 Contd….
5.Shaping:
- behavioral reinforcement
technique
- commonly used in MR and
behavioral problems
 RELAXXX

1. 7 months of the year

have 31 days; how many
have 28 days.
a. 12
b. 3
c. 1
d. 9
 INTERPERSONAL MODEL
Proponents: Harry Stack Sullivan and
Hildegard Peplau.

• Behavior evolves around interpersonal

relationships.

• Psycho analytic theory emphasis a

person’s intra psychic experience and
interpersonal theory emphasis
interpersonal experience.
 Sullivan’s concepts
• Anxiety: feeling of emotional
discomfort.
• Self-system: collection of
experiences adopted by the individual
to protect against anxiety.
• Satisfaction of needs: fulfillment of
all requirements eg: oxygen, water.
• Interpersonal security: It is the
feeling associated with relief from
anxiety.
 SULLIVAN’S INTERPERSONAL MODEL OF
PERSONALITY DEVELOPMENT
AGE STAGE DESCRIPTION

Birth to 18 Infancy Rely on caregivers to

months meet needs & desires
18 months Childhood Learning to delay immediate
-6years need for
gratification of needs &desires
6-9years Juvenile Fulfilling peer relationship

9-12years Preadolescence Relate successfully to same

sex peers
12-14years Early adolescence Learns to be independent
&forms relationship with
opposite sex
14-21 years Late adolescence Establishes an intimate,
long –lasting relationship
with someone of the opposite
sex
 Contd….
Peplau’s interpersonal nursing roles:

• Stranger
• Resource person
• Teacher
• Leader
• Surrogate
• Counselor
 Role of patient and Nurse
• Nurse as a ‘participant observer’
• Establish trust and empathizes.
• Patient shares his concerns with
the nurse.
• Nurse provides an atmosphere
of uncritical acceptance and the
patient speaks out openly.
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THANK YOU