Therapeutic Models &

Its Relevance To Nursing Practice

Raymund Christopher R. Dela Pena, MAN, RN, RM

Assistant Professor II, College of Nursing
University of Northern Philippines
 PSYCHOANALYTICAL MODEL
(or Psychodynamic Theory)

 By Sigmund Freud;

 Emphasizes unconscious processes or psychodynamic factors as the

basis for motivation and behavior;

 He believed that repressed (driven from conscious awareness) sexual impulses

and desires motivate much human behavior.

 Personality is developed by early childhood; 2

Personality Components/Processes
 LEVELS OF
CONSCIOUSNESS
 Defense Mechanisms

o Psychological strategies that are unconsciously used to

protect a person from anxiety arising from unacceptable
thoughts or feelings.

o Involves a distortion of relaity in wome way so that we are

better able to cope with a situation.
 DEFENSE MECHANISMS

REPRESSION
Unconscious and involuntary forgetting of painful
ideas, events and conflicts.

A nursing student who failed the recent board exam, can’t remember any of the
questions asked.

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DEFENSE MECHANISMS

DENIAL
Unconscious refusal to admit an unacceptable idea or behavior.
Sometimes mistaken for rationalization.

“I’m not drunk… I can still drive…”

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Alcoholics
Battered wives
DENIAL
Anorexia nervosa
Drug dependents

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DEFENSE MECHANISMS

RATIONALIZATION
Attempts to make or prove that one’s feelings or behaviors
are justifiable.

A student states, “I failed the recent board exam

because there was a leakage and it doesn’t had any
credibility.”

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DEFENSE MECHANISMS

IDENTIFICATION
A conscious or unconscious attempt to model oneself after a respected
person.

“I want to be just like you… a very good reviewer …… nurse….”

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DEFENSE MECHANISMS

INTROJECTION
Unconsciously incorporating wishes, values, attitudes of others as if
they were your own.

While her mother is gone, a young girl disciplines her brother just like her mother would.

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DEFENSE MECHANISMS

COMPENSATION
Covering up for a weakness by overemphasizing
or making up a desirable trait.

An academically weak high school student was sworn as the new president of
the supreme SC.

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DEFENSE MECHANISMS

REACTION FORMATION
A conscious behavior that is the exact opposite of an unconscious
feeling.

An older brother who dislikes his younger brother sends him gifts for every holiday.

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DEFENSE MECHANISMS

SUBLIMATION
Channeling instinctual drives into acceptable activities.

A former NPA hitman, talks about the importance of life, democracy, justice, and following laws of the land.”

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DEFENSE MECHANISMS

DISPLACEMENT
Discharging pent-up feelings to a less threatening object.

After the board exam, Andy went directly to his room and smashed his reading table.

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DEFENSE MECHANISMS

UNDOING
Doing something to counteract or make up for a transgression or
wrongdoing.

After hitting his wife, Venicio offered jewelries and money to her.

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DEFENSE MECHANISMS

PROJECTION
Blaming someone else for one’s difficulties or placing one’s
unethical desires on someone else.
Involves in the development of DELUSIONS;

A nursing graduate blamed a dean of a nursing school in Recto for not passing the nursing exam.

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DEFENSE MECHANISMS

REGRESSION
Return to earlier and more comfortable developmental level.

An examinee went directly to her room and sleeps in fetal position and thumb
sucks after knowing she failed the board exam……..…… for physicians.

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 PSYCHOSOCIAL MODEL

 or Developmental Model;

 Spans the total life cycle from birth to death;

 Each stage of development is an emotional crisis involving positive and

negative experiences;

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Erik Erikson’s Psychosocial Development
 Harry Stack Sullivan’s
Interpersonal Psychodynamic 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.

 Peplau went on to form an interpersonal model emphasizing the need for a

partnership between nurse and client as opposed to the client passively receiving
treatment and the nurse passively acting out doctor’s orders.
Hildegard Peplau Interpersonal Relations
Jean Piaget's Theory of Cognitive Development

 Suggests that children move through four different stages of mental

development.

 Focuses not only on understanding how children acquire knowledge,

but also on understanding the nature of intelligence.