Theories and Therapies in Mental Health Nursing

Healthcare professionals can use theories to understand human development and behavior. Theories can also provide a framework for planning individualized care for patients and to guide the application of therapies to treat individuals with mental health disorders.

Now, an early developmental theory about human behavior was developed by Sigmund Freud, called psychoanalytic theory. This theory is based on the idea that a person’s behaviors are influenced by their unconscious thoughts.

Freud also developed the theory of psychosexual development, comprised of 5 stages from infancy to adulthood that explains how emotional disturbances are rooted in failure to progress through each stage.

For example, a child aged 0 to 1 year is in the oral stage. During this stage, an infant finds pleasure and satisfaction through feeding and sucking.

The child also begins to recognize their parent or caregiver as separate from themselves, and any disruption in the availability of the parent or caregiver could impair the child’s development, resulting in maladaptive behaviors later in life.

Other developmental theories propose alternate ways to explain human development. Jean Piaget proposed a theory of cognitive development, which looks at how children develop their thinking and make sense of their world.

According to Piaget, children's development occurs in four distinct stages from birth to age 15. For example, during the concrete operations stage from age 8 to 11, children develop an understanding of the world in terms of words, numbers, and time.

They also begin to use logic to understand principles like cause and effect, as well as size and difference; which allows the development of skills like arranging their toys according to their common or different characteristics, like color or shape.

A learning disability or mental health disorder may be present if a child does not progress through the stages of cognitive development as expected.

Another developmental theory is Erik Erikson's theory of psychosocial development which focuses on aspects of human development, such as personality, thinking, and behavior.

Erikson described eight stages, from infancy to adulthood, comprised of opposing conflicts that must be resolved for successful development to occur.

For example, in the third stage, initiative versus guilt, which occurs between 3 to 6 years, preschoolers experience a desire to assert control over their environment and interactions with others.

As they learn to initiate activities, plan goals, and successfully master tasks, they develop self-confidence and a sense of initiative.

On the other hand, a lack of praise for the child’s efforts, harsh control, or being overly critical of mistakes or messiness can impair the development of initiative, resulting in a sense of guilt.

Moving on, humanistic theories view humans holistically, and emphasize the positive aspects of humanity. As an example, Abraham Maslow proposed that human behavior is shaped by the drive to fulfill human needs, which he identified and arranged in a pyramid.

Maslow’s Hierarchy of Needs ranks basic physiologic needs, like air, food, shelter, and sleep at the bottom, and more advanced needs, such as self-esteem and self-actualization, closer to the top.

In most situations, people must meet the needs at the bottom of the hierarchy before meeting needs at the top, and if these needs go unmet, illness can develop.

Finally, there are biobehavioral theories, like the General Adaptation Syndrome developed by Hans Selye, which describes how the body responds and adapts to physical and psychosocial stress.

There are three stages, including alarm, when the body triggers the fight-or-flight response, resulting in increased respiratory rate, heart rate, and blood glucose; resistance, when the body attempts to stabilize and adapt to the stressors; and lastly, if stress is overwhelming or long-lasting, the exhaustion stage occurs, when the body’s attempt to adapt starts to fail, energy levels become depleted, and death may occur.

Now, mental health disorders can be treated through therapies like psychotherapy, which uses discussion and education to treat mental disorders.

These include individual therapies, or therapies where a patient meets one-on-one with a therapist; or group therapies, which allow for the treatment of several patients at once.

During individual therapy, cognitive therapy is used to help patients change their irrational or unhelpful thinking patterns and beliefs, and is typically used to treat depression, anxiety, and family or interpersonal conflicts.

Behavioral therapy, on the other hand, helps to change maladaptive behaviors by reinforcing positive behaviors, and can be useful in treating mental illnesses, like bipolar disorder or substance use disorders, as well as developmental disabilities.

During group therapy, patients benefit from receiving positive feedback, discovering similarities with others, and building shared hope.

One type of group therapy is self-help groups, where patients facing similar issues, like substance use, grief, or disability share experiences and provide each other with emotional support.

Psychotherapy can be used alone or combined with somatic therapies, which are focused on treating the body. Somatic therapies can include electroconvulsive therapy, or ECT, which can be used to treat severe depression; and pharmacotherapy which treats disorders through medications that alter neurotransmitter activity.

Alright, as a quick recap… Healthcare professionals can use theories to understand human development and behavior. Theories can also provide a framework for planning individualized care for patients and to guide the application of therapies to treat individuals