NUR2459- Concept Guide- Module 1-3
Module 1: Foundations for Psychiatric/Mental Health Nursing
How has our understanding of mental health evolved over time?
18th Century begins to establish state asylums.
1802-1887 Dorothea Dix devoted her life to reform the treatment of the mentally ill.
1882 Frist school of psychiatric nursing.
1950’s (early) the use of Phenothiazine (Thorazine) was discovered to help control behaviors and improve/clear thinking.
1950’s 600,000 were residents in mental institutions.
1960’s Began deinstitutionalization. Discharged of patients from state mental hospitals back to the community (treatment
was inhumane, hope medication was a cure, lack of funding)
1970’s Maslow’s hierarchy of needs of psychological needs was created.
1909-1999 Hildegard Peplau established the nursing theory of interpersonal relationships.
, NUR2459- Concept Guide- Module 1-3
Identify styles of therapy- understanding the focus on the therapy.
Behavioral therapy - This is a form of psychotherapy. The goal is to modify maladaptive behavior patterns by reinforcing
adaptive behavior. (good for phobias)
Systematic desensitization is a technique for assisting individuals to overcome their fear of a phobic stimulus.
It is “systematic” in that there is a hierarchy of anxiety-producing events through which the individual
progresses during therapy. An example of a hierarchy of events associated with a fear of elevators may be as
follows:
1. Discuss riding an elevator with the therapist.
2. Look at a picture of an elevator.
3. Walk into the lobby of a building and see the elevators.
4. Push the button for the elevator.
5. Walk into an elevator with a trusted person; disembark before the doors close.
6. Walk into an elevator with a trusted person. Allow doors to close, then open the doors and walk out.
7. Ride one floor with a trusted person, then walk back down the stairs.
8. Ride one floor with a trusted person and ride the elevator back down.
9. Ride the elevator alone.
Key Points to Behavior Therapy
■ Today’s principles of behavior therapy are based on research conducted by Pavlov and Skinner.
■ Pavlov introduced a process that came to be known as classical conditioning.
■ Skinner, in his model of operant conditioning, gave additional attention to the consequences of the response as an
approach to learning new behaviors.
■ Skinner believed that the connection between a stimulus and a response is strengthened or weakened by the
consequences of the response.
■ Various techniques for modifying client behavior include the following:
■ Shaping: A technique in which reinforcements are given for increasingly closer approximations to the desired
response
■ Modeling: The learning of new behaviors by imitating the behavior of others
■ Premack principle: The concept that a frequently occurring response can serve as a positive reinforcement for a
response that occurs less frequently
■ Extinction: The gradual decrease in frequency or disappearance of a response when the positive reinforcement is
withheld
■ Contingency contracting: A contract specifying a specific behavior change and the reinforcers to be given for
performing the desired behaviors
■ Token economy: A type of contingency contracting in which the reinforcers for desired behaviors are presented in the
form of tokens
■ Time-out: An aversive stimulus or punishment during which the client is removed from the environment where the
unacceptable behavior is being exhibited
■ Reciprocal inhibition: A technique that decreases or eliminates a behavior by introducing a more adaptive behavior
that is incompatible with the unacceptable behavior
■ Overt sensitization: A type of aversion therapy that produces unpleasant consequences for undesirable behavior
Module 1: Foundations for Psychiatric/Mental Health Nursing
How has our understanding of mental health evolved over time?
18th Century begins to establish state asylums.
1802-1887 Dorothea Dix devoted her life to reform the treatment of the mentally ill.
1882 Frist school of psychiatric nursing.
1950’s (early) the use of Phenothiazine (Thorazine) was discovered to help control behaviors and improve/clear thinking.
1950’s 600,000 were residents in mental institutions.
1960’s Began deinstitutionalization. Discharged of patients from state mental hospitals back to the community (treatment
was inhumane, hope medication was a cure, lack of funding)
1970’s Maslow’s hierarchy of needs of psychological needs was created.
1909-1999 Hildegard Peplau established the nursing theory of interpersonal relationships.
, NUR2459- Concept Guide- Module 1-3
Identify styles of therapy- understanding the focus on the therapy.
Behavioral therapy - This is a form of psychotherapy. The goal is to modify maladaptive behavior patterns by reinforcing
adaptive behavior. (good for phobias)
Systematic desensitization is a technique for assisting individuals to overcome their fear of a phobic stimulus.
It is “systematic” in that there is a hierarchy of anxiety-producing events through which the individual
progresses during therapy. An example of a hierarchy of events associated with a fear of elevators may be as
follows:
1. Discuss riding an elevator with the therapist.
2. Look at a picture of an elevator.
3. Walk into the lobby of a building and see the elevators.
4. Push the button for the elevator.
5. Walk into an elevator with a trusted person; disembark before the doors close.
6. Walk into an elevator with a trusted person. Allow doors to close, then open the doors and walk out.
7. Ride one floor with a trusted person, then walk back down the stairs.
8. Ride one floor with a trusted person and ride the elevator back down.
9. Ride the elevator alone.
Key Points to Behavior Therapy
■ Today’s principles of behavior therapy are based on research conducted by Pavlov and Skinner.
■ Pavlov introduced a process that came to be known as classical conditioning.
■ Skinner, in his model of operant conditioning, gave additional attention to the consequences of the response as an
approach to learning new behaviors.
■ Skinner believed that the connection between a stimulus and a response is strengthened or weakened by the
consequences of the response.
■ Various techniques for modifying client behavior include the following:
■ Shaping: A technique in which reinforcements are given for increasingly closer approximations to the desired
response
■ Modeling: The learning of new behaviors by imitating the behavior of others
■ Premack principle: The concept that a frequently occurring response can serve as a positive reinforcement for a
response that occurs less frequently
■ Extinction: The gradual decrease in frequency or disappearance of a response when the positive reinforcement is
withheld
■ Contingency contracting: A contract specifying a specific behavior change and the reinforcers to be given for
performing the desired behaviors
■ Token economy: A type of contingency contracting in which the reinforcers for desired behaviors are presented in the
form of tokens
■ Time-out: An aversive stimulus or punishment during which the client is removed from the environment where the
unacceptable behavior is being exhibited
■ Reciprocal inhibition: A technique that decreases or eliminates a behavior by introducing a more adaptive behavior
that is incompatible with the unacceptable behavior
■ Overt sensitization: A type of aversion therapy that produces unpleasant consequences for undesirable behavior
