GOVERMENT COLLEGE OF NURSING

BILASPUR (C.G.)

SESSION - 2020-2021

SUBJECT - MENTAL HEALTH NURSING

ASSIGNMENT ON -

“INDIVIDUAL THERAPY”

SUBMITTED TO - SUBMITTED BY-

Ms Kundan Khalkho Nikita Nelson
Asst. Professor MSc (N) 1st Year
Mental Health Nursing
INTRODUCTION-

Individual psychotherapy is a method of bringing about change in a person by exploring his or her
feelings , attitudes,thinking and [Link] a nurse provides individual psychotherapy, the nurture is
functioning as a therapist .
Therapy is conducted on a one-to-one basis that is the therapist treats one patient at a time. Patient
generally seek this kind of therapy based on their desire.

Such therapy helps in-

-Understand themselves and their behaviour

-Make personal change.
-Improve interpersonal relationship
-Get relief from emotional pain or unhappiness.

DEFINITION -

It is a form of therapy that deals with conscious conflicts and current problems.

Psychotherapy is the use of psychological methods, particularly on the based on regular personal
interactions with adult, to help a person change behavior and overcome problems in desired ways.

Individual psychotherapy is a method of bringing about change in a person by exploring his or her feelings,
attitude, thinking and [Link] is a process of meeting with therapist to assist a person in dealing with
symptoms or problems a person having.

INDICATIONS-

 Stress related disorders.

 Alcohol and drug dependency.
 Sexual Disorders
 Marital disharmony.
 Mild to moderate major depression
 Mild to moderate anxiety disorder
 Crisis , acute distress or acute adjustment disorder.
 Obesity and eating disorders.

GOALS -
 Remove or modify existing symptoms.
 Mediate disturbed pattern of behaviour.
 Promote positive personality growth and development.

THERAPY PROCESS-

[Link] STAGE
[Link] STAGE
[Link] THROUGH STAGE
1. INTRODUCTORY STAGE -

In the introductory stage client and therapist meet and bring to work [Link] stage usually involves
history of the client’s life, including any medical problems and current medications. If the client is a
referral , the therapist may already have the information.
The exploration of the client’s background and problems will include any precipitating factors
or events that led the client to seek help.
The client and the therapist also begin to form some ideas about each other regarding personality
and [Link] there is mutual respect and liking and whether they can work together and to be
invested emotionally in the task of therapy is known as Treatment Alliance

2. .WORKING STAGE-

In the working stage of theory the client is able to become more trusting, to disclose and to begin exploring
with the therapist the thoughts,feelings and behaviour, that lead to the pain or problems. Today the whole
process may be completed in 20 sessions.
Increased trust allows the client to experience grater recall and insight and to express previously
repressed [Link] the client understands and function more effectively, the last stage of working through
is reached.

3. WORKING THROUGH STAGE -

In the final stage of therapy the working through stage, the client achieves a higher level of understanding
or the self and relationships with the other and begins to try out new ways of perceiving, thinking, feeling
and behaving. The client may need a great deal of support and encouragement during this stage and may
rework emotional material more than one time
.the qualities are so powerful in our personal lives are also the qualities that are effective in therapy.
In therapy there are two people the client and the [Link] client is in confliction a process of growth and
change and is experiencing through pain or discomfort to cause awareness of a need for help.

APPROACHES/INDIVIDUAL PSYCHOTHERAPIES--

1. PSYCHODYNAMIC THERAPY
2. HUMANISTIC THERAPY
3. BEHAVIOUR THERAPY
4. COGNITIVW THERAPY
5. HYPNOSIS
6. ABREACTION
7. REALITY THERAPY
8. SUPPORTIVE THERAPY

1. PSYCHODYNAMIC THERAPY-
The psychodynamic theory is a psychological theory Sigmund Freud (1856-1939) and his later followers
applied to explain the origins of human behavior.
The psychodynamic approach includes all the theories in psychology that see human functioning based upon
the interaction of drives and forces within the person, particularly unconscious, and between the different
structures of the personality.
Psychodynamic theory states that events in our childhood have a great influence on our adult lives, shaping
our personality. Events that occur in childhood can remain in the unconscious, and cause problems as adults.
Personality is shaped as the drives are modified by different conflicts at different times in childhood (during
psychosexual development).
Psychodynamic theory is strongly determinist as it views our behavior as caused entirely by unconscious
factors over which we have no control.
Unconscious thoughts and feelings can transfer to the conscious mind in the form of parapraxes, popularly
known as Freudian slips or slips of the tongue. We reveal what is really on our mind by saying something
we didn't mean [Link] believed that slips of the tongue provided an insight into the unconscious mind and
that there were no accidents, every behavior (including slips of the tongue) was significant (i.e., all behavior
is determined).
Psycho dynamic theory primarily based on psychoanalytic theory,the assumption that when a patient has an
insight into an early relationship and experiences as the source of his or her problems they can be resolved.

2. HUMANISTIC THERAPY -

Tthis therapy started in 1950. the focus of psychology should not be on observational behaviour and how it
can be manipulated.

Humanistic therapy centers on the on the patient’s view of the world and his or her [Link]
goal is to help patients realize their full potential through the therapist’s genuineness, unconditional positive
regard, which fosters the patient’s sense of self worth and empathetic understanding for the patient’s point of
view
. This therapy is non directive but focuses on helping the patient to explore and clarify his or her own
feelings and choices.
Humanistic psychology is a perspective that emphasizes looking at the the whole person, and the
uniqueness of each individual. Humanistic psychology begins with the existential assumptions that people
have free will and are motivated to acheive their potential and self-actualize.

3. BEHAVIOR THERAPY -
Behaviorism is concerned primarily with the observable and measurable aspects of human behavior.
Therefore when behaviors become unacceptable, they can be unlearned. Behaviorism views development as
a continuous process in which children play a relatively passive role.

Behavior therapy does not foster awareness but emphasis the principles of learning with
positive or negative re enforcement and observational modeling. It is a form of treatment for problems in
which a trained person deliberately establishes a professional relationship with the patient, with the objective
of removing or modifying existing symptoms and promoting positive personality, growth and development.

Behavior Techniques -

 Systematic desensitization -
 It is developed Joseph Wolpe
 Relaxation training; Relaxation produces physiological effects opposite to those of anxiety
 Hierarchy construction; 10 - 12 condition in order of increasing anxiety
 Desensitization to stimulus; Gradually exposure of individual from least to most anxiety provoking
situation in a deeply relaxed state.
 It is suitable for -
1. anxiety disorder
2. Phobic anxiety disorder
3. Obsessive Compulsive disorder
4. Certain sexual disorder

 Flooding
 Exposing the individual directly with the situation
 Based on the principles that escaping from anxiety reinforces the anxiety through conditioning
 Prematurely withdrawing from the situation may reinforce the phobia.
 Not suitable for the client with the heart diseases and fragile psychological adaptation.

 Aversion Therapy
 When a noxious stimulus (punishment) is presented immediately after a specific behavioral response,
theoretically, the response is eventually, the response is eventually inhibited and extinguished.
 Types of noxious stimulus-
1. Electric shock
2. Substance that induces vomiting
3. Coporal punishment
4. Social disapproval

Aversion therapy is suitable for-

-Alcohol abuse
-Paraphilias
-Impulsive and obsessive behavior

 Shaping -
 A method of training by which successive approximation towards a great behaviour are reinforced.
 Shaping or behaviour shaping is a variant of operant conditioning. Instant for waiting for a subject to
exhibit a desired behaviour any behaviour leading to the target behaviour is rewarded.
 Speech therapy in autistic child is suitable.

 Time out-
 Time put is a aversion stimulus or punishment during which the client is removed from the environment
where the unacceptable behaviour is being exhibited.
 The client is usually isolated so that reinforcement from attention of others is absent.
 This is often used in childhood disorders.

INDICATIONS OF BEHAVIOUR THERAPY-

 Obsessive compulsive disorder

 PTSD
 Depression
 Social phobia
 Bipolar disorder
 Schizophrenia
 Autism
 Personality disorder
 Substance abuse
 Eating disorder
4. COGNITIVE THERAPY - Cognitive therapy focuses on identifying and correcting disorted thinking
thinking patterns that can lead to emotional distress and problem behaviors.

Cognitive therapy is a psycho therapeutic approach based on the idea that behavior is secondary to thinking.
It focuses on how patients think about themselves and their world, make changes in current ways of thinking
and behavior.
Patients are taught problem solving skills and stress reducing methods they learn that there
psychological difficulties can be solved through cognitive processing.

 INDICATIONS-
 Depression
 Anxiety disorder
 Panic disorder
 Phobias
 Anticipatory anxiety
 For teaching problem - solving method

 DURATION OF COGNITIVE THERAPY-

Atypical cognitive therapy schedule consist of about 15 visits over a three month period.

5. HYPNOSIS -

Hypnosis is a superficial or deep trance (a somnolent state/sleep like) resembling [Link] induced in a
patient by suggestions of relaxation & concentrating attention on a single [Link] client becomes highly
suggestible, submissive.

He can be induced to recall forgotten events,becomes insensitive to pain, gain relief from tension,
anxiety & other psychological symptoms. It affects behavioral change & control of attitude .The person
becomes highly suggestible to the commands of the [Link] is an ability to produce or remove
symptoms or [Link] of a part of the body or emotions.

This therapy is used in- smoking, overeating, ab reaction of past experiences, psychosomatic
disorders,conversion & dissociate disorders,habit disorder & anxiety disorder or other addiction disorder.

6. ABREACTION THERAPY -

Abreaction is a process by which repressed material, particularly a painful experience or conflict is brought
back to consciousness. The person not only recalls but also relieves the material, which is accompanied by
the appropriate emotional response. It is most useful in acute neurotic conditions caused by extreme stress.

Abreaction can be brought about by strong encouragement to relieve the stressful events.
The procedure is begun with neutral topics at first, & gradually approaches area of conflict. Abreaction can
be done with or without the use of medication.

7. REALITY THERAPY - This is a psycho therapeutic technique which focuses on the present behavior
& development of patient’s ability to cope with the stress of reality & take a greater responsibility for the
fulfillment of his needs.

To achieve these purposes the therapist becomes involved in an active relationship with patient,
rejects his unrealistic behavior & teaches better ways to meet his need in the real [Link] patient needs to
be stressed on that the past cannot be changed, so he must take responsibility of right or wrong actions of
present.
8. SUPPORTIVE THERAPY - It is a form of “surface therapy”.The therapist helps the patient to relieve
emotional distress & symptoms without probing in to the past or attempting to change or alter the basic
personality of the individual.
The therapist reinforce the existing defenses used by the client & utilizes various techniques
such as -

-Ventilation,
-Environmental Modification or Manipulation,
-Reeducation,
-Reassurance,
-Ab reacting
-Explanation,
-Suggestion,
-Reinforcement,
-Recreation,
-Work as therapy.
-Relaxation.

ADVATAGES AND DISADVANTAGES OF INDIVIDUAL PSYCHO THERAPY

ADVANTAGES DISADVANTAGES
1. Can be set up quickly 1. Client can talk but not make any real changes
2. Patient with a trained professional to talk to 2. Some clients don’t have interest in talking
3. Helps define the problem the client is having about their problems.
4. Improves communication skills 3. May not provide enough help for the severity
5. Teaches better way to cope of problems.

ROLE OF NURSE -

-Reinforce positive behaviour.

-Co-ordinate with other team members.

-Allow patient to take decision.

-Explain about the treatment.

-Develop a trusting relationship.

-Set limits on unexpectable behaviour.

CONCLUSION -
Individual psychotherapy is a method of bringing about change in a person by exploring his or her feelings ,
attitudes,thinking and [Link] is a form of therapy that deals with conscious conflicts and current
problems.
Goals are to Remove or modify existing [Link] disturbed pattern of
[Link] positive personality & growth and development.
BIBLIOGRAPHY-

1. [Link] Indra Kumar, “A Textbook Of Psychiatry & Mental Health Nursing” , EMMESS,First
Edition 2014,Page no - 21-34

2. Dr Bimla Kapoor, Textbook Of Psychiatric Nursing Volume-II, Kumar Publishing House, First
Edition,Page no - 114

3. Fontaine-Fletches Mental Health Nursing Person Education ,Fifth Edition, Page no-322-325

4. Katherine M Fortinan,Patrica [Link], Psychiatric Mental Health Nursing”,Mosby, Third Edition,

Page no - 238

5. Mary [Link],Essentials Of Psychiatric Mental Health Nursing” [Link] Company ,Fourth

Edition, Page no -112

Website-

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