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There are many theories which underpin health and social care practice. The most of them is humanistic theory, focusing in particular areas rather than addressing holistic requirements where those practice is dealing with people with different vulnerabilities, different age group, different inherited and nurtured intellectuality, natural disability and or accidental, old age or circumstantial trauma, etc., and their varied needs. This newsletter will explain couple of those relevant to the need of health care professional and its service users with the benefits of its applications including my care setting.
In general in my health care, by knowing and analyzing those theories – the management can make their plan and reform existing practices in line with the theories to achieve its goal to provide better service to users (Straus, Tetroe, and Graham, 2013), health professional and care workers can gather knowledge about various aspect of human needs (Maslow’s 1970) and users desire (Gramet, Jacobs, and Sopczuk, 2010), in differential stages of cognitive development (Piaget’s theory), dealing with users of various behavioral characteristics and environmental conditionings (Behaviorists theory, Watson’s 1913), as these are very helpful to turn works positive attitude towards users and the effectiveness of their work.
For details, some theories presented below quoting its main contents which is self-explanatory to show its adaptable and relevant aspects by which the provider, its professionals & workers and service users are and will be benefited greatly and continuously.
Following ‘Humanistic theory’ is about the basic need of human being which match closely with the principle of practice including person-centred approach of my care setting and other health and Social Care Practice. Therefore, I am quoting it’s outlined contents without any compromise. By learning this theory, I recognized that we (prover, workers) can still improve our practice further taking the unrecognized areas of need of our service users. Users will get their required need fulfilled.
Humanistic theory is a theory that focuses on you and your experiences.
Maslow’s (1970) hierarchy of needs is a motivational theory, it is his look at what motivates people to do the things that they do to behave the way they behave. The five hierarchy of need are:
Psychological needs: food, water, air, shelter and sleep.
Safety needs: security, order, law, stability and freedom.
Love and belongingness needs: friendship, sex, acceptance, and receiving and giving affection.
Esteem Needs: self-respect, respect from others, status, prestige and achievement. Self-actualization needs: self-fulfillment and personal growth.
Individuals who have their basic needs and well as their safety and security needs provided and belong to a social network where they are loved, respected and supported are likely to have a high self-esteem and confidence to develop to their maximum potential.
Humanistic psychology makes us to understand Human development according to how the ‘Self’ develops. ‘Self’ in terms of either one is short, hardworking, shy, engineer or child minder. There two types of self-esteem which are low and high. Individuals with low self-esteem have the tendency to lose their confidence and feel unaccepted in the society if their expectations are not met. People with high self-esteem have faith in themselves and trust their own judgment.
Abraham Maslow and Carl Rogers are both known for this humanistic psychology. These two theorists believe that all human being is practically good and healthy. So therefore, human being should be treated well (ref). Assumption should not be made about any individual.
Carl Rogers also talk about Ideal self which means setting realistic goals in life.
Health and social care settings are supposed to provide the basic, safety and facilitate the social needs of service users. This will help improve their self-esteem and confidence and will ultimately help them develop to their maximum potential
Other most useful theory in relation to health and social care practice is the following, ‘Cognitive-Developmental Theory’. In this theory Jean Piaget tell us about personality development and its stages over the age ranges. In my care setting managers, workers and professional can learn a lot about the cognitive development and functioning (Piaget showed his more interest about functioning) of users, how their understanding, process information, thinks, memories & reflect, come up with ideas, how knowledge grows, how they learn from others around them, how that influence their mental structure, they’re over all progress through all stages regardless of environmental influences. By learning this manager can improve his plan to address the need of users, help-built workers to perform better and care worker can use their knowledge to deal with users appropriately.
Piaget’s Cognitive-Developmental Stages:
Sensorimotor development (0-2 years) The infant exercises rudimentary sensory (seeing touch, hearing, tasting, smelling) and motor (kicking, punching, moving around, hitting objects) awareness and functions almost exclusively by means of reflexive responses. The child cannot think abstractly.
Preoperational thought (2-7 years) The child demonstrates an increase in language abilities and concepts become more elaborate. However, the child can only view the world from its own perspective. Their intellectual state is immature.
Concrete operations (7-11 years) The ability to consider the viewpoints of others and understand relational concepts is evident. However, the child cannot solve problems of an abstract nature.
Formal operations (11-15) Abstract thinking is now possible and scientific problem-solving strategies emerge.
• Ego Integrity & Despair
Occurs during late adulthood (65+) when they become senior citizens and retire, a time for them to think back on everything they accomplished. If they weren’t able to achieve it they might end up in despair and it can lead to depression (Maslow 1943).
Managing loss and change
How do individuals manage loss and change? Humanistic psychologists would approach this type of hurt from the viewpoint of how the individual will perceive the meaning of the self of separation and loss. Ex if the large part of a parent’s self-concept is associated with being a parent, when the child leaves home they will see it as a very devastating experience.
Is the belief that your future is fixed or determined either by your genetic inheritance or by your social environment and experience.
Nature: This account of behaviour and personality development focuses on what we are born with. This include characteristics like Left-handedness, intelligence, susceptibility to certain illnesses, temperament (shy, withdrawn, or outgoing and confident)
Nurture: refers to all that happens within the environment. It involves the way someone is brought up and the way they are treated by parents, teachers and peers. All these influence behaviour and development and goes towards building a personality.
The nature-nurture debate can be illustrated further by looking at intelligence and gender.
Among the theories of about behavior, Behaviorist theory is more relevant to health and social care practice. In this theory, strict behaviorists believe that any person can potentially be trained to perform any tasks regardless of their genetic background personality traits and internal thoughts; it only requires the right conditioning (Watson’s 1913).
There are two types of conditioning in behaviorisms.
Health and social service practice deals with clients with such conditions and people need training to improve their physical, mental health and occupational capacity. My care settings training plan can be improved to consider those in place for the greater benefit of the users and encourage workers to understand and work according this plan based on Behaviorists theory.
Classical conditioning happens when a natural reflex responds to a stimulus and operant conditioning, which is a method of learning that occurs through reinforcements and punishments.
Behaviorisms was first established in the 1993 publication of JB Watson ‘s classic paper, “Psychology as behaviorists see it”. The following quote from Watson best sums it up. “Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I’ll guarantee to take any one at random and train him to become any type of specialist I might select—doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors.”
Erik Erikson (1959) talks about Psychological stages; his ideas were mostly influenced by Freud’s (1923) theory. Erikson was an ego psychologist; he talked about the role of culture, society and the problems that can occur within the ego itself. Erikson (1959) theory of psychosocial development has eight stages, like Freud, he thought that a crisis happens at each stage of development.
For Erikson these crises are of psychosocial nature because they involve the individual’s psychological and social development
Erikson’s psychosocial theory can be applied to understand the clients from psycho background to improve their condition, this is an area where health and social care professional struggling.
We have Basic Trust Vs basic mistrust 0-1years). Child will develop trust if a proper care and love is given and vice-versa.
Autonomy Vs doubt (1-3 years): A child will explore the world if given an opportunity, he/she will grow with confidence but if the opportunity is not given, the child will have doubt about their abilities
Initiatives Vs Guilt (3-5 years): at this stage, a child starts to assert control over his/her world through social interaction and he/she feels capable if this is achieved but a child that is unable to achieve this will be left with a sense of guilt and lack of initiative.
Industry and inferiority (6-11 years): at this stage, children are always eager to feel gadgets, they are curious about how things work, this will boost a sense of control, a guideline and a strong perceptive of the environment.
Identity and role confusion (adolescence): if an adult decline to bring about a feeling of uniqueness in a child, this may lead to desolation, incomplete and mistrust.
The last three stages of this theory happen in adulthood.
Intimacy Vs isolation (young adulthood): At this stage, the young adult is expected to have purposeful relationships with others morally, emotionally and sexually. If this does not happen, it will result to desolation.
Generativity Vs self-absorption (middle adulthood): In this, the adult is keen to reveal his/her worries to others, but self-absorbed person will be engaged in worldly gain and their contented state.
Integrity Vs despair (old age): person with sense of integrity have already fixed psychosocial crises, looking back at their lives with pride, contentment and peace of mind. A person in despair will have dashed hopes, depression and pain due to lack of integrity.
Based on these theories, individuals behave differently towards similar situations such as change and stress. Health and social care personnel can use this to understand our clients better and empathize with them. A psychotherapist cans device suitable treatment for individuals who still have unresolved conflicts at earlier stages of their psychosocial development.
Psychologists have used classical conditioning and operant conditioning to study behaviorisms. Operant conditioning uses the system of reward for good behaviour and punishment for bad behaviour. This can be applied in educational and health and social care settings to encourage service users to behave appropriately. For example, we can give them tokens, for good behavior and let them know what is wrong so that they do not repeat undesirable behaviours.
Social Cognitive theory
Revolves around an individual’s thoughts; which determine their behaviour, emotion and eventually their personality. As Albert Bandura (1963) said, children observe people around them that can influence their behaviour, such as: parents, family, TV characters, friends in their peer group and teachers at school.
They pay attention to these people and learn their behaviour, at a later time they may copy the behaviour they observed and it’s more likely the child will follow the behaviour the society deems appropriate for its sex.
Also, there is social learning theory which is known as observational learning developed by Albert Bangura. These theories state that watching and copying people around you can change the way you behave either good or bad (ref). children in particular learn by copying others in their environments.
The Nature-Nurture debate have also been used to describe why individuals behave the way they do. Nature focuses on human development, intelligence and behaviours which are genetically inherited; this makes you who you are. Whereas Nurture is about what we possess as a result of our interaction with our environment and how we have been treated in the past either by friends, family, teachers and parents etc. (ref).
Some people belief that you cannot do anything about your life that everything is fixed.
With Choice and interaction, one can be born into a royal family or born rich yet choose to go on drugs. Another important theory that underpins HSC is psychoanalytical theory proposed by Sigmund Freud and colleagues. Psychoanalytical theory can be used to bring back underlying unconscious information in individuals. For instance, if a child grows up in a family that is involved in crime, there is a possibility of him being a criminal when he becomes an adult. Erikson theory is based on the psychoanalytic approach to human development founded by Sigmund Freud and it is in eight stages.
Health and social care professionals and other users are encouraged to read more popular theories as the above are not a complete set of theories to cover all aspects and those are the theories I prefer and felt relevant which may not be the choice of there. At the same time, I have tried to demonstrate the application as I consider it best for my care setting, which may be different for the practice in other health and social care organization depending on their own need and understanding the purpose of individual theory. However, I will feel happy if any service provider, health professional, care manger, care worker, service user & their family and stakeholder are benefitted reading this Newsletter.
Watson JB, 1993
Gramet, Jacobs, and Sopczuk, 2010
Piaget J, 1896-1980
Erikson E, 1959
Freud S, 1923
Bangura A, 1977
Carl R, 1902-1987, McLeod S, 2014
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