Psychology for Health and Social Care

The aim of this essay is to explore my understanding of the psychological factors which influence human behaviours and the effects these factors may have on individuals who use health and social care services. I will focus on the basic approaches such as behavioural, cognitive, humanistic and psychodynamic to understand these behaviours. I will also use concepts from psychology and sociology to understand those individuals. I will also explain and determine the professional practice underpinned to enable service providers to enhance and maintain the social functioning or valued roles in service provision of health and social care

According to Kalish (2010) Psychology is the study of human behaviour, thought processes and emotions. It can contribute to our understanding of ourselves and our relationships with other people, if it is applied in an informed way.

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Working in the caring profession, we spend most of our time interacting with other people such as service users, healthcare professionals and agency. The key part of our job is to promote health and well-being (GSCC, 2010). Most people are familiar with definition of health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of diseases or infirmity’ (WHO, 1946). If this is perceive as an important goal, health and social care professional need the knowledge and skills to help people work towards achieving it. Understanding the concept of Psychology and Sociology is essential tool for health care professional to learn factors that influence human behaviour that would help promote individuals health and well-being.

In understanding what influences human behaviour one must have a knowledge of Lifespan development, a scientific approach to understanding patterns of growth, change and stability in behaviour that occur throughout the entire life. According to Feldman (2005) It compasses physical, cognitive, social and personality development.

Physical development is one of the areas in lifespan development that examines the body’s physical makeup, including the brain, nervous system, muscles, and senses, and the need for food, drink, and sleep. Cognitive development on the other hand involves the ways that growth and change in intellectual capabilities influence person’s behaviour whereas Social development seek to understand the way in which individuals’ interactions with others and their social relationship grow, change, and remain stable over the course of life. Personality development involves the ways that the enduring characteristics that differentiate one person from another change over the life span.

In addition life span is usually divided into broad age ranges Sigelman (2009): The prenatal period is the period from conception to birth followed by infancy and todllerhood from birth to age 3. The preschool period started from ages 3 to 6 and middle childhood is from ages 6 to 12. The adolescence period is between 12 to 20 years of age. Young adulthood is from 20 to 40. Middle adulthood ages 40 to 65 and late adulthood age 65 to death.

There are substantial individual differences in the timing of events in people’s lives. According to Feldman (2005) People mature at different rates and reach developmental milestones at different points. Environmental factors play a significant role in determining the age at which a particular event is likely to occur. For example, the typical age of marriage varies substantially from one culture to another, depending in part on the functions that marriage plays in a given culture. Culture and ethnicity play an important role in development, both broad culture and aspects of culture, such as race, ethnicity and socioeconomic status.

There are few well known theoretical perspectives used in lifespan development the major are psychodynamic, behavioural, cognitive, and humaninistic. Each emphasizes somewhat different aspects of development.

The psychodynamic perspective (Greenberg, 2009) focuses on the inner person. Advocates of this prespective believe that much of behaviour is motivated by inner forces, memories, and conflicts to which a person has little awareness or control. The inner forces, which may stem from one’s childhood, continually influence behavour throughout the life span. The psychodynamic perspective is most closely associated with a single person such as Freud psychoanalytic theory (Louw, 1998), where he suggest that unconscious forces act to determine personality and behaviour. To freud, the unconscious is a part of the personality about which a person is unaware. It contains infantile wishes, desires, demands, and needs that, because of their disturbing nature, are hidden from conscious awareness. Freud suggested that unconscious is responsible for a good part of our everyday behaviour. He identified three areas of a person’s consciousness. The ID relates to an individual’s impulses and biological instincts. The ego acts as the mediator between the id and the external environment, it manages reason and common sense. Finally the super-ego contains the demands of the id through moral influence on the ego.

According to Freud Memories banished to the unconscious, or unacceptable drives or urges do not disappear. They continue to exert a powerful influence on behavior. The forces, which try to keep painful or socially undesirable thoughts and memories out of the conscious mind, are termed defense mechanisms. There is a perpetual battle between the wish, repressed into the id, and the defense mechanisms.

We use defense mechanisms to protect ourselves from feelings of anxiety or guilt, which arise because we feel threatened, or because our id or superego becomes too demanding. They are not under our conscious control, and are non-voluntaristic. With the ego, our unconscious will use one or more to protect us when we come up against a stressful situation in life. Ego-defense mechanisms are natural and normal. When they get out of proportion, neuroses develop, such as anxiety states, phobias, obsessions, or hysteria. (Cramer, 2006). An example of ego-defense mechanisms is Denial, where the person ignores or disregards information that would be painful to acknowledge such as In a case of Mr X. a service user who refuse to acknowledge his sister died on vehicular accident. Understanding these theories are very useful in opening up our understanding of people. For a health worker therapeutic communication is necessary in responding to such situation of Mr. X to avoid conflict behaviour.

Another theory that provides an alternative psychodynamic view is the Psychosocial Development. According to Erikson cited in Newman, (2011) both society and culture challenge and shape us. He explained that Psychosocial Development encompasses changes in our interactions with and understandings of one another as well as in our knowledge and understanding of ourselves as members of society. Erikson’s theory suggests that developmental change occurs throughout our lives in eight distinct stages. The stages emerge in a fixed pattern and are similar for all people. Erikson argued that each stage presents a crisis or conflict that the individual must resolve. Although no crisis is ever fully resolved, making life increasingly complicated, the individual must at least address the crisis of each stage sufficiently to deal with demands made during the next stage of development.

It is hard for us to grasp the full significance of psychodynamic theories represented by Freud’s psychoanalytic theory and Erikson’s theory of psychosocial development. Freud’s introduction of the notion that unconscious influences affect behavior was a monumental accomplishment, and that it seems at all reasonable to us shows how extensively the idea of the unconscious has pervaded thinking in Western cultures. In fact, work by contemporary researchers studying memory and learning suggests that we carry with us memories of which we are not consciously aware that have a significant impact on our behavior.

On the contrary some of the most basic principles of Freud’s psychoanalytic theory have been called into question because they have not been validated by subsequent research. For such reasons, many developmentalists question Freud’s theory (Feldman, 2005).

Erikson’s view that development continues throughout the life span is highly important and has received considerable support. However, the theory also has its drawbacks. Like Freud’s theory, it focuses more on men’s than women’s development. It is also vague in some respects, making it difficult for researchers to test rigorously. And, as is the case with psychodynamic theories in general, it is difficult to make definitive predictions about a given individual’s behavior using the theory. In sum, then, the psychodynamic perspective provides good descriptions of past behavior, but imprecise predictions of future behavior (de St. Aubin & McAdams, 2004)

The behavioral perspective on the other hand suggests that the keys to understanding development are observable behavior and outside stimuli in the environment. If we know the stimuli, we can predict the behavior. In this respect, the behavioral perspective reflects the view that nurture is more important to development than nature. Behavioral theories reject the notion that people universally pass through a series of stages (Shaffer,2009) Instead, people are assumed to be affected by the environmental stimuli to which they happen to be exposed. Developmental patterns, then, are personal, reflecting a particular set of environmental stimuli, and behavior is the result of continuing exposure to specific factors in the environment. Furthermore, developmental change is viewed in quantitative, rather than qualitative, terms. For instance, behavioral theories hold that advances in problem-solving capabilities as children age are largely a result of greater mental capacities, rather than changes in the kind of thinking that children are able to bring to bear on a problem (Sigelman, 2009).

Behaviourist approach to understanding a person would focus on their learning. it emphasizes the role that conditioning can have on people, where we learn how to behave due to the responses we have previously received when we either behave like that, or differently. It focuses on the relationship that humans have with stimuli and response such as Classical conditioning (Watson,1970) a type of learning in which an organism responds in a particular way to a neutral stimulus that normally does not bring about that type of response and Operant conditioning (Skinner,2011), a form of learning in which a voluntary response is strengthened or weakened by its association with positive or negative consequences.

Principles of operant conditioning are used in behavior modification (Miltenberger,2011), a formal technique for promoting the frequency of desirable behaviors and decreasing the incidence of unwanted ones. Behavior modification has been used in a variety of situations, ranging from teaching mentally challenge people the rudiments of language to helping people stop smoking. An example of this is the case of Mr. A before he can have his cigar in the morning staff will assist him first to take his tablet.

Research using the behavioral perspective has made significant contributions, ranging from techniques for educating children with severe mental retardation to identifying procedures for curbing aggression (Miltenberger,2011). At the same time, some controversies surround the behavioral perspective. For example, both classical and operant conditioning consider learning in terms of external stimuli and responses, in which the only important factors are the observable features of the environment (Sigelman, 2009). In such an analysis, people and other organisms are like inanimate “black boxes”; nothing that occurs inside the box is understood-nor much cared about, for that matter.

The cognitive perspective focuses on the processes that allow people to know, understand, and think about the world (Banbury, 2004). The cognitive perspective emphasizes how people internally represent and think about the world. By using this perspective, developmental researchers hope to understand how children and adults process information and how their ways of thinking and understanding affect their behavior. They also seek to learn how cognitive abilities change as people develop, the degree to which cognitive development represents quantitative and qualitative growth in intellectual abilities, and how different cognitive abilities are related to one another.

Piaget (2004) suggested that human thinking is arranged into schemes, that is, organized mental patterns that represent behaviors and actions. In infants, such schemes represent concrete behavior-a scheme for sucking, for reaching, and for each separate behavior. In older children, the schemes become more sophisticated and abstract, such as the set of skills involved in riding a bike or playing an interactive video game. Schemes are like intellectual computer software programs that direct and determine how data from the world are looked at and handled.

Piaget (2004) suggests that the growth in children’s understanding of the world can be explained by the two basic principles of assimilation and accommodation. Assimilation is the process in which people understand an experience in terms of their current stage of cognitive development and way of thinking. Assimilation occurs when people use their current ways of thinking about and understanding the world to perceive and understand a new experience. In contrast, accommodation refers to changes in existing ways of thinking in response to encounters with new stimuli or events. Assimilation and accommodation work in tandem to bring about cognitive development

Piaget’s cognitive development provided masterful descriptions of how intellectual growth proceeds during childhood descriptions that have stood the test of literally thousands of investigations. By and large, then, Piaget’s broad view of the sequence of cognitive development is accurate. However, the specifics of the theory, particularly in terms of change in cognitive capabilities over time, have been called into question (Feldman, 2005) For instance, some cognitive skills clearly emerge earlier than Piaget suggested. Furthermore, the universality of Piaget’s stages has been disputed. A growing amount of evidence suggests that the emergence of particular cognitive skills occurs according to a different timetable in non-Western cultures (Feldman, 2005). And in every culture, some people never seem to reach Piaget’s highest level of cognitive sophistication: formal, logical thought (McDonald & Stuart-Hamilton, 2003).

Ultimately, the greatest criticism leveled at the Piagetian perspective is that cognitive development is not necessarily as discontinuous as Piaget’s stage theory suggests. Remember that Piaget argued that growth proceeds in four distinct stages in which the quality of cognition differs from one stage to the next. However, many developmental researchers argue that growth is considerably more continuous. These critics have suggested an alternative perspective, known as the information processing approach (Feldman, 2005). which focuses on the processes that underlie learning,memory, and thinking throughout the life span.

The unique qualities of humans are the central focus of the humanistic perspective, the fourth of the major theories used by lifespan developmentalists (Louw, 1998) Rejecting the notion that our behavior is largely determined by unconscious processes, by learning from our environment, or by rational cognitive processing, the humanistic perspective contends that people have a natural capacity to make decisions about their lives and to control their behavior (Frick,1989). According to this approach, each individual has the ability and motivation to reach more advanced levels of maturity, and people naturally seek to reach their full potential. The humanistic perspective emphasizes free will, the ability of humans to make choices and come to decisions about their lives. Instead of relying on societal standards, then, people are assumed to be motivated to make their own decisions about what they do with their lives.

According to Rogers (1980), one of the major proponents of the humanistic perspective, suggested that all people have a need for positive regard that results from an underlying wish to be loved and respected. Because it is other people who provide this positive regard, we become dependent on them. Consequently, our view of ourselves and our self-worth is a reflection of how we think others view us (Rogers, 1970). Rogers, along with another key figure in the humanistic perspective, Abraham Maslow (1998), suggests that self-actualization is a primary goal in life. Self-actualization is a state of self-fulfillment in which people achieve their highest potential in their own unique way. Although the concept initially was deemed to apply to only a few select, famous people, such as Eleanor Roosevelt, Abraham Lincoln, and Albert Einstein, later theorists expanded the concept to apply to any person who realizes his or her own potential and possibilities (Santrock, 2011).

Despite its emphasis on important and unique human qualities, the humanistic perspective has not had a major impact on the field of lifespan development. Its lack of influence is primarily due to its inability to identify any sort of broad developmental change that is the result of increasing age or experience. Still, some of the concepts drawn from the humanistic perspective, such as self-actualization, have helped describe important aspects of human behavior and are widely discussed in areas ranging from health care to business (Santrock, 2011).

Each perspective continues to evolve and change, as befits a growing and dynamic discipline. Nowadays Research based evidence to support models and theories are crucial to the practice. An important recent contribution to the psychology of health has emerged through a field of study called psychoneuroimmunology (Daruna,2012) the Studies claimed that our emotions play a key role in the link between the world we inhabit and our immune responses. This is conceptualized within the ‘biopsychosocial’ model of health which emphasizes the complex interaction between biological factors and physiological systems (life sciences), psychological processes (thoughts, feelings, behaviours) and the social and cultural context in which people live and children grow up (sociology and social policy). This field of study provides strong evidence to support the need for holistic care.

Overall each approach gives us a unique insight into human psychological processes. It is not a matter of deciding which approach is ‘true’, but which ones are likely to be most useful in a given situation, or how insights from different perspectives can be used together to explain what appears to be happening. In therapeutic settings, many psychologists use an eclectic approach, which means selecting the combination of explanations and therapeutic approaches that best seem to suit the needs of the individual client. However, these theories may give us understanding of people a caution has to be displayed in applying a little knowledge we have acquired that is used in specialist professions such as psychologist.

Furthermore theories can provide us with a way of explaining why people behave in a certain way, or why their circumstances are affecting them in a particular way as it was explained above. Walkers (2007) provides many ways in which psychological theory and research can contribute to improvements in health and social care practice. He said that through theory and research we could appreciate how people’s understandings and needs vary, so that we can try to ensure that the individualized care we provide is both appropriate and optimal this are shown in patient centered approach (marx.200x) where care provision aimed to respect and response to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. This is seen in the case of Mr. X who refused to undergone dental surgery unless he talked to his previous dentist, who he hasn’t seen for 5 year, to get a second opinion.

Walkers (2007) also added that we could gain a better understanding of communication processes so that we can identify ways of improving the therapeutic relationship and work more effectively in interprofessional and inter-agency contexts such information that are linked in Unit 1 communication techniques and Unit 5 working in partnership.

Similarly these psychological perspective helps us identify factors that affect how people cope with such situations as acute and chronic illness, pain and loss, and the demands of everyday life, so that we can help them, and ourselves, to cope better and reduce the risks of stress-related illness. It also informs us about factors that influence people’s lifestyles and what motivates certain health-related behaviours such as smoking, dietary change and exercise. Helps us apply evidenced-based interventions to enhance health and well-being, and help people to change or modify their lifestyle. such example can be seen in Unit 10 safeguarding, Unit 2 Principle of Support and Unit 9 Empowering service user where risk assessment, support provision and care planning was discussed.

In addition another good example could be Challenging-behaviour (Emerson,2001), which may be displayed in many ways for example Verbal aggression such as shouting, swearing; Physical aggression like scratching, biting, punching and kicking; and Damaging property like throwing objects.

At best, It is disruptive and very upsetting, at worst, it can be very stressful and traumatic for everyone involved. a behaviour that must be taken seriously. We may not understand the reasons for the callenging-behaviour, but there is usually some underlying factors involved. The intention may not be to hurt anyone, it could be out of frustration because they find it difficult to cope with their feelings, they could just be ‘letting off steam’. As this could be explain on our knowledge of psychology.

The key to managing this challenging-behaviour is to have an understanding of their illness, knowing the patient and any known ‘triggers’, using low-arousal de-escalation techniques, knowledge of risk-assessing the immediate area (noise levels, temperature, other people, proximities, lighting etc), and as a last resort, physical intervention techniques. Having good communication and de-escalation skills are priceless, and institution provide training in de-escalation and the management of violence and aggression.

Challenging behaviour can take on many forms and they may not always be clear in their intentions. For example, a patient who is known to display physical aggression one day raises his hand very quickly just above shoulder height, in an instant staff are prepared, but the patient scratches behind his ear. Although the original intentions are not clear, was he about to punch someone? it was a false alarm. It is very important that if we have to intervene, knowing when to and when not to is critical. This is where training and experience takes play.

The best ways to deal with the behaviours is to try and understand the behaviours and what they represent. Through the use of theory of psychodynamics by Look at other factors such as their general mood throughout the day/week, anything that may have happened to upset them, are there any known triggers or changes in their daily routine. Many times, simple things will be overlooked. One thing we have learned in experience is that if we find something that works, don’t dismiss it, use it.

In summary, psychological perspective provides us understanding concept underpinned professional practice that enables us to enhance and maintain the social functioning of individuals in health care setting. It also help us to apply evidence-based psychology to enhance our therapeutic work and guide us to become a reflective thinker who does not draw on simplistic explanations for the behaviour of others. In addition it encourage us to work more effectively as a member of a multiprofessional team furthermore promote and protect the health and well-being of patients or clients and their caregivers likewise preserve our own health and well-being.

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