Applied Psychology 1

ASS 100S

Applied psychology in the care of health care users

By C. Settley

Outcomes

• Student should explain various psychological developmental processes across the human life span with reference to identifiable stages and attendant features.

• Student should Identify the issues, problems, crises and unique challenges associated with each stage and discussed with reference to understanding of others and implications for service delivery within health care.

Outcomes

• Student should discuss various stages of development in relation to own stage of development and the likely impact on understanding of and empathy towards health care users.

• Student should explore different in theoretical approaches for their usefulness in explaining and contributing towards an understanding of psychological development in a variety of contexts.

Psychological developmental processes

• A theory of development:• Children’s abilities and behaviour change over time• Some changes are small and some dramatic• Continual process• Some theories emphasise that human development

takes place in stages• Not enough evidence to say which theory is correct• Agreement that development takes place continually• Thus the theories complement each other

Psychological developmental processes

• Erik Erikson (1902-1994)- psychologist interested in human development

• Proposed that over a lifespan there are psychological tasks that need to be undertaken (stage theory used as framework for other theories)

• Many modern psychologists have been influenced by Erikson’s work

• He associated different chronological ages with developmental tasks that are usually achieved at that age

• Described each as a psychological crisis which needs to be resolved at each stage in order to move on emotionally

Erik Erikson’s Stage TheoryTable 2.1,page 30

• This theory shows how the developing person adjusts to new demands from the environment and from people in his or her life:

Approximate Age Developmental Task Psychological Crisis/Outcome

Birth to 18 months Attachment to a reliable and caring care giver. Success leads to trust in others, a lack leads to mistrust.

Trust vs Mistrust

18 months – 3 years Gaining basic self control of self and environment (e.g. toilet training). Success leads to feelings of autonomy and independence, but failure leads to shame and doubt

Autonomy vs Shame

Erik Erikson’s Stage TheoryTable 2.1,page 30 continued

Approximate Age Developmental Task Psychological Crisis/Outcome

3-6 years Becoming purposeful and directive. Children begin to exert control over the environment. Success will lead to a sense of purpose, but trying too hard will lead to disappointment and guilt

Initiative vs Guilt

6- puberty Coping with demands of schooling and relationships. Success leads to feelings of competence, but failure leads to feelings of inferiority

Industry vs Inferiority

Erik Erikson’s Stage TheoryTable 2.1,page 30 continued

Approximate Age Developmental Task Psychological Crisis/Outcome

Adolescence Making the transition from child to adult; developing a sense of self and personal identity. Success leads one to stay true to oneself, but failure leads to confusion about roles and a weak sense of self

Identity vs Role Confusion

Early Adulthood Forming intimate and lasting relationships. Success leads to strong relationships, but failure leads to isolation and loneliness

Intimacy vs Isolation

Erik Erikson’s Stage TheoryTable 2.1,page 30 continued

Approximate Age Developmental Task Psychological Crisis/Outcome

Middle Adulthood Fulfilling life goals that involve family, career and society; being concerned about leaving a lasting legacy for future generations. Success leads to feelings of achievement, but failure leads to feelings of uselessness

Generativity vs Stagnation

Later Years Looking back over one’s life and accepting its meaning. Success leads to feelings of fulfillment, while failure leads to despair and regret

Integrity vs Despair

Early Development: From conception to infancy

• Humans are alike, though there are many differences• Due to genes• Genes will ensure that human development happens in a

certain sequence and in a particular time frame• Cell growth is universal• Some people believe babies are born with their

personality and abilities already formed which they inherit• Others believe that the community shapes it

(nature/nurture debate)• Genetic conditions like Albinism, Color blindness &

Down Syndrome

Early Development: From conception to infancy

• Environmental factors which cause risks or danger to the baby before birth:

• - the age of the mother• - the stress experienced by the mother during pregnancy• - the mother’s diet• - the mother’s abuse of alcohol and/or drugs• - illnesses to which the mother is exposed during pregnancy

eg. FAS (Fetal Alcohol Syndrome)• Physical and emotional health are closely linked. Health

professional s needs to be aware of the need to counsel pregnant women and make them aware of things that can affect the fetus.

Early Development: From conception to infancy

• Fetal alcohol syndrome (FAS) or foetal alcohol syndrome is a pattern of physical and mental defects that can develop in a fetus in association with high levels of alcohol consumption during pregnancy. Alcohol crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damage neurons and brain structures, which can result in intellectual disability and other psychological or behavioral problems, and also cause other physical damage. The main effect of FAS is permanent central nervous system damage, especially to the brain. Developing brain cells and structures can be malformed or have development interrupted by prenatal alcohol exposure; this can create an array of primary cognitive and functional disabilities (including poor memory, attention deficits, impulsive behavior, and poor cause-effect reasoning) as well as secondary disabilities (for example, predispositions to mental health problems and drug addiction. Alcohol exposure presents a risk of fetal brain damage at any point during a pregnancy, since brain development is ongoing throughout pregnancy.

Physical development in the first two years of life

• Rapid growth• Within 4-6 months the baby is double its birth

weight, and by the age of 2 years the child is about half its adult height

• Thereafter, growths slows down until the next ‘growth spurt’ at puberty

• Motor skills: divided into gross motor skills(large muscle movements) and fine motor skills(small muscle movements)

Gross Motor Movement

• Developmental milestones: Major developmental milestones Age when reached

Lifts head 2-3 months

Sits alone 5.5-7.5 months

Crawls or creeps 7-9 months

Stands alone 11.5-14 months

Walks 12-14 months

Fine motor development:Emotional and social

development

• Infant temperament:• Foundation of personality• Refers to individual differences in babies in

attention, arousal and reactions to the environment, like routines, changes and new situations

• Mostly a result of genetic factors• Very little to do with good or poor caregiving

Emotional Attachment

• Babies are born with skills to help them interact and form relationships

• Foundations for their social development in the future• Attachment is the special bond that links the baby with

the primary caregiver, which is also felt by the caregiver• Voice recognition• Smiles- reflex action• Feeding• Comfort• Sick babies- lengthily stays in hospitals

Speech and language development

• Begins with the sounds that babies make when they are born

• Speech takes place in a sequence

• First sounds are called ‘cooing’

• Consonant sounds at 5 months of age

• By 8 months babies keep quiet when somebody talks to them

• At 1 year of age they can say words

The development of Self- control

• From 7-8 months old, parents expect babies to listen and behave in certain ways

• Expectations are around safety issues• Behave in socially acceptable ways• Control of bodily functions (toddlers)• Timing of toilet training differs in cultures. Expected to be achieved

when the child starts attending school• Learning to control emotions- to learn to control temper• Waiting on receiving a treat or joining an pleasurable activity is

called delay gratification• Achieving autonomy (as described by Erikson) to develop self

control. When kids are not able to do this, there may be feelings of shame and doubt

Thoughts about early development

• First few years: the foundation of a person’s life• Attachment is nb! (Erikson)- foundation for trust• Good health care, adequate food and close nurturing relationships in

early childhood lay the building blocks for children for physical and emotional health for the rest of their lives

• Africa- infant death is high• First 5 years are the most dangerous as they are dependent on others

and vulnerable• Caregivers assist with development of motor skills- principle of

stimulation• Cognitive development abilities• Eg when learning to walk- in some cultures babies are helped to

practice walk. At the same time it seems that babies develop this skill earlier when left alone

Early Childhood: Social Relationships

• Learn to relate to others• Siblings, how many and where a child fits in the family can have

implications for a child• Eg being the eldest• Eg being the only child• Relationships with siblings and parents are the earliest and last the

longest• Siblings provides secure attachments for each other( emotional

support)• As kids get older, they rely more on peers than family

Early Childhood:Children and Play

‘Play is the natural work of childhood’ (Erik Erikson)

• Play is important for child development• Play is limited by physical abilities• 3 months- fascinated by objects and want

to grasp them, but lack the capability• 1 year- interested in other children, but play

alongside rather than with them• As kids grow, they play more • Pretend games

Early Childhood:Children and Play

‘To play it out is the most natural and self-healing process in childhood’ (Erik Erikson)

• They learn the rules of turn taking and sharing

• They learn how their behavior affects others

Functions of play

• Physical development. Physical skills. Important not to become discouraged as children may give up and simply never learn that ability

• Important for brain development and learning. Exploring of the environment. Learning about objects, how to solve problems. Learn how to be creative.

• Learns kids about friendships. Learn how to share, interact, how to understand others and how to cooperate. Important skills as it aids in making friends, fit into groups and adjust to society. Learn how to stick to rules, wait their turn and know how to be both a good winner and good loser.

Functions of play

• Play helps to learn kids about their cultures. What is acceptable in their own cultural context. traditional games and singing songs that are passed on from generation to generation. Gives them a sense of history.

• Helps children learn about themselves (intrapersonal knowledge). This means that through play, the child's thoughts, feelings and behaviors can be known and understood by the child. Sometimes children express their feelings through acting out their experiences and through stories, and this helps them come to terms with what they experience.

Child experiences through drawings

• Undergoing surgery can be a terrifying experience for a child. But stress and fear, and the use of pain relief after the procedure, can be reduced with simple means: drawings, continuity and dialogue. This has been shown by research at the Sahlgrenska Academy.

Middle childhood: Going to school

• Most children went to pre- school• But for some it may be the first time being away from home/parents/primary care

givers• Social demands increases as children come into contact with a broader circle of

peers• Educators are important figures• Children learn to cope with rules and regulations, with sitting still and remembering• Q: How do children learn?• A: Genes, personality, environment, watching, observing and copying

How children learn (by copying the actions of others)

Middle childhood: Going to school

• Habituation: "Habituation is defined as a behavioral response decrement that results from repeated stimulation and that does not involve sensory adaptation/sensory fatigue or motor fatigue. Traditionally, habituation has been distinguished from sensory adaptation and motor fatigue by the process of dishabituation; however this distinction can also be made by demonstrating stimulus specificity (the response still occurs to other stimuli) and/or frequency-dependent spontaneous recovery (more rapid recovery following stimulation delivered at a high frequency than to stimulation delivered at a lower frequency).“ (Rankin et al., 2009).

Middle childhood: Going to school

• Examples of Habituation• Habituation is one of the simplest and most common forms of

learning. It allows people to "tune out" non-essential stimuli and focus on the things that really demand attention. Imagine that you are in your backyard when you hear a loud bang from your neighbour's yard. The novel sound immediately draws your attention and you wonder what is going on or what might be making the noise. Over the next few days, the banging noise continues at a regular and constant pace. Eventually, you simply tune out the noise. This is an example of what is known as habituation.

Middle childhood: Going to school

• Another example would be spritzing on some perfume in the morning before you leave for work in the morning. After a short period of time, you no longer notice the scent of your own perfume. A co-worker pops by your office for a quick chat and comments that she really like your perfume. Because you have habituated to the scent, you no longer notice it. Your co-worker, who is encountering the scent for the first time, notices it right away

Middle childhood: Going to school

• The Characteristics of Habituation• Some of the key characteristics of habituation include the following:• If the habituation stimulus is not presented for a long enough period

of time before a sudden reintroduction, the response will once again reappear at full-strength, a phenomenon known as spontaneous recovery.

• The more frequently a stimulus is presented, the faster habituation will occur.

• Very strong stimuli tend to result in slower habituation. In some cases, such as very loud noises like a car alarm or a siren, habituation will never occur.

• Changing the intensity or duration of the stimulation may result in a reoccurrence of the original response

Learning by association

• One of the first modern theories of learning is learning by association. For example, a baby is uncomfortable and begins to cry. The mother picks the baby up to comfort it. The baby learns to associate crying with being picked up and will therefore cry whenever it wants to be picked up even if there is no discomfort. This is called learning by stimulus-response (S-R) association

Learning through consequences

• Learning by result of what the behaviour brings

• Eg if a child discovers coming early to a meal, will allow her/him to receive the best food, he/she is likely to come early next time.

Learning through the help of someone else

• Mediated learning

• By showing, telling, explaining and guiding them

• Starts early in childhood

Piaget's Stage Theory of Development

• Piaget was among other things, a psychologist who was interested in cognitive development. After observation of many children, he posited that children progress through 4 stages and that they all do so in the same order. These four stages described below:

• The Sensorimotor Period (birth to 2 years)• During this time, Piaget said that a child's cognitive

system is limited to motor reflexes at birth, but the child builds on these reflexes to develop more sophisicated procedures. They learn to generalize their activities to a wider range of situations and coordinate them into increasingly lengthy chains of behaviour.

Piaget's Stage Theory of Development

• Pre-Operational Thought (2 to 6 or 7 years)• At this age, according to Piaget, children acquire representational

skills in the areas mental imagery, and especially language. They are very self-oriented, and have an egocentric view; that is, preoperational children can use these representational skills only to view the world from their own perspective.

• Concrete Operations (6/7 to 11/12)• As opposed to Preoperational children, children in the concrete

operations stage are able to take another's point of view and take into account more than one perspective simultaneously. They can also represent transformations as well as static situations. Although they can understand concrete problems, Piaget would argue that they cannot yet perform on abstract problems, and that they do not consider all of the logically possible outcomes.

Piaget's Stage Theory of Development

• Formal Operations (11/12 to adult)• Children who attain the formal operation stage are

capable of thinking logically and abstractly. They can also reason theoretically. Piaget considered this the ultimate stage of development, and stated that although the children would still have to revise their knowledge base, their way of thinking was as powerful as it would get.

Theory of Moral Development

Theory of Moral Development

Theory of Moral Development

• Kohlberg theorized that there were 6 stages of moral development, separated into 3 levels: pre-conventional, conventional, and post-conventional. Age ranges are considerably more vague in Kohlberg’s theory, as children vary quite significantly in their rate of moral development.

• At the pre-conventional level, children are only interested in securing their own benefit. This is their idea of morality. They begin by avoiding punishment, and quickly learn that by pleasing others they can secure positive benefits as well. No other ethical concepts are available to children this young. The parallel with Piaget’s sensorimotor phase is obvious – for a child whose conceptual framework does not extend beyond their own senses and movements, the moral concepts of right and wrong would be difficult to develop

Theory of Moral Development

• The conventional level is the one in which children learn about rules and authority. They learn that there are certain “conventions” that govern how they should and should not behave, and learn to obey them. At this stage, no distinction is drawn between moral principles and legal principles. What is right is what is handed down by authority, and disobeying the rules is always by definition “bad.” This level is split into two stages: in the first, children are interested in pleasing others and securing the favor of others. In the second, they extend that principle to cover the whole of their society, believing that morality is what keeps the social order intact. Kohlberg believed that many people stay in this stage for their whole lives, deriving moral principles from social or religious authority figures and never thinking about morality for themselves

Theory of Moral Development

• At the post-conventional level, children have learned that there is a difference between what is right and wrong from a moral perspective, and what is right and wrong according to the rules. Although they often overlap, there are still times when breaking a rule is the right thing to do. Post-conventional moral principles are either utilitarian principles of mutual benefit (closely related to the “social order” stage, but universal and non-authoritarian in nature)

References

• http://people.uwec.edu/piercech/fas/fas...htm. Retrieved 08/01/2015.

• http://www.debate.org/opinions/should-mothers-be-held-criminally-responsible-for-their-children-having-fetal-alcohol-syndrome. Retrieved 08/01/2015.

• http://sahlgrenska.gu.se/english/news_and_events/news/News_Detail/different-methods-can-reduce-hospital-fear-in-children.cid1053604

• http://psychology.about.com/od/hindex/g/def_habituation.htm