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BTEC National 90 Credits/ Diploma in Health and Social Care Essay

Overview of the unit
This unit highlights the different psychological perspectives and encourages learners to apply these approaches to the study of health and social care. The value of psychological studies to the understanding of health and social care will also be examined.

Learners will initially consider the meaning of the term ‘theories’ in the context of psychology, and will begin to appreciate the diversity of psychological theories as they progress through the unit. Learners will examine the principal psychological perspectives and then apply them to the health and social care sectors to gain understanding of the potential value of psychology in these sectors.

On completion of this unit learners will have considered the psychological approach to studying health and social care. The unit encourages reflection, and will be valuable to those learners intending to work with people in a caring capacity.

Learning outcomes
On completion of this unit a learner should:
1 Understand psychological perspectives
2 Understand psychological approaches to health and social care.

Grading criteria for the unit:

To achieve a pass grade the evidence must show that the learner is able to:

P1 explain the principal psychological perspectives
P2 explain different psychological approaches to health practice
P3 explain different psychological approaches to social care practice.
M1 assess different psychological approaches to study
M2 compare two psychological approaches to health and social care service provision
D1 evaluate two psychological approaches to health and social care service provision.

P1: Explain key points of the following principal psychological perspectives In this assignment there will be an explanation on the key pinots of the following principal psychological perspectives.

Behaviourist perspective: Behaviorist psychologists explain all human behavior as resulting from experience. Two key thinkers associated with this perspective are Pavlov (classical conditioning) and skinner (operant conditioning). Although these two theories believed that different processes were involved, they both explained all types of behavior as being the result of learning-everything from shyness to aggression, from happiness to depression. This is quite different from, say the psychodynamic or biological approaches.

The first theory of learning is called classical conditioning. This theory was developed by a Russian physiologist called Ivan Pavlov (1849-1936). He was working with dogs to investigate their digestive system. The dogs were attached to a harness, as shown opposite, and Pavlov attached monitors to their stomach and mouths so he could measure the rate of salivation (production of saliva).

One day he noticed that a dog began to salivate when the laboratory assistant entered the room with a bowl of food, but before it had actually tasted the food. Since salivation is a reflex response (which until then was thought to be produced only as a result of food touching the tongue), this seemed unusual. Pavlov speculated that the dog was salivating because it had learned to associate the laboratory assistant with food. He then developed his theory in the following way.

This type of learning is associated with the theories of Burrhus Frederic Skinner (1904-1990). Skinner was an American psychologist who worked mostly with rats and pigeons, to discover some of the key principles of learning new behaviors. He used a very famous device, called a Skinner box, illustrated below. The box contains a level which, when pressed, releases a food pellet into the box, thus reinforcing lever-pressing behavior.

When the rat is first placed the box it will run around, sniff the various items and at some point it will press the lever, releasing a food pellet. After a while, when the rat has repeatedly performed this action, it will learn that this behavior (pressing the lever) is automatically followed by the release of a food pellet (the consequences). Because the pellet is experienced as reinforcing (something the rat would like to have more of), this consequence increases the probability of the behavior being repeated. There are two types of reinforcing: positive reinforcement and negative reinforcement. Skinner investigated negative reinforcement by running a very low electrical current on the floor of the Skinner box.

Psychodynamic Perspective: This approach is associated with the Austrian psychologists Sigmund Frued (1856-1939), who developed the theory of psychoanalysis. A key follower of Freud was Erik Erikson (1902-1994), who adapted aspects of Freud’s approach.

Freud described the occasion when a Member of Parliament was referring to the MP for Hull, with whom he disagreed about some policy. Instead of saying ‘the honourable member from Hull’ he stated to say, ‘the honourable member from Hell’. Freud was one of the earliest thinkers to bring to public attention the idea that we are not always aware of all aspects of ourselves. He suggested that what we are aware of is represented in our conscious mind but that many of our memories, feelings and past experiences are locked up in part of our mind he called the ‘unconscious’. We cannot access the content of our conscious, but they often ‘leak out’ in dreams and slips of the tongue. Freud believed that the conscious mind was like the tip of an iceberg- only a small part being available to awareness. Part of the unconscious that we can easily access he called the pre-conscious. This contains information not yet in consciousness but that can easily be retrieved (e.g. the name of Aunt Edie’s cat). The rest, well under the surface consisted of the unconscious.

The importance of early experience in determining later behaviours is clearly illustrated by Freud’s development theory of psychosexual stages. He believed that we all go through several stages of psychosexual development. At each stage, the individual’s libido (energy) is focused on a part of the body that is particularly relevant at that stage. If the needs of the developing child are met at each stage, it moves on to the next development stage. If, however, there is struggle or conflict or some unsatisfactory experience, the individuals becomes ‘fixated’ (stuck) at this stage. This result in certain ways of being, or personality traits, which are carried through into adulthood and which can explain behaviour later in life.

The earliest stage is the ‘oral stage’. This focus here is on the mouth and activities such as sucking, biting and licking. Freud believes that there could be two reasons for fixation. If the infant was weaned too early, it would feel forever under-gratified and unsatisfied and would develop into a pessimistic, sarcastic person. If, on the other hand, it was over-gratified (weaned too late) the individual would develop a gullible personality, naively trusting in others and with a tendency to ‘swallow anything’. This stage lasts from birth to approximately 18 months.

If the infant successful passes through the oral stage without becoming fixated, the next stage is the ‘anal stage’, which last fro, approximately one to three years. Here there libido is focussed on aspects to do with potty training, with child feeling forced to use the potty before they are ready, or feeling over-controlled in various area, they may rebel; by retaining their faces: the child refuses to ‘go’, thus holding on to control and withholding satisfaction from the parent.

During the stage of four to five the child passes through the ‘phallic stage’. Fixation at this stage is associated with anxiety and guilty feeling about sex and fear of castration for males. If this stage is not resolved, the theory suggests that a boy may become homosexual and a girl may become lesbian. Freud thought these were abnormal fixation: however most people today would not view them this way.

Between that age of five to seven and the onset of puberty, the child enters the ‘latency stage’, which is not strictly speaking a developmental phase but a time when the focus is on social pursuit such as sport, academic excellence and the development of friendships.

The final psychosexual stage is the ‘genital stage’, which begins at puberty. Freud believed that the less fixated the individual has become during earlier stages, the more easily this stage will be negotiated, resulting in the ability to form strong heterosexual relationship with an ability to be warm and loving as well as to receive love in a new, mature fashion. A second important feature early experience is the development of ego defence mechanisms. The use of a defence mechanism allows us to block out events that threaten to overwhelm us.

A final influence is that of the mind. Freud suggested that the in which he called the psych is divided into three dynamic parts. The lid is a part of the much which totally unconscious and which exist at birth. The superego is a formed as a result of socialisation and consists of all instructions, morals and values that are repeatedly enforced as we are growing up. The main role of superego is to try to subdue the activity of the lid. The ego tries to balance the demands of the lid and the superego

This table will suggest examples:
Name of defence mechanise

The person forgets the event
Forgetting a traumatic event in childhood (e.g. a car crash) Regression
Reverting to an earlier stage of development
Wetting the bed when a sibling us born, having been dry before Denial
Pushing an event or emotion out of consciousness
Denying that a loved one has died
Redirecting desires onto a safe object
Kicking the cat at home because your boss gave you hard time at work

Erik Erikson was psychologist who agrees with much of Freud’s theory in so far as he thought that we developed through a series of stages. However, the thought that these continued throughout our lifetime and were essentially social nature. He also believed that Freud put too much emphasis on our desire for individual’s gratification and not enough on our needs to be accepted by society and lead a meaningful life. Erikson suggested that we move through a series of psychosocial cries with different social factors at each stage. For example between birth and the age of one, the life crisis concern developing trust or mistrust in self and other. The social focus this stage is the mother.

Psychosocial stages

Key focus of stage
Positive outcome
Negative outcome
Stage one (0-1years)
How the infant is parented
Dependable, responsive caring parenting lead to a sense of trust Parenting that lacks warmth and affection or is inconsistent leads to mistrust Stage 2 (1-3years)
Being enabled to do things by yourself
Being supported in growing independent lead to a sense of autonomy Being criticised and over-controlled lead to a felling of doubt about your own competence Stage 3 (3-6 years)
Interaction with the world
Being encouraged to try out new skills and explore the world lead to sense of imitative Being hampered in the desire to find things out (e.g. criticised, told not to be silly) lead tp a sense of guilt and a lack of confidence Stage 4 (6-12 years)

Understanding how things are made and how they work
The ability to succeed at realistic tasks lead to a sense of industry Being pushed to take on tasks they are not ready for leads to a sense of inferiority Stage 5 12-18 years)
Developing a consistent sense of identifying by experimentation Experimentation leads to a secure sense of identity
The inability to experiment and develop a sense of indentify leads to role confusion and negative identity

Social learning: Culture refers to the shared values, norms and language, customer and practise of a group. Although we tend to think of culture as being specific to different countries, it also refers to different sub-groups within society. For example, people from different socioeconomic groups within the UK will share different aspects of culture, such as the value placed on eating at a table rather than on your lap in front of the television: the way in which money is spent and how to talk to your elders. It is important to understand how culture affects our behaviour in order to gain full understanding of the people we encounter and those we work with.

There are many influences in our behaviour- from peers, siblings, parents, television, sports personalities and other celebrities. According to the social learning theory, role models are very important. While we may learn new behaviours fro, anyone the likelihood of imitating such behaviours is strongly influenced by the way we perceive the person performing the behaviour (the model). If we observe someone we admire behaving in particular way, we are more likely you imitate such behaviour. This diagram below illustrates factors associate with a model that influences whatever we will imitate him or her.

Our behaviour is dramatically influenced by the presence of other, however much we may believe ourselves to be truly individual in out beliefs and behaviour. Nowhere is this more clearly demonstrated than in the experiments conducted in the 1950s by social psychologist Solomon Asch. He was interested in a concept called major influence. This is when the presence of other people causes us to change our public behaviour or opinions because we do not want to stand out from the crowd.

This is an important concept in psychology that has a big impact in the way we behave toward others and expect them to behave toward us. If we believe ourselves to be worthwhile, pleasant, and likeable them we will almost certainly be polite and cheerful toward those we meet, thus creating a favourable impression. In response, those who come into contract with us perceive us favourable and behave in an s positive way towards us, with the result that out positive self-belief are confirmed. If on the other hand, we are angry full of resentment, believe the world is against us and so on, then we are likely to behave in s more aggressive, confrontational or argumentative way, in which will confirm our views of ourselves and the worlds.

There is a similarity between role theory and the self-fulfilling prophecy, in that role theory suggests that because we live within particular culture, society and social group we are influenced by other people. This influence helps lead us to adopt certain roles and tries to live up to the expectations that go with this role.

Social learning theory explains behaviour as the result of learning form people we are exposed to in our environment. We can also learn new behaviours from people we observe, either in real life or in the media. This is knows as observational learning and this theory was developed by the American psychologist Albert Bandura.

The person we learn from is known as the role model and the process of imitating is called modelling. However we do not imitate all behaviour we observe and remember. Whether or not it is our interest to imitate particular behaviour is influenced by characteristics of the model. If we see a model being punished for a certain behaviour we are likely you imitate it than if we see him or he being positively reinforced.

Humanistic psychology looks at human experience from the viewpoint of the individual. It focuses on the idea of free will and the belief that we are all capable of making choices. Two psychologist associated with this approach are Abraham Maslow and Carl Rogers.

Mallow (1903-1970) was an American psychologist who believed that we are all seeking becomes the best that we can possibly be-spirally, physically, emotionally and intellectually. He called this self- actualisation. He constructed a theory known as the hierarchy of needs, in which he explained that every human being requires certain basic needs to be met before they can approach the next level.

As the diagram shown, Maslow believed they until our basic physiological needs ate meet we will focus all our energies on getting them met and not begin or progress further. When we are well-housed well-fed and comfortable physically, we begin to focus on our emotional needs, such as the need to belong and be loved and to feel self-esteem. When our lived are such that these needs are also met, we strive to self-actualise.

Rogers (1902-1987) was partially interested in the concept of sel. There are many aspects of the self but two are especially important here. Self-concept refers to the way we view ourselves. This includes physical and biological attributes such as male or female, blond or brunette, tall or short, as well as personality traits such as being kind, humble, assertive, and hard-working. The self-concept is formed from nearly age and young children internalise other people’s judgments of them, which them become part of their self-concept. Roger believed that we also hold a concept of self called the idea self. This represents a view of us as we felt we should be and as we would like to be.

Self-esteem: how valuable we fell, literally the amount of esteem we give to ourselves. Someone with high self-esteem will believe they are loved and lovable and that they are important and valued. An individual with low self-esteem, may feel unwanted and worthless, or no value to anyone else, unloved and unlovable.

Self-concept: the way we see ourselves. In early life this comes from what we are told about ourselves.

Cognitive/information processing
This psychological perspective has gained enormous ground since the 2960s, when the influence of behaviourism began to wane. With the development of computer came the idea that brain activity was like the operation of a computer. A great deal of research has been devoted to understanding cognitive processes such as attention, memory, perception information processing, problem solving, through, language and other aspect of cognition.

Jean Piaget (1896-1980) was a Swiss psychologist who initially worked on measuring intelligence. During his research he noticed that children of the same age made the same mistake in logic, however bright they were. He came to the conclusion that cognition develops through a series of stages, each new stage building on the previous one.


Key features
Stage 1: sensori-motor
0-2 years
The world is experienced through motor activity and the senses Stage 2: pre-operational
2-7 years
Language develops along with memory. The child is egocentric and unable to conserve Stage 3: concrete operational
7-11 years
The child can now understand conservation but cannot yet solve problems mentally Stage 4:formal operational
The child cannot use abstract thoughts and represent problems mentally

George Kelly (1905-1966) developed a unique psychological theory known as the psychology of personal constructs. He saw the individual as a scientist, making predictions about the future, testing them and, if necessary, revising them according to new evidence. A construct is a way of constructing (interpreting and making sense of) reality and the environment. Kelly believed that we do not have to be constrained by our past history but can seek out new, alternative, more positive meanings.

Biological perspective
The theory of maturation holds that the effects of the environment are minimal. The child is born with a self of genetic instructions passed down from its parents, and it’s cognitive, physical and other developmental processes merely unfold over time, rather than being depended upon the environment to mature. It is in effect a theory which stated that development is due to nature not nurture. This is quite a contact to learning theory or humanistic theory, where the effects of nurture are paramount. Arnold Gesell (1880-1961) believed that development occurred according to a sequence of maturational processes. For example, development in the womb follows a fixed set of stages: the heart begins to form first, along with a rudimentary nervous system. Bones and muscles develop next and over time the organism develops into a fully functioning human being, ready to be born. As the child develops from birth onwards, its genes allow it to flower gradually into the person he or she is meant to be. The environment should provide support for this unfolding of talents, skills personality and interests but the main thing driving this development is the maturational process.

The autonomic nervous system produces its effects through activation of nerve fibre throughout the nervous system, brain and body or by stimulating the release of hormones from endocrine glands (such as the adrenal and pineal glands). Hormones are biochemical substances that are released into the bloodstream and have a profound effect on target organs and on behaviour. They are present in very small quantities and individual molecules have a very short life, so their effects quickly disappear if they are not secreted continuously.

There are a large number of hormones including:
Melatonin, which is released by the pineal gland and acts on the brainstem sleep mechanism to help synchronise the phases of sleep and activity Testosterone, which is released in the testicle and may influence aggressiveness Oxytocin, which is released by the pituitary gland and stimulates milk production and females orgasms Some hormones are released as response to external stimuli.

Central nervous system
Autonomic nervous system
Consists of the brain and spinal cord
Regulates organs of the body and processes such as heart rate and blood pressure: only one branch is activated at any time

Sympathetic branch
Parasympathetic branch

Associated with arousal and the fight or flight response
Associated with rest and relaxation

Genes affect behaviour in many ways. Some discords, such as Huntington’s disease, are caused by a single dominate gene, which either parent can pass on to their children. Other, such as caustic fibrosis and sickle cell anaemia, are caused when both parents pass on the gene for the disorder. Some of the changes in behaviour are listed below, through this list is not comprehensive: Hallucinations and delusions

Severe confusion
Progressive memory loss
Inappropriate speech: use of jargon or wrongs words
Personality changes including anxiety and depression, withdrawal from social interaction. Decreased ability to care for oneself and inability to maintain employment.

P2: Explain different psychological approaches to health practice.

In this task there will be an explanation on the different psychological approaches to health practice.

Psychodynamic perspective:
Understanding challenging behaviour
The basic tenet of this perspective I that much of our behaviour is driven by unconscious forces. It is therefore important to recognise that we may not be able to understand behaviours using question and answer techniques, as the individual may not be aware of what is troubling them. It is necessary to delve a little deeper and try to interpret behaviour, on the assumption that the behaviour is in some way a symptom of what is going on in the unconscious.

Understanding and managing anxiety
When we are anxious we often have fears about even that have happened or might happen, about things we have done or might do, and about whether the world is safe or unsafe place. We often try to control anxiety using a variety of strategies. Sometime we use denial- the ostrich approach where we bury our heads in the sand and pretend the object of our anxiety doesn’t exist. Sadly, for mot of us, the anxiety still seeps through, and may present itself in the form of physical symptom.

Cognitive perspective:
Supporting individuals with learning difficulties
Individuals with earning difficulties can experience enormous frustration in their daily live as they seek to make sense of what can be bewildering experiences. The cognitive approach can be used to help people who misread situation. By identifying irrational thoughts, an individual can be guided to change them, with consequent benefits for their emotional and behaviour. Cognitive work of this type can improve self-esteem and reduce outburst, which may be triggered by lack of understanding of the requirements of a given situation (for example, having to wait in turn for a meal.)

Supporting individuals with emotional problems:
The cognitive perspective is widely used with individuals with a wide variety of emotional problems. This perspective begins by examining how distorted and irrational negative thoughts influence feelings, which hen lead to change in behaviour.

Support individuals with depression:
The psychologist Aaron Beck has formed a helpful approach to understanding depression, known as cognitive behaviour therapy. The pattern of behaviour common to these suffering from depression is described by Beck as a cognitive triad. To begin with, the individual thinks he is worthless and inadequate. This self-appraisal then lead to the beliefs that this lack of worth means that the future will be just as bad as the present. This then generalises to a conviction that the world contains problems and difficulties that he individual us powerless to overcome. The goal of cognitive therapy is to challenge these negative thoughts and to encourage the patient to develop alternative, more positive, ways of seeing the world.

Identifying negative-irrational/distorted thinking
This can be done by keeping a diary and recording every instance of negative thinking and the feelings that follow. Initially this can be difficult, as these patterns are so automatic it can be difficult to notice them. However it will get easier over time. For example: asking yourself: What is the evidence for such negative thinking?

Are there alternative explanations? It can be helpful to think how others would response or ask them How does it affect me to think so negatively
What type if thinking errors am I making (for example, magnifying or catastrophizing)

Supporting individuals with post-traumatic stress disorder
This disorder consists of a set of symptoms as outlined below:

Re-experiencing the traumatic event (intrusion)
Frequent recall of the event
Intense emotional upset produced by stimuli that symbolise the event (e.g. fireworks may symbolise a battlefields)

Avoiding of stimuli associated with the event (or numbering of responsiveness) The person tries to avoid thinking about the trauma or encountering stimuli that will bring it to mind The person may be unable to remember the event

Decreased interest in other
A sense of estrangement
An inability to feel positive emotions

Increased arousal
Difficulties falling or staying asleep
Difficulties contracting
Hyper- Vigilance
An exaggerate startle response
The above are some, or all of the symptoms experienced by individuals with a diagnosis of pat-traumatic stress disorder (PTSD).

Biological perspective:
Arnold Gesell developed an assessment scale to enable judgement to be, made about whether a child’s behaviour and understanding matches that their chronological age (how old the child is). This scale enables the child’s scores to be compared against their scores at an earliest age to determine whether development is proceeding satisfactorily. It also enables a skilled and trained assessor to indentify developmental problems that may emerge for an individual, thus allowing for early and appropriate intervention. There are three overlapping stages at which development can be measured: Between two and a half years to age six

Between four and six years old
Between six and nine years old

At each age there are various tests to assess different aspects of development. One test administered at around the age of four consists of comprehension questions. It measures the child’s ability to use perceptual; accuracy and skills involved in regulating its own behaviour and emotions by asking him to plan solutions to hypothetical social situations. This allows for a judgment to be made on the child’s ability to deal with actual social situations as it reaches the age of about five years old.

The cubes test, which is used primarily with children aged two to six, assess the ability to follow directions and perform a structured task. Visual perception and fine motor co-ordination skills involves in colouring, cutting and handwriting are assed against developmental norms. The child’s attention span, together with the ability to perceive different shapes accurately, is also measured and together these give information about reading comprehension, spelling and mathematical skills.

M1: Asses different psychological approached to study
In this assignment their will be an assessment of different psychological approaches to study.

Essay Topics:

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