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Psychological approaches to health practice Essay

Explain different psychological approaches to social care practice In this assignment I am going to look at four different psychological approaches and how they can be linked to health and social care situations, two of the approaches will be linked to health care situations and the other two to social care situations. The first approach that I am going to link to a social care situation is the behaviourist perspective, where psychologists explain all human behaviour as resulting from experience. Two of the major psychologists linked with this approach are Pavlov and Skinner and although these two believed that different processes were involved they agreed that behaviour was the result of learning. I am going to concentrate on the work of Skinner. Burrhus Frederic Skinner was an American psychologist that worked mainly with pigeons and rats to investigate the important principles of learning new behaviours. He was responsible for a very famous piece of equipment, the Skinner box, which was a box that contained a lever that when pressed released a food pellet. This box reinforced lever pressing behaviour.

Once the rat was put inside Skinners box it would sniff and move around and at some point push the lever and release the food pellet. When the rat has pushed the lever many times it will learn that this behaviour, pushing the lever, is followed by the release of the food pellet, the consequence. As the rat would like to have more food the pellet is experienced as reinforcing and this increases the chance of the behaviour being repeated. Skinner also investigated negative reinforcement by running a very small electric current on the floor of the box containing the rat and if the rat pushed the lever then the current would be turned off. This action was negative reinforcement. An example of this is taking a painkiller to relieve the symptoms of a headache which results in the headache going away then you have been negatively reinforced for taking a painkiller. Skinner also investigated that punishment happens when behaviour is followed by a consequence which is an unpleasant experience.

He did this by having a box where the rat received a small electric shock when it pushed the lever. The consequence of pushing the lever was unpleasant, an electric shock, so the rat learned not to push the lever. The principles of operant conditioning can be used to create more helpful behaviours and remove the unhelpful ones. The principles of reinforcement and punishment are a very powerful way to alter a person’s behaviour. This process is sometimes known as behaviour modification.

My father uses this approach daily at work as he is a senior prison officer at HMP Wayland to maintain order within the regime and my mother uses the same ideas, for classroom management at Wayland Academy, on a daily basis. In both situations, good behaviour is rewarded and poor behaviour is punished but in very different ways. At Wayland Academy, where I have completed my first work placement, there is a behaviour policy called the Red Card Procedure and it is used in every classroom throughout the school. The policy is a four stage policy designed to promote good classroom behaviour and pupils receive consequences for behaviour that disrupts the learning of other students.

The procedure is:

Step 1 – Consequence 1 (C1) – The student receives a 10 minute detention for a first occurrence of any behaviour that disrupts others learning. This behaviour can include calling out, unnecessarily demanding the teacher’s time and using foul language. Step 2 – Consequence 2 (C2) – The student receives a 10 minute detention for a second occurrence of any behaviour that disrupts others learning. This means that the student now has a total of 20 minutes detention with the class teacher. Step 3 – Consequence 3 (Time out) – After the third occurrence of disruptive behaviour the student is sent outside the classroom and the teacher goes out and speaks to them privately explaining that they have reached their final chance of remaining in the lesson. If their behaviour is not improved after this they will be removed from the remainder of the lesson and have a 60 minute after school detention the following week. Step 4 – Consequence 4 (Red Card) – If another example of disruptive behaviour now happens the student is removed from the remainder of the lesson and receives a 60 minute after school detention.

The Red Card Procedure works on the same basis as Skinners theory that punishment occurs when behaviour is followed by a consequence that is unpleasant. If the student demonstrates disruptive behaviour then they are punished by the removal of their free time, in the form of detention, and it is hoped that this punishment will teach the student to stop the disruptive behaviour. Aldworth, C. Billingham, M. Lawrence, P. Moonie, N. and Whitehouse, M (2010) Health and Social Care Level 3 Book 1 BTEC National Harlow: Pearson Education Limited – Pages 339-340 The second approach that I am going to link to a social care situation is the cognitive perspective where psychologists believe the brain was like a computer system and much work has gone in to understanding the cognitive processes of attention, memory, perception, information processing, thought, problem solving and language. One of the two main psychologists within this approach, that I am going to talk about, is George Kelly. He developed a very unique psychological theory known as the Psychology of Personal Construct where he saw the individual as a experimenter, making their predictions about the future, testing them and if they need to they revise them according to new evidence.

For example if an individual becomes deaf in their middle age then it might be likely that they withdraw from society and become isolated. On the other hand if they interpret it as a challenge then they may try and find new and exciting ways to work around the deafness and continue with a fulfilling life. Individuals with learning difficulties may experience frustration within their daily lives as they seek to make sense of confusing experiences. The cognitive approach can help individuals with learning difficulties in misunderstood situations, by identifying irrational thoughts, an individual can be a guide to change them, with consequent benefits on their emotions and behaviour. This work can improve an individual’s self-esteem and reduce outbursts which may be caused by a lack of understanding of the requirements that are needed for a situation. While I was on placement at Wayland Academy, I worked with the Year 7 Gold Group, which is a nurture group. The individuals in this nurture group all have certain learning difficulties .

The group is limited to a maximum of 15 students so the staff have enough time within a lesson to go around and help everyone understand the lesson objectives and stop them from becoming frustrated. For example, one of the students within the classroom has Aspergers Syndrome which is a form of autism but it differs from other conditions on the autism spectrum by its relative preservation of linguistic and cognitive development. The teacher and classroom assistant have certain strategies to allow this student to access learning. While they are sitting and working with him they are continually refocusing his attention on to the required task, and this may involve moving the work into his eyeline if he has become distracted. Another strategy is to repeat and reword the given task until the student has understood fully.

The teacher and the classroom assistant knows when the student has understood because when he has understood he responds to them in full sentences and when he is still struggling he only gives one word answers. Aldworth, C. Billingham, M. Lawrence, P. Moonie, N. and Whitehouse, M (2010) Health and Social Care Level 3 Book 1 BTEC National Harlow: Pearson Education Limited – Pages 350-351 and 359-361 http://www.patient.co.uk/doctor/Asperger’s-Syndrome.htm

Now I am going to move on and look at health care situations and the first psychological approach I am going to look at is the humanistic perspective. Humanistic psychology looks at the human experience from an individual’s viewpoint and uses the idea of free will and that everyone is free to make choices. One of the two psychologists I am going to talk about is Carl Rodgers and was very interested in the whole idea concept of self. Self-concept looks at the way each individual views themselves, this includes biological and physical attributes. Self-concept is noticed at a young age, when children internalise other individual’s judgements about them and think it is true. For example if a child gets called naughty or silly throughout their childhood then their self-concept will contain these aspects and possibly shape their future in a negative way. On the other hand if a child is praised and encouraged to succeed then they will have a positive self-concept and will try better at what they do because they start to see themselves as worthwhile.

Carl Rodgers is famous for forming a particular type of counselling which is based on unconditional positive regard from the counsellor, to try and help the patient gain a more positive sense of self. Unconditional positive regard refers to the idea that the counsellor supports and validates the individual’s experiences, feelings, beliefs and emotions unconditionally, whether good or bad. Over time this helps the patient accept themselves and think more positively about who they are. One of the features of this approach to helping others is to develop empathy. Empathy is the opposite of sympathy where you would feel sorry for an individual empathy us to really listen to the individual and be in tune with their emotions, and respect them for who they are This is not always easy to do because as we may not understand why the individual feels so bad about themselves about an issue we may be able to easily discharge.

Nevertheless, if we try to respect the individual we maybe working with then we might start to understand the importance to them and we can become closer to displaying empathy. True empathy requires us to move aside all judgements we may have and as the saying goes ‘Put ourselves in their shoes’. Like empathy, understanding is of critical importance when applying this perspective to health care practices. Rodgers frequently referred to more then just understanding at an intellectual level: he talks about empathetic understanding which means using your own emotions and sensitivity to become a more effective person to help any individual. A lot of the time many people allow their own personal experiences and personal judgements get in the way of helping the individual by saying “Well, that’s not a problem – they should just pull themselves together! I have dealt with worse myself.” This can turn into a major barrier between patient and counsellor, instead of creating a barrier counsellors use useful questions like; How does that make you feel?

Can you identify what you are afraid of?
Could you tell me a little bit more about that?
That seemed to upset you?

All of these questions enable the individual to break down the problem without realising it so it helps the counsellor what to say and what to suggest for the next step. It has been shown , by a recent study in the Journal of Consulting and Clinical, that cognitive behaviour therapy for adherence and depression can be effective for decreasing depression and increasing adherence to medication in HIV-infected drug users. The intervention group received 9 treatment sessions over a period of 3 months, involving informational, problem-solving, and cognitive behavioral steps. At each step, the participants and the therapist collaboratively defined the problem, generated alternative solutions, made decisions about the solutions, and developed a plan for implementing them. At post-treatment, the intervention group showed significant improvements and showed a significant reduction in symptoms of depression. Depression and substance abuse are the most comorbid disorders associated with HIV-infection, and it is suggested that even a small change in adherence can result in improved outcomes for HIV patients.

The results of this study suggest that the integration of cognitive behavior therapy into substance abuse counseling may be useful for decreasing depression and improving adherence to medication (with continued sessions) in HIV-infected patients with a history of injection drug use. Aldworth, C. Billingham, M. Lawrence, P. Moonie, N. and Whitehouse, M (2010) Health and Social Care Level 3 Book 1 BTEC National Harlow: Pearson Education Limited – Pages 348, 349 and 357 http://www.beckinstituteblog.org/2013/03/cbt-is-effective-for-adherence-and-depression-in-hiv-infected-injection-drug-users/ The second approach I am going to discuss in relation to a health care situation is the social learning perspective. The social learning perspective is where influences happen on our behaviour from the environment around us, for example; from peers, siblings, parents, sports personalities, television and other celebrities.

According to this theory role models have a huge impact on an individual’s life. While we may learn our behaviour from observing another person behave and imitating what they do, behaviour is strongly influenced by the way we perceive the role model performing the behaviour. Albert Bandura was one of the theorists within the social learning approach and he developed observational learning, which is learning behaviour from watching and observing others such as television personalities. The individual we learn from, known as the role model, and the process of imitating their behaviour is called modelling. However we do not imitate all behaviour we have observed, because it is in our interests to imitate particular behaviour influenced by the actions of the role model.

If we see our role model being punished and we do not like the way they have been punished then we as individuals are less likely to repeat that behaviour, on the other hand if they have been positively reinforced and the individual sees that then they are more likely to repeat that behaviour. As above role models play a huge part in influencing behaviour of those who observe them. For example Jamie Oliver the celebrity chef has had a huge impact on primary schools around the UK, with his School Dinners Project he has managed to get local authorities to re-introduce freshly cooked meals rather than pre-cooked because they are far healthier for the human body providing the correct nutrients for a child’s needs. He has also, through his Food Foundation created the Kitchen Garden Project which educates primary school children about the joys of growing and cooking from scratch.

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