Erikson's Theory of Psychosocial Development ; by 19HJMDF

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									                             The Patient "Doctor
                                Relationship
o   Simple –complicated ) Relationship.

o   A matter of Common sense –Skills need to be learned.
                               The Patient "Doctor
                                  Relationship
   techniques of talking and listening to people.



   To diagnose, manage, and treat an ill person, doctors and therapists
    must learn to listen.



   They need the skills of active listening, which means listening both to
    what they and the patient are saying and to the undercurrents of the
    unspoken feelings between them
   An effective relationship is characterized by good rapport


   Rapport is the spontaneous, conscious feeling of harmonious
    responsiveness that promotes the development of a constructive
    therapeutic alliance.


   It implies an understanding and trust between the doctor and the
    patient. Frequently, the doctor is the only person to whom the patients
    can talk about things that they cannot tell anyone else.


   Most patients trust their doctors to keep secrets, and this confidence
    must not be betrayed.
                 Establishing Rapport
   putting patients and interviewers at ease;

   finding patients' pain and expressing compassion;

   evaluating patients' insight and becoming an ally;

   showing expertise;

   establishing authority as physicians and therapists;

   balancing the roles of empathic listener, expert, and authority.
   Empathy

To put oneself in another person's place.

   Sympathy:

Feeling sorry.
   Biomedical model:
approach to pt care in which only the biological and medical aspects
  of apt illness are considered.



   Biopsychosocial model:
Comprehensive approach.
   Transference:

The pt are transferring feelings toward others in their
  life onto the physician.

   Counter-transference:

Emotional reactions to the pt from the doc that often
  involve the doctor past experience.
               Physician styles:
   The paternalistic style.

   The shared decision making style.

   The consumer based style
   Professional Boundaries



   Difficult Doctor-Patient :Relationships
       The Seductive Patient
       The “Hateful” Patient
       The Patient With a Thousand Symptoms
       The Patient in the Hospital Setting
       The Mentally Disturbed Patient
       The Dying Patient
   Correct diagnosis and treatment is only half the way
               Factors that impede compliance:

Low level of distress

Denial of illness

Poor communication

Complex regimens

Treatment that is embarrassing

Pts perception

Side effects
Factors that enhance compliance

    Rapport

    Simple regimen

    Increased level of distress

    Waiting room time

    Increased time with doc

    Family support
       Erikson's Theory of
Psychosocial Development ;
                    What is Psychosocial Development?



   Erik Erikson’s theory of psychosocial development is one of the best-
    known theories of personality in psychology.


   Much like Sigmund Freud, Erikson believed that personality develops in
    a series of stages.


   Unlike Freud’s theory of psychosexual stages, Erikson’s theory
    describes the impact of social experience across the whole lifespan.
   One of the main elements of Erikson’s psychosocial
    stage theory is the development of ego identity.


   Ego identity is the conscious sense of self that we
    develop through social interaction.
   According to Erikson, our ego identity is constantly changing due to
    new experience and information we acquire in our daily interactions
    with others.



    In addition to ego identity, Erikson also believed that a sense of
    competence also motivates behaviors and actions.

    Each stage in Erikson’s theory is concerned with becoming competent
    in an area of life.
   If the stage is handled well, the person will feel a sense of mastery,
    which he sometimes referred to as ego strength or ego quality



   If the stage is managed poorly, the person will emerge with a sense of
    inadequacy.
stage         Basic Conflict   Important Events   Outcome


    Erikson's Psychosocial Stages Summary Chart


Stage-1                                           Children
                                                  develop a
                                                  sense of trust
-infancy      Trust vs.        Feeding            when
birth to 18   mistrust                            caregivers
months)                                           provide
                                                  reliabilty, care,
                                                  and affection. A
                                                  lack of this will
                                                  lead to
                                                  mistrust.
Stage-2                                          Children need
                                                 to develop a
                                                 sense of
                                                 personal
Early Childhood Autonomy vs.   Toilet Training   control over
(2 to 3 years)  Shame and                        physical skills
                Doubt                            and a sense of
                                                 independence.
                                                 Success leads
                                                 to feelings of
                                                 autonomy,
                                                 failure results
                                                 in feelings of
                                                 shame and
                                                 doubt.
Stage-3                                       Children need
                                              to begin
                                              asserting
                                              control and
                                              power over the
                 Initiative vs. Exploration   environment.
Preschool
                 Guilt                        Success in this
(3 to 5 years)                                stage leads to a
                                              sense of
                                              purpose.
                                              Children who
                                              try to exert too
                                              much power
                                              experience
                                              disapproval,
                                              resulting in a
                                              sense of guilt.
Stage-4                                 Children need
                                        to cope with
                                        new social and
                                        academic
                                        demands.
                Industry vs.   School
School Age (6                           Success leads
                Inferiority
to 11 years)                            to a sense of
                                        competence,
                                        while failure
                                        results in
                                        feelings of
                                        inferiority.
Stage-5
                                           Teens needs to
Adolescenc    Identity vs. Social
               Role        Relationships   develop a sense of
e (12 to 18
              Confusion                    self and personal
years)
                                           identity. Success
                                           leads to an ability to
                                           stay true to yourself,
                                           while failure leads
                                           to role confusion
                                           and a weak sense of
                                           self.
Stage-6                                Young adults
                                       need to form
                                       intimate, loving
young
Adulthood
            intimacy vs.   relationshi relationships
(19 to 40   isolation      ps          with other
years                                  people. Success
                                       leads to strong
                                       relationships,
                                       while failure
                                       results in
                                       loneliness and
                                       isolation.
Stage-7                             Adults need to create
                                    or nurture things that
                                    will outlast them,
Middle    Generativity   Work and   often by having
Adulthood vs.
                         Parenthood children or creating a
(40 to 65
          Stagnation                positive change that
years)
                                    benefits other
                                    people. Success leads
                                    to feelings of
                                    usefulness and
                                    accomplishment,
                                    while failure results
                                    in shallow
                                    involvement in the
                                    world.
Stage-8                                          Older adults
                                                 need to look
                                                 back on life and
                                                 feel a sense of
Maturity(65 to   Ego Integrity   Reflection on   fulfillment.
death)           vs. Despair     Life            Success at this
                                                 stage leads to
                                                 feelings of
                                                 wisdom, while
                                                 failure results
                                                 in regret,
                                                 bitterness, and
                                                 despair.

								
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