applied psychology and health care users

1. Applied
Psychology 1
ASS 100S
Applied psychology in the care of
health care users
By C. Settley

2. 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.

3. 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.

4. 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

5. 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

6. Erik Erikson’s Stage Theory
Table 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

7. Erik Erikson’s Stage Theory
Table 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

8. Erik Erikson’s Stage Theory
Table 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

9. Erik Erikson’s Stage Theory
Table 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

10. 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

11. 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.

12. 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.

14. 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)

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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.

25. 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.

26. 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.

27. 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

28. How children learn
(by copying the actions of others)

29. 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).

30. 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.

31. 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

32. 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

33. 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

34. 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.

35. Learning through the help of
someone else
• Mediated learning
• By showing, telling, explaining and guiding
them
• Starts early in childhood

36. 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.

37. 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.

38. 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.

39. Theory of Moral Development

40. Theory of Moral Development

41. 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

42. 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

43. 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)

44. References
• http://people.uwec.edu/piercech/fas/fas...htm. Retrieved
08/01/2015.
• http://www.debate.org/opinions/should-mothers-be-held-crimin
.
• http://sahlgrenska.gu.se/english/news_and_events/news/New
• http://psychology.about.com/od/hindex/g/def_habituation
.htm