physical and psychosocial therapies

7/30/2019 Physical and Psychosocial Therapies

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PHYSICAL AND PSYCHOSOCIAL THERAPIES

Psychotherapy is a general term referring to therapeutic interaction or treatment contracted

between a trained professional and a client or patient; family, couple or group. The problems

addressed are psychological in nature and of no specific kind or degree, but rather depend on

the specialty of the practitioner.

Psychotherapy aims to increase the individual's sense of his/her own well-being.

Psychotherapists employ a range of techniques based on experiential relationship building,

dialogue, communication and behavior change that are designed to improve the mental healthof a client or patient, or to improve group relationships (such as in a family).

INDIVIDUAL PSYCHOTHERAPY

Individual Psychotherapy is a process of meeting with a therapist to assist you in dealing with

symptoms or problems you are having. A common aim of therapy is to gain understanding that

informs one to make new choices that achieve a better outcome for one's life. This may involvelearning new skills, trying out new behaviors, working through old issues, grieving, or letting

go of things that no longer serve health or well-being. We may not so much change ourexperiences, but rather see more clearly how we relate to them and find a source of peace about

the ones that have been troubling to us. From this awareness it becomes possible to move with

greater flexibility and creativity in the world.

In Individual psychotherapy in initial appointment, Therapist will assess a variety of personalbackground information, including situations or conditions that may affect the problem for

which a person seeking psychotherapeutic treatment. Patient participate in this process by

completing history forms, sometimes specific symptom check lists, and by talking about their

situation. A thorough history helps therapist to determine if there is a medical or other problemrequiring additional referral for care. It also helps in identifying what therapeutic methods may

be most effective for patient. This also allows therapist to develop a treatment plan tailored to

patients needs based on the initial and ongoing assessments. Patient will be given informationabout recommendations (such as for specific types of therapy, biofeedback, medications, or

bodywork, etc.) and are encouraged to ask questions to help patient understand their care

better.


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Some Issues for which Individual Psychotherapy may help:

Personal Growth & Exploration

Peak Performance Enhancement

Spiritual Issues

Life Adjustment Issues

Coping with Changes

Grief or Loss

Work-Life Balance

Self-esteem/Confidence Issues

Chronic Pain & Pain Disorders

Past Trauma

Relationship Issues

Adolescent Issues

Eating Disorders

Weight Issues

Depression or Sadness

Anxiety Problems

Sexuality Issues

Stress-related problems

Stress management


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Coping with Health problems

Excessive fears

Advantages with Individual Therapy:

No one except the therapist will know your secrets.

The therapist gets more time to handle your particular problems.

You can often penetrate deeper into your inner problems than with group therapy.

You do not have to listen to other people, which may feel better if you have lots of your

own problems.

You can arrange a time which suits you and you do not have to co-ordinate your

calendar with other people and available group therapy slots.

GROUP PSYCHOTHERAPY

Group therapy is a type of psychotherapy that involves one or more therapists working withseveral people at the same time. This type of therapy is widely available at a variety oflocations, including private therapeutic practices, hospitals, mental health clinics and

community centers. Group therapy is sometimes used alone, but it is also commonly integrated

into a comprehensive treatment plan that also includes individual therapy and medication.

The Principles of Group Therapy

In The Theory and Practice of Group Psychotherapy, Irvin D. Yalom outlines the key

therapeutic principles that have been derived from self-reports from individuals who have beeninvolved in the group therapy process:3

1. The instillation of hope

2. Universality

3. Imparting information


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4. Altruism

5. The corrective recapitulation of the primary family group

6. Development of socialization techniques

7. Imitative behavior

8. Interpersonal learning

9. Group cohesiveness

10. Catharsis

11. Existential factors

The Effectiveness of Group Therapy

Group therapy can be very effective, especially in certain situations. Studies have shown that

group therapy can be an effective treatment choice for depression and traumatic stress.

Advantages with Group Therapy:

Group therapy usually costs much less. One therapist charges, for example, 100

/month for group therapy 90 minutes once a week, and charges 80 /month for one 45-minute session.

Meeting other people with problems can give a wider perspective of your own

problems.

Listening to other people helps you understand that you can view and handle problems

in more than one way.

Other people can give encouragement and emotional support; a general feeling for the

human condition: "We are all in the same boat."

Group therapy is of special value in treating problems involving communication with

other people, such as social phobia (shyness).

MUSIC THERAPY

Music therapy is an allied health profession and one of the expressive therapies, consisting of

an interpersonal process in which a trained music therapist uses music and all of its facets

physical, emotional, mental, social, aesthetic, and spiritualto help clients to improve or

maintain their health. Music therapists primarily help clients improve their health across

various domains (e.g., cognitive functioning, motor skills, emotional and affective

development, behavior and social skills, and quality of life) by using music experiences (e.g.,

free improvisation, singing, songwriting, listening to and discussing music, moving to music)

to achieve treatment goals and objectives.


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Research has shown that music has a profound effect on your body and psyche. In fact, theres

a growing field of health care known as music therapy, which uses music to heal. Those who

practice music therapy are finding a benefit in using music to help cancer patients, children

with ADD, and others, and even hospitals are beginning to use music and music therapy to

help with pain management, to help ward off depression, to promote movement, to calm

patients, to ease muscle tension, and for many other benefits that music and music therapy can

bring. This is not surprising, as music affects the body and mind in many powerful ways. The

following are some of effects of music, which help to explain the effectiveness of music

therapy:

Brain Waves: Research has shown that music with a strong beat can stimulate

brainwaves to resonate in sync with the beat, with faster beats bringing sharperconcentration and more alert thinking, and a slower tempo promoting a calm,

meditative state. Also, research has found that the change in brainwave activity levels

that music can bring can also enable the brain to shift speeds more easily on its ownas needed, which means that music can bring lasting benefits to your state of mind,

even after youve stopped listening.

Breathing and Heart Rate: With alterations in brainwaves comes changes in other

bodily functions. Those governed by the autonomic nervous system, such asbreathing and heart rate can also be altered by the changes music can bring. This can

mean slower breathing , slower heart rate, and an activation of the relaxation

response, among other things. This is why music and music therapy can help

counteract or prevent the damaging effects of chronic stress, greatly promoting notonly relaxation, but health.

State of Mind: Music can also be used to bring a more positive state of mind,

helping to keep depression and anxiety at bay. This can help prevent the stress


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response from wreaking havoc on the body, and can help keep creativity and

optimism levels higher, bringing many other benefits.

Other Benefits: Music has also been found to bring many other benefits, such as lowering

blood pressure (which can also reduce the risk of stroke and other health problems over time),

boost immunity, ease muscle tension, and more. With so many benefits and such profound

physical effects, its no surprise that so many are seeing music as an important tool to help the

body in staying (or becoming) healthy.

AROMA THERAPY

Aromatherapy is a form of alternative medicine that uses volatile plant materials, known asessential oils, and other aromatic compounds for the purpose of altering a person's mind, mood,

cognitive function or health.

Some essential oils such as tea tree have demonstrated anti-microbial effects, but there is still a

lack of clinical evidence demonstrating efficacy against bacterial, fungal, or viral infections.Evidence for the efficacy of aromatherapy in treating medical conditions remains poor, with a

particular lack of studies employing rigorous methodology, but some evidence exists that

essential oils may have therapeutic potential.

Modes of application

The modes of application of aromatherapy include:

Aerial diffusion: for environmental fragrance or aerial disinfection

Direct inhalation: for respiratory disinfection, decongestion, expectoration as well as

psychological effects

Topical applications: for general massage, baths, compresses, therapeutic skin care

Materials

Some of the materials employed include:

Absolutes: Fragrant oils extracted primarily from flowers or delicate plant tissuesthrough solvent or supercritical fluid extraction (e.g., rose absolute). The term is also

used to describe oils extracted from fragrant butters, concretes, and enfleuragepommades using ethanol.


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Carrier oils: Typically oily plant base triacylglycerides that dilute essential oils for use

on the skin (e.g., sweet almond oil).

Essential oils: Fragrant oils extracted from plants chiefly through steam distillation(e.g., eucalyptus oil) or expression (grapefruit oil). However, the term is alsooccasionally used to describe fragrant oils extracted from plant material by any solvent

extraction.

Herbal distillates or hydrosols: The aqueous by-products of the distillation process

(e.g., rosewater). There are many herbs that make herbal distillates and they have

culinary uses, medicinal uses and skin care uses. Common herbal distillates are

chamomile, rose, and lemon balm.

Infusions: Aqueous extracts of various plant material (e.g., infusion of chamomile).

Phytoncides: Various volatile organic compounds from plants that kill microbes. Many

terpene-based fragrant oils and sulfuric compounds from plants in the genus "Allium"

are phytoncidesthough the latter are likely less commonly used in aromatherapy due totheir disagreeable odors.

Vaporizer (Volatized) Raw Herbs: Typically higher oil content plant based materials

dried, crushed, and heated to extract and inhale the aromatic oil vapors in a direct

inhalation modality.

Popular uses

Lemon oil is uplifting and anti-stress/anti-depressant. In a Japanese study, lemon

essential oil in vapour form has been found to reduce stress in mice. Research at The

Ohio State University indicates that Lemon oil aroma may enhance one's mood, andhelp with relaxation.

Thyme oilPeppermint oil is often used to deter ants, by applying a few drops on their

trail.

Both lavender and tea tree oil are used as antiseptics, sometimes in lotions or soaps.

Lavender oil is said to help heal wounds and burns.


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Lavender, Jasmine and Peppermint are used for anti-stress, anti-anxiety and as an anti-

depressant.

PLAY THERAY

Play therapy is generally employed with children aged 3 through 11 and provides a way for

them to express their experiences and feelings through a natural, self-guided, self-healing

process. As childrens experiences and knowledge are often communicated through play, it

becomes an important vehicle for them to know and accept themselves and others.

Models of Play Therapy

An individual engaging in sandplay therapy.
http://en.wikipedia.org/wiki/File:Sandspiel1.jpghttp://en.wikipedia.org/wiki/File:Sandspiel1.jpg


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Equipment used for sand play therapy.

Play therapy can be divided into two basic types: nondirective and directive. Nondirective play

therapy is a non-intrusive method in which children are encouraged to work toward their ownsolutions to problems through play. It is typically classified as a psychodynamic therapy. In

contrast, directive play therapy is a method that includes more structure and guidance by the

therapist as children work through emotional and behavioral difficulties through play. It often

contains a behavioral component and the process includes more prompting by the therapist.Directive play therapy is more likely to be classified as a type of cognitive behavioral therapy.

Both types of play therapy have received at least some empirical support. On average, play

therapy treatment groups when compared to control groups improve by .8 standard deviations.

USES OF PLAY THERAPY

Play Therapy is a form of counseling or psychotherapy that uses play to communicate with andhelp people, especially children, to prevent or resolve psychosocial challenges. This is thought

to help them towards better social integration, growth and development.

Play Therapy can also be used as a tool of diagnosis. A play therapist observes a client playing

with toys (play-houses, pets, dolls, etc.) to determine the cause of the disturbed behavior. The

objects and patterns of play, as well as the willingness to interact with the therapist, can beused to understand the underlying rationale for behavior both inside and outside the session..

According to the psychodynamic view, people (especially children) will engage in play

behavior in order to work through their interior obfuscations and anxieties. In this way, play

therapy can be used as a self-help mechanism, as long as children are allowed time for "freeplay" or "unstructured play." Normal play is an essential component of healthy child

development.

One approach to treatment is for play therapists use a type of desensitization or relearning

therapy to change disturbing behavior, either systematically or in less formal social settings.These processes are normally used with children, but are also applied with other pre-verbal,
http://en.wikipedia.org/wiki/File:Sandspiel_Figuren1.jpg


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non-verbal, or verbally-impaired persons, such as slow-learners, or brain-injured or drug-

affected persons.

OCCUPATIONAL THERAPY

According to the World Federation of Occupational Therapy, occupational therapy is a

profession concerned with promoting health and well being through engagement in

occupation." Occupational therapy (also abbreviated as OT) is a holistic health care

profession that aims to promote health by enabling individuals to perform meaningful and

purposeful activities across the lifespan. Occupational therapists use treatments to develop,

recover, or maintain the daily living and work skills of their patients with a physical, mental or

developmental condition. Under the supervision of occupational therapists, occupational

therapy assistants may contribute to the treatment process. Occupational therapy is a client-

centered practice in which the client has an integral part in the therapeutic process.

Occupational therapy process

An Occupational Therapist works systematically through a sequence of actions known as the

occupational therapy process. There are several versions of this process as described by

numerous writers, although all include the basic components of evaluation, intervention, andoutcomes. Creek has sought to provide a comprehensive version based on extensive research

which has 11 stages.

The Canadian Practice Process Framework (CPPF), has eight action points and three

contextual elements.

Fearing, Law, and Clark suggested a 7 stage process. A central element of this process model is

the focus on identifying both client and therapists strengths and resources prior to beginning to

develop the outcomes and action plan.

The Occupational Therapy Practice Framework: Domain and Process (2nd edition) (AOTA,2008) presents a 3 stage process, and includes interrelated constructs that define and guide

practice.


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PRACTICE AREAS OF OCCUPATIONAL THERAPY

Children & Youth

A Broader Scope in Schools

Autism

Bullying

Childhood Obesity

Driving for Teens With Disabilities

Transitions for Older Youths

Education

Distance Learning

Re-entry to the Profession

Health & Wellness

Chronic Disease Management

Obesity

Prevention

Mental Health

Depression

Recovery and Peer Support Model


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Sensory Approaches to Mental Health

Veterans and Wounded Warriors Mental Health

Productive Aging

Community Mobility and Older Drivers

Aging in Place and Home Modifications

Low Vision

Alzheimers Disease and Dementia

Rehabilitation

Autism in Adults

Cancer Care and Oncology

Hand Transplants and Bionic Limbs

New Technology for Rehab

Telehealth

Veteran and Wounded Warrior Care

Work and Industry

Aging Workforce

New Technology at Work

COLOR THERAPY

Chromotherapy, sometimes called color therapy, colorology or cromatherapy, i s acomplementary medicine method. It is said that a therapist trained in chromotherapy can use

light in the form of color to balance "energy" wherever a person's body be lacking, whether on

physical, emotional, spiritual, or mental levels. The practice has been labelled pseudoscientific

by some of its critics.

Color therapy is unrelated to light therapy, a scientifically-proven form of medical treatment

for seasonal affective disorder and a small number of other conditions, and photobiology, the

scientific study of the effects of light on living organisms.


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AIMS OF COLOR THERAPY

Color Therapy aims to balance and enhance our body's energy centers/chakras by using the

colors of the light spectrum, which can help to stimulate our body's own healing process.

USES OF COLOR THERAPY

Colour Therapy can be used for any problem whether, physical, mental, emotional or spiritual

for specific problems as well as an over all relaxation therapy.

Colour Therapy can be used safely and effectively - either alone or alnogside any other

therapy, whether complementary or orthodox medicine - for adults, children, babies and non-

human animals alike. (However, no complementary therapy should ever be considered as an

alternative to orthodox medical advice.)

Colour energy can be the catalyst for our healing process and encourages normal and healthy

workings of the body.

Colour Therapy should notbe something you just go to a therapist to 'have done to you'.

Colour is everywhere and should be utilized as part of our everyday life. A professional Colour

Therapist can explain and advise you on how you can use colour at home for health and

wellbeing.


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MILIUE THERAPY

Meaning

The word milieu is French for middle. The English translation of the word is surroundings or

environment. Milieu therapy is the scientific planning of an environment for therapeuticpurposes.

Definition

A scientific structuring of the environment in order to effect behavioral changes and toimprove the psychological health and functioning of the individual (Skinner, 1979).

Goals of milieu therapy:

1. Manipulate the environment so that all aspects of clients hospital experience are

considered therapeutic.2. Client is expected to learn adaptive coping, interaction and relationship skills that can

be generalized to other aspects of his or her life.

3. Achieving client autonomy

Principles of milieu therapy

To promote a fundamental respect for individuals (both clients and staff).

To use opportunities for communication between client and staff for maximum

therapeutic benefit.

To encourage clients to act at a level equal to their ability and to enhance their self

esteem( autonomy is reinforced)

To promote socialization.

To provide opportunities for clients to be part of unit management.

Individuals are held responsible for own actions.

Peer pressure is utilized to reinforce rules and regulations.

Team approach is used.

Group discussions and temporary seclusions are favoured approaches for acting out

behaviour.

The nurses function is to act in ways that consistently promote these goals.

ADVANTAGES AND DISADVANTAGES OF MILIEU THERAPY:


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The therapeutic and anti therapeutic effect of milieu therapy will depend on the hospital

setting. If the hospital organization believes in this type of approach for mentally ill patients,

the effect can be achieved. Otherwise it is difficult for a unit to achieve these goals. In ourcountry it may be difficult for a unit to achieve these goals. In our country it may be difficult

initially but once the hospital gets to know the advantages for the patients, such an approach

will be practical.

Advantages:

1. Milieu therapy creates a different type of attitude and behaviour in the patient because

the environment is like home.

2. Instead of adopting a sick role, the patient makes decisions in the ward management

and cares for other patients. In other words, he becomes less dependent and passive.

3. The patient learns to adopt a behaviour which is acceptable in the therapeuticenvironment like learns to control hostility.

4. The patient learns to make decisions which improves his self confidence.

5. Milieu includes safe physical surroundings, al the treatment team members, and other

clients, which is supported by clear and consistently maintained limits and behavioural

expectations.

6. A therapeutic milieu is a safe space, a non punitive atmosphere, which minimize the

environmental stress and provides a chance for rest and nurturance of self, a time to

focus on the developments of strengths, and an opportunity to learn to identify

alternatives or solutions to problems and to learn about the psychodynamics of thoseproblems.

7. Patient develops harmonious relationships with other members of the community.

8. Develops leadership skills.

9. Becomes socio centric.

10. Learns to live and think collectively with the members of the community.

Disadvantages:

1. Role blurring between staff and patient.

2. Group responsibility can easily become nobodys responsibility.

3. Individual needs and concerns may not be met.

4. Patient may find the transition to community difficult.

5. Milieu therapy is limited to only hospitalized patients.


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6. Conflict resolution is needed as part of the staffs skills.

7. Low client- to- staff ratio.

REFRENCES:

Townsend Mary C. Essentials of Psychiatric/Mental Health Nursing. F A Davis

Company, Philadelphia. 1999. 195-201

Shives Rebraca Louise. Basic Concept of Psychiatric Mental Health Nursing. 6th

edition. Lippincot William and Wilkin. 2005. 203-208

Kay j, Tasman A & Lieberman J A. Text book of psychiatry. Vol. 11. (3 RD EDN).

Newyork: John Willey & sons ltd. 2003. 309-322.

Fortinash K M, Patricia A and Worret H. Psychiatric mental health nursing (3 rd)Mosby publications. 2001. 212-234.

Kaplan and sadaock j Benjamin. Synopsis of psychiatry- Behavioral Science, clinical

approach. (6th edition). Williams & Wilkins Publishers; Baltimore: 1998. 434-445.

physical and psychosocial therapies

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