This document defines conceptual models and describes four major models that influence current nursing practice: existential, psychoanalytic, behavioral, and interpersonal. It provides an overview of each model, including its basic assumptions, therapeutic approaches, roles of patient and therapist, and applications to nursing. The existential model focuses on present experiences rather than past ones. The psychoanalytic model views behavior as caused and driven by unconscious forces. The behavioral model assumes all behavior is learned and can be changed. The interpersonal model sees personality developing through social interactions and relationships.

1. CONCEPTUAL MODEL
AND THE ROLE OF A
NURSE
Tejal D. Virola
M.Sc. Nursing (MHN)

2. Learning Objectives
• Define Conceptual Model
• Explain various models influencing
current practice

3. INTRODUCTION
• A model is a means of organizing a complex
body of knowledge. For example, the linkage
• between the various concepts related to
human behavior may be represented in the
form of a model, which can now be referred to
as a conceptual model.

4. The various models or theoretical
approaches influencing current
practice are:
• Existential model
• Psychoanalytical model
• Behavioural model
• Interpersonal model

5. EXISTENTIAL MODEL
• The existential model centers on a person's
present experiences rather than his past ones.
• The theorists who particularly emphasized the
importance of existential model are Perls,
Glasser, Ellis, Rogers, Frankl

6. Roles of Patient and Therapist
• Patient participates in meaningful experiences
to learn about real self.
• Therapist helps patient recognize value of self,
clarify realities of situation and explore feelings.

7. Applications to Nursing
• Based on the existential model of behavior,
nursing developed the concept that the nurse
works to restore the patient to a state of 'full
life’ from a state of self-alienation.

8. PSYCHOANALYTIC MODEL
• All human behavior is caused, and thus, is
capable of explanation.
• All human behavior from birth to old age is
driven by an energy called the libido.
• The personality of the human being can be
understood by way of three major
hypothetical structures; id, ego and superego.

10. • The human
personality functions
on three levels of
awareness: conscious,
preconscious and
unconscious
• Human personality
development unfolds
through five innate
psychosexual stages
oral, anal. phallic,
latent and genital

11. Psychoanalytical Process
• Psychoanalysis,
described by
Freud, makes use
of free association
and dream
analysis to affect
reconstruction of
personality.

12. • The patient is an active participant, freely
revealing all thoughts exactly as they occur
and describing all dreams.
• By termination of therapy, the patient is
able to conduct his life according to an
accurate assessment of external reality and
is also able to relate to others uninhibited
by neurotic conflicts

13. Roles of the Patient and the
Psychoanalysis
• The patient is to be an active participant,
freely revealing all thoughts exactly as they
occur and describing all dreams.
• The psychoanalyst is a shadow person; while
the patient is expected to reveal all his
thoughts and feelings, the analyst reveals
nothing personal.

14. Application to Nursing
• Helped mental health professionals to
understand psychopathology and stress
related behaviours.
• Illustrates the importance of not taking human
behavior at face value.
• Helps the psychiatric mental health nurse to
discern and explore the meaning behind
human behavior.

15. BEHAVIOURAL MODEL
Basic assumptions of behavioral model are:
• All behavior is learnt
• All behavior occurs in response to a stimulus
• Human beings are passive organisms that can be
conditioned or shaped to do anything if correct
responses are rewarded or reinforced
• Maladaptive behavior can be unlearnt and
replaced by adaptive behavior
• Deviations from behavioral norms occur when
undesirable behavior has been reinforced.

17. Therapeutic Approaches
• Systematic desensitization
• Token reinforcement
• Shaping
• Chaining
• Prompting
• Flooding
• Aversion therapy
• Assertiveness and social skills training

18. Role of the Behavioural Therapist
• Helps the patient unlearn his symptoms and
replace them with more satisfying behavior
• Uses the patient's anxiety as a motivational
force towards learning
• Teaches the patient about behavioral
approaches and helps him develop behavioral
hierarchy
• Reinforces desired behaviours

19. Role of the Patient
• As a learner, the patient is an active
participant in the therapy process
• Patient practices behavioral techniques
• Does homework and reinforcement exercises
Therapy is considered to be complete when the
symptoms subside.

20. Application to Nursing
• Nurses commonly use behavioral
techniques in a wide variety of mental
health settings.
• Additionally, nurses who work with
patients having physical disability,
chronic pain, chemical dependency and
rehabilitation centers also apply these
techniques.

21. INTERPERSONAL MODEL
• Human beings are essentially social beings.
• Human personality is determined in the
context of social interactions with other
human beings
• Anxiety Plays a central role in the formation of
human personality by serving as a primary
motivator of human behavior.
• Self-esteem is an important facet of human
personality that forms in reaction to the
experience of anxiety.

22. • Security mechanisms are used to reduce
or avoid the experience of anxiety.
• Early life experiences with parents,
especially the mother, influence an
individual's development throughout life.
• Human development proceeds through
six stages of development: infancy,
childhood, juvenility, pre-adolescence,
early adolescence and late adolescence.

23. Interpersonal Therapeutic Process
• The interpersonal therapist, like the psychoanalyst,
explores the patient's life history.
• Components of self-esteem are identified,
including the security operations that are used to
defend the self.
• The process of therapy is essentially a process of
re-education as the therapist helps the patient
identify interpersonal problems and then
encourages him to try out more successful styles
of relating.
• Therapy is terminated when the patient has
developed the ability to establish satisfying human
relationships, thereby meeting his basic needs.

24. Roles of the Patient and the
Interpersonal Therapist
• Sullivan describes the therapist as a participant
observer, who should not remain detached from
the therapeutic situation.
• The patient's role is to share his concerns with the
therapist and participate in the relationship to the
best of his ability.
• The relationship itself is meant to serve as a model
of interpersonal relationships. As the patient
matures in his ability to relate, he can then improve
and broaden his other life experiences with people
outside the therapeutic situation.

25. Application to Nursing
• Sullivan's interpersonal theory has been the
cornerstone of psychiatric-mental health nursing
curricula in the undergraduate and graduate
levels.
• Nurse-patient one-to-one interaction or
interpersonal process is based on Sullivan's
interpersonal theory.
• The use of interpersonal process recordings in the
clinical aspect of psychiatric-mental health
nursing courses is also derived from Sullivan's
interpersonal theory