1. Assumptions and key ideas:
1. No human behavior is accidental; each psychic event is determined by preceding ones.
2. Unconscious mental processes occur with great frequency and significance.
3. Psychoanalysis is used to uncover childhood trauma, which may involve conflict and repressed feelings.
4. Psychoanalytic methods are used: therapeutic alliance, transference, regression, dream association, catharsis.
2. Freud—shifted from classification of behavior to understanding and explaining in psychological terms and changing behavior under structured conditions.
1. Structure of the mind: id, ego, superego; unconscious, preconscious, conscious.
2. Stages of psychosexual development (Table 10.1. Freud's Stages of Psychosexual Development).
3. Defense mechanisms (see Psychosocial Integrity).

(Erikson, Maslow, Piaget, Duvall)

1. Erik Erikson—Eight Stages of Man (1963)
1. Psychosocial development—interplay of biology with social factors, encompassing total life span, from birth to death, in progressive developmental tasks.
2. Stages of life cycle—life consists of a series of developmental phases (Table 10-2. Erikson's Stages of the Life Cycle and Table 10-3. Summary of Theories of Psychosocial Development Throughout the Life Cycle ).
1. Universal sequence of biological, social, psychological events.
2. Each person experiences a series of normative conflicts and crises and thus needs to accomplish specific psychosocial tasks.
3. Two opposing energies (positive and negative forces) coexist and must be synthesized.
4. How each age-specific task is accomplished influences the developmental progress of the next phase and the ability to deal with life.
2. Abraham Maslow—Hierarchy of Needs (1962)
1. Beliefs regarding emotional health based on a comprehensive, multidisciplinary approach to human problems, involving all aspects of functioning.
1. Premise: mental illness cannot be understood without prior knowledge of mental health.
2. Focus: positive aspects of human behavior (e.g., contentment, joy, happiness)
2. Hierarchy of needs—physiological, safety, love and belonging, self-esteem and self-recognition, self-actualization, aesthetic. As each stage is mastered, the next stage becomes dominant (Figure 10.1. Maslow's Hierarchy of Needs).
3. Characteristics of optimal mental health—keep in mind that wellness is on a continuum with cultural variations.
1. Self-esteem: entails self-confidence and self-acceptance.
2. Self-knowledge: involves accurate self-perception of strengths and limitations.
3. Satisfying interpersonal relationships: able to meet reciprocal emotional needs through collaboration rather than by exploitation or power struggles or jealousy; able to make full commitments in close relationships.
4. Environmental mastery: can adapt, change, and solve problems effectively; can make decisions, choose from alternatives, and predict consequences. Actions are conscious, not impulsive.
5. Stress management: can delay seeking gratification and relief; does not blame or dwell on past; assumes self-responsibility; either modifies own expectations, seeks substitutes, or withdraws from stressful situation when cannot reduce stress.
3. Jean Piaget—Cognitive and Intellectual Development (1963)
1. Assumptions—child development is steered by interaction of environmental and genetic influences; therefore, focus is on environmental and social forces (see Table 10-3. Summary of Theories of Psychosocial Development Throughout the Life Cycle for comparison with other theories).
2. Key concepts:
1. Assimilation: process of acquiring new knowledge, skills, and insights by using what the child already knows and has.
2. Accommodation: adjusts to change by solving previously unsolvable problems because of newly assimilated knowledge.
3. Adaptation: coping process to handle environmental demands.
3. Age-specific developmental levels—sensorimotor, preconceptual, intuitive, concrete, formal operational thought Table 10-4. Piaget's Age-Specific Development Levels .
4. E. M. Duvall—Family Development (1971)—developmental tasks are family oriented, presented in eight stages throughout the life cycle.
1. Married couple:
1. Establishing relationship.
2. Defining mutual goals.
3. Developing intimacy: issues of dependence-independence-interdependence.
4. Establishing mutually satisfying relationship.
5. Negotiating boundaries of couple with families.
6. Discussing issue of childbearing.
2. Childbearing years:
1. Working out authority, responsibility, and caregiver roles.
2. Having children and forming new unit.
3. Facilitating child's trust.
4. Need for personal time and space while sharing with each other and child.
3. Preschool-age years:
1. Experiencing changes in energy.
2. Continuing development as couple, parents, family.
3. Establishing own family traditions without guilt related to breaks with tradition.
4. School-age years:
1. Establishing new roles in work.
2. Children's school activities interfering with family activities.
5. Teenage years:
1. Parents continue to develop roles in community other than with children.
2. Children experience freedom while accepting responsibility for actions.
3. Struggle with parents in emancipation process.
4. Family value system is challenged.
5. Couple relationships may be strong or weak depending on responses to needs.
6. Families as launching centers:
1. Young adults launched with rites of passage.
2. Changes in couple's relationship due to empty nest and increased leisure time.
3. Changes in relationship with children away from home.
7. Middle-aged parents: Dealing with issues of aging of own parents.
8. Aging family members:
1. Sense of accomplishment and desire to continue to live fully.
2. Coping with bereavement and living alone.

1. Primary prevention—lower the risk of mental illness and increase capacity to resist contributory influences by providing anticipatory guidance and maximizing strengths.
2. Secondary prevention—decrease disability by shortening its duration and reducing its severity through detection of early-warning signs and effective intervention following case-finding.
3. Crisis intervention (see Psychosocial Integrity).
4. Tertiary prevention—avoid permanent disorder through rehabilitation.

1. Assumptions:
1. Roots in neurophysiology (i.e., neurotransmitter functions versus effects).
2. Stimulus-response learning can be conditioned through reinforcement.
3. Behavior is what one does.
4. Behavior is observable, describable, predictable, and controllable.
5. Classification of mental disease is clinically useless, only provides legal labels.
2. Aim: change observable behavior. There is no underlying cause, no internal motive.