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The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is used in a broad range of helping professions in health and social care settings as well as by medical and social science researchers. [1]
Psychiatrist Dr Adolf Meyer in the late 19th century stated that: "We cannot understand the individual presentation of mental illness, [and perpetuating factors] without knowing how that person functions in the environment." Psychosocial assessment stems from this idea. The relationship between mental and emotional wellbeing and the environment was first commonly applied by Freudian ego-psychologist Professor Erik Erikson in his description of the stages of psychosocial development in his book called Childhood and Society in 1950. Mary Richmond considered there to be a strict relationship between cause and effect, in a diagnostic process. In 1941 Gordon Hamilton renamed the existing (1917) concept of "social diagnosis" as "psychosocial study". [2]
Psychosocial study was further developed by psychosocial therapist professor Florence Hollis in 1964 with emphasis on treatment model. [3] It is in tension with diverse social psychology, which attempts to explain social patterns within the individual. Problems that occur in one's psychosocial functioning can be referred to as "psychosocial dysfunction" or "psychosocial morbidity." That refers to the lack of development or diverse atrophy of the psychosocial self, often occurring alongside other dysfunctions that may be physical, emotional, or cognitive in nature. There is now a cross-disciplinary field of study, and organisations such as the Transcultural Psychosocial Organization (United Nations High Commissioner for Refugees), and Association for Psychosocial Studies.
Psychosocial assessment considers several key areas related to psychological, biological, and social functioning and the availability of supports. It is a systematic inquiry that arises from the introduction of dynamic interaction; it is an ongoing process that continues throughout a treatment, and is characterized by the circularity of cause-effect/effect-cause. In assessment, the clinician/health care professional identifies the problem with the client, takes stock of the resources that are available for dealing with it, and considers the ways in which it might be solved from an educated hypothesis formed by data collection. This hypothesis is tentative in nature and goes through a process of elimination, refinement, or reconstruction in the light of newly obtained data. [4]
There are five internal steps in assessment:
Assessment includes psychiatric, psychological and social functioning, risks posed to the individual and others, problems required to address from any co-morbidity, personal circumstances including family or other carers. Other factors are the person's housing, financial and occupational status, and physical needs. [5] Assessments when categorized, it particularly includes Life history of the client that include data collection of living situation and finances, social history and supports, family history, coping skills, religious/cultural factors, trauma from systemic issues or abuse and medico-legal factors (assessment of the client's awareness of legal documents, surrogate decision-making, power of attorney and consent). Components include: the resource assessment of psycho-spiritual strengths; substance abuse; coping mechanisms, styles and patterns (individual, family level, workplace, and use of social support systems); sleeping pattern; needs and impacts of the problem etc. Advanced clinicians incorporate individual scales, batteries and testing instruments in their assessments. In the late 1980s psychologist professor Hans Eysenck, in an issue of Psychological Inquiry, raised controversies on then assessment methods and it gave way to comprehensive Bio-Psycho-Social assessment. This theoretical model sees behavior as a function of biological factors, psychological issues and the social context. Qualified healthcare professionals conduct the physiological part of these assessments. This thrust on biology expands the field of approach for the client, with the client, through the interaction of these disciplines in a domain where mental illnesses are physical, just as physical conditions have mental components. Likewise, the emotional is both psychological and physical.
The clinician's comprehension and set of judgments about the client's situation, the assessment through a theory of each case, predicts the intervention. Hence a good psychosocial assessment leads to a good psychosocial intervention that aims to reduce complaints and improve functioning related to mental disorders and/or social problems (e.g., problems with personal relationships, work, or school) by addressing the different psychological and social factors influencing the individual. For example, a psychosocial intervention for an older adult client with a mental disorder might include psychotherapy and a referral to a psychiatrist while also addressing the caregiver's needs in an effort to reduce stress for the entire family system as a method of improving the client's quality of life. [6] Treatment for psychosocial disorders in a medical model usually only involve using drugs and talk therapy. [7]
Psychosocial adaptation is a process a person experiences in order to achieve good fitness in person-environment congruence known as adjustment, a state of wisdom oriented activities and psychosocial equilibrium. [8] Psychosocial support is the provision of psychological and social resources to a person by a supporter intended for the benefit of the receiver's ability to cope with problems faced. [8] The allocentric principle within social relationships that promote health and well-being moves individuals to aid victims of terminal illness, disaster, war, catastrophe or violence to foster resilience of communities and individuals. It aims at easing resumption of normal life, facilitating affected people's participation to their convalescence and preventing pathological consequences of potentially traumatic situations. This might extend in forms of informational and instrumental support. [9]
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed as an approach to treat depression, CBT is often prescribed for the evidence-informed treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Some types of psychotherapy are considered evidence-based for treating diagnosed mental disorders; other types have been criticized as pseudoscience.
Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles. OTs have training in the physical, psychological, and social aspects of human functioning deriving from an education grounded in anatomical and physiological concepts, and psychological perspectives. They enable individuals across the lifespan by optimizing their abilities to perform activities that are meaningful to them ("occupations"). Human occupations include activities of daily living, work/vocation, play, education, leisure, rest and sleep, and social participation.
Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.
Applied psychology is the use of psychological methods and findings of scientific psychology to solve practical problems of human and animal behavior and experience. Educational and organizational psychology, business management, law, health, product design, ergonomics, behavioural psychology, psychology of motivation, psychoanalysis, neuropsychology, psychiatry and mental health are just a few of the areas that have been influenced by the application of psychological principles and scientific findings. Some of the areas of applied psychology include counseling psychology, industrial and organizational psychology, engineering psychology, occupational health psychology, legal psychology, school psychology, sports psychology, community psychology, neuropsychology, medical psychology and clinical psychology, evolutionary psychology, human factors, forensic psychology and traffic psychology. In addition, a number of specialized areas in the general area of psychology have applied branches. However, the lines between sub-branch specializations and major applied psychology categories are often mixed or in some cases blurred.
Occupational therapy (OT) is a healthcare profession that involves the use of assessment, intervention, consultation, and coaching to develop, recover, or maintain meaningful occupations of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to support mental health and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in activities that occupy an individual's time. It is an independent health profession sometimes categorized as an allied health profession and consists of occupational therapists (OTs) and occupational therapy assistants (OTAs). OTs and OTAs have different roles, with OTs licensed to complete comprehensive occupational therapy evaluations. Both professionals work with people who want to improve their ability to participate in meaningful occupations.
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.
Psychopathology is the study of mental illness. It includes the signs and symptoms of all mental disorders. The field includes abnormal cognition, maladaptive behavior, and experiences which differ according to social norms. This discipline is an in-depth look into symptoms, behaviors, causes, course, development, categorization, treatments, strategies, and more.
Psychological trauma is an emotional response caused by severe distressing events, such as bodily injury, sexual violence, or other threats to the life of the subject or their loved ones; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not always produce trauma per se. Examples of distressing events include violence, rape, or a terrorist attack.
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to the World Health Organization (WHO), it is a "state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others.
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on behaviorism's theory of learning: respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.
In social work, a caseworker is not a social worker but is employed by a government agency, nonprofit organization, or another group to take on the cases of individuals and provide them with advocacy, information and solutions. Also, in political arenas, caseworkers are employed as a type of legislative staffer by legislators to provide service to their constituents such as dealing with individual or family concerns. A social worker who works as a caseworker obtains social casework education and training naturally through their compulsory degree works. In social work, casework means to engage a client in learning their situation, to build a suitable plan of action, and helping the client to solve their problems through client commitment and use of their own and community resources, the coordinated service is called case management. British MPs and members of the United States Congress often provide constituent services through caseworkers for better use of their allotted funds.
Pain disorder is chronic pain experienced by a patient in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and occurs more frequently in girls than boys. This disorder often occurs after an accident, during an illness that has caused pain, or after withdrawing from use during drug addiction, which then takes on a 'life' of its own.
Emergency psychiatry is the clinical application of psychiatry in emergency settings. Conditions requiring psychiatric interventions may include attempted suicide, substance abuse, depression, psychosis, violence or other rapid changes in behavior.
A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a name for community personnel who worked in the new community mental health agencies begun in the 1970s to assist individuals moving from state hospitals, to prevent admissions, and to provide support in homes, jobs, education, and community. These individuals were the forefront brigade to develop the community programs, which today may be referred to by names such as supported housing, psychiatric rehabilitation, supported or transitional employment, sheltered workshops, supported education, daily living skills, affirmative industries, dual diagnosis treatment, individual and family psychoeducation, adult day care, foster care, family services and mental health counseling.
Crisis intervention is a time-limited intervention with a specific psychotherapeutic approach to immediately stabilize those in crisis.
A psychiatric assessment, or psychological screening, is the process of gathering information about a person within a psychiatric service, with the purpose of making a diagnosis. The assessment is usually the first stage of a treatment process, but psychiatric assessments may also be used for various legal purposes. The assessment includes social and biographical information, direct observations, and data from specific psychological tests. It is typically carried out by a psychiatrist, but it can be a multi-disciplinary process involving nurses, psychologists, occupational therapist, social workers, and licensed professional counselors.
Psychology encompasses a vast domain, and includes many different approaches to the study of mental processes and behavior. Below are the major areas of inquiry that taken together constitute psychology. A comprehensive list of the sub-fields and areas within psychology can be found at the list of psychology topics and list of psychology disciplines.
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences to self and others. Related terms include substance use problems and problematic drug or alcohol use.
The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood is a diagnostic manual that provides clinical criteria for categorizing mental health and developmental disorders in infants and toddlers. It is organized into a five-part axis system that includes the following domains: clinical disorders, relational context, medical and developmental conditions, psychosocial stressors, and functional emotional development. The manual has been translated into several languages and it is used globally for the assessment of children up to five years of age.
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