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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]
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 Erik Erikson in his description of the stages of psychosocial development. 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".
Psychosocial study was further developed by Hollis in 1964 with emphasis on treatment model. 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. [2]
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. [3] 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 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. [4] Treatment for psychosocial disorders in a medical model usually only involve using drugs and talk therapy. [5]
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. [6] 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. [6] 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.[ citation needed ]
Medical psychology or medico-psychology is the application of psychological principles to the practice of medicine, primarily drug-oriented, for both physical and mental disorders.
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.
A mental disorder is an impairment of the mind disrupting normal thinking, feeling, mood, behavior, or social interactions, and accompanied by significant distress or dysfunction. The causes of mental disorders are very complex and vary depending on the particular disorder and the individual. Although the causes of most mental disorders are not fully understood, researchers have identified a variety of biological, psychological, and environmental factors that can contribute to the development or progression of mental disorders. Most mental disorders result in a combination of several different factors rather than just a single factor.
Biopsychosocial models are a class of trans-disciplinary models which look at the interconnection between biology, psychology, and socio-environmental factors. These models specifically examine how these aspects play a role in topics ranging from human development to health and disease.
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. For example, a human factors psychologist might use a cognitive psychology theory. This could be described as human factor psychology or as applied cognitive psychology. When applied psychology is used in the treatment of behavioral disorders there are many experimental approaches to try and treat an individual. This type of psychology can be found in many of the subbranches in other fields of psychology.
Occupational therapy (OT) is a healthcare profession that involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to improve mental and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in any activity that occupies 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). While OTs and OTAs have different roles, they both work with people who want to improve their mental and or physical health, disabilities, injuries, or impairments.
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.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, with extreme examples being violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; 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 produce trauma per se.
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to 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. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite, thinking of harming oneself or others, self-isolating, and frequently zoning out.
A psychiatric history is the result of a medical process where a clinician working in the field of mental health systematically records the content of an interview with a patient. This is then combined with the mental status examination to produce a "psychiatric formulation" of the person being examined.
Medical model is the term coined by psychiatrist R. D. Laing in his The Politics of the Family and Other Essays (1971), for the "set of procedures in which all doctors are trained". It includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and prognosis with and without treatment.
Psychiatric rehabilitation, also known as psych social rehabilitation, and sometimes simplified to psych rehab by providers, is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or emotional disorder and who may be considered to have a psychiatric disability.
Crisis intervention is a time-limited intervention with a specific psychotherapeutic approach to immediately stabilize those in crisis.
Dual diagnosis is the condition of having a mental illness and a comorbid substance use disorder. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcohol use disorder, or it can be restricted to specify severe mental illness and substance use disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in people who use substances is challenging as substance use disorder itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.
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.
A psychological injury is the psychological or psychiatric consequence of a traumatic event or physical injury. Such an injury might result from events such as abusive behavior, whistleblower retaliation, bullying, kidnapping, rape, motor vehicular collision or other negligent action. It may cause impairments, disorders, and disabilities perhaps as an exacerbation of a pre-existing condition.
Pediatric psychology is a multidisciplinary field of both scientific research and clinical practice which attempts to address the psychological aspects of illness, injury, and the promotion of health behaviors in children, adolescents, and families in a pediatric health setting. Psychological issues are addressed in a developmental framework and emphasize the dynamic relationships which exist between children, their families, and the health delivery system as a whole.
The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised is a developmentally based 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. The book has been translated into several languages, and its model is utilized for the assessment of children up to five years of age.
Rehabilitation psychology is a specialty area of psychology aimed at maximizing the independence, functional status, health, and social participation of individuals with disabilities and chronic health conditions. Assessment and treatment may include the following areas: psychosocial, cognitive, behavioral, and functional status, self-esteem, coping skills, and quality of life. As the conditions experienced by patients vary widely, rehabilitation psychologists offer individualized treatment approaches. The discipline takes a holistic approach, considering individuals within their broader social context and assessing environmental and demographic factors that may facilitate or impede functioning. This approach, integrating both personal and environmental factors, is consistent with the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF).
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