1. Community mental health model (Gerald Kaplan) - levels of prevention
    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
    4. Tertiary prevention-avoid permanent disorder through rehabilitation.
  2. Behavioral model (Pavlov, Watson, Wolpe, Skinner)
    1. Assumptions
      1. Roots in neurophysiology.
      2. Stimulus-response learning can be conditioned through reinforcement.
      3. Behavior is what one does.
      4. Behavior is observable, describable, predictable, and controllable.
      5. Aim: change observable behavior. There is no underlying cause, no internal motive.
    2. Aim: change observable behavior. There is no underlying cause, no internal motive.
  3. Comparison of models

Summary of Theories of Psychosocial Development Throughout the Life Cycle

Freud Piaget Sullivan Erikson

Emphasis on Pathology (intrapsychic)
Normal children
Pathology (interpersonal)
Both health and illness

Anxiety
No emphasis on ego, anxiety, identity, libido
Anxiety

Unconscious, uncontrollable drives
Cognitive development
Unconscious, uncontrollable drives
Problems are manageable and can be solved

Ego needing defense
Tasks can be accomplished through learning process
Self-system needing defense
Need to integrate individual and society

Pathological Development Influenced by
Early feelings; repressed experiences in unconscious
Individual differences and social influences on the mind
Unconscious mind and interpersonal relationships (IPR)
Ego, anxiety, identity, libido concepts combined with social

Change Possible with
Understanding content and meaning of unconscious
Socialization process to facilitate cognitive development
Improved IPR and understanding basic good-bad transformations
Integration of attitudes, libido, and social roles for strong ego identity

Age Group
First 5 years of life
Middle childhood years
Adolescence
Middle age, old age

Focus on
Emotional development
Cognitive skills
Emotional and interpersonal development; relationships with opposite sex
Emotional, interpersonal, spiritual

Psychosexual aspects
Cognitive, interactive aspects
Psychosocial asepects; developing sense of identity
Psychosocial aspects

Cause of Conflicts and Problems
Oral, anal, genital stage problems (especially unresolved oedipal/ castration conflicts)
Faulty adaptation between individual and environment for intellectual development
Threats to self-system; disturbed communication process; 7 stages not complete
Unresolved conflicts, crises in 8 successive life cycle stages

Prognosis
Few changes possible after age 5
Little change in adult cognitive structure after middle adolescence
Change usually possible with improved IPR
Change not only possible but expected throughout life

Sexual problems part of disturbed behavior
Sex as a variable in learning (age, IQ)
Sexual problems are only one type of faulty IPR affecting behavior
Sexual identity as one of many problems solved by interaction of desire and social process