R Psychosocial Issues in the Health Care of Children and Young people.
A case study discussing the application and analysis of theories applicable to the psychological care of and child and their family.
A case study discussing the application and analysis of theories applicable to the psychological care of and child and their family. I’m going to discuss a case study of a child named Jake. The name has been changed to comply with NMC confidentiality (Nursing and Midwifery Council 2012). Jake is four, and has been admitted to hospital due to a head injury. He also suffers from Asthma. The story behind this accident is vague and this family had previously contact with social services for child protection issues and the suspicion of abuse. This essay will consider the psychological effects this abuse may have on Jake; it will not discuss the actual reporting of the abuse. Jake is at an age where he requires psychological support and interaction to enable his development; Piaget demonstrated this though his Theory of Cognitive Development. Piaget believed that children go through a multiple number of stages of development and move from one stage to another once they achieve specific developmental milestones (Oakley 2004). This is backed up by Ericson’s stages of psychosocial development. He believed each stage of development has a specific conflict that the child has to overcome before moving to the next stage. If a child is unable to successfully overcome a particular conflict, the child will remain stuck at that stage until they are able to resolve that issue (Shaffer 2005). It is thought that in order to move through these stages children need stimulation, encouragement and love from those around them. This will allow them build their trust, confidence and sense of security overall helping them successfully develop psychologically, in the form of social skills, cognitive and emotional development. In this case Jake may not have had the opportunity for this development due to possible neglect and abuse. He is less likely to be encouraged and may be anxious and insecure with a lack of trust in all adults. This means he may not thrive and will be ‘stuck’ at Piaget and Ericson’s development stages (Wadsworth 2004). There are many psychological theories and explanations that can be applied to this case with Jake, due to these disruptive and uneasy first few years of his life. Jake is very likely to have experienced a lot of stress. Stress can be defined as physical, mental, or emotional factor that affect the functioning of the body (Weller 2009). It becomes a problem when stress reactions are so severe that the child is unable to handle them effectively, which could apply to Jake. This stress experienced from abuse starts as a daily hassle, but can lead to more long term chronic stress (Thomas 2007).Jake is currently experiencing both types of stress, firstly due to the chronic stress of abuse and secondly the additional stress of coming into hospital. Being only four he is not old enough to manage stress or understand what he’s going though, therefore it’s likely to have a huge effect on him and his development as he can’t manage it effectively. At this age, this stress response allows the child to gain control in the short term yet not manage the long term stress. He is likely to express extreme behaviors in order to cope including, withdrawal, denial and impulsive acting out. These are defense mechanisms, which are ineffective in the long term, and lead to a more extreme way to cope, this could be shown by, panic, depression, self-harm and refusal to play with his peers (Kostelnik 1998). This is the type of coping mechanism a boy of Jake’s age is likely to express. Stress is said to be divided into three different ‘types'. Positive stress, this is experienced in everyday life and is essential for development such as meeting new people or going to a new school. Tolerable stress causes more distress but is...
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