Learning Objectives
By the end of this section, you will be able to:
- Define humanistic theories and therapies
- Identify nursing application of humanistic theories and therapies
Humanistic theory emerged after the concepts of psychoanalytic and behavioral theories. Humanistic theory states that persons must be viewed as holistic beings with free will and choice, as continually moving toward self-actualization, which is the realization of full potential or inner fulfillment considered as a drive or need present in everyone.
Humanistic theory places the person at the center of mental health care where they are supported to identify personal strengths and discover their own perspectives. Humanistic theory has a wellness focus and acknowledges environmental effects on health (Sussex Publishers, 2022). Two humanistic theorists are discussed here: Abraham Maslow and Carl Rogers.
Definitions
The humanistic theory is based on identification of holistic human needs. When these needs are met, persons can grow and achieve their goals in life. When needs go unmet, persons may struggle to move to next levels in life. In therapy utilizing these guidelines, the therapist and client work together to determine the client’s life accomplishments and where assistance is needed for growth.
Abraham Maslow
Abraham Maslow (1908–1970) believed humans were motivated by unmet needs. Maslow created a model that started with the most basic needs of all human beings and worked into the most esoteric and abstract human needs (Figure 2.5). These needs were incremental and necessary for a client to become a fully functioning whole person. He initially had five levels of needs: physiological, safety/security, belonging and love/social, esteem, and self-actualization. Later, he added cognitive and aesthetic needs (placed between esteem and actualization). These additions represented the need to obtain and understand knowledge and the need for beauty and symmetry (McLeod, 2018).
Carl Rogers
Psychologist Carl Rogers (1902–1987) is known for his humanistic theory and person-centered approach to therapy. He said that an individual’s actions are motivated by the potential of self-actualization, by the possibility of achieving their best self, their highest potential. He based his theory on the idea of self-concept, which is a person’s awareness of who they are. Self-concept has three components, according to Rogers: self-image, self-esteem, and the ideal self. He believed that humans have the ability to be self-aware, to evolve, and to recover with the person-centered therapist offering unconditional positive regard, empathy, and congruence. This supportive process allows the person to work toward their chosen goals in their own way (Millacci, 2022).
Humanistic Therapies Applications in Mental Health Nursing
Maslow’s theory has had a profound effect on nursing. Understanding the humanistic model demonstrates to the nurse what the priority client needs are. The nurse must be able to understand that physiological needs must be met before higher-level needs, such as safety or love and belonging. It is important for the nurse to know this in the assessment phase of the interaction with the client, when recognizing and analyzing cues. It is important that the nurse prioritize and personalize the care of every client.
Maslow’s hierarchy of needs theory is a major foundation of nursing practice as is Carl Rogers’s theory. His belief was that client care should be done with empathy and should encourage clients to voice their emotions and form trusting relationships with the nurse that provide a foundation for client self-awareness and self-care. Nurses should respect clients, their autonomy, and treat them with genuine empathy and understanding in order for clients to reach their potential.
Because humanistic therapy is a holistic approach, aspects of care focus on the client’s personal development and recovery. Strength identification is part of this process, and feedback from the nurse is meaningful. Also significant to nursing practice are the concepts of person-centered care and therapeutic communication wherein nurses establish rapport with clients by focusing on them as individuals. As the person reacts to others and to different situations, the nurse can assist the client to find relevance and plan their own success. This nursing focus on the client as an individual encourages trust and transparency in the process.
Clinical Judgment Measurement Model
Humanistic Approach to Client Care Scenario
Layer 4 of the CJMM provides contextual elements of clinical decision-making in the form of realistic client-care environmental factors. Consider the following example:
- Environmental cues: secure psychiatric hospital unit
- Client observation cues: young adult, panic anxiety
- Medical record cues: history of bipolar mood disorder
- Time pressure cues: client rapidly losing personal control
To analyze these cues, nurses must interpret the information. This client has a safety need. The nurse assures the client as to safety and the availability of nursing staff to assist the client. The nurse says, “You can tell us how you are feeling.” The nurse reminds the client of their prior success in self-management and assures the client of the staff’s interest in returning the client to self-care, thereby establishing trust and person-centered care.