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Introduction

A theory can be depicted as a conventional description that accounts for known facts or phenomenon (Corey, 2009). For instance, the micro and macro healthcare theories give an explanation about psychologists’ view on ways to improve peoples’ health. Others theories include: Lister’s theory of antisepsis, Harvey’s theory about blood circulation, Darwin’s evolution theory and many more.  On the other hand, a hypothesis goes hand in hand with a theory and can be described as an assumption that gives a probable account of an occurrence and thus serving as the starting point of an argument or experimentation to reach the desirable facts. Based on this, it is worth noting that theories are a means of influencing how evidence is gathered, evaluated, understood and utilised to explain phenomena.

Consequently, psychological studies carried out have shown that the materialization of therapy as profession has led to the preface of higher standards of the socialization process. Nevertheless, there is emphasis on the need for a balance between practical training and theoretical erudition (Armstrong, 1983). Studies have shown that counselling uses theoretical knowledge to comprehend the dynamics of behaviours exhibited by individuals and as a result choose the appropriate therapeutic approaches to explain the situations. It is worth noting that psychological theories assist the counsellors to improve their experience in the discipline as well as providing an operational framework to develop acceptable norms and virtues for the society as a whole (Gilbert, 2010).

Moreover, Veatch (2000) indicated that in both micro and macro health care practices the scope of physicians communications to the patient must be measured by the  patients need and that need is the information material to the decision. Veatch (2000) continues to say that the test for determining whether a particular peril must be divulged is its materiality to the patients decision: all risks potentially affecting the decision must be unmasked.

Both micro and macro healthcare theories should measure the exposure for the patient’s risks that are mandatory whenever the patient would deem it. Veatch (2000) also say that in these two theories we derive the breadth of the disclosure of risks legally to be required. The scope of the micro and macro healthcare theories is not subject as to either the physician or the patient hence it remains objective with due regard for the patients informational needs and with suitable leeway for the physicians situations. According to Veatch (2000) we agree that risk is material when reasonable person in what the physician knows or should know to be the patient’s positions would be likely to attach significance to the risk or cluster of risks in deciding whether or not to forego the proposed therapy.

In his studies, Veatch (2000) noted that micro and macro healthcare demands a communication of information which is important and are inherent and potential hazards of every proposed treatments and the alternatives of the treatment. In micro health care the factors contributing significance to the dangerousness of a medical technique are of course the incidence of injury and the degree of the harm threatened (Veatch, 2000).

In addition, the concept of medical paternalism is in direct conflict with the principle of patient autonomy (McCarthy & Schafermeyer, 2004).  Medical paternalism suggests those physicians and other healthcare professionals because of their education and training and in addition what is best for their patients. McCarthy & Schafermeyer  (2004) further say that health care professionals believe they are justified in overriding a patients autonomy.

Cox & Hill (2010) commented that for some practice nurses, general practitioners and managers whose education and knowledge base may be firmly rooted in the comfort zones of linear thinking.   Collaboration  that occurs at a micro-level between patients, practitioners, professions, and agencies, ignoring macro-level organizational issues for example relating to power, politics, and organizational culture in health care (Cox & Hill, 2010). The most complete models of collaborations attend to both micro and macro-levels of analysis and are grounded in a strong theoretical background of healthcare theory and research.

The rationale for selecting healthcare macro and micro theories uses particular perspectives is that they build a strong conceptual model to guide critical reflection into individual, relational, and organizational aspects of healthcare collaboration (Cox & Hill, 2010). Healthcare theory draws upon the sciences arts and humanities and brings with it the challenges of thinking in interdisciplinary ways. Both macro and micro healthcare theories take inspiration from diverse field of study that includes human understanding, scientific explanation, and artful appreciation.

In the macro health care context of primary care and practice the experience of the micro-practitioner-patient relationship and care environment (Cox & Hill, 2010). It is now widely accepted that metaphor plays an important role in healthcare theory and research as a way of thinking differently in order to see and understand situations in new ways.

McCarthy & Schafermeyer  (2004) indicated that ethical situations in health care can be divided into two broad categories that include macro and micro. Macro situations involve issues that are not specific to given health care practitioner for example pharmacist and they include issues that must be addressed by all health care practitioners and society in general such as abortion, assisted suicide, genomics, rationing of and access to health care, organ transplantation and vitro fertilization. 

Micro healthcare situations on the other hand are those that may confront individual practitioners in the course of their daily practice. McCarthy & Schafermeyer  (2004) further noted that in the case of pharmacists they include the use of placebos, patient confidentiality such as revealing information about patients medications to his or members of her family and relatives, informed consent such as what and how much information about medication should be disclosed to a patient.

Corey (2009) suggests that theories vary from explicit hypotheses and develop to operational representations and frameworks that aid in thinking in relation to reality. Thus it is essential to be familiar with implied theories since they strongly control understandings of health care. Micro healthcare theories study of the psychological behaviours of an individual’s, decision making capabilities and they include;

  • Psychoanalytic theory and
  • Adlerian Theory

On the other hand, macro healthcare theories can be defined as those presumptions that give an account about the healthcare trends in the society as a whole. These include;

  • Postmodern theory and
  • Family systems theory

Lastly it is important to note that theories are fundamental to healthcare training, research and support. Thus the selection and implementation of a theory should be done in a way that shapes the manner that is not strenuous to psychological practitioners and researchers (Corey, 2009).

Micro healthcare theories

Psychoanalytic theory

This theory is involved in distinguishing between the mentally unsound minds individuals to their mentally sound counterparts in the community. This perspective tries to explain the reason why some people develop mental impairment while others do not. This theory is also concerned with the way a personality grows out of a person. It tries to establish the origin of a particular dominant trait in an individual or the person’s character. These two perspectives enable affected individuals to face their fears and correct possible negative perceptions towards certain situations. They also enhance an individual’s memory in the sense that one is able to recall thoughts, get over past traumatizing or troubling experiences and keep the mind clear and focussed (Armstrong, 1983).

Assumptions

Psychoanalytic theory assumes that an individual’s character is greatly influenced by his or her experience at a tender age. This character or personality can be characterised as Id, ego and the super ego. The id personality is poorly developed. It’s that urge for simple ways of acquiring happiness. An individual will not give an action a second thought before executing it. The ego personality tends to make people make rightful decisions. An action is thoroughly thought through and its consequences weighed before it is executed (Lucy, 2000). The Ego personality identifies one as having the ability to make sound judgement. When one is capable of developing emotions, like mercy, this person exhibits the super-ego personality. The three categories blend in or are integrated in an individual, to bring out their general character.

This theory further suggests that the nurturing of an individual’s character is established through sequential occurrence of certain stages known as psychosexual stages. These stages are the oral, anal, phallic, latency and the genital stage (Gilbert, 2010). The oral stage of personality development is experienced by babies from the immediate time of birth to the age of about 18 months. At this stage, the babies will derive joy or absolute satisfaction by stuffing things in their mouth either by drinking or chewing. The anal stage is experienced between the ages of 18 months to 3 years. It’s called the anal stage since the children will derive pleasure due to the fact that they are capable of going to the bathroom to relieve at the appropriate time.

The phallic stage is the age in which boys try to contain the Oedipus complex by fighting sexual desires for their mothers while girls try to fight off their sexual desires for their fathers, a condition known as the Electra complex (Armstrong, 1983). This stage is usually experienced between the ages of 3 to 6 years. In latency stage of personality development the kids are merely establishing non-sexual bonds and involved in educational activities which persists from the age of 6 to 12 years. The genital stage of personality development is characterised by maturity and productivity in the society. This stage which progresses into adulthood also sees development of meaningful conjugal relationships.

Limitations

Failure to undergoing the above personality development stages in their natural sequence, one may be in a fixed position where accommodating the next stage may be cumbersome or even impossible. A situation like this may lead depression or anxiety hence the need for therapist. However, on such sensitive cases like anxiety and depression, there arises a great need for minority populations and minority therapists’ balance, a situation that has not yet received the much needed attention. In fact most of the therapists do not have the much needed knowledge and expertise to enable them break the multicultural barrier in their services delivery. Therapists may not be well trained to cope with situations like social hostility, either individual cases or community inclined hostilities, language barrier aspects and interpretation (Corey, 2009).

Benefits and Multicultural implications

Research studies carried out show that in psychoanalytic therapy, the therapist offers a good environment for the client such that the latter is in a comfortable situation to reveal his or her feelings when in need. It is worth noting that this clear environment created between the therapist and the client is of beneficial nature since there is sharing of burdens with other people who can offer solutions. In addition, studies carried out on the behavioural patterns in psychological trends of clients in need of this therapy have shown that psychoanalytic therapy is usually viewed as a more active and effective methodology than others (Corey, 2004).

Nevertheless, most researchers and theorists of psychoanalytic therapy posses a belief that this method of psychological counselling and therapy is more significant than others especially during the early phases of individual symptoms of distress. This is taken into consideration basing on the fact that it creates a comfortable environment between the customer and the psychotherapist thus a stronger relationship. Individuals now more than ever can make conclusive links between their present life and their past with the help of professionals like psychoanalytic psychologists (Gilbert, 2010).

Multicultural qualified accepted therapists’ numbers could be on the rise through formulation and implementation of policy frameworks. In addition, Cultural similarities in the therapeutic dyad can enhance the treatment by facilitating understanding regarding cultural traditions and language. However, the similarities have also been viewed as an obstruction and awareness in such a manner that the process remains dominant. Lastly, it is worth noting that cultural matching habitually enhances conduct and it may undermine the capability to recognize drawbacks related to educational issues for the psychotherapist (Gilbert, 2010).

Adlerian Theory

Adlerian theory aims at ensuring a person’s productivity by correcting their fantasies or imagined self-perceptions. This involves their way of life and social wellbeing. This can also be viewed as the individual self-description ones personality. Adlerian tends to go to the deep core of one’s psychology controlling one’s thoughts in a bid to aid them to make them face life using a more realistic approach (Armstrong, 1983).

Goals

Adlerian theory helps affected individuals set achievable goals and be in a position to make promises which one can meet. Persons facing personality inferiority are offered backing in order to help them face life from a positive perspective. Adlerian therapy aims at making affected people feel comfortable among other people thus the main goal is to confront and hearten the individuals’ goals and ground and as a result make them valuable and equitable to the socially (Lucy, 2000).

Adlerian psychotherapy’s other goal includes assisting an individual to build up from a partial implementation person into a wholly functioning being. This implies to a situation where an individual is in a position to solve every problem of life with greater courage, extensive cooperation and with a bigger sense of satisfaction and contribution to the society. In order to achieve this, individuals are advised to work hard and identify the measures that can fully assist him or her to gain his best inborn personality without any imitations or hypocrisy

In other words, it is worth noting that the general goal of therapy is to boost a person’s reaction of the society.  Adler further argues that individuals must provide stimulation, support, and encouragement to each other in order to co-exist in a particular ecosystem without conflict.  In addition, an individual ought to consider that through reawakening audacity and imagination in the customer, an unknown feeling of society may develop as the individual discovers that he has a touch of value to present. Therapists argue that quite a number of people are often cared for in a erroneously lenient way and have absorbed it, though the individuals have not learnt to feel or communicate an indisputable caring for the rest.

Assumptions

Adlerian therapy involves creating a virtual bond or connection between the affected person or the client and the therapist. One’s mental capabilities are verified according to one’s ability to blend in a typical social setup and the subsequent reactions, and in turn the positive impact that person creates in that social setup. Counsellors try to establish the cause of inaccurate self- perceptions by putting into consideration aspects like past experiences, family setup and aspirations or dreams (Corey, 2009).

Limitations

There are no instant remedies for these superficial self-perceptions to the affected persons and instead focus is put on therapies extending over a long duration. Adlerian therapy lacks the support needed to come up with clear guiding policies in order to cater for wide range of mental related cases and to reach a greater number of affected individuals. Much of the Adlerian principles lack conclusive backup and are rendered unfit to deal with real life situations involving human beings (Gilbert, 2010).

Benefits

The Adlerian therapy is known to improve the level of interaction at the community level. The theory is quite broad and can be used to tackle quite a huge range of psychological related issues in a given community. These numerous issues in return allow for a therapist to use several methods of approach depending on the problem at hand (Armstrong, 1983).

Through subjecting members of the society unit to this session, people are able to develop effective communication channels between them thus leading to a culture good parenthood. The culture of accommodation and acceptance is being nurtured through solving problems involving step individual related issues, or where a member of the society is faced with a certain psychological disorder. Nevertheless, it is worth noting that the psychological implications of this theory is there is an allowance for greater compassion towards a society that is progressively more pluralistic thus individuals to stay in touch with understanding how people believe (Gilbert, 2010).

Multicultural implications

The Adlerian therapy is seen to instil relationships between parents and their children, marriage and family relationships, individual evaluation, children and adolescents. This theory in one way or another has helped avert break ups, broken ties between parents and their children, possible drug abuse cases in terms of individuals undergoing proper counselling.

The connection between societal culture and Adlerian theory is manifested. It is worth noting that the theoretical traces of the activities and times of an individual in a psychological setting at all times crash the traditions largely. However, these two should not be equated as similar because there are many reasons that show the differences at large. First, an individual ought to understand that popular culture usually disfigures and shortens the philosophy and secondly, paradigms at the cultural level normally become inconsistent and mix up (Corey, 2009). Consequently, people confound adlerian theology with societal cultural drift. It is advisable to note that adlerain therapy takes control of the lifeless expressions of most individuals and aspects of culture regardless of the mindful fears, resistance and questioning.

Macro healthcare theories

Postmodern theory

This type of macro healthcare theory can be described as a wide belief system associated with the philosophical and cultural view of the events that result from modernism. It is worth noting that based on this theory; scholars are in a position to learn that reality is usually difficult to understand through human examination (Corey, 2009). In addition, one can derive that knowledge is a communal creation that individuals gain gradually through regular interactions with each other and that readers are the people who are better placed than authors when it comes to deriving the meaning of words. Based on this, an individual can depict that postmodern theory perceives reality as what individuals or social groups make it to appear.

Goals

Postmodern theory ‘s main goal is the art of figuring out the ongoing patterns of relationships and  attaching importance to each activity that humans engage in the race towards acquiring ideal health prominence. The post modernists work towards reviving beliefs of observation and power of reason. Consequently, Corey (2004) argues that the individuals who follow these theoretical doctrines employ the virtue of faith and universal tolerance to cultural conflicts.  In addition, it is worth noting that the quest for fundamentals or prerequisites of an ideal psychological healthcare is done through absorption of machine image.

Assumptions

Postmodernists overturn the modernist analysis of verbal communication as the main source of understanding the essentials of reality. Based on this, one can learn that Knowledge is not only administered but also inclined by the social procedures that are followed by community members. Subsequently, postmodernism snubs the utilization of psychological explanations of realism as a symbol. Nietzsche (1844-1900) argues that it is significant of an individual’s own idea. "We are engaging in public pastimes, rituals, or life forms and for such enterprises there are no vindicating foundations".

Limitations

Postmodernism theory has been observed to claim that all human understanding is equally convincing regardless of the absurdity that is found in certain claims. For example, some information in form of myths that never exists once broadcasted to individuals for knowledge purposes is taken as true by post modernist. Nevertheless, it is worth noting that a person who questions other beliefs that people are associated to, is considered small minded thus it is possible to derive that post modernism is responsible for the divisions that take place within the society (Lucy, 2000).

Consequently, research has shown that postmodern theory does not tolerate those individuals within the community that claim to have the knowledge of absolute truths about phenomena or occurrences. For example, the theorists and believers of this theory are psychologically hostile towards those people that claim to attach the meaning of human beginning and end to the Bible teachings. According to a German philosopher, Friedrich Nietzsche (1844-1900) dispute that those people who embrace the Judeo-Christian ethical system, which he terms as ‘slave morality’ have a poor medical condition that is  characterized by weakness and fear thus such  postmodernists people tend to snub this ethic and create their own standards.

Postmodernism is usually criticized for viewing the individual as the sole constitute of the society (Armstrong, 1983). For example, the beliefs of post modernists do not include God in the creation of humans thus the Bible is not entirely recognised as a holy book in a postmodern society. In addition to this critique, it is viewed that Postmodernists usually outlook progress, as detrimental regardless of what discipline or field it falls in. For instance educational, scientific or, political are all perceived to be unfavourable thus development is associated with the command of the marginal.

Lastly, other theorists have criticized post modernists for the belief that Propositional facts that are evident and discovered as inexistent. According to this theory, only a society’s stand on facts is relevant and not an individual’s position thus it qualifies to be a macro health care issue. Nevertheless, postmodernists usually develop an intolerant attitude towards those e individuals who do not share similar views within the society resulting to cultural and ethical relativism that leads to terrible costs in a society (Corey, 2009).

Benefits

Postmodernism tolerates the right to individual freedom of opinion regarding the facts that a person thinks that are absolute. Based on this, one can learn that post modernism theory makes an individual less hypercritical towards personal tastes, styles and behaviours which are less predictable. Nevertheless, it is worth noting that the psychological implications of this theory is there is an allowance for greater compassion towards a society that is progressively more pluralistic thus challenging neo-modernists to stay in touch with understanding how people believe (Gilbert, 2010).

Corey (2004) notes that postmodernism accords individuals an allowance for becoming more open minded to emotional and spiritual truths that go beyond the constraints of logic, reason and science. In addition, one can observe that postmodernists attitude towards the oppressed and the marginalized is empathetic thus instils a belief in an individual that value can be added to the people in the family and society who are usually considered to be unworthy. Lastly, it is worth noting that post modernism offers an allowance for a greater lenience between beliefs as well as opening vacancies for greater affection and reception for non-Christians which results to a generation of harmony in the entire community (Lucy, 2000).

Multicultural implications of post modern theory

The link between post modern culture and postmodern theory is manifested. It is worth noting that the theoretical traces of the activities and times of an individual in a psychological setting at all times crash the traditions largely. However, these two should not be equated as similar because there are many reasons that show the differences at large. First, an individual ought to understand that popular culture usually disfigures and shortens the philosophy and secondly, paradigms at the cultural level normally become inconsistent and mix up (Corey, 2009). Consequently, people confound postmodernism with postmodern cultural drift. It is advisable to note that Postmodernism takes control of the lifeless expressions of most  individuals and aspects of culture regardless of the mindful fears, resistance and questioning.

Family systems theory

The Family theory involves family therapy which dwells on establishing bonds among family members, ensuring effective modes of communication and how the family members relate with each other. It ensures establishing of a common ground among the members of a family in times of feuds and occasional contentious issues. This leads to stable families which are capable of handling challenging issues as they come and still run smoothly.

Goals

Family therapy tends to bring about a sense of understanding and acceptance in cases where one of the family members may be faced with psychological disorder which would usually have serious negative implications on a given family if not well handled. This type of therapy could also be applied when dealing with matters to do with step family issues (Gilbert, 2010).  Therapists are bound to encouraging the affected members of that family to embrace accommodation for the new members in the family setup. In this way, the virtual barriers between members in that step family.     Family therapy ensures cohesion in a family experiencing barriers inclined to racial difference, conflicting sexual orientation and difference in religious views.

Assumptions

The family theory takes the form of a therapy session which generally evaluates the family of interest getting to know how that family functions, how each member relates to one another. Each member is subjected to this therapy at a time. This helps to gather different views from each family member and avert bias cases. The systems theory is put to task whereby each member is evaluated to see his or her position in the family unit as a whole and the reactions which crop up in relation to that person. The therapist, after thorough evaluation of that family decides on the concept to use, by altering the operations of that family unit in a bid to tackle the issues posing problems to that unit.

Limitations

The family therapy could cause a relapse of past psychological issues that had been tackled and dealt with in the past. It is possible to cause more harm when such an individual is put through such a session (Corey, 2009). The family members already going through other personality or anxiety related disorders would render the family therapy futile. This family therapy is also not recommended for individuals who are not familiar with its functions, or functions related to this family theory. This process would prove cumbersome for small children.

Benefits

The family therapy is increasingly being used to solve complex issues relating to marriage. Couples are subjected to these sessions, in order to foster, relations among them and other members of the extended family (Armstrong, 1983). By subjecting members of family unit to this session, parents and children are able to develop effective communication channels between them thus leading to a culture good parenthood. The culture of accommodation and acceptance is being nurtured through solving problems involving step family issues, or where a member of the family is faced with a certain psychological disorder.

Multicultural implications

This is seen in cases where in a family system, there are individuals who have differing sexual orientation, racial distinction, and differing religious views. The family therapy is able to tackle these barrier challenges creating stable functional family setups. studies carried out on the behavioural patterns in psychological trends of clients in need of this therapy have shown that psychoanalytic therapy is usually viewed as a more active and effective methodology than others (Corey, 2004).

Nevertheless, most researchers and theorists of the family systems therapy posses a belief that this method of psychological counselling and therapy for married couples is more significant than others especially during the early phases of individual symptoms of distress. This is taken into consideration basing on the fact that it creates a comfortable environment between the customer and the psychotherapist thus a stronger relationship. Individuals now more than ever can make conclusive links between their present life and their past with the help of professionals like family systems psychologists (Gilbert, 2010).

Multicultural qualified accepted therapists’ numbers could be on the rise through formulation and implementation of policy frameworks. In addition, Cultural similarities in the therapeutic dyad can enhance the treatment by facilitating understanding regarding cultural traditions and language. However, the similarities have also been viewed as an obstruction and awareness in such a manner that the process remains dominant. Lastly, it is worth noting that cultural matching habitually enhances conduct and it may undermine the capability to recognize drawbacks related to educational issues for the psychotherapist (Gilbert, 2010).

Conclusion

Corey (2005) in his book, Theory and practice of counseling and psychotherapy, argues that diverse therapeutic integration offers a platform for provision of  a unique chance for the counselor to build a distinct therapeutic connection specific to a particular person in need.  Nevertheless, it is worth noting that with a good foundation of knowledge about therapeutic theories and presumptions, a psychological scholar is well placed when it comes to offering sensitive and comprehensive counseling to an individual in need of behavioral change. 

The writer further argues that the association between the therapist and the customer is vital since this provides the latter with a chance to express the emotional experiences that people undergo through in the day to day life as well as discussing and providing solutions to problems. In addition, married couples gain knowledge of new behaviors and an opportunity to practice them (Armstrong, 1983).

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