The Psychotherapy of Hildegard Peplau in the Treatment of People with Serious Mental Illness

By Thelander, Burton L. | Perspectives in Psychiatric Care, July-September 1997 | Go to article overview
Save to active project

The Psychotherapy of Hildegard Peplau in the Treatment of People with Serious Mental Illness

Thelander, Burton L., Perspectives in Psychiatric Care

TOPIC. The use of Peplau's interpersonal nursing theory with people suffering from serious mental disorder.

PURPOSE. To describe Peplau's theory and its application using a case study.

SOURCE. Author's own clinical work.

CONCLUSION. Peplau's theory can be used to help patients resolve symptoms by guiding them through the steps of observation, description, analysis, formulation, validation, testing, integration, utilization.

Key words: Nurse-patient relationship, Peplau's interpersonal nursing theory, psychotherapy, schizophrenia, serious mental illness

In the age of managed care, we hear little about long-term psychotherapy with people experiencing serious mental illness (SMI). This is unfortunate, because despite the biopsychopharmacological movement, the number of those diagnosed with SMI has not decreased. While it is an accepted fact today that people who are depressed recover best with a combination of psychotherapy and medication, the same has not been documented for those suffering from schizophrenia. Many believe these people cannot be helped by psychotherapy. While many of us know anecdotally of patients who have recovered, we seldom read of these in the psychiatric nursing literature.

A person with serious mental illness suffers from symptoms over an extended period of time that constantly or intermittently remit and relapse. These symptoms seriously interfere with function and quality of life in such areas as work, social interaction, recreation, intimate relationships, and meeting community standards.

Dr. Hildegard Peplau introduced an interpersonal relations paradigm for the study and practice of nursing in the late 1940s and early 1950s (Peplau, 1995). The paradigm evolved from her work with H. Sullivan, E. Fromm, F. Fromm-Reichmann, other eminent clinicians, and her experience working with seriously mentally ill patients in public and private psychiatric hospitals (O'Toole & Welt, 1989). Her Interpersonal Relations Theory has had particular relevance and usefulness in understanding and intervening to reduce symptoms, re-establish relatedness, restore a sense of self-identity, improve function, and promote health.

Practicing psychotherapy at a public psychiatric hospital, I have found interpersonal theory and interventions useful for patients with a wide variety of diagnostic labels, including schizophrenia, depression, mood disorders, borderline personality disorders, and mild mental retardation. These interventions are useful both in one-to-one therapeutic relationships and milieu interventions. The theory and interventions provide an effective adjunct for psychopharmacology and psychiatric rehabilitation, particularly with people who have complex behavioral problems refractory to psychopharmacological intervention. My anecdotal clinical experience is not consistent with Beeber's (1995) contention that the Peplau model does not fit psychiatric nursing practice in inpatient settings. Employed as a certified specialist/nurse psychotherapist with an assigned caseload of patients with complex behavior problems and as Assistant Director of Nursing responsible for milieu intervention, I sought to answer Beeber's questions:

* How do phenomena/patterns within a person's life experience create problems for the person?

* What are the contextual variables that affect the person?

* What strategies in the one-to-one relationship are effective in intervening with people experiencing these problems?

I discovered that patients are able to identify patterns and contextual variables through my use of the interpersonal paradigm and psychotherapeutic interventions suggested by Peplau (1989a, b; 1995, 1996b). This paper will briefly discuss concepts and definitions of Peplau's paradigm that help explain the reasons for the seriously mentally ill person's problems, and it concludes with a case presentation.

I will not make an effort to contrast the assumptions and expectations of this practice paradigm with the medical model, which relies primarily upon biology and neuroscience to explain etiology and pharmacological interventions to treat it.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

The Psychotherapy of Hildegard Peplau in the Treatment of People with Serious Mental Illness


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?