management of acute and chronic pain: opioid therapy.

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management of acute and chronic pain often includes opioid therapy.

management of acute and chronic pain: opioid therapy.

-The management of acute and chronic pain often includes opioid therapy. In both the acute and chronic pain settings, however, opioids have several disadvantages including risk of nausea and vomiting, somnolence, constipation, respiratory depression, androgen deficiency, physical dependence, and tolerance. Opioid medications also carry a risk of abuse or addiction by either the patient or non-medical users. For these reasons, consideration of non-opioid strategies for pain management is beneficial. While opioids will certainly continue to have a place in pain management despite their disadvantages, the use of non-opioid medication options may limit the amount of opioid necessary or even result in improved pain control. In fact, given that the majority of both acute and chronic pain is thought to be complex and multi factorial, a multi modal analgesic approach is ideal for management. Acetaminophen is typically considered first-line therapy for chronic pain conditions, including osteoarthritis (OA) and chronic pain associated with total knee arthroplasty. However, many times patients are treated inappropriately with opioids instead.

Acetaminophen is considered first-line treatment for many pain conditions because of its safety advantages. Compared with other analgesics available, acetaminophen is associated with very few adverse events and is considered safe to use chronically. Healthcare providers strive to “first do no harm.  Therefore, for most chronic pain conditions, a trial of acetaminophen should be used and monitored for effect before initiating other analgesics, including opioids. However, acetaminophen is not without risks. Safety concerns associated with acetaminophen include serious liver damage if ingestion is greater than the recommended total daily dose of 4,000 mg. Long-term high doses of acetaminophen and accidental overdose from inadvertently consuming multiple acetaminophen products are the leading causes of acute liver failure in the U. S. For this reason it is important that the patients who are utilizing acetaminophen chronically for pain are educated on proper dosing and administration, and are aware of any other acetaminophen-containing products they may use. The disadvantage of acetaminophen is that it often cannot provide a sufficient analgesic effect and does not exert a specific anti-inflammatory effect, causing many patients to discontinue or switch therapies.

REFERENCES

Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain United States, 2016. MMWR Recomm Rep. 2016; 65(1):1-49.

 
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WEEK 1 FORUM:Maternal Substance Use Debate

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WEEK 1 FORUM:Maternal Substance Use Debate

(WEEK 1 FORUM:Maternal Substance Use Debate)

2) Instructions for the second part:  Below you will find a link to a true story about a young woman named Jennifer Johnson.  http://www.nytimes.com/1992/07/24/news/mother-cleared-of-passing-drug-to-babies.html

Below you will find a link to another story where the National Institutes of Health released a study that showed that maternal cocaine use was not as bad for babies.  In the second link, the New York Times provided additional support to the study.

1)  http://www.ncbi.nlm.nih.gov/pubmed/11489591

2)  http://www.nytimes.com/2009/01/27/health/27coca.html?pagewanted=all&_r=0

This week discussion forum requires you to answer the following questions:

1.  Should mothers receive prosecution for prenatal damage to the fetus?

2.  Should mothers that use drugs during pregnancy face criminal prosecution?

3.  Would the chances of prosecution keep pregnant women from seeking prenatal care and/or delivering the baby in a hospital setting?

4.  Research suggests that mothers who smoke tobacco during pregnancy and/or in the presence of their children up to the age of 5 years old increases the risk of their children experiencing asthma.  Should smoking mothers also be prosecuted?

5.  How did your feelings about this topic change as you read the later “chapters” in Jennifer Johnson’s story?

READING

CHFD307 CHILD AND ADOLESCENT DEVELOPMENT | LESSON 1

Introduction to Theories

Topics to be covered include:

·         Development theories

·         Research methods

·         Heredity and the environment

·         Prenatal development and birth

Introduction

In the first lesson of childhood and adolescent development, we will look at theories that relate to the nature versus nurture debate. This lesson will focus on how nature and nurture interact to influence children’s development. We will discuss five development theories and research methodology in child research. We will then look at heredity and the environment, where we will delve into genetics and the ways in which genes and the environment interact, so that we can better understand why development differs from individual to individual. Thereafter, we will explore the stages of prenatal development and birth, as well as common risks to mothers and their infants. To end the lesson, we will discuss the biological and environmental vulnerabilities that infants face, and how caring, constructive relationships enable them to make sense of life so that they can build resilience.

Themes

Child development falls under developmental psychology, and studies the physical (motor), cognitive, emotional and social processes that occur from the beginning of life through adolescence. Child psychology views childhood as a unique stage that society should protect from developmental problems, and enhance through schooling, healthcare and nutrition (Parke & Gauvain, 2009).

According to Parke and Gauvain (2009), the following three major themes contextualize child development studies.

ORIGINS

DEVELOPMENT

INFLUENCES

We will now explore five theories of child development, each of which focuses on a specific area of development.

Structural Organismic Perspectives

Jean Piaget

‹›(WEEK 1 FORUM:Maternal Substance Use Debate)

· Structural Organismic Theories

Structural Organismic theories view the human organism as progressing through universal, structured stages of development (Parke & Gauvain, 2009). Sigmund Freud focused on how personality and emotions are formed in early childhood. In psychoanalytic and psychodynamic theory, the id, ego andsuperego  are interrelated facets of the personality that play different roles throughout the child’s development.

Infants are controlled by the instinctual drives of the id. As the infant develops, the ego takes greater control, whereby the child becomes rational, understands reality and uses socially acceptable behaviors to satisfy their needs. Finally, when the child develops a conscience by internalizing social or parental values, the superego takes control.

Early experiences, specifically in the first six years, impact the way in which the id, ego and superego develop and interact. This forms the child’s personality. For example, early unsatisfied needs and the nature of attachment to caregivers will impact later behaviors.

In contrast to Freud, Jean Piaget focused on the biological process of intellectual development. Piaget’s theory is based on two biological principles: organization, which describes cognitive development as a biologically organized process, and adaptation, which describes the process of development as the child adapts to their environment.

In Piaget’s theory, the intellectual process of understanding the world comprises four stages in which cognition progresses from immediate, sensory experiences to abstract, complex problem solving and understanding of the world. More specifically, infants use motor and sensory facilities, preschoolers use mental structures and symbols such as language and pictures, school-goers increasingly use logic, and adolescents can engage in abstract thinking.

Knowledge Check

1

Question 1

Please select the correct statement about development theories.

 

Ethological   theory and psychoanalytic theory have nothing in common.

 

In   operant conditioning, desirable behavior is reinforced by a positive   response to the behavior.

 

Dynamic   systems and contextual approaches only look at the environment but not the   individual.

 

Structural   Organismic perspectives focus on the biological aspects of development.

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Research Methodology

‹›(WEEK 1 FORUM:Maternal Substance Use Debate)

·

Research in psychology is scientific, and is thus based on theories from which hypotheses are formulated. Hypotheses are tested by collecting and analyzing data using measurable and replicable techniques. We will now discuss five important issues in child development research: sampling, data collection, research design, studying change over time, and ethics.

Knowledge Check

1

Question 1

Please select the correct statement about the following research. A researcher wants to find understand how junk food affects behavior in two-year olds.

 

The   researcher should use the correlational method.

 

The   researcher must obtain informed consent from parents and guardians of the   sample, as well as ethics approval from the review board.

 

A   representative sample would be found at the local play group.

 

The   researcher should USE a case study approach.

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Heredity and the Environment

Heredity explores the biological origins of development, or the ‘nature’ in the nature versus nurture debate.

GENOTYPE

PHENOTYPE

FERTILIZATION

CHROMOSOME PAIRS

DNA

Genetic Influences in Development

Possible Alleles from an Aa Mother and aa Father

 

From Mother

(WEEK 1 FORUM:Maternal Substance Use Debate)

A

a

 

From Father

A

AA

Aa

 

a

Aa

aa

Gene-environment interaction is a critical process in understanding development. Genes cannot work alone, as they are programmed to respond to signals in the environment. Two basic concepts allow us to understand how genetics influence development.

Firstly, a gene usually has two alleles or alternate forms that carry a trait such as eye color – one from the mother and one from the father. Secondly, the alleles can be the same from both parents or different. For example, blue eye alleles may be inherited from mother and father, or blue eye alleles can be inherited from the mother while brown eye alleles are inherited from the father. If the alleles from both parents are the same, the person is homozygous for that trait. If the alleles are different, the person is heterozygous.

Let’s say the mother is Aa and the father isAa . As you can see in the table, the three possible combinations of alleles received by the child are:

1.    AA

2.    aa

3.    Aa (which is the same as aA)

The first two combinations are homozygous. A person with two alleles for blue eyes will have blue eyes. The third combination is heterozygous. If a trait is heterozygous, the traits may:

BLEND

COMBINE BUT NOT BLEND

DOMINANCE

SEX-LINKED GENES

GENE INTERACTION

DEVELOPMENTAL DISORDERS

DOWN’S SYNDROME

Genetic Engineering

Advances in genetics have pros and cons. Genetic counseling enables couples to be tested for defective genes, and to undergo assisted reproductive techniques in which defective eggs or sperm are substituted for healthy donor ones. It is also possible to detect abnormalities by sampling cells from a fetus. This testing gives the parents the option to abort abnormal fetuses.

This raises ethical issues around determining when defects are serious enough to warrant abortions. What will the child’s quality of life be? Will they be able to lead relatively pain-free, productive lives? Is a painful death expected in a few years or months?

Gene therapy may allow us to cure and ameliorate defective genes in the future. So far, scientists have had limited success in treating deadly disorders. One treatment uses viruses that have had their harmful properties removed to carry healthy genes into patients’ cells. Few treatments have been successful, and it will still take time to perfect gene therapy.

This blind girl benefited from a supportive environment

Heredity-Environment Interactions

· HEREDITY-ENVIRONMENT INTERACTION

· RANGE OF OUTCOMES

· PATHWAYS OF INFLUENCE(WEEK 1 FORUM:Maternal Substance Use Debate)

Contemporary psychologists argue less about the nature versus nurture debate than their predecessors did, and instead concentrate on how people develop based on heredity-environment interaction. While genes are influenced by the environment, genes also contribute to shaping the environment. Our genetic endowment both limits and capacitates us, while environmental and social contexts exert a powerful influence over us.

Range of reaction is a concept that explains that our ranges of possible developmental outcomes are established by our genetic makeup. Enriched environments enable us to achieve higher outcomes within the range, while unsupportive or unstimulating environments generally result in lower outcomes within the range.

Individual Differences, Heredity and Environment

The central question that developmental psychologists ask is why people develop so differently. Behavior geneticists use statistics to calculate heritability factors to estimate what percentage heredity contributes to a certain developmental outcome. Remember however, that exposure to environmental influences and development stages must be considered.

Family Studies

For this reason, many studies involve family members because of their biological relatedness and shared environments. Adopted children may be compared with their adoptive and biological parents, and siblings and identical and fraternal twins may be compared. For example, studies have found that intelligence and spatial and verbal abilities have a positive correlation with genetic relatedness, while memory and creativity have no correlation with genetic relatedness (McCartney, Harris, & Bernieri, 1990; Plomin, 1990).

Temperament

Studies have also found that children from the same families have widely varying temperaments, while children from the same cultures have similar tendencies (Kagan, 1994; Thomas & Chess,1986). Furthermore, difficult babies who have stressed mothers have been found to experience more developmental problems, whereas difficult babies with calm, supportive parents do not usually experience these problems (Rothbart & Bates, 2006). Goodness of fit between the child’s temperament and environment refers to how parents and socializing agents accept and adapt to each child, and is thus critical in child development.

How much of temperament is genetic versus environment?

Prenatal Development

There are three stages of prenatal development that occur in the 38 weeks of pregnancy: the zygote, the embryo and the fetus.

Zygote

When the sperm fertilizes the ovum, the fertilized egg or zygote implants in the uterine wall. The zygote stage is about two weeks.

 

Week 1

Week 2

 

Embryo

Once the zygote is implanted, the embryo stage begins. The physiological structures and systems begin to develop, the embryo begins to look like a human, and in the eight weeks since fertilization its size increases by around two million percent. Development occurs from the head down (cephalocaudal), and from the center out (proximal-distal). By the end of the embryonic stage, the fingers and toes are visible. Most miscarriages occur in this period because the embryo detaches from uterine wall.

 

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

(WEEK 1 FORUM:Maternal Substance Use Debate)

Fetus

The final stage, the fetus, begins in the third month of pregnancy. Muscles and the central nervous system cause movement and reflexes like swallowing. If babies are born prematurely, between 22 and 26 weeks, their systems may be developed enough to survive. This is called the period of viability. If they are too premature they may not survive because their respiratory systems are not sufficiently developed.

 

Week 9

Week 16

Week 20

Week 38

 

Risks

Teratogens are external agents that cause fetal development problems by disturbing the motor, neural, emotional, cognitive and physical systems. Teratogens include:

· Illegal, prescription and nonprescription drugs, alcohol and nicotine.

· Environmental toxins such as pesticides, herbicides, household cleaners, radiation, lead, cosmetics and food additives.

· Medical interventions in pregnancy and childbirth.

· Maternal diseases and disorders such as mumps, rubella and Rh factor incompatibility where the mother’s and infant’s blood are incompatible.

· Bacterial, viral and parasitic infections such as toxoplasmosis, gonorrhea, chlamydia, syphilis and HIV/AIDS.

· Maternal age. Women under the age of 15 and over the age of 35 have more complications.

· Poor diet.

· Stress and negative emotions.

Birth

‹›

· Birth

Parents experience many emotions around the time of birth such as anticipation, anxiety, excitement, fear, joy and awe. Birth is also an intense and complex experience for the infant as it leaves its familiar warm, dark and wet environment in the uterus, and faces the next stage of its life in a dry, bright environment.

Birth involves three stages. In the first stage, the mother goes into labor and experiences contractions. In the second stage, the infant is born by passing through the birth canal and vaginal opening. In the last stage, the uterus expels the placenta.

Natural childbirth has become more popular since the 1970s (Parke & Gauvain, 2009). More mothers are sharing the experience with their families at home or birthing centers, using midwives and preparing for birth with their partners. Lamaze is a popular method that involves the mother-to-be and her partner. The method teaches the couple how the mother-to-be should breath and relax her muscles to make childbirth easier. Water births, birthing stools and giving birth in the kneeling position are also becoming more popular.

If there are birthing complications, women may need to be hospitalized. Cesarean sections surgically remove the infant through an incision in the mother’s abdomen. Cesarean sections assist mothers and infants who are having difficulty in the birth process, and are convenient for physicians and families who wish to plan their schedules.

There are disadvantages associated with Cesarean sections, including longer recovery times and increased risk of infection for mothers, lower birthweights in subsequent births, increased infant exposure to maternal medications and more trouble breathing and breastfeeding (Emory, Schlackman & Fiano, 1996; Kennare, 2007; Liu, 2007).(WEEK 1 FORUM:Maternal Substance Use Debate)

Knowledge Check

1

Question 1

Please select the two correct statements.

 

Biological   and environmental adversities may be overcome if the child has access to a   caring relationship.

 

Most   miscarriages occur in the final stage of pregnancy.

 

Low   birthweight babies face biological and environmental risks.

 

Pregnancy   is a natural process and there is not much the mother can do to influence it.

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Conclusion

In this lesson, we have looked at nature versus nurture theories, and focused on how nature and nurture interact to influence child development. We first discussed the major themes in child development theory, and then we explored five development theories that focus on different aspects of development. Thereafter, we looked at research methodology in child research, and then we moved onto heredity and the environment, where we investigated genetics and heredity-environment interactions. In the final section of the lesson, we explored prenatal development and birth and the associated risks. The lesson ended with a discussion on vulnerability and resilience in children who have been exposed to biological and environmental adversities.(WEEK 1 FORUM:Maternal Substance Use Debate)

KEY TERMS

References

Emory, E. K., Schlackman, L. J., & Fiano, K. (1996). Drug-hormone interactions on neurobehavioral responses in human neonates. Infant Behaviorand Development, 19 (2), 213–220.

Field, T. M., Diego, M., & Hernandez-Reif, M. (2007). Massage therapy research. Developmental Review, 27, 75–89.

Goldberg, S., & DiVitto, B. (2002). Parenting children born premature. In M. Bornstein (Ed.), Handbook of parenting (Vol. 1, 2nd ed., pp. 329–354). Mahwah, NJ: Erlbaum.

Gross, R. T., Spiker, D., & Haynes, C. W. (Eds.). (1997). Helping low-birthweight, premature infants. The Infant Health and Development Program. Stanford, CA: Stanford University Press.

Kagan, J. (1994). Galen’s prophecy. New York, NY: Basic Books.

Kennare, R. (2007). Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstetrics and Gynecology, 109, 270–276.

Klaus, M. H., & Kennell, J. H. (1982). Parent-infant bonding. St. Louis, MO: Mosby.

Klebanov, P. K., Brooks-Gunn, J., & McCormick, M. C. (2001). Maternal coping strategies and emotional distress: Results of an early intervention program for low-birthweight young children. Developmental Psychology, (37), 654–667.

Korner, A. F. (1989). Infant stimulation: The pros and cons in historical perspective. Bulletin of National Centerfor Clinical Infant Programs, 10 , 11–17.

Liu, S. (2007). Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. Canadian Medical Association Journal, 176, 455–460.(WEEK 1 FORUM:Maternal Substance Use Debate)

Masten, A.S., & Obradovic, J. (2007). Competence and resilience in development. In B. M. Lester, A. S. Masten, & B. McEwen (Eds.), Resilience in children (pp. 13–27). New York: Blackwell.

McCartney, K., Harris, M. J., & Bernieri, F. (1990). Growing up and growing apart: A developmental meta-analysis of twin studies. Psychological Bulletin, 107, 226–237.

Moffitt, T. E., & Caspi, A. (2006). Evidence from behavioral genetics for environmental contributions to antisocial conduct. In J. E. Grusec & P. Hastings (Eds.), Handbook of socialization (pp. 259–283). New York: Guilford Press.

Parke, R., & Gauvain, M. (2009).Child Psychology: A contemporary viewpoint  (7th ed.). New York, NY: McGraw-Hill.

Plomin, R. (1990). Nature and nurture: An introduction to human behavioralgenetics.  Pacific Grove, CA: Brooks/Cole.

Rothbart, M., & Bates, J. (2006). Temperament. In W. Damon & R. Lerner (Series Eds.), & N. Eisenberg (Vol. Ed.), Handbook of child psychology (Vol. 3, 6th ed., pp. 99–166). New York: Wiley.

Rutter, M. (2006). Genes and behavior. New York: Blackwell.(WEEK 1 FORUM:Maternal Substance Use Debate)

Scarr, S. (1996). How people make their own environments: Implications for parents and policy makers. Psychology, Public Policy and Law, 2, 204–228.

Tessier, R., Cristo, M. B., Velez, S., Giron, M., Line, N., Figueroa de Calume, Z., et al. (2003). Kangaroo mother care: A method for protecting high-risk low-birth weight and premature infants against developmental delay. Infant BehaviorDevelopment, 26 , 384–397.

Thomas, A., & Chess, S. (1986). The New York Longitudinal Study: From infancy to early adult life. In R. Plomin & J. Dunn (Eds.), The study of temperament: Changes, continuities and challenges (pp. 39–52). Hillsdale, NJ: Erlbaum.

 
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The Use of Coercion in Interrogations

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Assignment 2: The Use of Coercion in Interrogations

(The Use of Coercion in Interrogations)

Week two assignment

 

Assignment due Wednesday the 23rd of August, would like it by Tuesday if possible please. Thank you.

 

Assignment 2: The Use of Coercion in Interrogations

 

The American Psychological Association (APA), the American Psychiatric Association, and the American Medical Association all oppose the use of coercion in interrogation. These organizations strictly prohibit their members from participating in interrogations in which coercion is used. These organizations claim that coercion is unethical.

 

The resolution of the APA (2008) on coercion in interrogation includes the following statement:

 

BE IT RESOLVED that the American Psychological Association affirms that there are no exceptional circumstances whatsoever, whether induced by a state of war or threat of war, internal political instability or any other public emergency, that may be invoked as a justification for torture or cruel, inhuman, or degrading treatment or punishment, including the invocation of laws, regulations, or orders. (para. 7)

 

Publicly revealed Central Intelligence Agency (CIA) transcripts and interviews with CIA employees detail that harsh methods were used to develop information from suspected terrorists. Use the key words “John Kiriakou interview with Brian Ross” on a search engine to read a CIA officer’s revelation on the methods used to develop information from a suspected terrorist.

 

A potential logical conclusion about the treatment of detained combatants is that coercion works and, because it works so well, it can be justified under some exceptional circumstances.

 

Reference:

(The Use of Coercion in Interrogations)

American Psychological Association. (2008). Chapter III. Ethics: Reaffirmation of

the American Psychological Association position against torture and other

cruel, inhuman, or degrading treatment or punishment and its application to

individuals defined in the United States Code as “enemy combatants”

(amended 2007 position). Retrieved from http://www.apa.org/about/policy/

chapter-3.aspx

 

Tasks:

 

Create a 2- to 3-page paper addressing the following:

 

Detail what the scientific literature states with regard to the use of coercion in interrogations. Include an unbiased evaluation of the use of coercion and when it may or may not be justified.

Include examples of coercive techniques and the purported effectiveness. You will need to address the possibility of false confessions as a result of coercive techniques.

Submission Details:

(The Use of Coercion in Interrogations)

 

Assignment 2 Grading Criteria

Maximum Points

Detailed what the scientific literature states with regard to the use of coercion in interrogations and included an unbiased evaluation of the use of coercion and when it may or may not be justified.

48

Included examples of coercive techniques and the purported effectiveness and addressed the possibility of false confessions as a result of coercive techniques.

36

Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources; and displayed accurate spelling, grammar, and punctuation.

16

Total:

100

 
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Making A Differential Diagnosis

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Making A Differential Diagnosis

(Diagnosis Differential)

Creating a it involves systematically considering various possible conditions or diseases that could explain a patient’s symptoms. This process helps healthcare professionals narrow down the potential causes and determine the most likely diagnosis.

Prior to beginning work on this assignment, please read Chapter 1: Differential Diagnosis Step by Step in DSM-5: Handbook of Differential Diagnosis and review the same case study you used to write your Weeks One and Two discussion forums and Week Three Assignment.

For this assignment, you will create a differential diagnosis for the patient in your chosen case. This assignment continues the work you started in the Weeks One and Two discussion forums and the Week Three assignment. Be sure to follow the instructions in Chapter 1: Differential Diagnosis Step by Step when creating your differential diagnosis. Your assignment must include the following:

  • Recommend a diagnosis based on the patient’s symptoms, presenting problems, and history.
  • Assess the validity of your diagnosis using a sociocultural perspective.
  • Compare at least one evidence-based and one non-evidence-based treatment option for the diagnosis. Research a minimum of two peer-reviewed sources to support your choices.
  • Propose and provide an explanation for a minimum of two historical perspectives and two theoretical orientations that are inappropriate alternates for the conceptualizations in this case.

The Making an assignment

  • Must be three to five double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center.
  • Must include a separate title page with the following:
    • Title of paper
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted
  • Must use at least two peer-reviewed sources in addition to the course text.
  • Must document all sources in APA style as outlined in the Ashford Writing Center.
  • Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center.

Carefully review the Grading Rubric for the criteria that will be used to evaluate your assignment.

 

 
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The definition of spiritual writing

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The definition of spiritual writing

(The definition of spiritual writing)

Question description

Please do a paragraph about this post with this instruction . post most have 4 or more sentences . you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the readings

The definition of spiritual care to me is identifying a patient’s spiritual needs such as their religion, if they have any religious practices and what helps them cope during times of illness or stress. Then using the data gathered to formulate nursing interventions (care plan) that consider the data collected regarding their spiritual needs during care to meet spiritually identified outcomes. This definition accords with what is in the topic reading because according to Shelly & Miller (2006), “Spiritual care means putting people in touch with God through compassionate presence, active listening, witness, prayer, Bible reading and partnering with the body of Christ which entails the church community and the clergy”. Blaber, Jones, & Willis (2015), also defined spiritual care as “that care which recognizes and responds to the needs of the human spirit when faced with trauma, ill health or sadness and can include the need for meaning, for self-worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener. Spiritual care begins with encouraging human contact in compassionate relationship, and moves in whatever direction need requires”.

Spiritual care is pertinent in times of suffering or illness because it is during these challenges of life that people perceive themselves as vulnerable and believe that they have lost their self-worth or strength, and what spiritual care does is reorient them to reality and make them understand that as long as there is life, there is hope. Hope is significant because it drives an individual to persevere during whatever challenges they are going through giving them meaning and purpose in life. It entails using open-ended questions to determine patient’s belief system, affirming what the patient has verbalized about their faith, reflecting on it and summarizing it with them, and creating a therapeutic environment to give the patients that have lost all hope due to disease and sickness, hope through faith, moral values, love, trusting relationships, and self-worth. It is imperative that health care providers are knowledgeable in identifying patients’ spiritual needs in other to instill spiritual care during interventions. Patients’ spiritual need should be assessed during the gathering of comprehensive health history and should be an organized analysis of a patient’s beliefs and faith that will enable them to find optimism which brings peace in times of illness or stress.(The definition of spiritual writing)

Illness and stress augment the spiritual need and trepidations of patients because of physical and emotional suffering, therefore spiritual care is pertinent in holistic care for interventions to be efficient and effective. The challenges nurses encounter during spiritual care is a poor approach to meet patients identified spiritual care due to lack of training although it is well received if it is presented in a spirit of kindness and modesty. The spiritual history assessment tools, such as the Faith, Influence of faith in life, Community and Address (FICA) enables the nurse to identify patient’s spiritual needs and plan interventions that consider these needs. From a Christian viewpoint, making a patient understand that the Lord has not forsaken them because they are ill or in distress, praying and sharing the scripture with them that by his stripes they are healed, testifying to the goodness of the Lord and encouraging them does not only bring hope and peace to the patient but also glorifies the Almighty father.

 
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Psychiatric Nursing

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Psychiatric Nursing

(Psychiatric Nursing)

sessing and Treating Clients with With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.

Learning Objectives

Students will:
  • Assess client factors and history to develop personalized plans of bipolar therapy for clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan ..

 

The Assignment

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
    •  you can use my sample/ edit or do a new assignment.

you can edit or use my sample with same medication therapy.

Walden University .. 6630n(Psychiatric Nursing)

2 Assessing and Treatment for Bipolar Disorder Patient Introduction Bipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017).

If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care.(Psychiatric Nursing)

Decision Selected My patient is an Asian American woman age 39 years with 4 children and 3 ground children. The husband notices that sometimes she will be singing loud to the top of her voice and dancing not to the music she sang. In another time she will just fill like not doing anything and nothing will interest her, and she will lay on the bed for hours without going to the business she spent her years building and love so much.Patient is withdrawn and non-interactive. 4 She is diagnosed Bipolar disorder.

1 Decision # 1 Reason Selected My best treatment of choice for this disorder will be to begin Risperdal 2 mg orally twice a day. Risperdal is the best choice to treat bipolar disorder. (Lee et al., 2011). Risperdal called risperidone is in the chemical class benzisoxazole derivatives which are antipsychotic. It is an effective medication for bipolar disorder (Lee et al., 2011). The reasons of choosing Risperdal is because it is used to treat schizophrenia and the risperidone works with the brain to stabilize the brain (Lee et al., 2011). Risperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior. Risperidone belongs to a class of drugs called atypical antipsychotics approved by U.S. Food and Drug Administration (FDA) The drug is also used to treat symptoms of bipolar disorder and irritability (NAMI, 2017).(Psychiatric Nursing)

Expected Results We will need to have some subjective and objective changes. 1Patient should be able to verbalize changes within the first month of the treatment.

During the next visit with the patient after one month, she is expected to express changes in the clarity of her brain. The freedom from indistinctness or ambiguity because of the medicine will help her to balance certain natural substances in her brain.She should also notice a change in her ability to concentrate on her activities (Lee et al., 2011). No side effects.

Differences between Expected outcome and Actual outcome Patient came back after a month (4 WEEKS) and report that she experiences some improvement in the symptom including some improvement with concentration. My patient reported some drowsiness. 1 Drowsiness is one of the side effect of high dose of Risperdal. The genetic testing, reveals that she is positive for CYP2D6. Asians are more likely to have decreased CYP2D6 activity compared to Caucasians (Lee et al., 2011). I will reduce the dosage of this medication. 1 A positive outcome should be that there was a little bit of improvement in symptoms, patient able to sleep, more concentration. Patient and family report drowsiness during the day time which is one the side effect of high dose Risperdal.

Decision Point Two Reason Selected The next best option is not to discontinue Risperdal, but to lower dose to Risperdal 1 mg orally at hours of sleep (HS) since expected outcome was not achieved based on decision one. My patient and , her family reported that patient has been drowsy during the day because of Risperdal 2mg. I will continue on Risperdal because the patient confirm improvement on the symptoms and the side effect observed was a regular adverse reaction because of her descendant background (American Psychiatric Association, 2017). The reduction to Risperdal 1mg BID to Risperdal 1 mg will be closely monitor.(Psychiatric Nursing)

Expected Results Risperdal 1mg orally at bedtime is a reduced dosage from the 2mg which is expected to eliminate the drowsiness and toxicity in the patient Stahl, (2013).The patient is expected to continue to have decrease in the bipolar symptom. The effect of the medication should be observable and notice by the family member as a testimony (American Psychiatric Association, 2017).

Differences between Expected outcome and Actual outcome During the patient four weeks follow up examination shows that the bipolar disorder symptom dissipated to noticeable level. This indicate a therapeutic effect of Risperdal 1mg at night brought about the therapeutic effect on the patient and patient is tolerating and adjusting to the medication in a positive way (Dean, 2017). The patient did not experience the drowsiness and there was no toxicity, therefore the expected result and the actual result were the same. Risperdal therapy will continue with this medication and the dosage, and a close monitoring will still be needed until the next four weeks appointment (Dean, 2017).

Decision Point Three Decision Selected Risperdal 1mg orally at HS will be continued Reason for Selection The decision to continue with the medication was because the desire result, and the actual result are in pari-passu. To change the current medication or tamper with the dosage may offset the patient and thereby destabilize the rate of her healing (Dean, 2017). The patient is still under assessment and close monitoring continue until the next appointment date.(Psychiatric Nursing)

Expected Results It is expected that the patient will increase in good mental stability and continue to maintain reduction in bipolar disorder symptom with the dosage of Risperdal 1mg at night (Robert et al., 2017). The patient is anticipated to having good sleep at night and well improve in her interaction with relatives and friends, with ability to concentrate on matters that concern her and carrier (Robert et al., 2017).

Differences between Expected outcome and Actual outcome The therapeutic decision is working in this patient in accordance to the expectation. The treatment agrees with the standard way of treatment of an Asian descendant, the starting procedural treatment for bipolar disorder to the maintaining of such patient that are been positive for CYP2D6.The side effect of drowsiness in the day and toxicity is agreement with Asian descent (Robert et al., 2017). The patient will have to be place on the same medication till the next visit for examination. The actual result is that the medication is achieving the therapeutic effect that is needed by the patient (Dean, 2017).

Ethical Considerations for Treatment plan Ethics demand that a patient should agree to treatment before it could be administering unto the patient. The law concerning patient’s preferences for treatment are overlook when the patient is in jeopardy of life threatening or severe psychiatric illness. Psychiatric advance directives are employing to make decision on the patient (Srivastava, 2011). When a practitioner treating a patient with bipolar is confronted with ethical conflicts of helping the patient to attain best result or their autonomy. The autonomy will be the choice of the practitioner (Srivastava, 2011). The law clearly stipulate that practitioners should always carefully consider what moral weight should be given to the values of doing well and avoiding harm (U.S. Food and Drug Administration, 2017).(Psychiatric Nursing)

2 Conclusion Psychiatric nurses should assess the function of the client not only during admission even during remission period and plan for rehabilitation services since functioning is a complex and demanding task. However, it is very important to bring back the client to his fullest possible level to normal life by planning effective psychoeducation about illness, communication training and teaching problem solving skills to client and family. 1 Many drugs are available for the treatment of bipolar disorder, but the professional will have to carefully select a medication that will be the best treatment for the patient. It is worth knowing that genetics influences the absorption of drugs, metabolism, excretion, and distribution. In the case study the Asian woman with positive CYP2D6 will exhibit a certain side effect which will not be in a patient with negative CYP2D6 (Dean, 2017). Therefore, the dosage and frequent of dispensing of drugs be based on the genetic testing (National Alliance on Mental Illness, 2017). The treatment of bipolar disorders in Asian descent must be handled carefully and in accordance with the Food and Drug Administration set guidelines (U.S. Food and Drug Administration, 2017). In conclusion the safety of the patient and the life of family and friends should be the paramount concern of the practitioners.(Psychiatric Nursing)

References American Psychiatric Association. (2017). 1 Treatment of Patients with Bipolar Disorder.

Retrieved from: 1http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf Dean, L. (2017). 1 Risperidone Therapy and CYP2D6 Genotype. Retrieved from:

1 https://www.ncbi.nlm.nih.gov/books/NBK425795/ Lee, S. Y., Martins, S. S., Keyes, K. M., & Lee, H. B. (2011). 1 Mental Health Service Use by Persons of Asian Ancestry With DSM-IV Mental Disorders in the United States. Psychiatric Services (Washington, D.C.), 62(10), 1180–1186.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698479/ Nami National Alliance on Mental Illness. (2017). 1 What Is Risperdal and What Does It Treat?

Retrieved from: 1 https://www.nami.org/learn-more/treatment/mental-health-medications/risperidone (Risperdal).

Robert, M., Keck, P., & David Solomon, D. (2017). 1 Bipolar disorder in adults:Choosing maintenance treatment. Retrieved from: 1https://www.uptodate.org/contents/bipolar-isorder-in-adults-choosing-maintenance-treatment Srivastava, S. (2011). Ethics Commentary: Bipolar Disorder: 1 Ethical Considerations in the Treatment of Bipolar Disorder. Retrieved from:

1 https://focus.psychiatryonline.org/doi/abs/10.1176/foc.9.4.foc461?journalCode=foc Stahl, S. M. (2013). 1 Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

U.S. 1 Food and Drug Administration. (2017). 1 The Facts on Bipolar Disorder and FDA- Approved Treatments. Retrieved from: 1https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm530107.htm

 
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Mental Health Counseling Discussion

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Mental Health Counseling Discussion

(Mental Health Counseling Discussion)

Mental health counseling is a therapeutic process that provides individuals with a supportive and confidential space to explore and address emotional, psychological, and behavioral challenges. Through open dialogue, clients collaborate with trained mental health professionals, such as counselors or therapists, to gain insight into their thoughts, feelings, and behaviors.

Effective counseling involves active listening, empathy, and non-judgmental understanding. Therapists employ various therapeutic modalities, such as cognitive-behavioral therapy (CBT), psychodynamic therapy, or mindfulness techniques, tailored to the client’s unique needs. The goal is to help individuals develop coping strategies, improve self-awareness, and build resilience.

This therapeutic alliance facilitates personal growth and enhances well-being by addressing issues like anxiety, depression, trauma, or relationship difficulties. The counseling process often empowers clients to identify and modify negative thought patterns, fostering healthier perspectives and behaviors. Additionally, counselors may provide psychoeducation to enhance emotional intelligence and equip individuals with tools for self-management.

Ultimately, mental health counseling is a collaborative journey toward positive change, fostering self-discovery and emotional healing. It acknowledges the interconnectedness of mental, emotional, and physical well-being, promoting holistic approaches to improve overall quality of life.

Think through how aspects of human development impact the effectiveness of counseling programs, focusing on how those programs might be adapted for people at particular stages in their lives.

Focus on how work and career development issues impact early adulthood. Consider this aspect of the human development trajectory and specific ways in which it impacts career development and career choices. The articles in this unit address theories in career counseling.

Consider individuals in the early adult phase of development (ages 24–34). In what ways might career planning programs be particularly helpful for this population of adults who find themselves at crossroads in their career decisions?

Imagine that you are in a position to develop a career planning program for young adults (ages 24–34) in your specialization. Create an outline of how you might go about each of the following steps in developing this program, pointing out how your approach would specifically address the needs of those considering a new career or career change:

· Planning the program.

· Organizing the program at the beginning

· Determining the initial requirements to implement the program (people, funds, space, approvals, et cetera).

· Projecting the resources required to administer the program on a daily and weekly basis.

· Evaluating the success of the program, including the kinds of results you would look for to measure its effectiveness.

 
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Professional Development Power Point

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Professional Development Power Point

(Professional Development Power Point)

Prepare a PowerPoint presentation of 8–10 slides that explains why an understanding of complimentary alternative medicine (CAM) and spirituality is important for members of health care teams; examines the ethical, legal, and financial principles related to CAM and spirituality; and describes how these forms of health care can impact plans of action.

 

Preparation

Your organization has seen an increase in the number of individuals using complimentary alternative medicine (CAM), traditional medicine, holistic health, and spirituality. In addition to your work on the interdisciplinary team, you have been asked by your organization to prepare and deliver an educational session on CAM, traditional medicine, holistic health, and spirituality that can be used by all health care teams. How will you complete this task?

You should focus on these concepts as they pertain to your population (from the Windshield Survey assessment), but also in a broader sense. Use the Capella library and the Internet to look for recent research articles or information on these topics to use as supporting resources in your assessment.

Requirements

For this assessment, prepare a PowerPoint presentation in which you:

  • Identify the topics you will cover in your educational plan.
  • Provide a list of resources your audience can use to further their understanding of complimentary alternative medicine (CAM).
  • Explain why it is important for nurses and members of other health care teams to develop an understanding of CAM, traditional medicine, holistic health, and spirituality.
  • Examine any ethical, legal, and economic principles related to CAM, traditional medicine, holistic health, and spirituality.
  • Describe how these forms of health care can affect a plan of action for individuals and populations.

Your presentation should include a slide with the title of your educational session, a slide with the topics that will be covered (your agenda), and a reference slide at the end. Use the notes section of each slide to provide additional information on each topic, along with supporting references. References and in-text citations must adhere to APA guidelines.

Additional Requirements

  • Include a title slide and reference slide. The completed assessment should be 8–10 slides in length, not including the title slide and reference slide.
  • Reference at least three current scholarly or professional resources.
  • Use current APA format for references.
  • Be creative!
 
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Assessment Methods

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Assessment Methods

(Assessment Methods)

Self-Monitoring: Influencing Effective Behavior Change in Your Clients,” article below

Select a health behavior other than exercise. Write a 1,200 word paper including the following:

Develop your own self-monitoring scale for this health behavior.

Explain how you would use this scale as an assessment tool in a behavioral health intervention.

Summarize three current behavioral assessment techniques. Include a minimum of three scholarly references.

Use article below Format your paper consistent with APA guidelines.

Self-Monitoring: Influencing Effective Behavior Change in Your Clients by Melissa Burgard, B.S., and Kara I. Gallagher, Ph.D., FACSM

Learning Objective To understand how to effectively use self-monitoring to assist clients with behavior change and improve client outcomes.

Key words: Behavior Change, Self-Monitoring, Weight Loss, Feedback, Clients.

Behavior change is a difficult process. As a health/ fitness professional, assisting clients with behavior change can be particularly challenging because client interaction is often limited. Many times, these meetings are not sufficient to target both eating and exercise behaviors and address the many barriers clients face. Because many health behaviors need to be targeted outside of these meetings, finding ways to track progress also is necessary to successfully provide clients with appropriate feedback and direction.

Thus, teaching clients to self-monitor is an effective strategy for targeting both eating and exercise behavior change. Self-monitoring allows you to review your clients’ current eating and exercise behaviors, identify what needs to be modified so clients can reach their personal health/fitness goals, and provide feedback. By definition, self-monitoring is ‘‘the systematic observation and recording of target behavior’’(Assessment Methods)

(1) and has been described as the most effective technique and the ‘‘cornerstone’’ of behavioral treatments for weight loss

(2). Self-monitoring increases a client’s self-awareness, and this has been shown to positively influence eating and exercise behaviors

(3). Several weight loss studies have shown that the more consistent participants were at self-monitoring and the more self-monitoring diaries were completed, the greater was the weight loss

(4–6). In a review of studies, D.S. Kirschenbaum, Ph.D., determined that consistency is best defined as recording at least 75% of eating and exercise behaviors

(7). This relationship also has been found in high-risk situations. In a study examining weight change during the holiday season, only the most consistent self-monitors lost weight

(8).Although self-monitoring is considered to be a valuable tool for behavior change, it does require the consideration of several factors to be applied and used appropriately with your clients. Teaching your client to effectively and consistently self-monitor is a process that is dependent upon the client’s personality, goals, and knowledge regarding his or her behavior. Taking individual differences into account, your goal as the health/fitness professional should be to ‘‘help clients be the best self-monitors they can be’’

(8).As a guide, you can use the following ‘‘Four Ps of Self-Monitoring’’ to determine the best self-monitoring fit for your clients.

Purpose of Self-Monitoring It is helpful to explain the benefits of self-monitoring to your clients so they understand the value and importance it has in promoting behavior change. Self-monitoring can lead to self-awareness regarding behaviors and can help the client regulate behavior more effectively by avoiding and coping with situations that often lead to failure. Self-monitoring records can help identify the specific nature of these situations by answering questions of how, what, when, where, and why. For example, self-monitoring can provide information regarding specific details of client behavior such as:(Assessment Methods)

How many calories do they eat? How much activity do they perform? What type of foods do they eat? What foods do they tend to overeat? What time of day are they most likely to exercise? What types of exercise do they enjoy? When do they eat the majority of their calories? When are they most likely to miss a planned exercise session? Where do they make poor food choices? Where do they have opportunities for exercise? Why do they miss exercise sessions? Why do they want to lose weight or begin an exercise program? By addressing the specific details of clients’ behaviors that occur outside of in-person sessions, you can better assist them with recognizing patterns of behavior that may impact progress.

Personalized Approach What to Monitor Once you have explained to the client the underlying purpose and benefits of self-monitoring, the next step is to decide with the client what behaviors to monitor in order to best reach their health/fitness goals. It is essential to keep in mind that this should not be a one-size-fits-all approach. Take a personalized approach to tracking client behavior that is based upon personality, environment, and individual characteristics and goals. For example, for clients who wish to lose weight, monitoring both eating and exercise information is the best way to determine if they are on track. For other clients, eating behaviors may be related to stressful situations, and thus, feelings of stress may be an additional variable you may want to monitor to assist with weight loss.(Assessment Methods)

Collecting baseline data is an important component of self-monitoring because it provides you with an understanding of what your clients are currently doing, which behaviors require minor modification, and which behaviors you may need to target more heavily. More information is helpful, but it is not necessary to have clients heavily self-monitor at the beginning of a program. Rather, collecting a typical weekday and a typical weekend day of information may be sufficient to capture a snapshot of current behaviors. Once this information is collected, it is beneficial to discuss these initial self-monitoring records with your clients. This will allow you to identify what areas or behaviors they find to be most troublesome and to gain greater insight into how they believe these behaviors can be changed.

Amount of Detail Some clients may prefer to keep highly detailed self-monitoring records that include, for example, date, time, place, mood, description of food, quantity of food, calories, grams of fat, and hunger level (Figure 1). Others will simply want to record whether they made healthy eating choices at each meal. In determining the amount of detail your clients should use, pay careful attention to clients’ attitudes regarding monitoring, personalities, and time constraints. For some, more will be better, and this will provide you with ample information to offer feedback and direction; others may become overwhelmed and disheartened by trying to attend to too many variables.

There are pros and cons to having clients provide a large amount of detail regarding behaviors. For example, although measuring body weight can tell you whether a client is on track, it does not provide you with information regarding the behaviors that may influence that weight. Conversely, having clients keep detailed self-monitoring records may offer too much information, thus making it more difficult to focus on the most crucial behaviors that need to be targeted for change.(Assessment Methods)

Persistence The frequency and consistency with which clients selfmonitor also may be a factor in the success of behavior change. If clients only self-monitor once a month, this is not likely to provide enough information for you to assess progress or for them to make positive behavior changes. The self-monitoring process should be frequent and consistent enough to provide valuable information yet not so cumbersome that clients become overwhelmed. Because self-monitoring is a skill that may need to be developed, your role is to encourage and guide your clients as they become more consistent with this behavior.

When determining the appropriate amount of self-monitoring for your clients, consider the following points: Will daily self-monitoring be beneficial? Will self-monitoring three times per week be adequate? What format will be most convenient for your clients?

Accurate Recording Encourage your clients to be accurate in their selfmonitoring efforts. Some clients may record only the healthy behaviors and fail to include the less healthy behaviors. For example, they may omit the handful of M&Ms they grabbed from a candy dish at work or forget to record the amount of salad dressing they used at lunch. One way to increase accuracy is to have clients carry a self-monitoring tool with them so they can record information immediately. For example, if a client is eating on the run and does not have time to sit down and record what they eat, they can use a small notebook to jot down this information. Alternatively, they can record this information on a small handheld voice recorder. This tool can be especially useful for monitoring exercise behaviors when a client may not have time to record information in writing. Although immediate recording may not always be possible, encourage your clients to record information as soon as they can after the behavior occurs.(Assessment Methods)

Positive Reinforcement Encourage your clients to positively reinforce themselves for effective self-monitoring. If clients have achieved their self-monitoring goals for the week or have improved upon their consistency, they should recognize and reward their efforts. This recognition and reward can take many forms and should be based on individual preference. Some clients may appreciate verbal recognition, while others may prefer a more tangible reward such as purchasing new workout gear. The important aspect is that the recognition and reward are commensurate with the effort the client has put forth. The importance of positively reinforcing clients cannot be overstated. Recognizing successful self-monitoring efforts will not only increase the likelihood of continued success but also will foster a positive client/trainer relationship.

A Tool for Health/Fitness Professionals Self-Monitoring Tools In addition to the benefits that self-monitoring can provide your clients, self-monitoring also can be a useful tool for you. The information gathered from your clients’ self-monitoring records can provide you with valuable insight into areas that may need to be targeted for change. For example, if a client consistently misses morning workouts, it may be helpful to explore whether these missed workouts are related to lack of time, dislike of morning exercise, or some other factor.

By examining self-monitoring records, you also may be able to identify patterns of behavior that may be contributing to a lack of success. This information can help you modify your approach and develop strategies to better assist your clients in reaching their health/fitness goals. Self-monitoring is an effective tool for facilitating behavior change. The information gathered from selfmonitoring records allows you to tailor interventions to target specific behaviors that are crucial to your clients’ success. By teaching your clients to self-monitor, you can empower them to take an active role in their behavior change process and provide them with the skills they need to maintain positive behavior changes long term.

References(Assessment Methods)

  1. Baumeister RF. Self-regulation and depletion of limited resources: Does self-control resemble a muscle? Psychol Bull. 2002;128: 247–66.
  2. Kirschenbaum DS, Gillis R, Smith GP. The Psychology of Weight Control. Champaign, IL: Human Kinetics; 1982.
  3. Burke LE, Choo J, Music E, Warziski M, Styn M, Kim Y, Sevick MA. PREFER study: A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management—Rationale, design and baseline characteristics. Contemp Clin Trials. 2006;27:34–48.
  4. Boutelle KN, Kirschenbaum DS. Further support for consistent self-monitoring as a vital component of successful weight control. Obes Res. 1998;6:219–24.
  5. Linde JA, Jeffery RW, French SA, Pronk NP, Boyle RG. Self-weighing in weight gain prevention and weight loss trials. Ann Behav Med. 2005;30:210–6.
  6. McGuire MT, Wing RR, Klem ML, Lang W, Hill JO. What predicts weight regain in a group of successful weight losers? J Consult Clin Psychol. 1999;67:177–85.
  7. Kirschenbaum DS. Self-regulatory failure: A review with clinical implications. Clin Psychol Rev. 1987; 7:77–104.
  8. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323–41.

15ACSM’S HEALTH & FITNESS JOURNALA JANUARY/FEBRUARY 2006 VOL. 10, NO. 1 Copyr ight © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

 
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The Problem: The Case Of The Troubling Inquiry

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The Problem: The Case of the Troubling Inquiry

(The Problem: The Case Of The Troubling Inquiry)

At lunch one day a friend, who is an excellent mid-level scientist in the company in which you work, tells you she wants to talk with you about a problem. She has a suspicion that she is being paid less that her male colleagues and wants your help. You have just been doing some research and know that the women scientists are in fact being paid less than the men with comparable experience and comparable education in the field. The hiring practice had been to bring people in at the lowest possible salary. You know that the research shows that because women tend to be more tentative about salary, they don’t ask for top dollar. You have just completed a salary survey in your company and know that women scientists are currently being paid 10% less then men with the same credentials in many cases. Your preliminary work indicates that to bring the women into parity with the men will cost approximately $37,500 per quarter.

Here is the assignment:

(The Problem: The Case Of The Troubling Inquiry)

Worksheet 5: For this part of the Assignment, you are asked to Be Reflective, asyou consider both how you made the decision as well as your response to theAssignment. In this segment you consider how you corrected for personal bias and your own blind spots—hubris—and have attended to the common good.This part of the Assignment must have citations and references. Use the questions as headings for each section, and write no more than a paragraph on each.

● Discuss whether or not the ethical analysis made sense. As you considered the section in the Baird text that described the process that those from the deontological school of thought use for ethical analysis, what were the strengths and weaknesses of this process? What were the problems with the process?What are the sticking points?

● Did you like the results? Did you like the reasons for taking the action, the rationale that is part of the deontological school of thought? Do you get a sense that you would follow these results or the rationale in real life? Why or why not?

● What insights do you have about this problem that you would like to share with others? What information would you appreciate from them?

● How would adding the world of emotion and conscience help clarify your decision, as described on the first page of Chapter 7 of the Baird text? Ethical maturity is often defined as not only being responsible but also considering others in the decision. Why is considering others important in the particular problem you were asked to resolve?

● Consider the spiritual perspective—spirituality being defined as that which gives life and work meaning and purpose. As you begin to see yourself in light of the community, how can you (and others in the organization) begin to discipline your desires so you can live fully in the present with faith and trust, avoiding self-righteousness and self-deception?

 
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