There is nothing either good or bad, but thinking makes it so Term Paper

There is nothing either good or bad, but thinking makes it so - Term Paper Example have heard a lot of medical professionals who talks about the positive effects of meditation therapy or counseling over the health progress of a sick person. Upon reflecting what these people are trying to convey, I have realized that it is by having a positive attitude and outlook in life that enables a sick person to easily recover from his/her illnesses as compared to another person who has developed a negative outlook in life. There are many situations that can prove that there is neither good nor bad and that the way we think makes something good or bad. We have always been told that cigarette smoking could lead to the development of cancer. Despite all the scientific evidences that can prove this idea right, we can still find a lot of medical practitioners who are chain smokers. Is it really difficult to quit smoking? Is cigarette smoking the only way to control work-related stress? Of course, we all know that the answer is â€Å"NO†. Have you ever wondered why most of these medical professionals find it very difficult for them to quit smoking whereas there are some people without medical background who could easily resist the temptation of smoking? If cigarette smoking is really addicting, how come there are some people who smoke but can anytime control their mind and convince themselves not to smoke? It is given that each person is subject to either internal and/or environmental stressor. Although stressor is always present in our daily life, each individual has their own strategy on how they choose to manage stress. In the book entitled â€Å"Psychology Applied to Modern Life: Adjustment in the 21st Century†, it was mentioned that mediation as a form of therapy is effective in terms of converting negative emotions such as the feeling of stress into a positive one (Weiten, Lloyd, Dunn, & Hammer, 2009, p. 130). This explanation mentioned in the book clearly suggests that it is how a person thinks that makes something either good or bad. Perhaps, some of

Oscar Zeta Acosta Essay Example for Free

Oscar Zeta Acosta Essay Abstract The paper that I wrote talks about Oscar Zeta Acosta and his impact on the Chicano community. In the leaders contribution I talk about how Acosta was an attorney for the Chicano movement and generated controversy. In the leaders contribution section I talk how Acosta addressed political, social, and educational injustices against Chicanos. Acosta used his time and profession to help the Chicano movement. He contributed through two of his books that are a major part of the Chicano literacy renaissance. He also clashed with the Judicial system a lot of times for reasons that he thought were right. In the section others perspectives I talked about how he was scrutinized by many people but was still recognized through his significance in the Chicano movement. Leaders Context Oscar Zeta Acosta was born in El Paso, Texas on April 8, 1935. A little after he turned five he and his family moved to Californias San Joaquin Valley because his family couldnt make a living during the Depression. His parents started working as migrant field workers. Acostas father was different from other people. He had a passion for competition he had to compete with people more then anything. When Acosta was little his father would always make him argue with him. As he said in his book Oscar Zeta Acosta: The Uncollected Works I guess that is where I became as nasty as I am. (5). When Acosta went to high school he wasnt one of the average Chicanos going to school. He became involved in sports and music he was also president of his class. He got a scholarship for music at the University of Southern California. But he decided not to go. After finishing high school, Acosta joined the U.S. Air Force. Acosta then worked his way through college, becoming the first member of his family to graduate. Acosta attended night classes at San Francisco Law School and passed the California Bar exam in 1966 on his second try. (Oscar Zeta Acosta: The Uncollected works) In 1967, Acosta began working as an antipoverty attorney for the East Legal Aid Society in Oakland, California. Then he moved to East Los Angeles, where he joined the Chicano Movement and generated controversy as an activist attorney during the years 1968-1973. But his activities began in Oakland but it was in East Los Angeles where he gained notoriety. He defended various Chicano protest groups and activists such as the Saint Basil 21 and Rodolfo Corky Gonzalez. As an attorney, he figured prominently in legal cases which addressed political, social, and educational injustices against Chicanos. Acosta is also a well known author of two most important novels of the Chicano Protest Movement. An Autobiography of a Brown Buffalo (1972), and The Revolt of the Cockroach People (1973) . Acostas characteristics involve him being savage, nasty, not giving up nor letting anyone out him down as he said in his novel The Autobiography of a Brown Buffalo I dont give a shit what other people have to say about me(130). I believe that all of these characteristics has made him, become who he was. Because he didnt care what others thought about him, he kept on going when things got hard . Acostas father had to do a lot with him becoming like this, because Acostas father would push Acosta to become better then anyone else made him become the nasty interior person he was. He would never show his emotions and never really found his true identity because Acostas father would always push him to do extracurricular activities, and he didnt have that extra time to spend it with the other Chicanos out on the block. It was until later on working as a Legal Aid and saw the Chicanos rioting and walking out for causes he didnt know existed. Leaders Contribution Oscar Zeta Acosta contributed to the Chicano community through two novels that he wrote. Those two novels were a literary contribution to the Chicano community and movement. He used his profession as an attorney to defend Mexican/ Chicano walk outs for better education. Acosta demonstrated his contribution through joining the Chicano movement. He used his profession as an attorney to defend various Chicano protest groups and activists such as the Saint Basil 21 which was The Catholics for la Raza the coalition in an ill-fated protest at St. Basil’s on Christmas Eve, 1969 and also the Rodolfo Corky Gonzalez where he led a Chicano contingent to the Poor People’s March on Washington D.C and issued a â€Å"plan of the Barrio† which demanded better housing, education and restitution of pueblo lands. Acosta figured prominently in legal cases which addressed political, social, and educational injustices against Chicanos. He frequently clashed with the judicial system, winning ardent supporters as well as making political enemies. He also contributed two novels that he wrote called Autobiography of a Brown Buffalo (1972), and The Revolt of the Cockroach People (1973) . Those were two novels that were highly acclaimed as major contributions to the Chicano literary renaissance. Acosta was a catalyst for change because he contributed his time and profession to the Chicano Movement. Acosta defended his community and race and he also took cases that defended Chicano education, and Chicano rights. He contributed to the Chicano literary renaissance. He is someone that may not be well known to everyone because no one talks about him now but during the Chicano movement he was a catalyst for change because he helped the Chicano community be what it is today by not attaining the injustices they had in the education and in the living of the Chicano community. Other Perspectives Oscar Zeta Acosta is a controversial Chicano author, activist and attorney whose work focuses on ethnicity and ways that people of Mexican ancestry in the United States forge an awareness of themselves and how they get treated by other people. Even though Acosta sometime contradicts himself he is still considered by a few a very great person and activist. The website  ¡Para Justicia y Libertad! said that Acosta was A gifted writer and storyteller, an activist, a civil rights attorney, and is considered the Malcolm X of the Chicano/a community. Also in the article called Oscar Zeta Acosta: One of God’s own prototypes he said Oscar was a legendary, compelling figure in Chicano history his remains in the shadows of the general American culture ( p.1) . There is one thing was for sure that most Chicana would say that he was a feminist and grouse! (Bandido 115) . Some Chicanas even dislike the way he talks about women in his book. He talks about women as if they were objects and he also talks about them in a vulgar way in the books by calling them bitches of hoers. He also talks in a very feminist way, when you read his books you can notice how he mentions or trys to lower the feminine perspective and the mentality of a women. Conclusion Based on the research I have conducted it is my view that Oscar Zeta Acosta was a key component in the Chicano movement because of the role he took by defending the Chicano community when no one would defend them, and especially because Acosta took his profession and his time to defend them. His work affected my life because it showed me that in life you have to pursue your goals to achieve them. Even though it might be tough there reachable. What surprised me about Acosta was his language in his books because I thought an attorney would not talk or especially write a book with vulgar and derogatory language. Another thing that also surprised me about Acosta was that he was a feminist I believed that someone that would defend people like the Chicano community because of the injustices they are facing in society would discriminate other people. Acostas importance during his lifetime was that he was an essential part in fixing the Chicano education and living in the Anglo world. Reflection Leader Selection.I am pleased with my catalyst for change choice Oscar Zeta Acosta. I learned more about the Chicano education injustices and also about the Chicano movement. Even tough there where parts that I wasnt pleased about hearing like on how he was a feminist and how vulgar he talked about women in his books and how he just thought they were objects. I still found my catalyst for change interesting like on how he wasnt like the rest of the Chicanos while he was growing up, he was like an outsider to his own race. Methodology. At first it was difficult to find books that Acosta has written or books that talk about him, because every book store I went to said they did not have them but they could always order them but it would take about to two weeks and when I would say no thank you ill try some where else they would look at me if I was crazy. At the end I ended up going to the downtown public library and I was luck there was only one copy of the books. Maybe next time what I would do differently is choose a person that has sources that are available everywhere. I believe that I did pace my self with reading the books and writing the paper. My time management was effective at times, because there was times I go carried away doing other things but I would still do my paper even though at times I would have to sleep late. Critical Reading. Reading the sources was some what difficult because of the language and sometimes the metaphors he used. What I learned about the whole reading concept is that it is going to be very useful in college and that you have to learn how to pace yourself when you read also that you have to skim the book, also having a dictionary in hand would be very useful to. Note taking did become easier as I worked along. I found note taking very useful since the books I was reading were not mine so I couldnt highlight the important information that I would be using for my research paper. I found the note taking system very useful, probably the other useful thing that would of helped me would have been if the books were mine because I wouldnt have speed threw the books to get them in by their due date. Writing. In writing my research paper the difficulty I faced was not knowing how to get my point across I found that difficult to do because everyone that read my research paper did not know who Oscar Zeta Acosta was. Probably the one thing that would of been useful was choosing a person that people knew at least the name to. The paper we got with the prompt and the instructions on what we had to answer helped a lot because while I was writing my paper I was looking back to see if I answered the prompt and followed the instructions and criteria. The skills that I believe that I need to work on is on my writing and how I try to get my point across because I found that hard to do. The skill that I believe that I was getting better at was knowing how to paraphrase. Experience. I did enjoy working on this project alone because I worked on it at my own pace, but I do enjoy working with others. I believe this research paper would have been better in group because you dont have top rush threw books because everyone can read a book, also because everyone has their own style of writing and looks at the prompts differently so it would have been easier because everyone could have contributed through their opinions and ideas and could have answered the prompt more efficiently. I believe that the most interesting part of this research paper was getting to know everything that your catalyst for change did, because I just knew a couple of thins that Acosta did like being a lawyer and defending the Chicano community, but I didnt know or have a clue everything else he did and how he acted and how he was a feminist. I believe that the most difficult thing about the research paper was the paper itself, because everything was just new to me because I have ever used MLA format before.

Current cognitive models of PTSD

Current cognitive models of PTSD The treatment literature of the past twenty years reflects an enormous interest in discovering the most effective psychological therapy for clients with a diagnosis of posttraumatic stress disorder, PTSD. The overall aim of this paper is to critically evaluate current cognitive models of PTSD and literature on the effectiveness of cognitive behavioural therapies to treat this disorder based on these models. Definitions of PTSD In the Fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (American Psychiatric Association, 1994) trauma is defined as: (a) The person experienced, witnessed or was confronted with an event that involved actual or perceived threat to life or physical integrity; and (b) the persons emotional response to this event included horror, helplessness or intense fear. Foa and Meadows (1997, p. 450). In DSM-IV psychological symptoms of PTSD are categorised into three cluster symptoms: re-experiencing, avoidance/numbing and increased arousal, which arise after the person is exposed to a traumatic stressor. The recurrent re-experiencing symptoms e.g. flashbacks, nightmares, intrusive thoughts, have been considered the hallmark of PTSD (e.g. Foa Rothbaurn, 1992). The second cluster includes avoidance of trauma-related stimuli and numbing of general responsiveness e.g. deliberately avoiding trauma-related stimuli and symptoms of emotional numbing (Foa, Hearst-Ikeda, Perry, 1995; Litz, 1993). The latter are considered distinguishing features of PTSD (Foa Meadows, 1997). The third symptom cluster includes increased arousal e.g. hypervigilance, exaggerated startle response, difficulty sleeping and irritability (APA, 1994). Current Government Guidelines on the treatment of PTSD Determining effective and efficient treatments for PTSD has become a priority in light of the conditions prevalence and the many techniques and interventions available. The National Institute for Clinical Excellence, NICE, reviewed the most robust outcome research and produced guidelines, to inform and guide clinical practice for the psychological treatment of PTSID in adults (NICE, 2005). The guidelines were based on an independent, systematic, rigorous and multistage process of identifying, reviewing and appraising evidence for the effective treatment of PTSD. These guidelines conclude that individuals with PTSD should receive either trauma focused Cognitive Behavioural Therapy, TFCBT or Eye Movement Desensitisation and Reprocessing, EMDR. However, a distinction is made between single incident trauma and more complex presentations, and the guidelines suggest increasing the total number of sessions accordingly. Although the guidelines appear helpful for the treatment of single incid ent PTSD, they are arguably not as informative for treatment approaches for a large group of individuals with complex PTSD. This presents difficulties for the clinician and client in deciding the most effective therapeutic options. Cognitive Behavioural Therapy (CBT) is the most extensively researched therapy for individuals with PTSD (Foa Meadows, 1997) and many studies support its efficacy in reducing symptom severity (e.g. Foa et al., 1995; Foa Jaycox, 1996; Foa, Rothbaurn, Riggs, Murdock, 1991; Resick Schnicke, 1992; Richards, Lovell, Marks, 1994; Thompson, Charlton, Kerry, Lee, Turner, 1995). However, CBT for PTSD encompasses diverse techniques. These include exposure procedures, cognitive restructuring procedures, and combinations of both these techniques. Exposure Therapy Exposure therapy is based on the premise that imaginal exposure (IE) to the trauma or feared situation, leads to symptom reduction. The theory argues prolonged activation of traumatic memories leads to emotional processing of the affective information, habituation of anxiety and integration of corrective information (Foa et al., 1995). Numerous studies have demonstrated that treatment based on exposure therapy is efficacious in reducing PTSD (e.g. Foa et al., 1999; Frueh, Turner, Beidel, Mirabella, Jones, 1996; Keane, Fairbank, Cadell, Zimmering, 1989). Foa, Rothbaum, Riggs, and Murdoch (1991) investigated exposure therapy, stress inoculation (a type of Anxity Management Treatment, AMT), supportive counselling, and a non-treatment group in the treatment of PTSD as a result of rape. Clinical ratings of symptoms and standardized psychometric tests were examined before and after treatment as well as at a 3-month follow-up. The stress inoculation intervention showed greater results than the counselling and non-treatment conditions at post-test. However, at the follow-up, the individuals participating in exposure therapy showed more improvements of PTSD symptoms than individuals in the other groups. Research has investigated the efficiency of exposure therapy compared to different methods of treatment. For instance, Tarrier et al. (1999) investigated exposure therapy and cognitive therapy in the treatment of individuals with PTSD arising from several different traumatic incidents. The two groups demonstrated noteworthy decrease in PTSD symptoms that was still present at the 6-month follow up. Although results were positive for both groups, there was no non-treatment control against which these two active treatments could be evaluated. Similarly, Foa et al. (1999) compared exposure therapy to AMT and then combined the two treatments. These three groups were compared to a non-treatment control group. All three of these treatments effectively reduced symptoms of rape-related PTSD and resulted in functional improvement. There were no differences among the three treatment groups on outcome measures, but all three groups improved more than the non-treatment comparison group did. In a study that once again compared exposure therapy to cognitive therapy, Marks, Lovell, Noshirvani, Livanou, and Thrasher (1998) examined these two treatments alone and in combination in outpatients with PTSD secondary to a wide range of traumatic events. A relaxation therapy condition was employed as the primary comparison group. All three active treatment conditions showed significant improvement, and greater improvement than that observed in the relaxation group. The three active treatments did not differ from one another on the key outcome variables. Several investigations have advanced the field of PTSD treatment, even though the methodology utilized in the outcome study limited the conclusions that could be drawn. Frank and Stewart (1983) reported the effects of systematic desensitization on women who had been raped and who developed significant psychological symptomatology. Compared to an untreated comparison group, those women treated with graduated exposure improved most on a range of anxiety and depression symptom measures. Richards, Lovell, and Marks (1994) compared imaginal and in vivo exposure in a randomized study of survivors of diverse traumatic events. At the 12-month follow-up, patients reported consistent reductions in PTSD symptoms and improved social adjustment. These data further substantiate the effectiveness of exposure therapy for some individuals, and also suggest that improvements in symptoms are also reflected in critical domains of life functioning. In summary, the existing data support the use of exposure therapy in the treatment of PTSD. In a previous review of this literature, Solomon, Gerrity, and Muff, (1992), (Sited in Shapiro, 1995) derived the same conclusion from data available at that time. Similar conclusions were drawn by Otto, Penava, Pollack, and Smoller (1996) in a more recent review of the literature. In what may ultimately prove to be an important lesson for the treatment of individuals exposed to traumatic events, Foa, Hearst-Ikeda, and Perry (1995) examined the efficacy of a brief intervention to prevent the development of chronic PTSD. For women who had been recently raped, the authors developed a program based upon that which worked so well in earlier trials with chronic PTSD. Exposure therapy figured prominently in the package of treatments assembled. This package also included elements of education, breathing retraining, and cognitive restructuring. When individuals receiving the package were compared to a matched control group, this study found that at 2 months after intervention only 10% of the treated group met criteria for PTSD, while 70% of the untreated comparison group did. As information continues to grow on exposure therapy, there is a distinct need for studies to examine combinations of treatments, to employ measures that assess social and occupational functioning, and to address the impact of treatments on comorbid psychological conditions. Clearly, the available efficacy studies demonstrate the value of extending the use of exposure therapies to patients with PTSD. However future studies assessing the generalization of exposure therapy from laboratory trials to clinical settings would be particularly useful. When exposure therapy has been compared to other forms of cognitive therapy, such as cognitive restructuring (see below), it has proved to be more successful in reducing PTSD. Tarrier et al., (1999) compared Cognitive Therapy (CT) with imaginal exposure therapy (IE) for 72 people with chronic PTSD, and concluded that there was no significant difference between the two groups initially or at 12 month follow up. Participants recruited were obtained from a sample of referrals to primary and secondary mental health services and voluntary services, indicating that they were representative of a genuine clinical sample. However, 50% of the sample remained above clinical significance for PTSD symptoms after treatment was completed, although this dropped to 25% at six-month follow-up. This lack of improvement may have been influenced by participants failure to attend sessions regularly. Furthermore, those who did not show improvement rated the therapy as less credible and were rated as less m otivated by the therapist. Therefore, it is argued that motivation for therapy and regular attendance plays an important role in outcome of therapy regardless of treatment model. A further limitation of this study was that no control group was used and non-specific treatment factors and spontaneous remission could also account for the improvements in reported symptoms. Cognitive Restructuring Cognitive restructuring is based on the theory that identifying and modifying catastrophic and unrealistic interpretations of the traumatic experience leads to symptom reduction. Recent models have emphasised the importance of correcting cognitive distortions in the adaptive recovery of people following trauma (Ehlers Clarke, 2000). Ehlers, Clark, Hackmann, McManus, and Fennell (2005) utilized cognitive therapy based on the cognitive model of PTSD (see Ehlers Clarke, 2000). From this model, the aim of therapy is to modify excessively negative appraisals, correct the autobiographical memory disturbance and to remove the problematic behavioural and cognitive strategies. In a randomised controlled trial, twenty-eight participants who were referred to a community mental health team were diagnosed with PTSD. Fourteen participants were randomly allocated to immediate cognitive therapy or a 13-week waiting list condition. Those receiving cognitive therapy had 12 weekly treatment sessions, based on the Ehlers and Clarke (2000) model of trauma focused CBT. Participants completed self-report measures of PTSD symptoms, depression, anxiety and also completed the Sheehan Disability Scale (APA, 2000). Measures were completed pre and post treatment and at 6 month follow up. Results found that CT for PTSD was superior to a 3-m onth waiting list condition on measures of PTSD symptoms, disability and associated symptoms of anxiety and depression. This study had no dropouts, which is a significant improvement on other studies, which Yielded high dropout rates. (e.g. Tarrier et al., 1999). Participants displayed a positive change in cognitive appraisals. The Ehlers and Clarke (2000) model suggest that two other pathways of change, change in autobiographical memory of the trauma, and dropping of maintaining behaviours and cognitive strategies as integral in reducing symptoms of PTSD. Although the treatment addressed these other two factors, these have not been systematically measured, so it is difficult to conclude whether clients experienced a change in these two areas. Further analysis indicated that demographic, trauma and diagnostic variables did not predict treatment outcome, suggesting that the treatment is applicable to a wide range of trauma survivors. However, the degree in variation of trauma and small sample numbers suggests that this finding would not be present in a larger sample. Co-morbid depression and previous trauma history, which was present in over half the sample, did not negatively affect outcome. Combinations of therapy Resick and Schnicke (1992) have proffered a multidimensional behavioural treatment package for women who have rape-related PTSD. This package, entitled cognitive processing therapy (CPT), combines elements of exposure therapy, Anxiety Management Training (AMT), and cognitive restructuring. The cognitive therapy component of CPT involves addressing key cognitive distortions found among women who have been assaulted. In particular, these authors have designed interventions for addressing difficulties in safety, trust, power, self-esteem, and intimacy in the lives of survivors. In a preliminary evaluation of CPT, the authors compared outcomes at pre-treatment, post-treatment, 3 months follow-up, and 6 months follow-up for a treatment group and a non-treatment comparison group (no random assignment was used). On clinician ratings and psychometric inventories of PTSD, the individuals receiving CPT improved markedly. At the post-treatment assessment, impressively, none of the treated patie nts met criteria for PTSD. In a recently completed study, Resick, Nishith, and Astin (2000) reported on a comparison of CPT and exposure therapy in the treatment of rape-related PTSD. In general, the two treatments were equally effective and more effective than a non-treatment control condition. CPT did also seem to reduce comorbid symptoms of depression, as well as those of PTSD. Combination treatments that include an array of cognitive-behavioural strategies have the advantage of addressing multiple problems that people with PTSD may exhibit, as well as incorporating techniques that have considerable empirical support in the clinical literature. Keane, Fisher, Krinsley, and Niles (1994) described a treatment package including exposure therapy, AMT, and cognitive restructuring as central features of their approach to treating PTSD. This package employs a phase oriented approach to treating severe and chronic PTSD that includes the following six phases: (1) behavioural stabilization; (2) trauma education; (3) AMT; (4) trauma focus work; (5) relapse prevention skills; and (6) aftercare procedures. Although this approach has clinical appeal, it wasnà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢t until psychologists Fecteau and Nicki (1999) examined such a package in a randomized clinical trial for PTSD secondary to motor vehicle accidents that the impact of a combination package such as that proposed by Keane et al. (1994) was assessed. Their intervention consisted of trauma education, relaxation training, exposure therapy, cognitive restructuring, and guided behavioural practice. Patients were randomly assigned to the intervention or to a non-treatment comparison group and received some 8à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬10 sessions of individualized treatment. The results of the intervention were successful as measured by clinical ratings, self-report questionnaires, and a laboratory-based psycho-physiological assessment procedure. Described by the authors as clinically and statistically significant, these treatment effects were maintained at the 6-month follow-up assessment. Bryant, Moulds, Guthrie, Dang, and Nixon (2003) studied the effects of IE alone or IE with CR in the treatment of PTSD. They hypothesised that CR combined with IE would result in greater PTSD symptom reduction than exposure alone, which in turn would have greater benefits than a supportive counselling condition. Fifty-eight civilian trauma survivors, diagnosed with PTSD as measured by Clinician Administered. PTSD Scale, version 2, CAPS-2, (Blake et al., 1995) were randomly allocated to one of the three conditions. Each participant received eight weekly 90-minute sessions of either IE, CR and IE or supportive counselling. Participants completed assessments at pre and post treatment and 6 month follow up. These measured PTSD symptoms and psychopathology. Forty-five participants completed treatment and analysis indicated that dropouts had higher scores for depression, avoidance and higher catastrophic cognitions than those who completed. Results indicated that participants receiving bot h IE and IE/CR had greater reductions in PTSD symptoms and anxiety than supportive counselling (SC). The major finding of this study was that therapy involving IE and CR leads to greater reductions in CAPS-2 intensity scores than therapy involving IE alone. Furthermore, those receiving IE/CR, but not IE alone, reported fewer avoidance, depression and catastrophic cognitions than those receiving SC. The results from this study indicated that the combination of IE and CR are effective in reducing symptoms of PTSD. It can be argued that the reasons why IE/CR may have been more effective than augmented treatments in the past (e.g. Foa et al., 1999) was that the study carefully controlled for the amount of time actively spent on each treatment component. Furthermore, participants were instructed on CR before commencing IE so they understood the rationale behind the techniques prior to addressing the strong emotional components of IE. This may have increased their understanding and belief that it was a credible treatment approach. The finding that CR enhanced the treatment gains of IE may have been mediated by several possible mechanisms. IE and CR may involve common elements, including processing of emotional memories, integration of corrective information and development of self-mastery (Marks, 2000). Combining both interventions may provide the individual with greater opportunity to benefit. CR may have lead to greater symptom reduction as it specifically addressed identification and modification of maladaptive cognitions that may contribute to maintenance of PTSD and associated problems (Ehlers Clarke, 2000). Paunovic and Ost (2001), compared treatment outcome data for CBT and exposure therapy for sixteen refugees with PTSD. The authors excluded those who became too distressed in the initial interview, expressed a lack of confidence in the therapist or were misusing alcohol or drugs. Results indicated there was no significant difference between participants completing CBT or exposure therapy, being simila r to Tarrier et als (1999) findings. Criticisms of Paunovic and Ost (2001)s study are that participants did not use a self-report trauma measure, so although results are positive, there is no clear analysis of whether participants felt their trauma symptoms decreased as a result of the treatment. Further, it is not possible to generalise these findings to traumatised refugees in general, as this work is unique. Working with the use of an interpreter raises several ethical and sensitive issues, as the participant must be able to develop a therapeutic alliance with the therapist and trust the interpreter (Tribe, 2007). It could be argued that participants may have been experiencing a greater degree of trauma, not least because they had not yet learned the native language. Discussion The most effective CBT programs appear to be those that rely on repeated exposure to the trauma memory (Foa et al., 1999; Foa et al., 1991; Foa Rothbaum, 1992) on cognitive restructuring of the meaning of the trauma, (Ehlers Clarke, 2000) or a combination of these methods, (Resick Schnicke, 1992). Importantly, studies have concluded that trauma focused CBT is more effective than supportive counselling (Blanchard et al., 2003; Bryant et al., 2003). Whilst the studies reviewed have helpfully added to our understanding of PTSD there are numerous limitations of the applications of the findings. One in particular is an over-reliance on non-clinical samples of participants such that many claims of clinically effective therapy have been made from research with participants who were not within mental health systems, and despite having PTSD symptoms had not actively sought treatment. In addition, dropout rates in studies are high, particularly for those studies that did not use a clinical sample. This might have skewed the evidence particularly with approaches that used exposure-based therapy. Furthermore, most of the studies reviewed screened out those individuals experiencing the greatest amount of distress, avoidance and co-morbidity. Therefore results are biased towards those clients who were able to tolerate treatment and whose symptoms were not as chronic. Indeed, inclusion and exclusion criteria appear to have a great impact on outcome of treatment. For example, studies with a strict inclusion criteria (e.g. no co-morbidity, substance misuse, self harm) appear to have significant improvements, whilst other studies i.e. Kubany et al., (2003), allowed participants to continue with other therapy while embarking on their therapy. This makes it methodologically difficult to ascertain exactly what has been effective in reducing PTSD symptoms. As inclusion and exclusion criteria are idiosyncratic across studies, it makes it difficult to draw general conclusions regarding treatment effectiveness with a clinical population across studies. Studies often chose to focus therapy on identified groups, e.g. police officers. However, clients who experience PTSD do not form a homogeneous group and further, the symptoms experienced may be diverse even within a sample of individuals who have experienced the same trauma. Treatment studies often do not control for other factors that may be important contributing factors in outcome such as the role of education, quality of the therapeutic relationship, therapeutic alliance and other nonspecific factors. The literature was generally from American, British or European sources although clearly trauma is intercultural. This raises issues about how different cultures interpret PTSD, an essentially Western concept, and also whether the treatments advocated would be effective cross-culturally. Previous research has strongly indicated that PTSD is not an appropriate term to use in non-western situations (Summerfield, 1997), hence therapeutic approaches need to account for this. It is not clear in the majority of the research when the participant experienced the trauma, and at what point therapy started. Frequently these characteristics are omitted from studies, therefore making it difficult to compare effectiveness of studies. It is important to consider the types of clients who have been represented in the research and to look at whether it is representative of those who seek treatment. Finally, very little has been reported on the impact of other difficulties an individual is experiencing as PTSD can have a wide ranging impact on an individuals quality of life and functioning and most often clients have more complex presentations. Only very few studies reviewed controlled for this variable (see Ehlers et al., 2005). This is an inherent difficulty when completing research with a trauma population as within research it is important to obtain a sample that have a similar degree of difficulties in order to assess treatment efficacy. Several papers have evaluated different types of therapy according to particular groups. However, it appears that one size does not fit all in relation to PTSID. In particular the issues of culture and gender are of importance (see Liebling Ojiambo-Ochieng, 2000; Sheppard, 2000). Individual formulations of presenting problems and contexts, which informs therapy that is adapted to suit individual clients needs, may in fact be more helpful. It remains important to consider individual differences and client choice when offering trauma therapy. Trauma therapy outcome studies are limited by the fact that sufferers usually have other mental health problems alongside PTSD such as depression or social anxiety. Evaluation of effective treatment of trauma survivors therefore might need to go beyond medical diagnostic categories as most of the research excludes clients with co-morbid problems. A multifaceted intervention, based on clients own views, which addressed these other difficulties, may help reduce relapse and improve long-term efficacy of any PTSD treatment. As outlined in the methodological limitations section, much of the research reviewed has not used a genuine clinical sample, there are high dropout rates, widely variable inclusion and exclusion criteria, and the heterogeneity of PTSD has perhaps not yet been accounted for. It is therefore difficult to ascertain what is specifically helpful or effective within the treatment components. This seems to be the next area for consideration in research. Further research into the optimal length of treatment and timing of therapy, the effect of co-morbidity and the differing effects of individual and group therapy approaches for traumatised clients are required. Further controlled research is needed to ascertain if the types of therapies reviewed can provide long term lasting effects in reducing PTSD symptomatology. Currently the empirical data is generally limited to the assessment of short term, focused interventions, and it would be helpful to have controlled studies on longer-term treatment for more complex trauma cases. Further research would benefit from considering the clients views and experiences of therapy, this perspective was lacking in the literature reviewed. Service user and carer perspectives are beyond the scope of this review, however they have been highlighted as an important consideration within the NICE guidelines and therefore require further consideration in future research. Conclusion There appear to be at least three treatments with excellent empirical support for treating PTSD; exposure therapy, cognitive therapy or a combination of these methods. These three approaches have excellent empirical support in well-controlled clinical trials, manifest strong treatment effect sizes, and appear to work well across diverse populations of trauma survivors. However future studies to examine the effectiveness of these approaches in clinic settings are warranted. There is much to be learned about the treatment of PTSD. It is certain there will be no simple answers for treating people who have experienced the most horrific events life offers. Undoubtedly, combinations of treatments as proposed by Keane et al. (1994) and Resick and Schnicke (1992) may prove to be the most powerful interventions. PTSD research in this area is only in the earliest stages of its development. Finally, an assumption about the uniformity of traumatic events has been made in the literature in general. Although it is reasonable to speculate that fundamental similarities exist among patients who have experienced diverse traumatic events and then develop PTSD, whether these patients will respond to clinical interventions in the same way is an empirical question that has yet to be addressed. Studies posing a question such as this would be a welcome addition to the clinical literature: Will people with PTSD resulting from combat, torture, genocide, and natural disasters all improve as well as those treated successfully following rape, motor vehicle accidents, and assaults? This is a crucial issue that requires additional scientific study in order to provide clinicians with the requisite evidence supporting the use of available techniques. Research on the prevalence of exposure to traumatic events and the prevalence of PTSD has mainly been carried out in the United States. Yet there are fundamental errors in assuming that these prevalence rates apply even to other Western, developed countries. Studies that examine the prevalence of PTSD and other disorders internationally are clearly warranted. Implicit in this recommendation is the need to examine the extent to which current assessment instrumentation is culturally sensitive to the ways in which traumatic reactions are expressed internationally. Much work on this topic will be required before definitive conclusions regarding prevalence rates of PTSD internationally can be drawn. Studies of the effectiveness of the psychological treatments across cultures and ethnic groups are also needed. What may be effective for Western populations may be inadequate or possibly even unacceptable treatment for people who reside in other areas of the world and who have different world views, beliefs, and perspectives. This issue will need to be more closely examined before we can draw definitive conclusions. It is suggested that despite the type of treatment provided to individuals with trauma there is ultimately a need for a flexible, integrative approach to treatment in order to deal with the complex and varying needs of individual trauma survivors. A range of outcomes has been found with the types of approaches outlined in this review, it is unclear who will respond best to which treatment approach. However, what is important in determining the success of any psychological treatment of PTSD is that it is dependent upon establishing and maintaining a therapeutic alliance that is strong enough for the client to experience as safe and trusting for positive emotional change to occur.

Breast Implants Essay -- Srgumentative Persuasive

Breast Implants   Ã‚  Ã‚  Ã‚  Ã‚   Why do women get breast implants? Do the breast implants make them feel good about themselves? Breast implants are a serious threat because, there are many risks involved, there are many disorders that are possible, and there are illnesses that you could catch after the operation. According to Marian Segal, many of the women who have had breast implants don’t exactly understand what is in their body.   Ã‚  Ã‚  Ã‚  Ã‚  Silicone contains organic compounds, which have the physical properties of oils,resins or rubber, and which are more stable when exposed to heat and oxygen thanordinary organic substances. This is the same stuff that goes into your body making you think that you look good ( MS Bookshelf).   Ã‚  Ã‚  Ã‚  Ã‚  There are many procedures that need to be followed in order to get an application for silicone inflatable breasts (MS Encarta). There are various test, experimentation, and evaluations that need to be done ("Student Handbook"). The most important ones are the; Chemical Characterization, Pharmacokinetic Studies. These are all tests that the Plastic Surgery and Reconstructive Surgery Devices Branch Division of General Restorative Devices and the Office Of Device Evaluation all require (ODE documents 6).   Ã‚  Ã‚  Ã‚  Ã‚  The Chemical Characterization, is an important test. It does all of the following. If fabrication of the device involves curing of polymeric components by chemical crosslinking, then data establishing should be provided. This may be done by a various met...

Trash Summary

Trash Summary Trash is an epic novel about three ordinary dumpsite boys that sort through trash for a living. One day they find a key that leads them to a train station locker. From there they start the journey of their lives. Throughout the book many characteristics are shown both good and bad. I have chosen to talk about the themes trust and resilience. I chose these topics because I think both of these were shown many times in the book and they are to things that you need in every day life. Trust is the reliance that you have on one another, the belief that someone will come through for you in a time of need.This was shown many times in the book my favourite example was when Rat, (or Jun-Jun) was there for Raphael and Gardo at the beginning of the book they needed a place to hide the wallet. At any give time he could have gone straight to the police and turned in Raphael and Gardo.. Sister Oliver’s trust, pity and innocence led her to believing the three boys lie, this ende d up putting her at great risk. Later on in the novel Gardo went back to the prison with the 20,000 pesos to give the guard for the bible.The guard tried to catch Gardo but he escaped just in time. I think this was a case where they were forced to trust the guard whether they wanted to or not, they had no option to get the bible or not. Resilience is the ability to bounce back and put up with severe amount of stress. That’s exactly what these boys put up with for the whole book, between being chased by corrupt police and breaking into a grave these boys had amazing mental strength. The best example of this is when Raphael got taken to the police station; he was tortured, beaten and almost killed.It took lots of resilience is just there will to see there adventure all the way through to the end. At any given time they could have quite gone to the police turned the other two in and made 20,000 peso. â€Å" We will fish for ever and live happy lives. That is our plan and nothin g will stop us. † This quote said by Jun-Jun shows that the three boys trust each other to the end of the world. They would die for each other happily. They have been through so much mentally and physically that they could put up with anything. I honestly do think nothing will stop them.

Dear Sir

Dear Sir Dear Sir Dear Sir By Maeve Maddox Daniel recently asked me, Is it correct to address someone by Sir even in informal contexts such as Instant Messaging or on a blog comment? The word sir serves a very useful purpose in English, even in those cultures that cherish democratic ideals to the extreme. Sir has been used as a respectful form of address in English since about 1350. Its use as a salutation at the beginning of letters can be traced to 1425. Originally used as a title for a knight, baronet, or (until the Seventeenth Century, a priest), the word sir, like sire, comes from a Latin word related to the word senior and had the meaning older or elder. Sir is still used to preface a knights given name: Now that Rudy Giuliani has been knighted, he can be called Sir Rudy. The form sire, with the sense of your majesty, is used to address a king. As a noun in more general use, sire has the meaning father or male parent. The word can also be used as a verb: John Brown sired several sons. The most frequent general use of sir is in the context of letter writing, a form of expression that is notoriously conservative in its language. For example, the British complimentary closing yours faithfully sounded really abject to my American ear the first time I heard it, but, living in England, I soon became accustomed to it for what it is, a polite convention that no one takes literally. Outside its conventional use as a written salutation, sir is a convenient word to have in a situation in which one wishes to politely catch the attention of a stranger: Sir, youve dropped your credit card. Excuse me, Sir, can you direct me to the town center? The female equivalent in such a situation would be Miss or Maam. Even in a democracyperhaps especially in a democracythe older forms of courtesy are never out of place. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Expressions category, check our popular posts, or choose a related post below:50 Slang Terms for Money45 Synonyms for â€Å"Old† and â€Å"Old-Fashioned†One "L" or Two?