Sunday, March 8, 2020
Group psychotherapy is a special form of therapy Essay Example Group psychotherapy is a special form of therapy Essay Group psychotherapy is a special form of therapy Essay Group therapy can profit many different people, from those holding troubles with interpersonal relationships to those covering with specific jobs such as depression, anxiousness, serious medical unwellness, loss, habit-forming upsets or behavioural jobs. Peoples develop a support web through each other no longer experiencing isolated by their status and deriving a greater sense of normalcy.A Therefore, during the group procedure, curative alteration is experient known as the curative factors . There are 11 curative factors: : Instillation of Hope Universality Imparting information Altruism The disciplinary palingenesis of the primary household group Development of socialising techniques Imitative behaviour Interpersonal Learning Group Cohesiveness Catharsis Experiential Factors These factors are mutualist and do non happen or work individually but represent many different parts of the alteration procedure. INSTILLATION OF HOPE What it is: In instillment of hope, the therapist Acts of the Apostless as a facilitator to engraft positive outlooks and corrects negative biass before the chief activity. Consequently, the activity will look meaningful to the group members, thereby actuate them to remain in the group. Why it is healing: Hope is a curative factor as it helps the client to better by detecting the other members cope with and get the better of their troubles. This in bend boosts up the self-pride of the client to take part and set up a curative resonance. Trained equals among the members besides encourage each other in take parting actively, hence, cut downing wellness attention costs and someway doing group intercession of more importance than single 1s. 3 ways to ease this healing factor: Sharing of experience A group member who has improved a batch from group therapy can be asked to come and associate his experience to new group members. For illustration, he/she may associate to them how his/her first group had been, how he/she had felt at the beginning of the group, and besides, how he/she felt after several Sessionss. From this feedback, new members will experience bucked up and more hopeful. Puting up homogenous groups Group therapy with people undergoing the same status, e.g. depression, utilizing cured people as group leaders. Group members will portion their narratives with one another and how they overcome their hard times. On seeing how others tackle with their troubles, members will be inspired and experience encouraged. Questions When the group begins, the therapist/leader can inquire inquiries like: Does this group sound like it would work for you? or what would your outlook for this group be? . Through these inquiries, some members may answer that they feel diffident or uncomfortable, while some might be believing positively. When to ease this healing factor: This curative factor is normally facilitated before the group starts. Universality What it is: At the beginning of the group therapy session, some members of the group may experience stray and believe that they are alone and apart from the other members. However, after interaction within themselves, they feel that they are all in the same boat , that is, they all portion more or less the same feelings and emotions. Why it is healing: Universality is healing since it a powerful beginning of alleviation cognizing that we all have practically similar concerns, quandary and life experiences that we portion in common. During the session, clients get the chance to see deep concern about their sense of worth, may it be strength or failings and their ability to associate to others. It is a manner for members of the group to show themselves freely about feelings like shame, stigma and self-blame that have long been a load for them. Finally, the sharing of deepest concerns may trip unplanned healing factors like katharsis which may farther be facilitated by the healer. 3 ways to ease this healing factor: Activity- e.g. Fear Hat: group members are asked to compose their extreme fright on a piece of paper. The documents are so assorted in the chapeau. Each member picks up a paper and read it aloud and asked to give solutions about how to face this fright. Normally, in such type of activity, members may happen that they have more or less common frights and solutions. Puting up homogenous groups: group therapy with people confronting the same job e.g. depression, might be much more easy for them to experience this catholicity and be more motivated to portion their life experiences. The healer can be a good facilitator by inquiring inquiries like: who felt the same? or do you experience the same asaÃâ Ã ¦ ? to do group members aware that they are non different and apart from each other. When to ease this healing factor: Universality is normally facilitated in the early phases of the therapy normally in the forming stage. Conveyance OF Information What it is: Didactic direction: Didactic instructions are instructions given by the professional ( healer ) . Direct advice: direct advice occurs in every therapy group whereby advice or suggestions come from the healer every bit good as group members. Why it is healing: Didactic direction allows clients to work together in coaction. The group leader helps members to cover with their groundless frights and certain incorrect thoughts about infectiousness. He provides members with information bout their unwellness, intervention option, future hazards and recommendations. He besides helps them face traumatic irritability with active header. Consequently, members in the group learn to go clear, accepting and non-judgmental perceivers. Direct advice can be used to find a group s age by the manner the members formulate inquiries. Advice-giving serves as a usher to be more clear and expressed about interpersonal pathology. 3 ways to ease this healing factor: A picture cartridge holder or informative movie related to the first order aim of the group session can be good. Subsequently, the healer ushers group members to reflect on the information conveyed by the picture. Didactic direction can be facilitated through talks by an expert with the assistance of a posting presentation related to the subject, e.g. alcohol addiction. To ease direct advice about a peculiar subject, images related to this subject can be distributed to group members and asked to portion their sentiments and suggestions among themselves. When to ease this healing factor: This healing factor is normally facilitated in the early phase of the freshly formed group and can be moreover facilitated by the healer throughout the therapy as it occurs with regularity. Altruism What it is: Through selflessness, members gain through giving, non merely in having aid, as portion of the mutual giving-receiving sequence. This means that if members help each other through coaction and corporation, all of them are traveling to derive something at the terminal may it be a touchable or an intangible end-product. Why it is healing: Group therapy with selflessness as healing factor offers the chance to clients to experience that they are good to others in footings of aid receiving systems and suppliers, that is, aid others feel that they have something of value to offer. The group becomes the secure zone for support, reassurance, suggestions and the hazard to unwrap certain similar jobs with one another. Consequently, group members build trust among them and number on each other for self-generated and true reactions and feedback, particularly patients get bying with serious unwellnesss. Altruism is a direct beginning of duties to those from whom members wish to have attention. 3 ways to ease this healing factor: Trade activities: doing a trade and offering it to a equal in the group is an effectual manner to ease selflessness. Questions: e.g. the healer may inquire a participant: who have you appreciated the most? . Hereby, the individual appreciated might experience aghast and happy. Activity: e.g. Scavenger hunting: a list of things to look for on the topographic point within a clip frame is given to two squads divided among the group members. The procedure of sharing the duty of whom to look for what and assisting each other builds up selflessness. When to ease this healing factor: Altruism is normally facilitated in the norming and executing stage. THE CORRECTIVE RE-ENACTMENT OF THE PRIMARY FAMILY GROUP What it is: Most clients who enter groups, have had a troubled, unsatisfactory background in the most of import group of their life: the primary household group. The group becomes a utility household in many ways: a therapy group consists of a leader or a co-leader who may stand for the parents, while the other group members may replace for siblings. Since the leader or co-leader is regarded as the parent, some group members tend to seek attending and fondness from them, while others perceive the leaders as dominating, important or commanding. Why it is healing: It is a valuable tool which helps clients in voicing out pent-up feelings through actions or gestures. These pent-up feelings are those they have one time felt in early relationships. The therapy group gives clients the chance to re-experience early household struggles ( e.g. parent-child struggles or sibling competitions ) in a right manner, and which may besides supply group members a opportunity to decide and rectify dysfunctional interpersonal relationships with the aid of the healer and other group members. Furthermore, this healing factor allows clients to research how childhood experiences have affected their behavior. 3 ways to ease this healing factor: Activity Given a scenario, group members act out a given function, e.g. , mother/father/daughter/son/siblings. The scenario should be something powerful which will do the participants feel angry or sad. Question After a function drama, the healer can be a good facilitator by inquiring inquiries like: How easy was it to move out the functions? , What did you larn from this exercising? , What can you make to better your moving? , or how of import is it to be able to move? . Activity E.g. Pull a Picture to Better a Relationship: Group members are asked to pull a image for person ( from the group itself ) , with whom they want to better their relationship. They can besides add some notes if they wish to. Then, they give it to that individual. Since the therapy group becomes a utility household, group members will be able to show their feelings to person in the group who may stand for the parents or siblings, and therefore, rectifying their behavior and relationship with that individual. When to ease this healing factor: This healing factor can be facilitated in the storming stage. In this stage, the intimacy and the strong bond which have already been established among the group members makes it easier for a client to accept feedback from others. Group members can so work out closely to rectify dysfunctional relationships. DEVELOPMENT OF SOCIALISING TECHNIQUES What it is: The development of basic societal accomplishments occurs in therapy groups. Group therapy focuses on bettering societal accomplishments through feedbacks. For illustration, group members offer feedback to one another about the rightness of others behaviors. Why it is healing: While this may be a painful and hurtful experience, nevertheless, the strong bond and the trust that exist between the group members make it easy to offer feedbacks and information about maladaptive societal behavior. The feedback is offered in a direct and honest manner. Clients are so less likely to experience offended by the feedback and will accept the facts, therefore, assisting to better clients relationship both within and outside the group. The development of socializing techniques is besides curative because the group scene is safe and supportive, and allows group members to experiment safely without fright of failure. 3 ways to ease this healing factor: Activity Role drama, e.g. exposing group members to polite societal books like traveling for a occupation interview or traveling to a eating house. After the activity, perceivers can notice on participants public presentation and how they can better their address or facial looks or gestures to look polite. Activity Formulate your sentences. This activity can be done to assist group members learn different ways to show themselves straight and clearly without judging or arousing others by re-formulating their sentences. It besides helps in bettering societal accomplishments. The undermentioned image gives an illustration of how to explicate sentences. Questions After a function drama, the healer can be a good facilitator by inquiring inquiries like: how hard was it to move out? or how of import is it to be able to move? . When to ease the healing factor: This healing factor is usually facilitated in the norming and acting stages, after coherence has been good established. Normally, before the norming and acting stages, group members have already acquired different ways of pull offing struggles, and they are more likely to be able to show themselves. Hence, the healing factor should be facilitated in the norming and acting stages. IMITATIVE BEHAVIOUR What it is: In a group therapy, clients tend to be influenced by the healer. For illustration, in a group, the healer will back up, listen, observe and offer non-judgmental feedback to group members. At a certain point, clients will follow these behaviors and integrate them. Not merely do they copy the healer, but they will, at a certain point, besides try to copy other group members. Why it is healing: Imitative behavior is healing because it is a signifier of larning members observe and learn how others tackle and overcome their troubles. Clients invariably seek out all those behaviors ( particularly positive 1s, because positive behaviors evoke a positive response from the group ) until they feel that a peculiar behavior fits them. 3 ways to ease this healing factor: Activity Role drama, e.g. Carrying person to acquire up from his/her place. In this activity, one by one, each member, including the healer, will seek to carry another group member to acquire up from his/her place in a right manner, without being aggressive. Throughout the activity, each member will detect how others dealt with the state of affairs and therefore, they will seek to copy some of the behaviors which they find suited. By the terminal of the activity, the last member to seek this out would be the 1 who has seen everyone act. Therefore, he will integrate the positive behavior, which will take to a positive response. Theme Covering with hard state of affairss . An activity related to this subject can be done, whereby each member will associate about a state of affairs he has late had. Other group members will so give solutions as to how they can cover with this state of affairs. Throughout this activity, there can be person who will come frontward with sensible thoughts or thoughts of wisdom. This will bring forth a positive response from the group. Hence, on seeing the elicited positive response, other members will seek to respond the same manner ; they will seek to copy those behaviors and present some solutions which they feel might be really much appreciated by others, therefore, making a positive response. Questions After a function drama, the healer can ease the imitative behavior by inquiring inquiries like: Do you believe that the individual might hold felt hurt by your behavior? or Can you seek to make like this? When to ease the healing factor: Imitative behavior can be facilitated in the early phases of the group, i.e. in the forming stages, since members will hold ample clip to experiment new behaviors. INTERPERSONAL LEARNING What it is: Interpersonal acquisition occurs largely within a group. It is through interactions and sharing of one s ain reactions and perceptual experience of each other s behavior. There are three of import constructs to ease interpersonal acquisition, foremost the interpersonal relationships, disciplinary emotional experiences and eventually societal microcosm. Why it is healing: Interpersonal communicating additions socialisation. It besides helps to understand each other by sharing intelligence and cognition. It is besides a average how it is possible to develop a trust between each other. It teaches the type of feeling one should hold towards others. It gives an chance to larn to near others. Learning from others feedbacks, if I confuse people by non stating what I truly think. It is another manner to indicate out one s ain wonts and idiosyncrasies that annoy other people. 3 ways to ease this healing factor: Subject: Geting penetration of one s job Question: the healer can inquire inquiries such as: who wants to propose solutions to this job? . Activity: Drawn to career- group members to discourse their ends if they were a politician, lawyer, instructor, curate or a physician, societal worker. When to ease the healing factor: Interpersonal acquisition can be facilitated in ramping and norming stages of group therapy. GROUP COHESIVENESS What it is: Cohesiveness is a basic belongings of groups. It is a bond that helps the group to work good together and be successful in making their ends. Cohesiveness has two dimensions: emotional ( or personal ) and task-related. The emotional facet of coherence is derived from the connexion that members feel to other group members and to their group as a whole. A good therapist- client relationship is said to be critical for a positive result and this is characterized by trust, heat, empathetic apprehension and credence. The relationship of the client- healer in single therapy encompasses the person s relationship to the group healer, to the other group members and to the group as a whole. All these relationships in the group are referred as group coherence . All the groups do non portion the same type of coherence. The importance of group coherence Group coherence is the manner how to acquire people in a group connected, committed and in harmoniousness with undertaking ends and aims. Both emotional connection and the experience of group effectivity contribute to group coherence. The demand for belonging is unconditioned in us all. Both during single or group therapy, this demand is addressed for case therapy groups may bring forth a positive trust, empathy and credence. An person is accepted merely if the latter adheres to the norms and effects set by the group. Group coherence as experienced by the members creates lasting relationships which might be for the first clip in some of the latter s life. There are many benefits to group coherence. Four chief benefits are: The communicating within the group is much more extensive.A In other words, people who like each other communicate better and more often with each other. Groups that are more cohesive have positive interactions with one another.A Peoples are more friendly and there is an increased feeling of the group as a whole.A As a consequence, the group acts as a whole non as persons. A group that has a high degree of group coherence is much more successful in accomplishing their goal.A The feeling of togetherness in the group motivates members to accomplish the coveted end and their attempts addition. The members in groups that are cohesive are much more satisfied with that group.A As a consequence, they are more willing to remain in the group longer and frequently recommend the group to others. The mechanism of action The healer needs to move as a facilitator hence making conditions for self- geographic expedition and to take the hurdlings that block the procedure of growing. Acceptance and understanding among members help to break beef up the group than being accepted by the healer. Therefore the experience felt by homo is truly of great value to the person in the group. The more an person is bonded to the group, the greater the regard he has to it and the higher his self- regard. Why it is healing: Group coherence is an of import concept in understanding the behaviour of groups. It is non simply a powerful curative force but is besides a stipulation for other curative factors to work optimally. Hence coherence is necessary for other group curative factors to run. Group coherence besides helps in promoting unfastened look of dissension. It has a sense of squad spirit and the willingness of its members to organize their attempts. Furthermore, it has a echt sense of equal assisting and societal support, stepping up for what is right, traveling squad along in the right way. It raises one s ego regard and assist alter their behaviours and attitudes towards others. The group members learn to be responsible and independent. 3 ways to ease this healing factor: Activities: Island game- all the group members should stand on a piece of newspaper ( the island ) so the healer will rupture pieces and the members should group together forestalling themselves from falling off the paper. Helium Stick: All the group members will seek to put the stick on the floor utilizing merely one finger. Subjects: Increasing the squad spirit between group members The session will be tied to commitment, coaction, teamwork or single and common answerability. When to ease the healing factor: This healing factor would be facilitated at the beginning of the group and can be facilitated during ramping stage as when uncomfortableness will emerge. The work will be more ambitious. Catharsis What it is: Catharsis is derived from the Greek word which is translated as cleansing or purification . It is a powerful and nonvoluntary experience of emotional discharge followed by a feeling of great alleviation. These emotional discharges can be expressed both positively and negatively. In general, those members of the group ( high scholars ) who showed a profile of katharsis normally express a signifier of cognitive acquisition. Catharsis is therefore an indispensable constituent of the alteration procedure. Catharsis is said to be more helpful once it is related to cohesiveness. Along with these group bonds, strong look of emotion is enhanced ensuing into positive results. Why it is healing: Catharsis helps to see and responds fruitfully to life s challenges. It is a good manner to manage choler and accomplish a desirable province of relaxation. Catharsis allows clients to air out out their feelings and helps in the command of affectional experiences and emotions. It helps group members to accomplish interpersonal acquisition. It besides helps in geting accomplishments for the hereafter and to derive personal growing in groups. Catharsis is besides curative when it applies to the look of negative affect particularly in true instances when an single understands himself or the other individual in the group. 3 ways to ease this healing factor: Subjects: Covering with struggles Activities: Argument after watching a calamity cartridge holder or intelligence Each member will state something negative about the other group member that they neer had the bravery to state hence there will be the consequence of surprise and surprisingness. When to ease the healing factor: Catharsis can be facilitated during the group treatment and in the norming stage. EXISTENTIAL FACTORS What it is: Experiential factors are all those factors related to existence ultimate duty for our ain behavior, basic isolation in footings of confronting life entirely, decease, hurting and unpredictability of being, and their confrontation against the rough experiential facts of life. Why it is healing: This healing factor should be facilitated as the full class of experiential factors is frequently graded higher as compared to other healing factors. Group members besides learn to develop greater familiarity with others and its bounds every bit good. Therapists facilitate experiential factors by doing clients larn about how to confront their restrictions with bravery, e.g. some factors like basic solitariness can non be taken off and resolved, but can merely be known and finally embraced as built-in portion of being. Clients with serious unwellness are brought aggressively back to world and prioritise their concerns in their proper position. Consequently, they may go more optimistic and lend their unwellness positively to their lives. 3 ways to ease this healing factor: Question Therapist can inquire inquiry like: how make you experience when you have to work with person you have non chosen? . Through feedback, members will gain that they are responsible for their ain life, no affair who comes in their life. Activity Fear Hat. In this activity, members will compose their secret frights on a piece of paper. The documents are so assorted in a chapeau. Each member picks up a paper randomly and read it aloud and gives solutions about how to face this fright. Throughout this activity, each member will go cognizant of all types of fright and rough facts of life that they might themselves confront one twenty-four hours or the other. They will besides larn how to accept those hard worlds. Activity Making a personal batch. In this activity, each group member draws a batch and divides it into six parts in which they write about the followers: a personal symbol, successes, defect ( s ) , dreams, stepping rocks and a quotation mark. The healer so asks each member to portion with the group what he has written on the batch. Becoming aware of their strengths, failings and what maintain them keep on to life will alarm group members and actuate them to withstand the tough experiential facts of life. When to ease this healing factor: Experiential factors are facilitated at the terminal of the group therapy session in the expiration stage because the healer wants the members to detach themselves from the group and travel out in the society and face life entirely because no affair how much support one may have from others, he is on his ain duty. Decision Group intercession is one avenue that holds considerable promise in accomplishing improved intervention results and an economically sustainable wellness attention system. The curative factors built-in in the procedure of group reding are powerful mechanisms of alteration and guarantee that appropriate chances exist for their happening. The happening and impact of these curative factors vary within a group and from group to group. Additionally, some factors play a more important function at different phases of the group than other factors. Not all group members experience the same curative factors in the same manner or to the same grade.
Friday, February 21, 2020
CFCs,Ozone Depletion and the Ozone Hole - Assignment Example These CFCs rise up to the atmosphere, destroying the layer. The chlorine atom of a CFC reacts with an oxygen atom of the ozone molecule, resulting in two molecules of oxygen. The ozone is destroyed. An important long-term effect of the destruction of the ozone layer is a rise in the ultraviolet radiation near the earth. This in turn is a reason behind rising skin cancer, degrading of several substances like plastics, paints and fabrics, and reduced yield of major crops. It was reported by the Environmental Effects Panel in 1991 that the consequences of Ã¢â¬Å"a sustained 10% loss of ozoneÃ¢â¬ would be a 26% rise in the occurrence of non-melanoma skin cancers (Anderson, Sarma and Sinclair, 31). A 1% loss would result in an increase of 100,000 to 150,000 cases of cataract-induced blindness throughout the world. The resulting rise in ultraviolet radiation would be responsible for a rise in the occurrence of melanoma. It was due to such drastic consequences that the Montreal Protocol was set signed by 24 nations on 16th September 1987 (Maunder 38). According to this Protocol there has to be a reduction in the consumption of CFCs by particular amounts, which would greatly reduce the degree of damage
Wednesday, February 5, 2020
Analysis of databases and IT Resources - Essay Example The organizations use the databases to decide the way forward of the organization. The decision making in the organizations should be derived from the analysis of trends in the database Ã¢â¬â the Big Data. The databases are reliable if they have been designed properly and the captured and stored information contained in them is accurate without redundancy and anomalies. The databases facilitate the analyst to manage the data in whatever the way the analyst wants but keeping in view the constraints of the design of the database. The document presents the details of the above mentioned my viewpoints on why and how much the decision making of the organizations should be dependent on the results obtained from the databases Ã¢â¬â the Big Data. Every organization deals with information regarding products, people including employees, customers, prospective benefactor(s), who (might) protract organizationÃ¢â¬â¢s functions and services. Moreover, each and every decision from solving a particular problem for deciding the future of an organization is based on availability, accuracy and quality of information. Ã¢â¬Å"Information is an organizational asset, and, according to its value and scope, must be organized, inventoried, secured, and made readily available in a usable format for daily operations and analysis by individuals, groups, and processes, both today and in the futureÃ¢â¬ (Neilson, 2007). In computing, the organizational information is neither just bits, bytes saved in a server nor limited to client data, the hardware and the software that store it. A data or information to which an (large) organization deals is too huge to control it manually and a process of gathering, normalizing and sharing that information to all its stakeholders. It might be difficult to manage this imperative huge information manually; moreover, the manual maintenance of information might not be reliable and accurate. Therefore, I believe that the organizations should use data bases for decision making be driven by Ã¢â¬ËevidenceÃ¢â¬â¢ derived from analysis of trends in the huge database. This is the reason that databases are formulated and high in demand. A database facilitates to store, handle and utilize implausible diverse organizationÃ¢â¬â¢s information easily. A database can be defined as Ã¢â¬Å"collection of information that is organized so that it can easily be accessed, managed, and updatedÃ¢â¬ (Rouse, 2006). Keeping in view the above facts, it can be stated that the crucial information needs to be accurate and stored correctly in reliable storages for its enduring usage. The database is one of the best storage mechanisms that are reliable as compared to the manual management of data. But, the quality and accuracy of data are too critical and fundamental for a database developed/maintained by any organization; either the database is developed for achieving a small goal with limited scope or it is a multi-billion dollar information system. It can be said that the value of data is directly proportional to the quality of data. It is one of many reasons that an inadequately designed database may present incorrect information that may be complicated to utilize, or may even stop working accurately. Therefore, the
Tuesday, January 28, 2020
Personal Illness Narratives: Rheumatoid Arthritis (RA) Introduction This essay employs excerpts from the narrative of a 38 year old woman named Francesca, a lady who has been given a diagnosis of rheumatoid arthritis (RA), to illustrate key concepts form the sociological, and psychological literature. This approach will illustrate the writers ability to critically appraise the literature, its relevance to the narrative in question, and using narrative, places these concepts within a real life clinical situation. This in turn provides insight into the value of narrative as a methodological approach in the 21st Century and how it intertwines with the rich tapestry of sociological theories and concepts that are available to the researcher studying the current sociological evidence base. For the purpose of this assignment, peer reviewed articles and textbooks were searched within the past 10 years. The work introduces RA as a clinical entity (pivotal to understanding the comments of Francesca) and goes on to outline the use of narrative, particularly its utility in the study of chronic disease. The essay then goes on to cover some key important issues, namely: The biomedical versus the sociological approach of illness management The Study of Personal Illness Narratives Sociological perspectives on depression Chronic Illness and Disability Social construction of medical knowledge and the Politics of Disability Labelling Stigma. For each of the above, concepts are presented and mapped against selected statements from the narrative of Francesca (written in italics for clarity). These statements illustrate real world data gleaned from Francesca; valuable comments that are grounded in the experiences of a person living with a chronic disease. The work also contains an appendix comprising a reflective postscript which outlines the way that the work evolved from earliest outline, to the finished product. Rheumatoid arthritis (RA) is a chronic inflammatory disorder that affects not only the synovial joints but multiple body systems (Goodacre 2008). The exact cause of RA remains unknown; it is a disease that affects more women than men, often of a young or middle age demographic unlike osteoarthritis which affects predominately older people. RA follows a somewhat unpredictable course of exacerbations and remissions. RA carries huge psychological problems in view of its unknown aetiology, uncertain prognosis, and loss of function. Additional symptoms include early morning stiffness, pain, limitation of activities of daily living, and socio- economic problems inasmuch as it may have a severe impact upon a persons ability to work and function in society (Kojima et al 2009). The discussion now begins with a section on models of illness. Biomedical and biopsychosocial models of disease The biomedical model of health takes the reductionist view that people are biological entities (Lewis 2009 p745). In the clinical management of RA there is some merit in this biomedical approach, for example the monitoring of inflammatory mediators in the blood as a marker of disease activity or responses to drug intervention is well established in the literature (Lee Kim 2009). This biomedical approach is reinforced by the GP comments from the narrative, i.e. That there was no cure and that the tablets were the key to preserving normal function. This approach may contribute to Francescas frustration, as it ignores the wider psychological and sociological ramifications of living with a chronic debilitating disease such as RA. It is unclear form the narrative whether the GP tempered his comments by adding that there are means by which the signs and symptoms of RA can be successfully managed. Critical appraisal of the literature reveals that biopsychosocial models advocate a more holistic view of illness, for example according to Smith (2002) the biopsychosocial model seeks to address not only the client and his or her illness but also their capacity to deal with being ill. The value of adopting the narrative approach as part of the biomedical model is effectively illustrated at the point where Francesca states I just burst into tears At the perceived effect that this illness will have upon her loss of function in the future. So whereas the biomedical model will operationalise function using objective outcome measures, here the use of narrative permits a biopsychosocial approach that provides rich client centred data on how it feels to be diagnosed with chronic and currently incurable disease. This in turn can help to inform our understanding of Rheumatoid arthritis as a disease thereby influencing the social construction of medical knowledge by giving voice to service users (Balen et al 2009). The Study of Personal Illness Narratives. Illness narratives concern a persons views and beliefs about their illnesses and the effect on their lives (HydÃÆ'Ã ©n 2007). There is increasing acceptance and recognition of the valuable role that such grounded narratives play in understanding the journeys that people with chronic diseases such as RA have to embark upon if they are to manage their illness on a day to day basis. For example Haidet et al (2006) found in a narrative study of people with diabetes that people narrated four illness-management strategies whose story elements were in dynamic interplay, each with unique variations for each individual revealing a level of complexity that had not been previously described. As a method, narrative provides rich data (Furman Cavers 2005; Poindexter 2002) and in this case gives a voice to Francesca that would otherwise remain unheard (Grills 1998).Much can be gleaned from studying Francescas narrative, for example Francesca begins to paint a picture of her hopes and fears upon being given a diagnosis of RA combined with an insight into her past and thoughts about the future. Francescas narrative provides us valuable insight into her views of the self- a key component of narrative (Voilmer 2005), her relationships to others, and how these relationships have changed or may change in the future. In her narrative Francesca gives us some insight into the pain of living with rheumatoid arthritis, in her comments we can detect also a stark dichotomy in that she notes how healthy she had been in the past then uses the term Excruciating to describe her current pain, thus Francescas narrative hints at the loss of self in that she will no longer be a dancer or even a valid spouse as exemplified by the narrative quote. I wont be the woman he fell in love with Here she literally describes herself as becoming another person. Here Francesca is able to provide the reader or researcher with valuable information on the loss of the self, which resonates with other narrative research (Roe Davidson 2005; Doba et al 2007). Francesca goes further and also hints at the change in her illness self concept (ISC) that is to say the extent to which a person is defined or consumed by their disease or disability (Morea et al 2008). Francesca also hints at the concept of disease as a biographical disruption, described by Bury, this is said to occur when a persons planned future cannot unfold as planned. (Bury 1982); will he even want to marry me? Im too young to have this. What makes Francescas narrative particularly interesting is the fact that she is a twin; this may emphasise any change in self since she has in essence an unchanging control (her twin sibling) to against which to compare herself as her disease, her self identity (and possibly disability) progresses. The next section outlines sociological perspectives on depression. Sociological perspectives on depression. Francescas depression is likely to be multifactorial; for example there is evidence that the disease RA itself causes depression (Kojima et al 2009) as will living with pain. From a sociological perspective Francescas strained personal relationships may contribute to depression, for example her fear of being rejected as a potential spouse (Waite Gallagher 2001), see below. will he even want to marry me? This feeds in to the earlier section on biomedical versus biopsychosocial models of health and illness and the different paradigms or world views in which they are situated. A biomedical explanation of depression is likely to focus on the biochemical aspects of the person whilst a more sociological approach would acknowledge the impact of socio economics, personal relationships and so on (Covic et al 2003). Caution is needed however here since the short excerpt of narrative that we have provides no direct evidence that Francesca is in fact depressed, indeed a review of the literature suggests that there is a tendency to over diagnose depression (Parker 2007). Chronic Illness and Disability. A chronic incurable disease such as RA would require Francesca to make significant adjustments to her life over time. The sociological literature now provides increasingly refined conceptualisations of these adjustments, acknowledging that the experience of chronic disease necessitates adaptations in multiple domains of the persons life. This adjustment is often referred to as a trajectory (Stanton et al. 2007). This concept, introduced by the sociologist Strauss in an attempt to capture experiences and behaviours occurring in response to chronic illness (Strauss Corbin 1998), goes beyond depicting the physiologic unfolding of disease and encompasses the total organisation of work done over the course of the illness (Strauss et al 1984). Francescas narrative hints at this changing trajectory tracing the commencement of her life changes to a time six months ago when she was much more active and defined herself as a dancer. Furthermore Francesca looks to her future and wonders about h er ability to fulfil the stereotype of a perfect spouse. It is important to engage with how Francesca and her fiancÃÆ'Ã © will make sense of the illness. The term illness cognition has been defined as a patients own implicit common sense beliefs about their illness (Leventhal and Nerernz 1985, p. 517). When people experience symptoms, they embark upon a cognitive search which enables them to interpret and make sense of the symptoms they are experiencing. Typically a critical review of the literature distils out into five categories: Identity, including the description of symptoms experienced and their meaning (e.g. pain, fatigue).In the narrative Francesca describes her pain as Excruciating for example. Belief about causes (e.g. accident, genetics or stress). People like to have a label for their symptoms for legitimisation although, once given, people are likely to interpret diverse symptoms as evidence of the label. Francesca has problems with causality and is likely to do so for the foreseeable future since there is no established medical cause for RA. Timeline (beliefs about duration and time for recovery), namely is it acute or chronic? These beliefs will be re-evaluated as time progresses. Consequences (e.g. loss of lifestyle, goals in life). These representations may only develop into more realistic beliefs over time. Francesca uses the narrative to discuss the change in her life from active dancer to unappealing spouse within the space of six months. Beliefs about controllability. (Furnham, 1989; Landrine and Klonoff 1992, 1994) These categories are pivotal to understanding how people make sense of, and decisions about managing a changeable chronic disease such as RA. Evidence of Francesca attempting to make sense of her symptoms by embarking upon a cognitive search may be seen in the example below: I couldnt understand it Im the healthiest person I know. Ive never had problems with my health never had a day off sick in my life. I never go to the doctor, no matter what, Ive always been fit as a flea. From the narrative provided we also have limited information concerning Francescas partners views, for example (although not from Dave himself) Dave wore me down, telling me Ive got to see a doctor This may be interpreted in various ways, not least that Dave was keen for Francesca to obtain a diagnosis and thereby a label to legitimise the illness, whether such labelling is disabling or enabling is not fully resolved in literature (Huibers Wessley 2006). Francescas comment does however open up the interesting issue of how partners cope with chronic disease, in RA in particular there is evidence that a strong marital relationship correlates with the couples psychological adjustment to the illness (Mann Zautra 1990). These authors go on to claim that in RA, partners are most affected by their perceived vulnerability to disease and coping ability, whereas the wives who have RA were more affected by pain itself and how they will cope with the effects of the disease- reflected in Francescas comments below; I started having excruciating pains in my feet when I woke in the morning To further corroborate the findings of Manne Zautra (1990) concerning male worries about coping at a more abstract level see the example below: Dave has been great but he has his own worries hes just been laid off from his job and hes worrying about paying for the wedding Mann Dieppe (2006) have also more recently acknowledged coping differences between males and females in RA, (n = eight women with RA ages 31-60 years and their partners, and 4 men with RA ages 43-75 years) although methodologically their sampling may be flawed in that those couples currently experiencing severe martial problems are unlikely to submit to the type of phenomenological interviews that they undertook. The social construction of medical knowledge and politics of disability It is not possible in an essay of this length to provide a full account of the politics of disability, primarily since the topic is multi-factorial, fluid and indeed is covered to an extent in the other sub sections of this work, furthermore we have insufficient data from the narrative to comment in depth. Kitchen and Wilton (2003) comment that our views of disability as a medical entity viewed in paternalistic terms have changed in favour or equality and empowerment. However Francesca can expect to experience a host of politically related issues, for example social exclusion and poverty (Foley Chowdhury 2007). Francesca has already stated in her narrative; Ive got to work- we need the money. In terms of medicines social construction, as far back as 1982, Wright Treacher (1982) claimed that medical knowledge inevitably contains a social component incorporating moral values and prejudices, and that diagnosis ascribes a certain meaning. We still see this thirty years later where the GP abruptly (allegedly) advocates of drugs to preserve normal function. This reinforces the paternalistic medical approach. RA in its early stages does not present with any obvious physical deformity and affects the young demographic, it is conceivable that she may experience disbelief from her peers; this may in turn make her life difficult in an era of financial unease, Government budgetary cuts and political uncertainty. Labelling. Labelling theory (social reaction theory) has its roots in the work of sociologist Howard Becker (Becker 1997). It centres on peoples tendency to negatively label those who are different from ourselves. As a person with chronic arthritis Francesca will not be immune to this labelling, for example being labelled as disabled or arthritic are all real possibilities. Arthritis organisations and acts such as the Disability Discrimination Act ( DDA) are at great pains to encourage activity and maintenance of full function and contribution to society, however all this may be negated by her GPs comments that there is; no cure and I had to take tablets everyday to be able to function normally. Labels can however be positive, Francesca describing herself as glamorous for example on two occasions in the narrative, and her previous label of salsa dance teacher is something that defines her in a positive way. Yes, Im a salsa dance teacher Stigma Stigma has recently been defined by Scambler (2009) as a social process, experienced or anticipated by exclusion, rejection, blame or devaluation that results from experience, perception or reasonable anticipation of an adverse social judgement about a person or group(p441) Francesca may feel stigmatised by all of the factors previously discussed, attitude of her GP, loss of self, worry about the future, inability to act out the role of spouse. Factors such as depression, the lack of a cause for her RA and her inability to teach salsa dancing may amplify her feelings of being stigmatised, it is also important form the wider perspective to acknowledge that stigma may affect Francescas partner. Struening et al (2001) for example reported that 43-92% of caregivers (to people with mental health problems) reported feeling stigmatised, again this suggests that living with this disease does not only affect Francesca but also her partner. Conclusion This essay has employed extracts from the narrative of a 38 year old lady with Rheumatoid arthritis, to illustrate some key sociological concepts. The essay has provided a valuable opportunity to map some key concepts from the literature onto a narrative excerpt. Whilst the essay has not been able to enter the field in great depth; It is a testament to the thick description provided by patient narratives that such a wealth of information can be generated form a relatively short piece of description. References Balen,R., Rhodes, C., Ward,L., (2009) The Power of Stories: Using Narrative for Interdisciplinary Learning in Health and Social CareSocial Work Education: The International Journal, pp1470-1227. Becker, H., (1997) Outsiders. New York, NY. Free Press. Covic, T., Adamson,B., Spencer,D., Howe,G., (2003) A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study Rheumatology, Vol 42 1287-1294. Doba, K., Nandrino, J.L., Lesne, L., Humez, L., C.(2008) Organization of the narrative components in autobiographical speech of anorexic adolescents: A statistical and non-linear dynamical analysis New Ideas in Psycholog,y Vol 26 (2) pp 295-308. Foley,D .,Chowdhury, J., (2007) Poverty, Social Exclusion and the Politics of Disability: Care as a Social Good and the Expenditure of Social Capital in Chuadanga, Bangladesh Social Policy Administration, Vol 41 (4)pp372-385. Furman, R. ,Cavers, A., (2005) Narrative poem as a source of qualitative data The Arts in Psychotherapy Vol 32 (4) pp313-317. Furnham, A., (1989). Overcoming psychosomatic illness: lay attributions of cure for five possible psychosomatic illnesses. Social Science and Medicine, Vol 29 pp61-67. Goodacre,J., (2008) Common chronic inflammatory arthropathies. in Porter,S (eds) Tidys Physiotherapy 14th edition. Churchill Livinsgtone Elsevier. Grills, S..(1998). Doing ethnographic research; fieldwork settings Thousand Oaks. Sage Publishers. Hahn, H., (1985)Toward a Politics of Disability: Definitions, Disciplines, and Policies Social Science Journal, 1985 Vol. 22(4) pp87-105. Haidet, P., Kroll,T.L., Sharf, B.F., (2006) The complexity of patient participation: Lessons learned from patients illness narratives Patient Education and Counselling, Vol 62 (3) pp323-329. Huibers,M.J.H., Wessely ,S., (2006) The act of diagnosis: pros and cons of labelling chronic fatigue syndrome Psychological Medicine, Vol 36, pp895-900. Cambridge University Press. Kitchin, R. ,Wilton, R., (2003) Disability Activism and the Politics of Scale. The Canadian Geographer, Vol 47, 2003. Kojima ,M., Kojima, T., Ishiguro, N., Oguchi, T., Oba, M., Tsuchiya, H., Sugiura, F., Furukawa, T.A., Suzuki, S., (2009) Psychosocial factors, disease status, and quality of life in patients with rheumatoid arthritis. S.J Psychosom Res , Vol 67(5) pp425-31. Epub 2009 Mar 5. Lee, W.S. Kim, T.Y.,(2009) Measuring of ESR with test 1 is more useful than the Westergren method in rheumatoid arthritis. Am J Clin Pathol, 2009 Nov;Vol 132(5) pp805. Leventhal, H., Nerenz, D.R., Steele, D.J., (1984). Illness representations and coping with health threats. In: Baum A, Singer J, eds. Handbook of Psychology and Health, Hillsdale, NJ: Erlbaum. pp219-252. Morea, J.M., Friend, R., Bennett, R.M., (2008) Conceptualizing and measuring illness self-concept: A comparison with self-esteem and optimism in predicting fibromyalgia adjustment Research in Nursing Health, Vol 31 (6),pp563-575 Published Online: 21Jul2008. Mann,C., Dieppe, P.,(2006) Different patterns of illness-related interaction in couples coping with rheumatoid arthritis Arthritis Care Research, Vol 55, (2), pp 279-286. Mann, S. L., Zautra, A. J., (1990). Couples coping with chronic illness: Women with rheumatoid arthritis and their healthy husbands. Journal of Behavioral Medicine, Vol 13 pp327-342. Parker, G., (2007) Is depression overdiagnosed? Yes. BMJ. Vol 335 (7615), p328. Poindexter, C.C.,(2002) Meaning from methods; Re-presenting Narratives of an HIV affected caregiver Qualitative Social Work, Vol 1 pp 59. Roe,D., Davidson, J., (2005) Self and narrative in schizophrenia: time to author a new story Med Humanities,Vol 31 pp89-94. Scambler, G., (2009) Health-related stigma. Sociology of Health Illness, Vol 31 Issue 3 pp 441-455 Published Online: 1 Apr 2009. Smith, R., (2002) The biopsychosocial revolution. J Gen Intern Med, Vol 17(4) pp309-311. Stanton, A.L., Revenson, T.A., ÃâÃ Tennen, H., (2007). Health Psychology: Psychological Adjustment to Chronic Disease. Annual Review of Psychology, Vol 58 pp565-592. Strauss, A.L., Corbin, J.M., Fagerhaugh, B.G., (1984). Chronic illness and the quality of life, 2 Ed. St. Louis: Mosby. Strauss, A., Corbin, J.M., (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded theory. Thousand Oaks, Sage Publishers. Struening, E.L., Perlick, D.A., Link, B.G., Hellman,F., Herman, D., Sirey, J.,(2001) Stigma as a Barrier to Recovery: The Extent to Which Caregivers Believe Most People Devalue Consumers and Their Families Psychiatr Serv,Vol 52 pp1633-1638, December 2001. Vollmer, F., (2005) The Narrative Self. Journal for the Theory of Social Behaviour, Vol 35,(2), pp189-205(17) Blackwell Publishing. Waite L,J., Gallagher, M.,(2001).The case for marriage: why married people are happier, healthier, and better off financially. New York, NY: Broadway Books. Wehowsky, A., (2000) Diagnosis as care diagnosis as politics International Journal of Psychotherapy, Vol 5, (3), pages pp241 255. Wright, P., Treacher, A. eds., (1982) The Problem of Medical Knowledge: Examining the Social Construction of Medicine (Edinburgh: Edinburgh University Press. Appendix Reflective postscript This is written in the first person since it is a reflective piece of writing This was a challenging yet fascinating project to complete. I was unsure how to approach the topic and how much weight to attach to the various theories available and the comments of Francesca , once it became clear that I was actually trying to explain what was going on with Francesca by using academic theory to illustrate her comments the task became rather enjoyable. Tight word count restrictions as always meant that I had to do some brutal editing, but the positive side to this is that it makes one more selective in ones writing. For example my earliest version was heavy on sociological theory and light on mapping this theory to the comments of Francesca, whereas the final version makes more explicit links between what Francesca says and the theory behind why she says it. The fact that I had some real comments to sink my academic teeth into made the process of literature searching interesting and relevant since I was able to think about Francescas comments and her personal situation for each search that I undertook. The areas that gave me most difficulty were the political aspects of disability since they seemed so wide ranging and actually intertwined with everything that I was writing about. All in all I have learned a great deal about the usefulness of narrative form this project.
Monday, January 20, 2020
Split Sisters and Split Personalities of Goblin MarketÃ Ã Ã Ã Ã "I have 50 different personalities, and still IÃ¢â¬â¢m lonely" (Amos). Perhaps everyone is truly composed of multiple personalities embodied within one whole. Whether these split personalities are actual or purely metaphorical, no one human being has a single sided mind, and a single sided position on everything. Within the brain many battles are raged between opposing sides of issues, between the personalities. "Goblin Market" is one of Christina RosettiÃ¢â¬â¢s "sister" poems, a form in which she used sisters to "represent different aspects of the split personality that was caused by conflicting attitudes and mixed emotions towards love" (Bellas 66). The two opposing young sides of a single personÃ¢â¬â¢s brain are separated into two different beings, two sisters. During the poem, the two sisters, Laura and Lizzie, contrast and become contrasting opinions and factions on love, femininity, and sensuality, eventually maturing and reconciling their conflicting beliefs into a mutual ground. "LauraÃ¢â¬â¢s love of the fruit is insatiable" (Mayberry 90). Lizzie is a more Victorian image of love "cautious, timid, and tedious" (Mayberry 43). In the Victorian days respectable women were expected to be good Christian women. Rossetti is a demonstration of these expectations. In reference to the awkward moral at the end of the poem Martine Brownley says. "Undoubtedly that was the only way that the quiet devoted recluse could tolerate what she had procured in the poem. The woman who pasted pieces of paper over the more explicit lines in SwinburneÃ¢â¬â¢s poetry could never have faced the actual implications of the stunningly effective parableÃ¢â¬ ¦ which somehow welled up from her unconscious self" ... ...look" for the first time in her life. The Victorian element of the 1800s has been brought down to a more reasonable level through Lizzie. The wild feminist in Laura has been tamed by the life threatening experience and the overpowering devotion of her sister. Ã Works Cited Amos, Tori. "Tori Amos in Conversation." Baktabak Recordings 1997. Bellas, Ralph A. Christina Rossetti . Illinois State University, Twayne Publishers Boston, 1977. Harrison, Anthongy H. Christina Rossetti in Context. University of NC Press, Chapel Hill and London: 1988. Mayberry, Katherine J. Christina Rossetti and the Poetry of Discovery. Louisiana State University Press, Baton Rouge and London. 1989. Brownley, Martine Watson, "Love and Sensuality in Christina RossettiÃ¢â¬â¢s Ã¢â¬ËGoblin Market." Essays in Literature 1979 Western Illinois University Vol. No. 2 Rpt in TCLC. Ã
Saturday, January 11, 2020
Identify One Primary Value Creation, One Support, and One General Management Process You Might Encounter at Zappos.
Wilfredo Gonzalez External Hiring November 26, 2011 Human Resource Recruitment and selection Ã¢â¬â Fall 2011 JR smith would have an advantage when hiring an external candidate for the Fort Lewis office. This candidate should be someone from the area well verse of the military rules, the demographics. This candidate will go though the full and formal hiring process of evaluation. The external hiring process relies on the candidateÃ¢â¬â¢s performance during screening, interviews and assessment. We have one current staff member that served in the National Guard for five years but only has a high diploma and another staff member that has fifteen years experience in customer relations but has never lived or served around military personnel. Therefore the candidate needed for the area of 19,089 people as of 2000, is someone who has military and civilian workforce experience, an MBA , and have strong customer service relations. The population of Fort Lewis in 2000 was 19,089 with a decline in 2010 of 8,043 in the amount of 11,046. Race/ethnicity| 2010 population| 2010 percentage| 2000 population| 2000 percentage| 2000-2010 change| White| 7,538| 68. 2%| 11,537| 60. 4%| -34. 7%| Black| 1,253| 11. 3%| 3,882| 20. 3%| -67. 7%| Two or more races| 1,058| 9. 6%| 1,230| 6. 4%| -14. 0%| Other race| 433| 3. 9%| 1,189| 6. 2%| -63. 6%| Asian| 336| 3. 0%| 650| 3. 4%| -48. 3%| Native Hawaiian/Pacific Islander| 258| 2. 3%| 342| 1. 8%| -24. 6%| American Indian/Alaska Native| 170| 1. 5%| 259| 1. 4%| -34. 4%| Total| 11,046| 100%| 19,089| 100%| -42. %| *Hispanic origin| 1,800| 16. 3%| 2,507| 13. 1%| -28. 2%| 2010 population by race/ethnicity| | | | | | http://data. spokesman. com/census/2010/washington/cities/fort-lewis-cdp-wa/ Research shows that organizations that foster strong cultures have clear values that give potential employees to embrace the cultures. Therefore a person with military back ground will be able to understand the struggles of the potential employees and help them the training needed for future employment. A strong culture may be especially beneficial to firms operating in the service sector sine JR smith are responsible for delivering the service and for evaluations important constituents make about this firm. Because research indicates that organizations may derive the following benefits from developing strong and productive cultures. It would better align the company toward achieving its vision, mission and goals. Give the employees high motivation and loyalty and it will help in shaping employee behavior at work, enabling JR Smith to be more efficient. The goal of having someone that has the correct customer experience management is to move customers from satisfied to loyal and then from loyal to advocate. CRM strategies and solutions are designed to focus on the product, price and enterprise. JR smith focus for the future is through job training, pension and VA benefits consultation and resume writing services with full time agents. Therefore a canadite with the customer service experience and military background will be valuable to the company from dealing with personal from the military. The fort Lewis area is made up of retired and transient service people ready to hit the work force but need a little help. A person with the expericance need for JR Smith management position will be able to guide them the right way with the back ground needed and degree. A person without the military back ground and only the degree will not understand the needs of the retired military personal. Reference Jean M. Phillips, Stanley M. Guly (2012). Strategic staffing. second edition, New Jersey: Person Hall education,INC. | | | | | | http://data. spokesman. com/census/2010/washington/cities/fort-lewis-cdp-wa/
Friday, January 3, 2020
Definition: A T4A Canadian tax information slip is a Statement of Pension, Retirement, Annuity, and Other Income. It is prepared and issued by an employer, a trustee, an estate executor or liquidator, a pension administrator, or a corporate director, to tell you and the Canada Revenue Agency (CRA) how much of certain types of income you paid during a tax year and the amount of income tax that was deducted. Use T4As in preparing and filing your Canadian income taxes. Other T4 tax information slips include: T4 - Statement of Remuneration Paid T4A(OAS) - Statement of Old Age Security T4A(P) - Statement of Canada Pension Plan Benefits T4E - Statement of Employment Insurance and Other Benefits T4RIF - Statement of Income From a Registered Retirement Income Fund T4RSP - Statement of RRSP Income For more information on T4As, see T4A Tax Slips for Canadian Income Taxes.