1 Undergraduate Studies ePortfolio Lorraine Helferich-Stiel BA in Psychology with Concentration in Criminal Justice, 2010
Personal Statement Personal Statement Pursuing a life and career in the mental health field is a journey that has taken me further then I would have ever been able to imagine. This pursuit has led me through personal changes and self reflections that I never would have dreamed. Only through this self-reflection and ownership of myself have I become an individual who is not only capable, but longs to help others along this same journey and into a more fulfilling and enjoyable life. Upon completion of my bachelor’s degree in psychology through Argosy University, I will be attending Capella University’s graduate program (starting in September, 2010) for mental health counseling, this program is CACREP accredited and meets the requirements for licensure in the state of Michigan. Upon completion of this Master’s program I intend to continue my studies going for my doctoral degree in psychology and ultimately my PsyD. While earning my graduate degree I am looking to gain extensive first hand experience in the mental health field and am currently pursuing a career that will help to further my experience of psychology and helping professions while providing me with contacts and resources that will be vital to my success as a Licensed Professional Counselor. Through furthered experience in the field I plan to create a network of professional s through which I may begin to find recognition and credibility which is essential in the mental health professions. On a personal note not only is the notion of continuing my professional goals and aspirations exciting, but so is the idea of continuing my personal growth and understanding leading to an ever fulfilling and meaningful life. The choices I make now will undoubtedly shape the path of my future and only by following one’s dreams can true happiness ever be found. While clinical psychology and counseling are my main goals I am also interested in research work and advancing the science of psychology and the understanding of various mental illnesses as well as their treatment and the effectiveness of such. Personal interests also include writing to be published and to share with all the valuable knowledge gained throughout my life long journey already, as well as, the even greater knowledge that is yet to come.
Resume Lorraine M. Helferich 4158 Brammer Dr., Traverse City, MI 49685 231-620-2836 firstname.lastname@example.org http://www.linkedin.com/pub/lorraine-helferich/22/a09/75
Summary Demonstrated achiever with exceptional knowledge of helping others to achieve their full potential in order to create meaning and fulfillment within their lives. Experienced in working with a diverse clientele. Extensive training and experience in working with difficult behaviors and creating a stimulating and nurturing environment for those who are faced with challenges including disability, mental illness, and dementia. Excellent computer skills Outgoing and driven to succeed. Outstanding communication and interpersonal skills in dealing with clientele as well as co-workers. Education M.A. in Mental Health Counseling Capella University, Minneapolis, MN (CACREP accredited) Sept. 2012
B.A. Psychology Argosy University, Phoenix, AZ GPA of 3.69 Transcripts available upon request Aug. 2010
A.A. in Criminal Justice University of Phoenix, Phoenix, AZ Transcripts available upon request 2008
Supervisor at Orchard Creek Assisted Living, Orchard Creek HealthCare Works directly with manager of assisted living to create an environment in which our clientele thrive and their physical and mental health are being well-provided for. Creates professional and meaningful relationships with family members in order to provide clients with a strong support system that is vital to their well-being. Works directly with physicians and other professionals in order to provide clients with proper care, medications, and other vital services imperative to client’s well-being. Provides direct care including all activities of daily living. Works with and trains staff to improve their direct care, med passing, and interpersonal skills. Creates and maintains clients’ personal and medical records in a way that complies with HIPPA. 2007-Present
Certified Nurse Assistant, Tendercare Assisted residents with activities of daily living such as bathing, dressing, and personal hygiene. Charted and reported to head nurse all concerns and pertinent information regarding resident’s health, safety, and mental well-being. 2005-2007
Resume Cont. Direct Care, Munson House AFC Supervised the house and 8 mentally ill adults for 12 hour shifts at a time. Cooked, cleaned, engaged residents in daily living activities, assisted residents in scheduling transportation and appointment, managing behaviors, and created a positive home environment for residents. Responsible for residents’ safety, physical and mental well-being.
Office Manager/Bookkeeper, Helferich Enterprises
Accounts receivable, accounts payable, collections, banking, createded financial statements, payroll, developed and maintained positive relationships with customers, vendors, and other business connections. 1994-2003
Reflection My academic career here at Argosy has guided me along a journey to self awareness and professionalism that I can only begin to put into words. Through my experiences over the past few years I have become adept in my writing and research skills. I have obtained along this journey a new appreciation for diversity and ethnic awareness as well as how this plays into one’s mental and physical well-being. As I leave Argosy and continue on my path towards my graduate degree I am confident in my ability to handle the challenges ahead as the education that I have received this far has prepared my to continue my personal and academic growth.
Table of Contents Cognitive Abilities: Critical Thinking and Information Literacy Research Skills Communication Skills: Oral and Written Ethics and Diversity Awareness Foundations of Psychology Applied Psychology Interpersonal Effectiveness
Sample of Critical Thinking Minnesota Multiphasic Personality Inventory (MMPI) Lorraine Helferich-Stiel July 26, 2010 Argosy University PSY415 Psychological Assessment Instructor: Dr. Brandhorst
MMPI-2 Cont. Minnesota Multiphasic Personality Inventory (MMPI) The Minnesota Multiphasic Personality Inventory (MMPI) was originally developed at the University of Minnesota by psychologist Starke R. Hathaway and psychiatrist J.C. McKinley in the late 1930’s (Cherry, 2010). The original test which was created to reflect psychological, medical, and neurological disorders that the physicians were interested in studying was published in 1943 (Schatz). This test was used for both adolescents and adults primarily 16-65 years old (Butcher, & Emeritus, 2005). In 1969 it became publicly known that there was a need for a revision of the MMPI since its original control group Dahlstrom, and AukeTellegen (Butcher, & Emeritus, 2005). Up until 1992 when the MMPI-A was published which was a better assessment tool for adolescents the MMPI-2 was still the standard test used for both adolescents and adults (Butcher, & Emeritus, 2005). was comprised of 700 individuals who were all patients, as well as, family and friends of the patients at the University of Minnesota Hospital (Schatz). Twenty years after the need for a revision was discovered a second version of the MMPI was released named the MMPI-2 this version of the test was written by James Butcher, John Graham, W. Grant The MMPI-2 is comprised of 567 true-false items that are intended to assess psychopathology in adults 18 years of age and older (Schatz). The test takes about 60-90 minutes to complete and should be administered by a mental health professional trained in the administration, scoring, and interpretation of the test (Cherry, 2010). In individuals less than 18 years of age the MMPI-A should be used to assess psychopathology (Cherry, 2010). The MMPI-2 should never be used as the sole basis for diagnosis; rather it should be used in conjunction with other assessment tools (Cherry, 2010). While the test is most frequently used to assess and diagnose mental illness, it is also used in many cases for legal reasons and in employment screening (Cherry, 2010). Scoring the MMPI-2 is relatively easy; however, interpretation is not additional scales that detect the tendency to respond untruthfully to some of the and is an art that only becomes easier with experience (Schatz). Today, in order to interpret the meaning of the scores clinicians look at the two highest scales in order to determine the meaning of MMPI-2 elevations (Schatz). “Interpretation of the MMPI scales demands a high level of psychometric, clinical, personological, and professional sophistication, as well as a strong commitment to the ethical principles of test usage” (Schatz). Recent research provided by Greene, Robin, and Albaugh in 2003 has shown strong support for the reliability of the MMPI-2 (Butcher, Mineka, & Hooley, 2009). The validity of the MMPI-2 has been approved with the addition of three items in the MMPI-2 (Butcher, Mineka, & Hooley, 2009).
MMPI-2 Cont. Clinical, Content, and Validity Scales The MMPI-2 looks to measure an individual’s score based on ten clinical scales with each of these defined clinical scales measuring a tendency to respond to one’s environment in ways that are deemed psychologically deviant (Butcher, Mineka, & Hooley, 2009). The ten clinical scales are as follows: Scale 1- Hypochondriasis (Hs) - this scale measures excess physical and somatic complaints in an individual (Butcher, Mineka, & Hooley, 2009). Scale 2- Depression (D) - this scale measures the individuals’ symptoms of depression (Butcher, Mineka, & Hooley, 2009). Scale 3- Hysteria (Hy) - this scale measures hysteriod personality features such as those who always see the world through “rose colored glasses”. This scale also measures such individual’s tendency to experience physical ailments when under stress (Butcher, Mineka, & Hooley, 2009). Scale 4- Psychopathic deviate (Pd) - This scale measures an individual’s propensity toward antisocial behaviors (Butcher, Mineka, & Hooley, 2009). Scale 5- Masculinity-femininity (Mf) - This scale measures the amount of gender role reversal an individual may be experiencing or perceiving (Butcher, Mineka, & Hooley, 2009). Scale 6- Paranoia (Pa) - This scale measures individual’s suspicious and paranoid ideations (Butcher, Mineka, & Hooley, 2009). Scale 7- Psychasthenia (Pt) - This scale measures the behavior of an individual in regards to anxiety, worrying, and obsessive behaviors (Butcher, Mineka, & Hooley, 2009). Scale 8- Schizophrenia (Sc) - This scale measures oddities in thinking, feelings, and social behaviors (Butcher, Mineka, &Hooley, 2009). Scale 9- Hypomania (Ma) - This scale measures mood states that are unrealistically elated and the tendency to give in to impulses (Butcher, Mineka, & Hooley, 2009). Scale 10- Social Introversion (Si) - This scale measures an individual’s tendency to experience social anxiety, withdraw, and try to overcontrol (Butcher, Mineka, & Hooley, 2009).
MMPI-2 Cont. When mental health professionals look at the elevated scores on each of these scales he or she begins to put together a picture of the individual’s personality and where he or she might be experiencing mental disorders that are affecting their lives. Some individuals may have a tendency to be untruthful in their answers to the 567 items posed by the MMPI-2. This tendency to answer untruthfully may come in when an individual is looking for a not guilty by reason of insanity verdict or looking to state that he or she is not fit to stand trial, untruthfulness may also become a problem when an individual is trying to make themselves look less or more ill than they really are, sometimes individuals are looking to please others including the therapist and in trying to do so might give untruthful answers to the items presented. In order to counter for these instances in which individuals might be untruthful or inaccurate reporters of their own behaviors, and thoughts the MMPI-2 uses four validity scales to help determine where problems in validity might lie (Butcher, Mineka, & Hooley, 2009). These four validity scales are as follows: Lie scale (L) - This scale measures the individuals tendency to create a favorable image by falsely exaggerating their virtue (Butcher, Mineka, & Hooley, 2009). Infrequency scale (F) - This scale measures the individuals tendency to lie or make false claims in the first part of the booklet in order to exaggerate psychological problems. This scale also detects random answering of the items (Butcher, Mineka, & Hooley, 2009). Infrequency scale (FB)- This scale measures the individuals tendency to lie or make false or exaggerated claims on items that appear towards the end of the booklet in order to exaggerate or falsely claim psychological problems (Butcher, Mineka, & Hooley, 2009). Defensiveness scale (K) - This scale measures if the individual has a tendency to view themselves unrealistically positively (Butcher, Mineka, & Hooley, 2009). Other validity scales that are used in the interpretation of the MMPI-2 are as follows: Cannot say score (?)- Measures the total number of unanswered items (Butcher, Mineka, & Hooley, 2009). Response Inconsistency scale (VRIN) - This scale measures the individual’s tendency to choose random or inconsistent items (Butcher, Mineka, & Hooley, 2009).
MMPI-2 Cont. Response Inconsistency scale (TRIM) - This scale measures an individual’s tendency to show themselves in an inconsistently true or false light (Butcher, Mineka, & Hooley, 2009). The use of these validity scales have helped to improve and actuate the validity of the MMPI-2 scores in being able to reliably predict and diagnose psychological disorders in an individual. There are dozens of content scales currently being used with the MMPI-2. These scales are special scales being used to account for differences in scores that relate to the general causes of diagnosis. These scales include; the APS Addiction Proneness Scale, the ASS Addiction Acknowledgement Scale, the MAC-R Mac Andrew Addiction Scale, and the MDS or Marital Distress Scale (Butcher, Mineka, & Hooley, 2009). Content validity is a measure that states that the test is useful in measuring what it is created to do (Argosy University, 2010). For example, the MMPI-2 is high in content validity since it is created to measure psychopathology and it appropriately does so. Face validity is the measure that states that a test measures exactly what it appears to measure. For example, the MMPI-2 is also considered high in face validity since it is comprised of items that ask one to consider his or her mental state or behavioral tendencies which are indicative of diagnosing mental health issues. Face validity can have its disadvantages as well. This is especially true in instances where it might be beneficial to the professional to assess an individual without him or her being aware of what is being assessed, thus, successfully decreasing the likelihood that the individual being tested will try to purposefully botch the test results. Other Considerations It is also important for an individual administering the MMPI-2 to an individual to keep in mind the minimum reading requirements that are needed to complete the test accurately and successfully (Butcher, Mineka, & Hooley, 2009). It is also of utmost importance for an individual administering and or scoring a MMPI-2 to remember that some responses (despite revisions made) differ not only in response mental health discrepancies but also to cultural and ethnic discrepancies in individuals (Butcher, Mineka, & Hooley, 2009).
References References Argosy University. (2010). Psychological assessment. Online lectures. Retrieved on July 26, 2010 from: http://myeclassonline.com/re/DotNextLaunch.asp?courseid=4283170&userid=5298152&sessionid=1b266426cf&tabid=LoV4bJERhAvtRMZo4LKun3tYym/YIg+SnN8yTM1siy/EaKpLhzsb/TAz6dPuU38R&macid=Gwo9/y0i3HOll77n8iil1BJQB7V3yiIlHHUVrrXUWggBR+Gv/eXiAkllxtohn3ahIiEfHD17e6tfx2GKIZjJ6lFm54dCEoc1M/HVTwHMOqFpNcHnn+f0DYJbjyVGPDaY8/JYv8UhsIhB5QH4dNSvY7xWihFCoe8//rz0YtGrUCjuyAdFdHkcHWZl0SUTBn+k Butcher, J., Mineka, S., and Hooley, J., (2009). Abnormal psychology. (14th ed.). Boston, MA. Pearson Education Inc. Butcher, J., Emeritus, (2005). Highlights from MMPI history a timeline perspective. Retrieved on July 11, 2010 from: http://www1.umn.edu/mmpi/documents/highlights.pdf Cherry, K., (2010). The Minnesota Multiphasic Personality Inventory- MMPI-2. Retrieved on July 11, 2010 from: http://psychology.about.com/od/psychologicaltesting/a/mmpi.htm Schatz, P. MMPI. Retrieved on July 26, 2010 from: http://schatz.sju.edu/psycheval/personality/mmpi/index/html
Sample of Research Skills Literature Review: A Look at the Effectiveness of Non-Pharmacological Therapies in Treating Depression Lorraine Helferich-Stiel July 23, 2010 Argosy University PSY492 Advanced General Psychology
Literature Review Cont. Literature Review: A Look at the Effectiveness of Non-Pharmacological Therapies in Treating Depression During the 2005-2006 National Health and Nutrition Examination Survey it was estimated that in any two-week period approximately 5.4% of the United States population was experiencing depression (CDC, 2008). These staggering figures translate to one in twenty individuals suffering from depression at any given time. Thus, it is no surprise that there is much controversy surrounding the effectiveness of non-pharmacological therapy for the treatment of depression. Society is constantly balancing the pros and cons of pharmacological treatments and their side effects against the effectiveness of non-pharmacological treatments. The study of psychology may be able to help reduce the frequency, duration, and types of symptoms in an individual suffering from depression with or without decreased amounts of medications. This ability to be able to manage depression is founded in the knowledge of the effectiveness of various types of treatments whether they are pharmacological or non-pharmacological in nature. Only by a careful comparison and contrast will these questions be completely answered in a way that is of use to society at large. The study of non-pharmacological interventions has taken the spotlight in the new fear of the use anti-depressants creating an increased suicide rate in certain individuals, especially teens and young adults (Hecht & Hecht, 2010). This concern expressed by the Federal Drug Administration (FDA) warrants further research to determine the effectiveness of such alternatives as cognitive behavioral therapy, physical activity, and social skills training in the treatment of depression and depressive symptoms. The literature reviewed consisted of ten articles that touch on the use of non-pharmacological therapies in the treatment of depression and their effectiveness to participant. These studies covered alternatives to anti-depressants including; cognitive behavioral therapy, social skills training, physical activity, problem-solving therapy, mindfulness based stress reduction, and prevention techniques in reducing depressive symptoms without the use of anti-depressants through varying age groups. Following is an analysis of the different alternative therapies researched and the general findings and implications of each. Effectiveness of Cognitive Behavioral Therapies in Reducing Depressive Symptoms Five of the ten articles reviewed focused on the use of cognitive behavioral therapy as the main alternative for anti-depressant usage in treating a depressed individual. This seems to infer that there has perhaps been more research on this type of non-pharmacological therapy in treating depression than any other single alternative approach. In fact, Embling claims that cognitive behavioral therapy has been referred to as one of the most widely and extensively studied psychological treatment; this is especially true when referring to depressive disorders (2002).
Literature Review Cont. Embling’s article titled The Effectiveness of Non-Pharmacological Treatments as Opposed to Pharmacological Treatments in Treating Depression: the Benefits and Risks, described a study that consisted of 39 participants between the ages of 19-65 (Embling, 2002). Eighteen participants received cognitive behavioral therapy and the other 18 participants were placed on a waiting list and served as the control group (2002). The study revealed that the cognitive behavioral therapy was a useful tool in treating depression (Embling, 2002). This seemed to be especially true in instances where the participants who were receiving therapy perceived themselves as being low in personality traits such as perfectionism and sociotrophy (Embling, 2002). Participants who were high in these personality traits seemed to have a harder time progressing through therapy (Embling, 2002). The study effectively created a random assignment from the pool of 39 participants to either the control group or the group who was to receive the therapy (Embling, 2002). However, the study was weak in the number of participants involved and all the participants were from the same general area (Embling, 2002). The article Over-simplification and Exclusion of Non-Conforming Studies Can Demonstrate Absence of Effect: A Lynching Party?; A Commentary on ‘Cognitive Behavioral Therapy for Major Psychiatric Disorder: Does it Really Work? A Meta-Analytical Review of Well-Controlled Trials’ by Lynch et al. which was written by Kingdon in 2010 claims that the reviews done earlier by Lynch regarding the effectiveness of cognitive behavioral therapies on major psychiatric disorders misses the mark as it dismisses the therapy as ineffective while failing to see the bigger picture (Kingdon, 2010). Kingdon states that the difference in cognitive behavioral therapy in treating psychiatric disorders including depression may be the difference in establishing rapport with a client, however, even if that is the only benefit cognitive behavioral therapy still has shown to be effective in decreasing symptoms of psychiatric disorders including depressive disorders (2010). The article by Kingdon looks at the big differences that even small amounts of effectiveness can have on individuals with severe psychiatric disorders. This benefit may be even greater when used in conjunction with other treatment methods (Kingdon, 2010). Issues in Portability of Evidence-Based Treatment for Adolescent Depression discusses the effect of two evidence based therapies for treating depressive symptoms in adolescents (Probst, 2008). The two types of therapies examined are cognitive behavioral therapy and interpersonal therapy (Probst, 2008). The article explains that even though both types of treatments have been proven effective in treating adolescents rarely does this population receive such treatment options for depression (Probst, 2008). Probst explains that this is in part due to fact that it is hard to translate these types of therapies from research into real world practice (2008). In order to create an atmosphere in which this type of treatment is deemed “portable” it is of utmost importance for the therapist to define what qualifies as a positive outcome for therapy (Probst, 2008). Is a positive outcome going to be described as decreased symptoms such as sadness and suicidal idealization or as increased
Literature Review Cont. functionalism such as good school attendance and participating in outside activities (Probst, 2008)? Probst explains that therapy becomes increasingly portable, and thus increasingly useful in real applications, when the desired outcome of therapy is clearly defined (2008). Probst’s article creates a well rounded understanding of the issues regarding the treatment of depressive symptoms by using evidence-based therapies, as well as, explaining that the effectiveness of such therapies is reliant on the way in which the researcher or therapist defines a positive outcome (2008). Hansen’s article title Cognitive-Behavioral Interventions: Where they Come from and What They Do outlines cognitive therapy, behavioral therapy, and cognitive behavioral therapy as they relate to the corrections system (2008). Hansen also explains how cognitive behavioral therapy can be used for preventing relapse of substance abuse (2008). While the article does little to prove the effectiveness of cognitive behavioral therapy on depression Hansen does a remarkable job of explaining the process and theories behind each of the three therapies (2008). The article titled Comparative, Clinical Feasibility Study of Three Tools for Delivery of Cognitive Behavioral Therapy for Mild to Moderate Depression and Anxiety Provided on a Self-Help Basis was based on a study originally comprised of 100 participants who were assigned to one of three self-help tools utilizing cognitive behavioral therapy techniques including; the Beating the Blues computer program, workbooks on depression and anxiety, and the Livinglifetothefullest internet website (Pittaway, Cupitt, Palmer, Arowobusoye, Milne, Holttum, Pezet, and Patrick, 2009). Only 50 of the original participants completed the study, however, dropout rates were consistent throughout the three test groups (Pittaway et al., 2009). The study concluded that those who stuck with the therapies all benefited from the cognitive behavioral therapy be seeing a reduction in depressive symptoms, as well as, a decrease in anxiety (Pittaway et al., 2009). The study did an excellent job of creating a random sample and pool of participants for the research. The study effectively compared and contrasted the effectiveness of three different types of cognitive behavioral therapies in treating depression concluding that each self-help method of cognitive behavioral therapy was effective. However, the study was not able to reach a conclusion regarding the superiority of one tool over another (Pittaway et al., 2009) Mindfulness Based Stress Reduction Therapy in Reducing Depressive Symptoms Psychosomatic Research; University of Twente Describes Research in Psychosomatic Research is a systematic analysis and review of the effectiveness of mindfulness-based stress reduction (MSBR) regarding the treatment of depression, anxiety, and psychological distress (Psychosomatic Research, 2010). The study consisted of participants who had a chronic medical disease (Psychosomatic Research, 2010). The study concluded that MSBR has small effects on depression, anxiety, and psychological distress for those suffering from chronic medical
Literature Review Cont. disease (Psychosomatic Research, 2010). The greatest improvement of symptoms with this treatment was in reducing anxiety Psychosomatic Research, 2010). The article included “eight published randomized controlled outcome studies” which gave the researcher a large amount of data from which to draw conclusions on the effectiveness of such therapy (Psychosomatic Research, 2010). However, the study only addressed the effectiveness of MBSR therapy on depression, anxiety, and psychological distress individuals who were currently suffering from a chronic medical disease which leaves the question of the effectiveness of such a therapy on individuals who were not experiencing chronic medical diseases as defined by the study. Physical Activity as an Intervention for Alleviating Depressive Symptoms Blake, Mo, Malik, & Thomas conducted a systematic review titled; How Effective Are Physical Activity Interventions for Alleviating Depressive Symptoms in Older People? This article explains that the occurrence of depressive symptoms increase with age (Blake, Mo, Malik, & Thomas, 2008). Depression in old age increases the risk of mortality and co-morbidity, increased age also can mean increased sensitivity to side-effects which prompts the researchers to look at non-pharmacological alternative to treating depression in the elderly (Blake et al., 2008). Many studies regarding the use of physical activity as an alternative to treating depressive symptoms showed promise at least in the short term (Blake et al., 2008). However, many of the studies examined did not look at the long-term benefits of this alternative treatment (Blake et al., 2008). The mean age of participants of the studies ranged from 65 to 82.4 years old (Blake et al., 2008). This study included a systematic review of ten research projects carefully chosen to meet the criteria of the given research question (Blake et al., 2008). The weakness of the study was the inability to generalize the results of the impact of physical activity on depressive symptoms in populations who were less than 65 years old. Social Skills Training Therapy in Reducing Depressive Symptoms Social Skills Training Therapy to Reduce Depression in Adolescents used Structured Learning Therapy (SLT) to decrease depressive symptoms by focusing on the development of social skills, self evaluation skills, and being able to appropriately express oneself (Reed, 1994). The study was comprised of 18 adolescents ages 14-19 (Reed, 1994). The participants were randomly assigned to either the control group or the SLT group (Reed, 1994). The males in the study showed significant improvement in the amount and severity of depressive symptoms they were experiencing, however, the participating females did not show significant improvement (Reed, 1994). Perhaps SLT is more effective in males and thus the effectiveness is relevant to gender (Reed, 1994). One must beware, however, of the small group size of participants which may have resulted in skewed results and may account for the differences in effectiveness across gender.
Literature Review Cont. Problem Solving Therapy as an Intervention for Depression The study conducted by Arean, Hegel, Vannoy, Fan, and Unutzer analyzed the Effectiveness of Problem-Solving Therapy for Older, Primary Care Patients with Depression (2008). Comparisons of primary-care-based psychotherapy (or problem solving therapy) to community based psychotherapy in treating late-life individuals suffering from depression or dysthymia were made (Arean et al., 2008). The study revealed that problem solving based therapy from a primary care physician was more effective than community based psychotherapy following 12 months of therapy and up to 24 months following therapy (Arean et al., 2008). However, when patients who had been out of therapy for longer than 24 months were examined, there were no differences in the effectiveness of the treatments (Arean et al., 2008). This study provided a useful tool in analyzing the usefulness of psychotherapy in depressed individuals 60 and over, however, the study did not generalize to populations younger than 60. Conclusion After reviewing the available literature regarding the effectiveness of non-pharmacological methods of treating depression it is apparent that many non-pharmacological treatment methods are highly effective in reducing depressive symptoms. Cognitive Behavioral Therapy seems to be the most widely explored alternative to medication when treating symptoms of depression. This is most likely due to the great degree of effectiveness which has been demonstrated in using this type of therapy to reduce depressive symptoms (Embling, 2002). Cognitive behavioral therapy seems to be a useful treatment option across the life span. The findings regarding alternative methods of treating depression rather than the use of anti-depressant type drugs raises the question by many of how effective are the drugs being used and how much of the effect on the reduction of depressive symptoms being measured is due to placebo effect (Devlin, 2010). Are Americans over using anti-depressants or is the effect on symptoms from anti-depressants significant enough to continue their popular use even if the effects are mostly placebo (Devlin, 2010)? In order to expand upon the research that has previously been conducted and explored regarding the use of non-pharmacological treatments for depression it is recommended that studies pertaining to suicide rates in various age groups be conducted and analyzed to see how they correlate to different treatment options including pharmacological treatment, non-pharmacological treatments, and combinations of the two. This collection of data will prove to be invaluable to mental health professionals everywhere in making informed and conscientious decisions regarding treatment options as they relate to depression in various age groups.
References References Arean, P., Hegel, M., Vannoy, S., & Fan, M., Unutzer, J. (2008). Effectiveness of problem-solving therapy for older, primary care patients with depression results from the IMPACT Project. The Gerontologist (Oxford), 48(3), 311-323. Retrieved on July 7, 2010 from: Education Journals Database Center for Disease Control. (2007). NCHS Databrief. Depression in the United States household population, 2005-2006. Retrieved on July 23, 2010 from: http://www.cdc.gov/nchs/data/databriefs/db07.htm Blake, H., Mo, P., Malik, S., & Thomas, S. (2009). How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review.. Clinical Rehabilitation (London), 23(10), 873-887. Retrieved on July 7, 2010 from: Psychology Journals Database Devlin, H. (2010). Talking therapies are more effective than Prozac-type drugs, says scientist. Serotonin enhancers offer only a placebo effect (Edition 2). The Times (London (UK)), 13. Retrieved on July 7, 2010 from: PsycArticles Database Embling, S. (2002). The Effectiveness of cognitive behavioural therapy in depression. Nursing Standard (Harrow-on-the-Hill), 17(14/15). Retrieved on July 7, 2010 from: Career and Technical Education Database Hansen, C. (2008). Cognitive-behavioral interventions: where they come from and what they do. Federal Probation, 72(2), 43-50. Retrieved on July 7, 2010 from: Social Science Journals Database Hecht B., & Hecht, F., (2010). Anti-depressants and suicide FDA warns. Retrieved on July 23, 2010 from; http://www.medicinenet.com/script/main/art.asp?articlekey=31649 Kingdon, D. (2010). Over-simplification and exclusion of non-conforming studies can demonstrate absence of effect; a lynching party? A commentary on 'Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials by lynch et. al.. Psychological Medicine (Cambridge), 40(1), 25-27. Retrieved on July 7, 2010 from: Psychology Journals Database Pittaway, S., Cupitt, C., Palmer, D., Arowobusoye, N., & Milne, R. (2009). Comparative, clinical feasibility of three tools for delivery of cognitive behavioural therapy for mild to moderate depression and anxiety provided on a self help basis. Mental Health in Family Medicine, 6(3), 145-154. Retrieved on July 7, 2010 from: Psychology and Behavioral Sciences Collection Database Probst, B. (2008). Issues in portability of evidence-based tretment for adolescent depression. Child & adolescent social work journal (New York), 25(2), 111-123. Retrieved on July 7, 2010 from: Social Science Journals Database Psychosomatic research: University of Twente describes research in psychosomatic research. (2010). Psychology and Psychiatry Journal (Atlanta), 310. Retrieved on July 7, 2010 from: PsycArticles Database Reed, M. (1994). Social skills training to reduce depression in adolescents. Adolescence (Roslyn Heights), 29(114), 293-302. Retrieved on July 7, 2010 from: Criminal Justice Periodicals Index Database
Sample of Communication Skills Helping Self Help Groups Lorraine Helferich-Stiel June 27, 2010 Argosy University PSY480 Biopsychosocial Effects of Substances Instructor: Dr. LaFrance
Helping Self Help Groups Helping Self Help Groups While many individuals see the prevailing medical model of treatment to be a flawed system many are turning to self-help group that rely on support from each other rather than medical interventions in order to combat and defeat addiction problems within individuals. This type of treatment such as in Alcoholics Anonymous which relies on addicts helping one and another to stay clean without intervention from professionals is widely accepted in America and other countries as well (Sternberg, 2003). Alcoholics Anonymous sees addiction as a disease process in which the addict is biologically different from others and therefore must abstain from substance abuse ( Hart, Ksir, & Ray, 2009). This type of a disease model takes the blame off the individual suffering and therefore it is seen as a medical condition that he or she needs to manage just as they would diabetes (Hart et.al., 2009). In this way the individual is seen as primarily responsible for managing their addiction each and every day without guilt for differences (Hart, et.al., 2009). During recovery an individual is likely to go through the following stages; pre-contemplation (does not identify a problem), contemplation (believes that a problem may exist), preparation (decides to change), action (actively works towards change) (Hart, et.al., 2009). The self help group will be available to help the individual recognize where in the steps they are currently and to help to keep them moving towards the action phase. Many times individuals receiving self help do so for an undetermined amount of time even after being “clean” for many years, this is relapse prevention (Hart, et.al., 2009). Within the self help model of treatment and recovery the patient is ultimately responsible for his or her own recovery through the process of taking active initiative in order to keep themselves clean (Hart, et.al, 2009). Many times in groups such as Alcoholics Anonymous a sponsor may be designated to a new participant. This individual is to serve as a mentor who is available to give support and a shoulder to lean on during hard times. The group serves as a type of family for the recovering individual and as a place where there supposed biological differences that lead to their dependence on substances are not the exception but instead the norm. This creates a sense of belonging and camaraderie.
References References Ksir, C., Hart, C., Ray, O., (2009). Drugssociety and human behavior. (13th ed.). New York, NY. McGraw Hill Publishing. Sternberg, B., (2003). Addiction. Gale encyclopedia of mental health disorders. Retrieved on June 27, 2010 from Gale online database.
Sample of Ethics and Diversity Awareness Final Project Week Seven Lorraine Helferich-Stiel June 27, 2010 Argosy University PSY312 Diversity Instructor: Dr. Allen
Final Project Diversity Final Project Week Seven Personally the author has a special place within her heart for the elderly as she deals with this population on a daily basis. She is in tune with how much they have and continue to offer to society. She is aware of the loss that they experience as they grow older and how this period in life can be either exhilarating or debilitating depending on the views of the individual involved. The author holds no bias or stereotypes for the elderly as she experiences daily the trials and tribulations along with the joys that are intertwined with this generation. She has experienced the differences that are unique to each and every individual in this stage of life just as in any other. Every generation is diverse in areas such as gender, culture, ethnicity, socioeconomic status, disabilities, and religion (Robinson-Wood, 2009). The author is not afraid of growing old but rather sees it as her right of passage into another phase of being. Death is not an enemy but rather an inescapable part of life which should be embraced, respected, and revered instead of feared. Growing old means having time to look back and contemplate all those little moments in life that really mattered but were rushed due to “not having enough time in the day”. Growing old means being able to share with others what one has learned whether the experiences were positive or negative. Growing old means that one is continuing a cycle of life. Between now and when I am old I would like to continue to help others in any way I can but especially through my career in mental health. I look forward to assisting those who are in need and in creating a life I can look back on and be proud of. My work that I am providing now through caring for the elderly and helping them along their last days of their journey are rewarding and are something that I am privileged to be able to do. I have never had a greater honor then being able to be a part of the death and dying process and the rebirth and awakening that often co-occurs in individuals who have lived the life that they perceive was theirs to live and for whom regret is a foreign word.
References References Robinson-Wood, T., (2009). The convergence of race, ethnicity, and gender; Multiple Identities in Counseling (3rd ed.). Upper Saddle River, NJ. Pearson Education Inc.
Sample of Foundations of Psychology Identifying Possible Biological Anomalies Lorraine Helferich-Stiel January 22, 2010 Argosy University Crime and Causes PSY493 UA Instructor: Jon Stern
Identifying Possible Biological Anomalies Identifying Possible Biological Anomalies Two days ago a young man was brought into the psychiatric ward through the hospital’s emergency department. At the time of admission the young man was severely depressed and there were concerns about suicidal ideals. The young man whom is eighteen years old is described as normally being quite calm and rather quiet. However, in the last 24 hours he has started complaining that he is not recognizing family members, or friends. The patient has started talking non-stop. Several times in the past 24 hours the patient has had to be retrained as he flew into rage and nearly physically harmed others around him. Since this patient is exhibiting behaviors that are obviously not ordinary for him it is possible that he is suffering from some sort of biological anomalies. It is necessary at this time to create a list of possible biological problems and anomalies that this young man may be suffering from in order to correctly diagnose and treat the patient. Following is a list of possible ailments that should be closely looked into: If the patient is experiencing low levels of serotonin this may contribute to his depressive state and violent outbursts (Conklin, 2010). Thus biochemical disruptions should be looked into. Impairment in the frontal and/or temporal lobes of the brain may cause impulse control problems and violent outbursts (Conklin, 2010). This being said the patient should be evaluated for abnormalities of the brain as well as possible brain damage. Psychological abnormalities such as schizophrenia could create disjointed thinking and paranoia, leading to violent outbursts (Conklin, 2010). This young man should be screened for psychological abnormalities. Bi-Polar type two disease is commonly associated with delusional episodes and can create a reality for the patient which he or she can perceive as threatening, thus, leading to violent tendencies (Conklin, 2010). Again a psychological evaluation may help to diagnose such an ailment. Due to the wide range of possible causes and things that may be contributing to the patient’s abnormal behavior and violence it will be important for the treatment team to explore all possible causes of the new behavior in order to correctly diagnose and treat the patient. It is recommended that blood tests, brain scans, and psychological evaluations commence immediately in an attempt to begin effective treatment of the patient as soon as possible. It is also important to note that imbalance in nutrients and medication reactions should also be looked into since adverse reactions have been noted in both scenarios. After a comprehensive workup of the patient a more in depth look into the causes of the sudden symptoms will hopefully help to treat the patient as well as to decrease the likelihood of relapses in the future.
References References Argosy Online. (2010). Crime and Causes. Module Two Online Lectures. Retrieved on January 20, 2010 from: http://myeclassonline.com/re/DotNextLaunch.asp?courseid=3860286 Conklin, J.E. (2010). Criminology (10th ed.). Allyn & Bacon.
Sample of Applied Psychology Final Project Week Four Lorraine Helferich-Stiel March 29, 2010 Human Sexuality PSY304 XC Argosy University Instructor: Christina Gonzalez
Human Sexuality Final Project Final Project Week Four Marsha and Liam have decided that they are ready to start a family. During their physicals priors to trying to conceive it was discovered that Marsha had contracted the Human Papilloma Virus or HPV. Both Marsha and Liam insist that they have been monogamous throughout their relationship and Marsha states that she was a virgin when she and Liam were married. Liam has never noticed any indication of the virus and now is doubtful about where Marsha may have contracted the Human Papilloma Virus from. As a family planning counselor for the local health clinic one would strive to help Liam and Marsha understand how Marsha might be testing positive for the virus and both of them still being telling the truth about their previous sexual experiences. Solving this crisis is of utter importance since the future of Marsha and Liam’s family, as well as, the future of their marriage may rest on the ability of the counselor to help them to understand the realities of the infection and how it is transmitted, as well as, symptoms. It is important that both Marsha and Liam recognize how common HPV is. Hocks states that, “some researchers estimate that as many as 75 percent of Americans of reproductive age may be infected with HPV” (2009p.282). Both Marsha and Liam may be telling the truth about their sexual monogamy and pasts as it is common for HPV to be spread without ever knowing one was infected (Hock, 2010). Liam may have been infected in a prior relationship and passed the infection along to Marsha who is now harboring the virus within her own body. HPV has no medical cure (Hock, 2010). However, in about 90 percent of women and girls within one to two years of being outbreak free their bodies will clear themselves of the viral infection (Hock, 2010). While there are no current treatments for the virus itself there is a new vaccine (Guardasil) that prevents the contraction of the types of HPV most known to cause cervical cancer in young women (Hock, 2010). For women and men who are experiencing current symptoms from HPV wart outbreaks can be treated by cryogenically removing the wart or by a treatment that uses acid in order to “burn” the wart. There are also prescriptions that can be applied by the patient in order to remove the wart (Hock, 2010). Both Marsha and Liam are at risk for future outbreaks within the next year to two until the bodies can eradicate the virus on its own (as long as they do not re-infect each other). The best way to prevent future outbreaks is by using condoms until they have both been cleared as HPV free by a physician. There is a risk of passing the virus to an infant during delivery if the mother is currently having an outbreak (Hock, 2010). In order to eradicate this risk surgical removal of any current warts and lesions is recommended (Hock, 2010). It is important for Marsha and Liam to remember that blame does no one any good when dealing with sexually transmitted infections. It is also important that they realize that the fact that one or both of them is carrying the virus is nothing to be ashamed and is actually more common then not. It is important that if either of them has any issues regarding; shame, guilt, or mistrust that they immediately seek mental health counseling in order to protect their relationship.
References References Hock, R., (2010). Human Sexuality. (2nd Ed.). Prentice Hall Publishing, Upsaddle River, NJ
Sample of Interpersonal Effectiveness Death and Dying Lorraine Helferich-Stiel April 23, 2009 Argosy University Developmental Psychology Stephanie Brookes
Death and Dying Death and Dying Death is a subject that can rouse controversial opinions about many issues involved. While some people are open to death and view it as a natural part of living, others may deny, try to delay, or to refuse to see their own mortality. The disease process in the terminally ill can be an experience that leaves one feeling as though they have been stripped of their dignity (Chochinov, Hack, Hassard, Kristjanson, McClement, and Harlos, 2002). This negative feeling of being stripped of one’s dignity can cause depression, and a wish to die sooner. This feeling of a loss of dignity was intensified when conditions that left the patient with a “ deterioration in one's appearance, a sense of being a burden to others, needing assistance with bathing, requiring inpatient hospital care, and having pain” (Chochinov et al., 2002). The aging process can create similar dilemmas for the elderly facing end of life issues. Many of the issues that create a sense of loss of dignity in the elderly are the same as the concerns of the terminally ill (Santrock, 2009). However, there are also many that take the time near the end o their lives to contemplate where they have been and are now, and to really look at what they have accomplished. This type of reminiscing can help individuals to accept death as a part of their own life cycle (Santrock, 2009). When individuals are able to reach this acceptance it may make it easier for their families to accept the loss of their loved one. This acceptance can help an individual to make the most of the life they have left and to leave their loved ones with a picture of death that includes dignity, respect, and peace. “Death is actually a part of our lives, something that is bound to happen. Since it is inevitable, it makes more sense to try to understand death instead of avoiding thinking about it” (Palavali, 2006 ¶22).
Death and Dying Cont. There are many influences that contribute to the cognitive acceptance of death. In order for one to really accept death they must first have a feeling of having fulfilled some purpose here on earth. This purpose helps one to define their life as worthwhile. It is easier to let go of life when one feels a sense of accomplishment and completeness in their time here on earth. Another influence that plays into the cognitive acceptance of death is ones ability to really feel emotions. Those who are easily able to recognize and effectively sort through feelings are much more likely to become accepting of impending death. It is also important, however, that in accepting death one does not become fixated on death and dying (Palavali, 2006). This type of fixation can become an obsession. Society plays a big part in the way an individual perceive the dying process and the state of death. In some cultures death is routinely seen as inevitable and as a natural process in the circle of life. In other cultures such as those held by many Americans, death is seen as something to fear and to try to avoid at all costs. However, American’s view of death creates anxiety for many making the prospect of dying a real fear even in every day living. In other societies where death is seen as a peaceful and even dignified process individuals are much more likely to accept death and afterlife whatever they feel that may entail. Denial of death can lead to a denial of all that is important in living (Bell, 2005). When one denies death they also deny that choices that make can affect the quality or quantity of their life. For example, if one truly is in denial regarding issues of death it is not an issue to them as to whether or not they should stop smoking because death from lung cancer will never happen to them. Denial is often broken when the issue of death hits too close to home. Instances of this would be when one loses a close friend or family member or has their own near death experience.
Death and Dying Cont. Spiritual beliefs can many times be comforting to those who are dying. These beliefs many times encompass an ideal that there is something more, something bigger than what one might be doing here on earth (Santrock, 2009). This type of thinking many times helps to bring about emotional changes in an individual such as a sense of peace, a sense of finality, and a sense of gratefulness that can bridge the gap between life and death in a smooth wave of emotion. Many times those that are dying feel a need to isolate themselves from the outside world (Santrock, 2009). This is not personal to any loved ones but instead the individual may have a need to really climb within themselves in order to find that peace. For some the only way this can happen is to isolate from reality. In the case study of Charles his life of drugs, violence, and mental illness prohibited him from coming to grips with the realities of death. This is evident in his paranoia and fear of dying that even goes to the point of obsession and compulsion. Paul on the other hand has lived a fulfilling and respectful life. He has raised his children and watched them have their own. He feels a sense of accomplishment and finality that allowed him to accept death and to help prepare his family for his own death.
References References Bell, W., (2005). Denial. Alternatives Journal 31,3. Retrieved on April 23, 2009, from Academic Search Complete database. Chochinov, H., Hack, T., Hassard, T., Kristjanson, L., McClement, S., & Harlos, M. (2002, December 21). Dignity in the terminally ill: a cross-sectional, cohort study. Lancet, 360(9350), 2026. Retrieved April 23, 2009, from Academic Search Complete database. Palavali, V., (2006). Loving life while accepting death. Humanist; Jul/Aug2006, Vol. 66 Issue 4, p37-39. Retrieved April 23, 2009, from Academic Search Complete database. Santrock J., (2009). Life-span development. (12th edition). New York, NY
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