Therapeutic Relationships And The Three Stages Associated...

Therapeutic Relationships And The Three Stages Associated...
Therapeutic relationships and the three stages associated with relationships
The whole reason for a therapeutic relationship is to facilitate a successful patient outcome. Each person is unique and has different needs.
Stages of development of a therapeutic relationship:
Orientation Stage–involves nurses learning about patients and they initial concerns and needs. Patents also learn about the role of the nurse. Patents are
informed about the general purpose of taking with the nurse. The initial purpose is plainly: identifying a problem on which you want to work, helping
you figure out what has been happening to you lately, or getting to know what has been bothering you. This first stage is about building trust first
before moving on to your initial assessment. Afterwards the nurses job is to manage the patients emotions and providing support and structure to the pt.
Working Stage–When patients are ready, the work toward changing their thoughts, feelings, and behaviors can begin. However, drastic changes might
not be the goal for some patients, particularly the chronically ill. Stabilization with meds, reduction of symptoms, and development of supportive
relationships are valid goals. The parts of this working stage begin with in depth data collection. This is where the nurse facilitates awareness, analysis,
and interpretation through in–depth exploration of issues and identification of priority issues. Reality testing is the next part, and is an important
strategy in the
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Person Centered Therapy
PCT Essay 1
Running head: AN ILLUSTRATION OF PERSON–CENTERED THERAPY
What do you consider to be the strengths and weaknesses of the person–centered approach? What concepts and methods might build effective bonds
with clients? Discuss any shortcomings in staying with this orientation.
Word Count: 2214
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PCT Essay 2
Abstract
This essay would attempt to explain the fundamental concepts and therapeutic methodologies that might build effective bonds with clients.
It would also discuss the strengths and weaknesses within the person–centered approach. The key concepts include self–actualization, conditions of
worth, the fully functioning person, and the phenomenological perspectives. The therapeutic ... Show more content on Helpwriting.net ...
Key Concepts & Methodologies
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Rogers maintained that to create a growth–promoting climate in which therapeutic change * can occur, and where clients can move forward and

become what they are capable of becoming,
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PCT Essay 5
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some fundamental conditions must be present. The client must be anxious or incongruent and in contact with the therapist. Therapists must be
genuine, whereby their words, nonverbal mannerisms and feelings are not to be contradicting. In addition, they must also accept the client and show
unconditional care towards them. The therapist must understand the client's thoughts, the ideas, experiences, and feelings, when communicating back
this empathic understanding
(Murdock, 2009).
Firstly, congruence (genuineness or realness) refers to the therapist's openness, genuineness and the willingness to relate to clients without hiding
behind a professional front.
Therapists who conduct sessions with this sincerity in mind have all their feelings available to them in therapy sessions and may share significant
emotional reactions with their clients.
However, congruence does not mean that therapists shift the focus of therapy to themselves in any way or have a predetermined direction, or impose a
professional agenda to their clients during sessions. [Corey, 2005]
Second, a therapist should show

Drug Study Assignment Essay
PHAR 1000 – Basic Pharmocotherapeutics
Eileen J. Arellano
Norquest College
Practical Nurse– Section D01
PHAR 1000 Written Assignment
Heather Zirk RN, BN
September 15, 2014 CASE STUDY:
Name of Client: Maggie Sears
Age: 66 years old
Primary Diagnosis: Cellulitis to left leg
Secondary Diagnosis: Depression Osteoporosis Type 2 Diabetes Mellitus
Past Surgical History: Tonsillectomy– as child Cholecystectomy– 15 years ago (51 years old)
Current Medications: "migraine pills" St. John's wort oil – for skin inflammation to left leg (for a week)
Past History: Smokes ВЅ a pack of cigarettes per day (since she was a teenager)
Weight: 70 kg
Height: 150 cm
DOCTOR'S ORDER:
Medications:
Ancef 750 mg IV q12h
Elavil 50 mg po ... Show more content on Helpwriting.net ...
If headache recurs, doses may be repeated q 2 hr (not to exceed 200mg/day)
Doctor's Order: 75mg q4H max 2 doses daily
Is this Safe?: NO. The dose should be lesser. 25–50mg for lesser interval of q2H.
Metformin
Safe Dosages: 500mg twice daily. May increase by 500mg at weekly intervals up to

2000mg/day. If doses >2000mg/day are required, give in 3 divided doses (not to exceed 2500mg/day)
Doctor's Order: 750mg TID with meals
Is this Safe?: YES
Buffered Aspirin (Salicylates)
Safe Dosages: 2.4g/day initially; increased to maintenance dose of 3.6–5.4g/day in divided doses (upto 7.8g/day for acute rheumatic fever)
Doctor's Order: 650mg (or .65g) q6H PRN
Is this Safe?: NO. The dose 650mg (or .65g) q 6H PRN that was ordered was lesser than what is a safe dose according to the drug guide. And dose
wouldn't be enough to help client's pain.
3. What would you do if the dosage ordered was not safe?
Clarify the order with the Physician involved. Refer to the drug guide or any reliable source if necessary.
4. Indicate potential drug

Ontological And Epistemological Debate About The Nature Of...
Ontological and Epistemological debates about the nature of the therapeutic relationship.
'Existence' and 'Relationship'. Can these two concepts exist independently of each other without the presence of the one to be necessary for the
presence of the other? Is it possible for anything to exist without being related to anything else nor being perceptible by touch? Is it possible for
something to exist if it cannot be described nor being visually present, even though it brings out strong feelings and a sense of connection?
Epistemologically, everything we see (people, objects, etc.) exists only in relationship to something else.
As Cottone (1988,363) mentions, relationship is what we are born from, nurtured by and getting educated from. Our existence is defined within the
domain of the society, and it is within society where we interact with others, socialise and satisfy our biological needs. ... Show more content on
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From the ancient years, the relationship between two people has healing properties and is the main influence for changes in people's lives.
Especially, in counselling and psychotherapy, the relationship between client and counsellor is the most significant part of the therapeutic procedure.
Many studies (Buborsky et al. 1983, O' Maley et al. 1983, Hill 1989) illustrate that it is the therapeutic relationship more that any other factor, which
determines the effectiveness of counselling therapy. Moreover, literature which reviews the way, in which clients experience the therapeutic process,
indicates that the many of the client's thoughts and feelings remain unspoken during the counselling sessions. (Dinnage, 1988, Mearns and Dryden,

Personal Strengths In Counseling Relationships
1. What personal & professional strengths do you have that you can use and build on to create helping relationships with your clients? My personal
strengths include a dedication to social justice, I am compassionate, I am open–minded and able to evaluate issues from various aspects and points of
view. Professionally, my strengths are experiences working with individuals from various ages, cultures, ethnicities, beliefs, and socioeconomic
statuses. I have worked with individuals with various mental health concerns, people with past and current substance use, and those experiencing
domestic violence. These strengths will assist me in creating helping relationships with my clients because I think it will foster a trusting and safe
environment which will encourage the clients to confide in me as well as work together to effect positive change in their lives.
2. What knowledge, skills, and values do you already have that help you form an effective helping relationship? I have learned how to ask open
ended questions to obtain as much information as possible. I am also learning how to validate and use reflexive listening. These skills will help the
clients know that I care about them and want to help. I believe that every person possesses strengths and the capacity to change. I also believe that
everyone has the right to have a life worth living, and has the right to live however they want as long as it doesn't harm others.
3. Describe how you currently view your overall

Substance Use Disorders: A Case Study
Establishing rapport with a client during the intake process is the foundation of a strong therapeutic alliance that is crucial for ensuring client return
and prevention of early termination of treatment (Marini, 2015). Yet, counselors often find it challenging to find this rapport with clients who present
with substance–use disorder (SUD). They may be ambivalent for being compelled to seek treatment by family or a judge. Denial and unwillingness to
give up substance use behaviors can make the client defensive and secretive. Even cultural, ethnic, and gender differences can foster client suspicion if
the counselor is perceived as biased or insensitive. Co–occurring mental disorders may also create challenges; clients who have a high risk of... Show
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The counselor should review disclosures and other policies with a relaxed manner and non–rushed pace to allow comprehension and time for questions
(Marini, 2015). This prevents the client from feeling overwhelmed, powerless, or mistrustful. Sending the client home with a relevant homework
assignment or light motivational readings can sustain the client's sense of involvement and rapport between sessions (Kelly, 2006). Also, follow–up
letters of appreciation and well–wishes convey a sense of caring when the client may otherwise lose motivation to change (Kelley,

Therapeutic Hypothermia: Preventing Damage After Cardiac...
Introduction Hypothermia protocol for the post cardiac arrest patient has been an evidence based practice of this therapy for about a decade now. This
intervention, often used in the critical care setting, is now expanding to primary emergency responders as well. This paper will present some of the
notable research that has been done on therapeutic hypothermia, and current use of this intervention. Control studies, animal studies, and case studies
have been published related to these medical interventions. Unfortunately, there are still many healthcare providers not using this intervention. Dainty,
Scales, Brooks, Needham, Dorian, Ferguson et al. (2011) study states, "observational research shows that therapeutic hypothermia is ... Show more
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Reperfusion injury is the harmful adverse effects attributed to reestablished circulation (Writing Group et al., 2003). Hypothermia inhibits or reduces
normal body functions such as apoptosis and inflammation, and these can often cause additional damage (Torgersen, Bjelland, Klepstad, Kvale,
Soreide et al., 2010). Also, by cooling the body to the designated range the metabolic rate slows down and decreases oxygen demand. This allows
tissue to avoid ischemia, in particular the brain and heart. The brain is protected in many ways including preserving the blood brain barrier and
decreasing harmful free radicals (Wall, 2011). More recent studies done on animals have been performed in order to manipulate the variables associated
with the hypothermia protocol in attempt to solidify the most effective treatment. Although animal studies allow for a more precise scientific method
and yield important information, they are not guaranteed to be identical in a human patient. One study involved pigs that underwent a mechanically
induced 100% occlusion of the LAD. The results suggested that only early–induced hypothermia, prior to reperfusion, yield a decreased infarct size.
Also hypothermia, regardless of onset time related to reperfusion decreased microvascular obstruction. In addition, the study utilized IV cold saline to
achieve a more rapid cooling. The pigs, about 50kg, reached less than 35 degrees Celsius in 5 minutes. The usual time for humans to cool using

Pharmacological Intervention Assignment : Patient X
The situation that was chosen for this pharmacological intervention assignment is the case of Patient X, a 35 year–old male with a history of recurrent
sigmoid diverticulitis who has opted for elective laparoscopic sigmoid hemicolectomy. In conjunction with his surgery, he will be starting a regimen of
alvimopan (Entereg) to prevent the development of postoperative ileus. His situation fits into the perioperative clinical focus of nursing practice
because the dosing recommendations for alvimopan include beginning the first dose preoperatively, 30 minutes to 5 hours prior to surgery (Erwele,
2008). This assignment will include an assessment of the patient, the establishment of a broad behavioral outcome and specific behavioral objectives ...
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Because of the significant interference these recurrent episodes are having on his life, and with understanding of the risks, benefits and alternatives of
the procedure, he has consented to proceed with laparoscopic sigmoid colectomy, including a pharmacological regimen of alvimopan. Common
adverse effects of alvimopan include nausea, vomiting and abdominal distention (Erowele, 2008). Preoperatively, he denies nausea and vomiting, and
his abdomen is soft and mildly tender in the left lower quadrant. Per his laboratory studies, Patient X has normal hepatic and renal function. He is not
obstructed and is not taking opioids for analgesia. Though he is able to perform his activities of daily life independently, the fact that alvimopan is
only available to patients who are hospitalized dictates that, per Orem's Theory of Self–Care, he has a self–care deficit that can be met by the
supportive–educative nursing system (Necor, 2014). Broad Outcomes
By the end of a 20–minute teaching session, Patient X will be able to describe why he is being prescribed alvimopan, the potential side effects, and
what he can do to minimize the impact of potential adverse effects.
Specific Objectives
Objective One: By the end of a 20–minute teaching session, Patient X will be able to express the outcome he hopes for from his

Assessment of Therapeutic Effects of Subcutaneous...
Background and Objective: Neurologic literatrure about therapeutic effect of subcutaneous corticosteroids in patients with migrainous chronic daily
headache is scare. Aim of this research is assessment of therapeutic effects of this management in the patients.
Methods: Consecutive patients with migrainous chronic daily headache in our headache clinic enrolled a prospective before and after therapeutic study
during 2010–2013. Fourty mg Metylprednisolone was divided in four subcutaneous injection doses. Two injections were done in right and left
suboccipital area exactly at retromastoid cervicocranial junction and two injections were performed in lower medial frontal area exactly at medial right
and left eye brow limit. A headache daily was filled out by the patient before and one month after intervention. The severity of pain was classified based
on the Pain Intensity Instrument, using a 0–to–10 point numeric rating scale. Paired t test and Chi–square served for statistical analysis.
Results: 504 patients (378 females, 126 males) with migrainous chronic daily headache underwent the study. Dramatic, significant, moderate and mild
or no improvement constituted 28.6%, 33.3%, 23.8%, and 14.3% of the post treatment courses respectively. Therapeutic effect of intervention on mean
pain scores was significant; t=7.38, df=20, p=.000. Two cases developed subcutaneous fat atrophy in frontal injection site and 3 cases experienced
syncope during injection.
Conclusion: Subcutaneous

Personal Counseling Characteristics
My Personal Counseling Characteristics Capuzzi, Stauffer, and Gross (2016) highlighted the existence of "core conditions" identified throughout the
counseling literature and research as an essential piece of the therapeutic relationship (p. 8). Possessing and demonstrating these characteristics and
behaviors strengthen the helping alliance and aid in effectiveness as a counselor when guiding the client to achieve optimal wellness (Capuzzi et al.,
2016). The following narrative outlines characteristics and behaviors emphasized as strengths necessary when developing a therapeutic alliance with a
client and those acknowledged as potential challenges or weaknesses hindering the development of a therapeutic alliance. Additionally, explanations are
discussed for selected strengths and challenges as well as strategies to address challenges and weaknesses.
An Area of Strength Warmth as a core concept essential to the helping relationship is regarded as the counselor's ability to convey "genuine caring and
concern" to clients (Capuzzi et al., 2016, p. 11). Without this ability to convey warmth as a counselor, thecounseling process will not be effective,
especially as I believe warmth is essential to building rapport and promoting an environment in which clients feel comfortable disclosing intimate
details of their lives. After all, a client may be more reluctant to disclose intimate aspects of their life if they believe that the individual to which they
are disclosing does not

The Effects Of Aspartame Consumption On Children 's Own...
Title: Neurobehavioral Effects of Aspartame Consumption. This title did not give the readers any clues as to whether the authors believe aspartame
causes neurobehavioral side effects. However, it does let the audience know the effects will be reviewed in this article.
Intended audience: The intended audience is professionals in the field of nutrition and dieting. Since the army helped fund the research written about in
this article it would not be a far stretch to believe that they were looking into feeding solders a healthy diet and wanted to see the effects of aspartame
in their own controlled setting.
Writer background: Professor Glenda Lindseth teaches Nursing Science, Nutrition and Dietetics, and Psychiatry at the University of North Dakota.
Sonya Coolahan MD is a physician who practices Internal Medicine at the Rapid City Regional Hospital in South Dakota. Dr. Thomas Petros is a
Psychologist who teaches at the University of North Dakota. Professor Paul Lindseth teaches Odegard School of Aerospace Sciences, at the University
of North Dakota.
Writer's angle: The writers are sharing their finding in a study of 28 students' consumption of aspartame in a controlled setting to see if there are any
neurologic effects.
Part 1: The one–sentence summary
The authors of this researched peer review highlight the effects of aspartame on the brain's cognitive abilities, depression, and headaches.
Part 2: The one–paragraph summary
In the research article, Neurobehavioral

Few Animal Studies Have Proved That Gabapentin Has A...
Few animal studies have proved that gabapentin has a potential to activate a serotonin receptor (5HT3) at the spinal level and also attenuate the
function of microglial cells[6]. In some parts of the brain such as periaqueductal grey (PAG) and anterior cingulated cortex, gabapentin has been shown
to elevate the level of GABA, a major inhibitory neurotransmitter, which might serve as an explanation of its' efficacy in partial management of
seizure[14]. Although gabapentin is approved to be used as an add–on treatment of focal epilepsies in 6 years and older patients and as monotherapy in
patients older than 12 years of age, it seems to show no efficacy when used in a management of generalized tonic–clonic seizures, generalized absence
... Show more content on Helpwriting.net ...
Due to an effect of gabapentin at the level of hypothalamus to regulate the temperature, it can also be used as an effective non–hormonal therapy for
hot flashes, a bothersome problem of menopause. It is shown to be more efficacy if used in patients with hot flashes that associated with sleep
interference [17]. Study shows that a bioavailability of gabapentin is low and it is dose–dependent. The bioavailability of 300 mg is around 60% and
decreasing to less than 30% if the dosage is 1600 mg 3 times a day [4; 11]. It has low protein binding property and it is eliminated unchanged in the
urine, which means it will not change into toxic metabolite or intermediate that can be harmful to the body. Gabapentin has a short half life of 5 to
9 hours, but with renal impairment, it will increase[4]. A dose adjustment is required in patient who has creatinine clearance of 60 ml/min and in
the elderly because of reduced renal function that has been thought to be decreased around 1% per year after the age of 40[4; 16]. A number
needed to treat (NNT) of gabapentin is 6.3 and its number needed to harm (NNH) is 25.6, therefore it is considered a safe drug [6]. The ceiling effect
has been reported to be 100 mg/kg in one study and 30–300 mg/kg in another study following oral administration [13]. The pharmacokinetic of
absorption of gabapentin is not linear unlike other newer anti–seizure medications. The explanation for this event is because gabapentin absorption
depends on

Benefits of the Placebo Effect
What if there was a new drug that's making you high, but is just a sugar pill? What if you can get drunk with non–alcoholic drinks? What if there was a
pill that can cure all your physical and emotional problems? This is known as the placebo effect. The placebo effect is a phenomenon in which some
people experience a type of benefit after the use of a placebo. A placebo is any substance with no known medical effects; such as sterile water, saline
solution, or a sugar pill. (About.com Psychology) Although it doesn't have known effects, people exposed to the placebo effect often gets the effect on
what it's supposed to do.
A placebo is a substance or other kind of treatment that looks like a regular treatment or medicine, but it is really not. It is actually a treatment or
substance that is inactive; this means that it is not a real medicine. The person who is getting a placebo does not know that the treatment is not real.
Sometimes the placebo is in the form of a "sugar pill," but a placebo can also be an injection, a liquid, a procedure, or any other type of therapy that
doesn't directly affect the illness being treated. Even though placebos do not act directly on the disease, it affects about 30% of people who
experienced it.(Tulsa Brain Tumor Clinic.) People taking placebos have experienced reduced pain, healed ulcers, eased nausea, and many other
illnesses.(ScienceDaily.) As many people suggest, the placebo is actually an expectancy effect; when people already know what

It Is Critical For Self Disclosure Ethical And Clinical...
It is critical for self–disclosure precautions, frequency in practice, potential risks, and potential advantages to be reconciled through a
research–integrated framework considerate of paramount ethical and clinical considerations. An attempt to do so will be made through first
overviewing self–disclosure ethical and clinical principles identified in the scholarly literature. These principles will then be synthesized into a
larger discussion in which there will be identification of which theoretical and conceptual positions are most supported by admittedly limited
empirical research and will therefore be discussed in their implications/application to various practice scenarios. In so doing, the discussion first
addresses the more conservative subject of whether or not to disclose and then progresses into discussing what can or should be disclosed to which
clients under what clinical circumstances and contexts (Audet, 2011). Moreover, because the possibility of a disclosing therapist invites an
uncharted level of intimacy into a professional relationship historically built upon secrecy and subtlety (Bottrill et al., 2010). Methodology A
comprehensive search of the PsycINFO database was conducted utilizing key words searches germane to the larger subject matter. Key words that
yielded the most relevant articles became the key words for this paper. In total, 50 papers were included. Excluded papers were not available in full text
form or were clearly not relevant. First, key

Analysis Of A Counselling Session Using A Case...
Analysis of a Counselling Session using a Case Conceptualisation and Drop–out Risk.
Counselling has one aim: to help the client. This is a simple aim however it is often difficult to put into effect, this was experienced first–hand in the
practice therapy session. Counselling encourages individuals to develop a self–awareness and enables them to make changes in their lives (Cross,
2010). The use of micro–skills is essential in any counselling session as it ensures that the client feels heard and understood and the use of the skills
impacts the strength of the therapeutic relationship (Geldard and Geldard, 2005; Lambert & Barley, 2001). The following will outline a summary of
the session as well as the clients presenting problems and my aims when approaching this particular session. The video will then be analysed in relation
to the micro–skills that were displayed or were attempted, the essay will then outline a case conceptualisation in regards to this particular client and the
factors that may influence them to prematurely discontinue with the therapy sessions.
Elham, The client, was a 21 year old Lebanese–Australian female who was feeling stressed and anxious about university, she had an upcoming
surgery and was worried about how this would impact her university work. She was also trying to maintain her work and home life. She discussed the
importance of her family and how they gave her support and strength to carry on, she also discusses her coping strategies as

What Makes A Successful Therapeutic Relationship?
Introduction Therapy is often said to be just as much of an art as it is a science. Namely because there is so much that goes into it. To create a
successful therapeutic relationship, there are some key elements that need to be a part of the formula. Each therapist may end up having a different
recipe, but it is important that a therapist knows what ingredients he or she may need and what they can add for it to be successful. Throughout this
paper, this writer will discuss characteristics she hopes to embody as a therapist, as well as the values and skills she wishes to bring with her into a
therapeutic relationship.
Values
There are many values this writer wishes to incorporate into a counseling relationship. The fundamental values this writer wishes to incorporate are:
flexibility, self–awareness, self–regulation, and empathy. The ability to be flexible and alter what one does in order to fit the client's needs is crucial to
establishing and maintaining a therapeutic relationship. Flexibility can be demonstrated in many different ways, such as the way the therapist interacts
with the client, the tone of voice that is utilized, down to the way the therapist provides material to the client. In being flexible, treatment is able to
remain focused on the client and his or her needs (Egan, 2014).
Possessing self–awareness is key to knowing and understanding the different attitudes, beliefs, and values one has and understanding when differences
could affect them. An example

Therapeutic Value Of A Dog Essay
Responsibility. Therapeutic Values. Protection. There are many promises and reasons that children tell their parents to allow them to have a dog in
their family. They will say how they will take the dog on walks every day and wake up with the new puppy early in the morning. Most of the time
their parents will fall for their unintentional trap. There are other reasons that will grab their parents attention. Every child should have a dog in their life
because the dog teaches responsibility, they have therapeutic values, and they will protect the family of even the smallest things.
Owning a dog teaches children responsibilities. Parents can create tasks based on their children's ages. Younger children can wash the doggie
dishes, refill the water dish, help brush them, and most of all give them love and attention. Older children can feed the dog, clean up after the dog,
train and exercise them, and love them as well. The way parents act towards the new dog is very important to how to child acts towards the dog. If
the parents are mean or become angry at the dog, then the child has the possibility of doing the same. Children at a young age have a very
impressionable mind. So, if parents lose their temper and say that they will get rid of him/her. The children will feel as though they can't be trusted.
Children might also see ... Show more content on Helpwriting.net ...
Most dogs have a protective instinct built into them. There are specific dogs that are categorized as guard dogs and were bred with certain
protective characteristics, such as German Shepards and Great Danes. Many claimed guard dogs are retired police dogs. Guard dogs are extremely
intelligent, quick on their feet and quick to think in pressure situations. They are said to have a watchful eye (Best Guard Dogs for Families with
Children). Protective dogs are highly devoted to their family. They will put themselves into harm's way if it means protecting the children or

Disruptive Behaviors Are A Challenge For Therapists
Disruptive behaviors are a challenge for therapists and require a different approach than those implemented for adults. Establishing rapport is the
foundation for the change process to begin. Sommers–Flanagan and Sommers–Flanagan (2007) assert that traditional counseling techniques are
ineffective for working with children and adolescents, and a multicultural therapy approach increases the likelihood of engaging them in therapeutic
relationships. Adolescents are a subculture and require a person–centered approach, whereas therapists believe that adolescents have the resources and
the ability to change. The therapeutic alliance formation involves the therapist's ability to utilize the individual's strengths as a mode of change. Findings
... Show more content on Helpwriting.net ...
Sommers–Flanagan and Sommers–Flanagan (2007) identified this approach as the–counselor–knows–it–all approach, whereas the child or adolescent's
opinions and beliefs are irrelevant. Establishing rapport with adolescents depends on the ability of the clinician to engage them in the therapeutic
process. The goals for this counseling session involve establishing a worker–client relationship and beginning the assessment process. Walborn (1996)
reports that a vital early step in the engagement process involves familiarizing the client with what to expect from therapy. Sommers–Flanagan and
Sommers–Flanagan (2007) upholds the position that counseling does not work with teenagers, because it is often not offered to them. Counselors often
attempt to mold them into miniature adults and implement techniques that work well with adults and not children. The techniques utilized in the initial
session discouraged the development of a client–worker relationship. Melissa became even more defensive as the session progressed. The clinician
focus was on the verbal message and not on the feelings underneath these statements. He continued to challenge her position on the need for therapy,
thereby upsetting the engagement process with this client. Within multicultural counseling, responsibility, knowledge, and skills lie with the
practitioners rather than the client system. Within this context, the therapist had his agenda, and instead

Using The Hydrate Rather Than The Anhydrous Form Of...
Theophylline is a bronchodilator used in the treatment of asthma, it has a low molecular weight of 180.2. It is slightly acidic, when in a saturated
solution of water and has a pKa of 8.81.
2.What are the implications of using the hydrate rather than the anhydrous form of theophylline (i) in formulation (manufacture of the tablet) and (ii) in
biopharmaceutics (dissolution)?20%
I.Manufacturing theophylline formulations come with challenges for both the anhydrous and hydrate. For the anhydrous form, a study showed that the
wet granulation of theophylline anhydrous in conjunction with microcrystalline cellulose, led to the formation of the monohydrate form of the drug.
This is significant because the monohydrate has slower dissolution than the anhydrous form of theophylline. Thus the method of manufacture is highly
important as the study showed directly compressed pellets had better dissolution profiles. Also it shows the importance of the choice of excipients as
pellets manufactured via wet granulation in the absence of microcrystalline cellulose showed similar release to that of directly anhydrous theophylline.
Theophylline monohydrate has a tendency to dehydrate during the drying process, it can do so at fairly cool temperatures of around 60вЃ°C. So this
makes temperature an important factor in the manufacture of monohydrate as phase transition can occur.
II.A study conducted in 1992 found

Carl Rogers's Theory : Person-Centered Therapy
Person–centered therapy otherwise known as client centered therapy is a non–directive approach to counseling created by Carl Rogers. This theory is
best described as based on the belief individuals, rather than their environment or subconscious motivations, can control their choices and values and
accomplish their own unique potential for change. Rogers' theory stresses how it is the individual's own responsibility for improving his or her life
with the primary motivating force of humans is reaching self–actualization which is the tendency to move in the direction of growth, adjustment,
socialization, independence, and self–realization (Erford, 2018). In terms of his theory, there are two fundamental ideas at the center of it all, the first
being about healthy development in terms of how the individual views their own well–being. A healthy individual can see the relationship between
their sense of who they are and who they feel they should be. The second fundamental idea from Rogers's concept of the conditions for healthy growth,
and the role of a therapist in fostering healthy growth. Throughout the process Rogers called person–centered therapy, the counselor seeks to provide
empathy, openness, and unconditional positive regard for the client. This research paper examines the concept of person–centered therapy, the types of
problems which can occur when using this approach, strengths of this using this type of therapy along with examining the weaknesses of using this type

Reflective Essay On Counselling
This reflective essay will try and develop an understanding of the experiences and theory that has been applied to a counselling roleplay and applied
content over the duration of the module. Furthermore, identifying what has been covered and what has not been covered in the roleplay, its strengths,
weaknesses, what needs developing and how it can help as counsellors within the field. The first topic will reflect on the skills and attributes that have
been applied to the roleplay and how it has been beneficial. The second topic will be a critical analysis on the roleplay conducted during counselling
focusing on what techniques have not been covered, what skills and attributes were not demonstrated in the roleplay. Then identifying how... Show
395–396). Another strength was having open questions for the client to answer from what feedback was received, in order to engage with the
exploration skills of counselling (Kottler & Shepard, 2015, p. 59). Open questions are very important to the exploration and overall process of
working through issues as well as building the relationship between client and counsellor, this approach links to the use of OARS which stands for
open ended questions, affirmation, reflective listening of content, feelings, emotions and summarizing (Klonek & Kauffeld, 2015, p. 118). OARS as an
open–ended technique of questioning client issues is very important as one of the main techniques of counselling is to make a quality of openness for
the client, so they can express themselves without feeling restricted (Lee & Prior, 2013, p. 101). The next positive point on the roleplay was the use
of empathic responses which were well conveyed by the counsellor on a median of good to very good. Empathy is the process in which to try and
understand issues from the client's perspective that could identify underlying emotions, feelings or issues (Kottler & Shepard, 2015, p. 91). During the
roleplay, there was a good reflection on content and paraphrasing. By reflecting on

Placebo
The Placebo effect of medication
Do we really need industrial medicine?
In this essay I will begin by explaining the five major points of the placebo effect, such as the understanding of placebo, the history, phenomenon,
experiments and case studies. Placebos are used in everyday life, from it being your doctor or even a commercial you've seen on the tv. Do we really
need prescribed medication or do we just think we do?
UNDERSTANDING PLACEBO
(Goldacre, n.d.)"The placebo effect is one of the most fascinating things in the whole of medicine. It's not just about taking a pill, and your performance
and your pain getting better. It's about our beliefs and expectations. It's about the cultural meaning of a treatment". The placebo effect is one ... Show
In an experiment involving pain symptoms, a placebo is giving to control group A and the actual pain pill is being giving to control group B. In every
experiment involving placebo it uses either the single–blinded method or double–blinded. In this experiment we are only using the single–blinded
method and this is where only the experimenter knows which patient or control group is receiving a placebo. In some experiments they use the
double–blinded method to make sure neither the patient or the control group know that they are receiving a placebo. The reason they do the
double–blind method is because when the patient asks the experimenter if she or he is receiving the placebo neither will actually

Assignment Questions On Mastering Competencies
Engagement Paper 3
MFT 645
Armig Yepremian
Chapter 13 in Mastering Competencies in Family Therapy by Gehart was about case conceptualization. This is an important chapter because as
growing clinicians we are going to have to conceptualize and present cases. This chapter addresses ways of gathering background information about the
family structure, and the boundaries of the families; such as, understanding closeness and distance, triangles in the family, and their hierarchy. This
chapter reminds clinicians how we must be culturally competent, because some communication stances, patterns, and the hierarchy structure in the
family can be culturally normal to our client. The chapter helps the clinician identify these patterns, ... Show more content on Helpwriting.net ...
Once that information is collected, the chapter addresses how to write the information gathered as a clinical assessment. In the article, Addressing
Cultural Impasses with Rupture Resolution Strategies: A Proposal and Recommendations by Daniel J. Gaztambide, as cited in Safran et al., (2011),
rupture is defined "as a tension or breakdown in the collaborative relationship between patient and therapist," ranging from minor transactions that over
time may impact the relationship to more dramatic negative processes such as overt hostility (P 185). Safran and Muran (2000) call this "rupture
markers." As the name suggests, rupture markers are signals that a strain or incongruence between client and clinician is taking place. P185. The
therapist addressing ruptures requires knowledge to be able to draw attention to the here–and–now transaction between patient and therapist,
emphasizing an intensive exploration and negotiation of each participant's contribution to the interaction. Being mindful of the power imbalance
inherent in the therapeutic relationship, the therapist grounds their intervention in an awareness of their feelings in the moment, addressing his or her
contribution to the impasse and accepting responsibility. Such recognition of the therapist's ability to make mistakes empowers the patient by
validating the reality of their experience.cP.185. Rupture resolution strategies promote treatment by placing a focus on addressing ruptures as

Essay about Philosophy and Therapeutic Recreation
As I make my way on this journey that is my life, I realize that I have always believed in the fundamental worth of all humanity and my responsibility
as a fellow human being to respect this premise and also to support individuals, as much as I am able, to help unearth it should this basic truth become
hidden to them. This is a guiding principle for me and I believe that many of the constructs of the field of Therapeutic Recreation (TR) are congruent
with this philosophy. Making the decision to obtain a Therapeutic Recreation Specialization (TRS) degree offered a theoretical rationale in which to
further explore the concept of leisure, define my professional philosophy and an opportunity to reflect critically on the field which I have ... Show more
When choosing to work with adults living with severe dementia, many people often ask me how or why I do it. It's simple. Not only do I believe that
all people have value, I likewise believe that all people can contribute to society. The client who can no longer articulate their thoughts or needs or
desires is teaching me to listen and find alternative means of communication. In essence, they are teaching me to be a better communicator. I think this
is congruent with Sayers concept of meaningful contribution. There are still so many things about the brain that we do not understand that I would
find it arrogant of me to assume that the person with dementia does not feel they are still contributing to society in some way.
This improved communication skill, from my perspective, is an essential and necessary benchmark for the establishment of an effective client
/practitioner relationship. O'Keefe (2008) urges us to listen to the narrative, there's a story to be heard, if only we adjust our philosophical positioning.
Eudaimonia, Leisure Ability Model, & A StrengthParadigm
Aristotle posits Eudaimonia, human flourishing and happiness, as the 'chief good' of humanity achieved through 'reflective activity' over a lifetime
(Aristotle, The Nicomachean Ethics, 2002). From my perspective, the reflective activity to which he alludes is the pursuit of leisure.

Clien Brown Reflection
I like the way Brown organized this book. She is gradually introducing some basic concepts prior to introducing a particular model or a larger concept.
For instance, she provides basic information about different social classes prior to introducing theories of identity formation. Brown highlights the
important of having awareness of our own schemata and rules that we might impose on others. She also emphasizes on the awareness of
psychotherapist's personal relationships to each of the social locations because these social locations can impact therapeutic relationship and potentially
become a source of trauma/threat for a client. I recall working with a client, who I shared many overt social locations with. Even though I had no
difficulty understanding her family upbringing, it was apparent that client felt shameful and guilty, especially when comparing my achievement and
her substance use. After the initial session, the ... Show more content on Helpwriting.net ...
Additionally, she highlights the importance of continuing to assess trauma and use culture to inform to inform treatment. It is extremely important to be
a cultural competence psychotherapist as it will help to avoid unintentionally inflicted secondary traumas. It will also help the healing process by
connecting trauma survivors to their own resources and honoring the inner and outer realities informing trauma and its meanings. How a client
translate his or her inner biological states of posttraumatic disequilibrium into outward expressions of distress are strongly affected by culture and
context. I aim to be a psychotherapist who possesses the ability to understand how a trauma survivor's multiple identities and social contexts lend
meaning to his or her trauma experience and promote recovery that includes their cultural

Identify the stages of a series of counselling sessions...
1 .1 Identify the stages of a series of counselling sessions The beginning The beginning of the counselling process starts when the client first meets the
counsellor, the saying "first impressions count" is absolutely true for both the client and counsellor, the client will be very nervous and unsure what is
about to take place. The way the counsellor approaches the client in this infant stage is vital for the client to gain trust and has the willingness to open
up in later sessions. Some clients may just rush into what is troubling them or say nothing, in both cases the counsellor will need to be patient, observe
and listen to what is being said as there will be vital information given and without understanding this it could damage... Show more content on
Helpwriting.net ...
1.2 Evaluate the importance of an appropriate opening of a series of sessions In my opinion the beginning of the counselling session is one of the
most important stage of the process, the client will be very nervous and will not fully trust the process they are about to embark on, their unknown
journey they will be nervous. The Client may hold back what they are feeling until they have gained the trust of the counsellor, and know they are safe
and in a confidential environment. Another important factor in the opening stage is to draw up a contract and discuss the content with the client, this
will demonstrate it's a working relationship and both the client and counsellor will know their barriers, it also gives structure and prevents any
misunderstanding in the relationship. By having a contract it demonstrates to the client they are safe and able to speak freely also it shows the client
that each session if totally confidential, there are exceptions to the rule and these will be included in the contract and what the process will be if they
disclose anything that is unlawful. Having unconditional positive regard from the beginning will display to the client there is no hidden agenda and
that the counsellor is non–judgmental, this will support the client to develop the working relationship and show the client they are valued and wanted,
they will start to relax to open up freely and loosen up their attitude towards the session. 1.3

Case Study Of Alkenylbenzenes
1 Introduction
1.1 Background China has a long history of safety use of many botanical or herb–based food items. More than 6000 different kinds of Chinese herbs
are identified and more than 600 of them are used as raw material to produce medical products , plant food supplements (PFS) , herbal teas and food
flavours . There is a growing interest by consumers and industry for the development of botanical products due to their "functional" properties or
health benefits. Consumers equate "natural" with "safe" when consider the ingredient used in these products . Moreover, the herbal teas can be
obtained easily in the supermarket or pharmacies with an relatively low costs. It is easy to find that the market size of botanical preparations has
increased significantly these years . However, the growing use of botanical compounds as direct drinking ingredients is accompanied by an increasing
concern , the ... Show more content on Helpwriting.net ...
An important group of compounds of concern in botanical preparations and herbal teas are alkenylbenzenes . The aim of this study is to assess the
exposure to alkenylbenzenes as a result of drinking the herbal teas obtained from Chinese market. The most known examples of alkenylbenzenes are
estragole (4–allyl–1–methoxybenzenes; CAS No.140–67–0), methyleugenol (1–allyl–3,4–dimethoxybenzene; CAS No.93–15–2), elemicin
(3,4,5–trimethoxyallylbenzene; CAS No.487–11–6), safrole (1–allyl–3,4–methylene dioxy benzene; CAS No.94–59–7), myristicin
(1–allyl–4,5–methylenedioxy–3–methoxybenzene; CAS No.607–91–0) and apiol (1–allyl–3,4methylene–dioxy–2,5–dimethoxybenzene; CAS
No.523–80–8). Some studies have already reported that these compounds may cause toxic effects on the liver by administration of high doses in
lifetime laboratory animal studies . The chemical structures of alkenylbenzenes are shown in

Therapeutic Alliance And Therapeutic Relationship
Therapist–Patient Relationship Historically, the alliance construct refers to the effective relationship between the therapist–patient and varying aspects
of the alliance have been studied, for example, the relationship and outcomes (Horvarth & Bedi, 2002, Lustig et al, 2002), the role of the alliance
(Horvarth & Luborsky, 1993) and the therapist's behaviours that predict the alliance (Duff and Bedi, 2010) and failures in the alliance (Duff & Bedi,
2010). Lambert & Barley (2001) argue that a supportive alliance accounts on average for 30% of the variance in outcomes, whereas theory and
techniques only accounts for 15% of the variance in outcomes. In comparison to the coaching relationship, the reverse is true as the same study (Grant,
2014) indicate theory and techniques account for 18.49% of the variance in outcomes whereas a supportive... Show more content on Helpwriting.net ...
It is the depth and breadth of the research spanning over 3 decades that provides researchers in the coaching domain a body of knowledge to build
upon, compare and contrast (De Haan, XXX). Throughout the literature, various terms are used to describe the relationship including, the therapeutic
alliance, ego alliance, working alliance and helping alliance and I will refer to the generic term of alliance (Horvath & Luborsky, 1993) as meaning,
"the client and counsellor's subjective experience of working together towards psychotherapeutic goals in the counselling context, including the
experience of an interpersonal bond that develops while engaged in this endeavour," (Duff and Bedi, 2010, p.91). The alliance is therefore viewed as
partnership with both parties actively contributing to the relationship with an emphasis on being

Reflection On Family Relationship
In this skills session my client brought her relationship with her mother and her feelings about that relationship. She brought feelings of "sadness"
"hurt" "upset" and "grief". She states early in the session "I'm constantly searching for some sort of love" and "affection from her". She describes
feeling neglected and disregarded by her mother and the rest of her family. She admits that these feelings have "stretched into the rest of her life"
and have left her feeling "unworthy" "not good enough" and like she "doesn't matter". She states that she feels "not worthy of affection" or "care"
or "regard". My client was questioning why her mother behaves the way she does towards her. She finds her mother's behaviour "difficult to
understand" and feels she doesn't "understand where it's coming from". During the session my client describes her mother's behaviour in a
particular scenario when she felt her mother behaved differently when she had an audience to play to. My client described feeling "ganged up on"
by her mother, who was "backed up" by her visiting relatives. It is clear my client wants a relationship with her mother and states this clearly when
asked. She is seeking answers "what is going on", "what is going on with this attitude?" My client states that she has suffered with feelings of being
"unworthy" for "most of her life" and suffered a nervous breakdown two years ago after which she sought help from counselling and her GP.
Considering what I have outlined above it would appear that my client's feelings of being unworthy and of not being good enough arise from feeling
that she doesn't matter to, or is disregarded by her mother and other family members. It would appear that my client's evaluation of her self worth or
self–esteem has been affected by her close family relationships. Carl Rogers (1959, p200 & p223) describes the development of the self–concept (how
an individual perceives themselves) and how this self–concept is heavily influenced by the conditions of self worth set out by others. Conditions of
worth are constraints or preconditions, which an individual perceives are placed upon them by individuals external to them. The individual believes
that these preconditions must be satisfied or

The Effects Of Induced Therapeutic Hypothermia On Cardiac...
"Medic respond, stoppage," chirped the intercom. The call went out for an adult male found down, pulseless and apneic, by family at approximately
2200 hours. EMS personnel arrived on scene, performed quality CPR and followed appropriate ACLS algorithms, and found an organized rhythm with
matching peripheral pulses at the third check. Per 2010 AHA guidelines, medics performed a 12 lead EKG, managed the patient 's hypotension with a
fluid bolus, and managed the patient 's airway by endotracheal intubation (American Heart Association, 2011). The patient displayed no neurological
response, the EKG revealed significant ST segment elevation in anterior and septal leads, and intubation was performed successfully without induction
or paralytic... Show more content on Helpwriting.net ...
The American Heart Association (2011) states that, "Therapeutic hypothermia is the only intervention demonstrated to improve neurologic recovery
after cardiac arrest" (Pp 77). Recommendations range between 32 and 36 degrees centigrade for 12 to 36 hours. Cooling may be achieved through
either introduction of cooled, isotonic, non–glucose–containing fluid, or surface cooling interventions like ice packs or cold packs. The AHA states,
however, that patient core temperature must be monitored by an esophageal thermometer, a pulmonary artery catheter, or a bladder catheter and that
peripheral temperature measurements via axillary, aural, or oral thermometers are inadequate for measuring core temperatures in targeted temperature
management. Therefore, while the AHA does recommend initiation of therapeutic hypothermia by EMS personnel in certain situations, agencies must
carry––and be trained in the use of––equipment to adequately measure the patient 's core temperature. Further, the AHA states that therapeutic
hypothermia results in increased neurologic function post–cardiac–arrest but does not identify a timeframe for initiation for these protocols, let alone
explore whether or not initiation of post–cardiac–arrest targeted temperature management by EMS influences patient outcomes. According to a study
published in the

The Powerful Placebo: From Ancient Priest To Modern Physician
The history of the placebo
The placebo, though unknown at the time, has been a fundamental part of medicine since antiquity. Simply put by Shapiro and Shapiro (who are
considered influential writers in placebo research), "the history of the placebo is the history of medical practice itself, until modern times". (Shapiro &
Shapiro, 1997) In their book, 'The Powerful Placebo: From Ancient Priest to Modern Physician', there is an extensive list of ancient medicine
medicaments and procedures all of which would now be deemed bizarre and inexplicable. For example, medicines included parts of frogs and
scorpions, the flesh of vipers and grated skull. It must be remembered that the eccentricity of these treatments is accounted for by the lack of ... Show
This is the phenomenon known as the placebo effect. (Benedetti, 2009)
However, it has only been in the last century, due to the rise of evidence–based medicine, that we have identified the placebo.
What is the placebo and the placebo effect?
The definition of the placebo and placebo effect is disputed but according to Shapiro and Morris, who wrote an extensive dissertation on the placebo:
"A placebo is defined as any therapy or component of therapy used for its nonspecific, psychological, or psychophysiological effect, or that it is used
for its presumed specific effect, but is without specific activity for the condition being treated." (Shapiro & Morris, 1978) "A placebo effect is defined
as the psychological or psychophysiological effect produced by placebos." (Shapiro & Morris, 1978)
Shapiro and Morris' definition is widely accepted and quoted, to words of similar effect, in other journals and books (for example 'Placebo
interventions, placebo effects and clinical practice'). Shapiro & Morris then differentiate pure placebos which they describe as 'treatments that are
devoid of active, specific components' from impure placebos, which 'contain non–placebo components'. A profound definition would be as follows,
"Impure placebos are substances, interventions or 'therapeutic' methods which have known pharmacological, clinical or physical value for some
ailments but lack specific therapeutic effects or value for the condition for which they have been

My Understanding of Person-Centred Counselling Essay
Write an essay of your own choice, e.g. "My understanding of person–centred counselling". Relate and refer to your own life experience and/or your
work context.
I am on a life–long path as a Skilled Helper (Egan) with some training in Integrative Psychotherapy. I am currently striving to integrate Carl Rogers'
ideas and practices into my existing knowledge framework whilst attempting to see previously identified phenomena through new eyes. My aim is to
use this knowledge to influence my practice as co–creator of therapeutic relationships. My principal aims in this essay are to define some of the basic
ideas of Rogers, to then describe how this links and informs his notions of a joint therapeutic endeavour through his Core ... Show more content on
Helpwriting.net ...
Rogers seems therefore to be describing an emotional consequence resulting from what the behaviourist BF Skinner called positive and negative
conditioning. He conceptualised Conditions of Worth as the limited ways in which a person could see him– or herself as being valued. The formulation
was also influenced by psychoanalyst Erik Erikson and his ideas of the early stages of development. Rogers asserted that the child who learns trust
and a sense of personal control are more likely to have a sense of self agency and robustness in the face of later difficulties. This comes about when
conflicts find a successful resolution leaving both parties emotionally respected and intact. Thus Rogers' more developed model of how a child is
socially instructed can encompass concepts such as shame (Psychoanalysis), Modelling (Albert Bandura) and ideas of Internalization, amongst many
others, and as such is more of a meta– model of growth of the personality.
In James' case he knew that if he worked hard at school he could gain his fathers approval. However it seemed that he was in the shadow of his
brother, who was also under the same pressure. He had turned to cheating to get better marks to avoid his father's disapproval. James' own sense of
right and wrong were being clouded by his loyalty to– and competition with his brother, also his need for approval from his father and his sense of duty
to protect his frail mother by "not

The Therapeutic Process and the Therapeutic Relationship...
This essay will explore the nature of the therapeutic process; using my fifty minute long real play session with one of my colleagues. Also, I will
explore my experience of the therapeutic relationship and how it influences therapeutic change and increase the affectivity of the therapy. In addition
to this, I will be attaining feedback from my client after discussing each stage of the therapeutic process in detail to help me understand what worked
well for the client and gain more insight into what I need to improve in order for my future sessions to be more successful. Before the beginning of
the session, I made sure I place the chairs in an appropriate position to promote equality and decrease the power dynamic between myself and the...
Show more content on Helpwriting.net ...
I made sure I used a welcoming tone as the way a counsellor greets their client will influence the clients feeling towards the counsellor, and their
confidence in the counsellor. It is equally important to be friendly so that the client feels at ease and valued as a human being. However counsellors
need to refrain from putting on an act and remain congruent and true to themselves from the beginning, while trying to meet them in a person to
person encounter to avoid intimidation Geldard and Geldard (2005). i asked her brief questions about her name and how she was to get acquainted
with her and build rapport. Asking questions helps facilitate a dialogue and encourages the client to talk and tell their story Miller (2006). The client
seemed tense and uneasy and spoke with a very high tone of voice when she greeted me and introduced herself. When asked about the main reason for
turning to therapy, she started fidgeting and looked unsettled; this could be because of the unfamiliar environment or she was not sure if she trusted
me enough to tell me her story. Either way, I remained silent whilst maintaining eye contact to give her the space, time she needed in order to settle
down and work out what she wanted to bring to the session. The client seemed very confused as though she was not sure of what to say and looked up
the ceiling taking pauses, blinking, sighing as she spoke about the presenting issue. i nodded continuously to

The Therapeutic Relationship : Working Alliance, Respect...
The therapeutic relationship is consists of several factors such as working alliance, respect and empathy, and multicultural competency. The relationship
as working alliance is how the therapist works diligently together with the client's for good results. In the helping process, respect is vital to clients in a
way that the client views the importance of the counseling. Empathy is another way of allowing your client know you care about them. Multicultural
competent is denoting the importance of the therapist or helper advice that needs to be followed on being a successful counselor. Working alliance is a
part of the helping process that the therapist are encouraged to be aware in the helping process. Greenson (1967) once stated that working alliance can
join together relationship itself and the relationship–as–means–to–achieving–desired outcomes. According to Bordin (1979), working alliance was
teamwork between the client and the helper committed to their goals and activities that were discussed in sessions. Bedi (2006) has stated that the
researcher has praised the therapist views on being the helper versus no praises to the client views. Unlike, Bedi's study expressed how client valued
the helping setting, helper's self–presentation, helper's education, helper's appreciation of the client, self–responsibility, and environment of the session.
However, the debate between many therapists' views is different on working alliance. Respect is an action that involves

Case Study Of Cellulitis
outcome measured the proportion of patients that had a repeat of cellulitis during the drug phase and follow–up phase (Thomas et al., 2013).
The results of this experiment showed some interesting information. In the end 136 patients were put into the penicillin group and 138 patients were
put into the placebo group. From these patients 15 (5%) took back consent or couldn't be found, 11 died (4%) and 206 (75%) were put into a
secondary care (Thomas et al., 2013). In total 247 (90%) of the patients did the minimum of 18 months of follow–ups and 214 (78%) said that they took
at least 75% of the tablets between the two groups (Thomas et al., 2013). During the trial, the primary outcome saw that it took a median of about 626
days in the ... Show more content on Helpwriting.net ...
Antoher group was given clarithromycin and hydroxychloroquine mix 500 mg and 200 mg respectively twice daily (Berende et al., 2016). And the
other patients got placebos twice daily (Berende et al., 2016). Everyone was blindly assigned.
At the end of the study 205 patients (73.2%) reported a minimum of one adverse effect, like diarrhea or nausea (Table 2) (Berende et al., 2016). Nine
people had a serious adverse effect and 19 had a bad enough side effect that they discontinued with the study (Table 2) (Berende et al., 2016). In the end
though most of the patients made it throughout the whole study.
To measure results the researchers used a 36–question questionnaire at the beginning at the end of the treatment of the 14 weeks, at 26 weeks, at 40
weeks, and finally 52 weeks after treatment (Berende et al., 2016). From the results 252(90%) of the patients completed the study. 76 out of 86 for the
doxycycline, 64 out of 96 for the clarithromycin–hydroxychloroquine and 92 out of 98 patients finished from the placebo group (Berende et al., 2016).
At the end of the study the results showed some interesting results. By looking at the questionnaire mean all the patients quality of life increased from
the original of 31.8 to 36.4 at the end of the treatment. Even though the scores were higher at the end of the treatment there was no significant
difference in any of the groups that were studied

Core Conditions Essay
Name of Student: Fiona CruickshankStudent ID: 51125153
Course Name: Counselling Skills 1.Course Tutor: Anne Smith
Counselling Skills Essay 1.Date Due: 17 Nov 2011
Counselling is a form of communication whereby one individual, from now on referred to as the listener, forms a helping relationship with one or a
group of individuals. (Hough 2010) A counselling type relationship is used in a multitude of everyday home and work settings. These individuals may
not call themselves counsellors or indeed have any formal counselling skills training. It is this training that sets apart therapeutic counselling from other
forms of helping communication. Sanders, (2007, p15) defines counselling skills as "interpersonal ... Show more content on Helpwriting.net ...
Why? Because as Sutton et al, (2008, p.36.) points out "counselling is essentially about facilitating change" and sympathy and pity leaves the client
stuck in the same place unable to move forward. Instead the listener must show feeling for the client, effectively trying to mirror or share their
sensitivities. This also demonstrates a depth of self awareness by the listener showing that they recognise the need for a clear distinction between
themselves and their client. Burnard, (1992) confirms that this also allows us to define clear boundaries within the professional counsellor–client
relationship. Empathy can be communicated non–verbally by facial expression, direct eye contact and recognising the need to reduce the physical
distance between counsellor and client.
This may be simply leaning forward which strengthens the conscious connection or "empathetic resonance" between listener and client. (Freshwater,
2010, p30). I recall times during my professional nursing career when I have felt frustrated, particularly when my medical colleagues showed poor
non verbal communication skills and did not fully engage with their patients: the consultation with a bedridden patient from the end of the bed or the
discussion held across a desk. These physical barriers merely impede the counselling relationship. Sutton et al (2008, p39) believes that the listener is
required to "build a bridge of empathy".

Social And Early Developmental Factors
Though not discussed explicitly stated, clearly there are cultural, social and early developmental factors that should be considered as each influence or
impact Jackie's symptoms or problems. Culturally it can be argued that due to the lack of integration between his mother's heritage and his fathers,
there was a discourse within him. As described by Jackie his father was a traditional Englishman, who did not allow his family to participate in his
mothers cultural affairs. It can be argued that due to the lack of convergence between his two cultural backgrounds, increased Jackie's anxiety. Yoon et
al., (2012), found that "both acculturation and enculturation positive contribute to SWB (subjective well–being) when increase in one cultural
orientation did not entail losing the other culture" (p. 93). However, given the information provided about Jackie and his family dynamic, it is clear that
Jackie's father often dismissed his mother's cultural heritage, thus forcing Jackie to acclimate to his English culture instead of his Indian heritage,
potentially causing anxiety. This anxiety also may be exacerbated by Jackie's migration to the United States, where he was forced to accommodate
another culture, after already having insufficient connectedness with his heritage. Social factors such as Jackie's difficulty connecting to individuals
and his impaired self esteem, as evidenced by his continual negative language about his abilities, can attribute to his inability to form

Client Centered Therapy
Jessica Jeffers
It is inevitable that in psychotherapy there are numerous theories. Theories arise out of scholarly investigations of ideas on human behavior. Human
behavior is an extraordinarily interesting subject and therefore produces a plethora of ideas from a variety of theorists. These theorists are influenced
by their education, culture, and time period. One of the most influential, empathetically understanding, theorists is Carl Rogers. His contributions to
human behavior have changed many of the theories that preceded him, and contributed his theory to many theories that followed him.
I want to explore Client/Person Centered Therapy. This is a type of therapy that was pioneered by Carl Rogers. This therapy is different ... Show more
Rogers may not have worked with his clients to produce and obtain goals, but he did have a ultimate goal in his therapeutic work. According to
Rogers, "They [clients] are then able to accept themselves as they are and to commit themselves to becoming more like they can and want to be" (as
cited in Truscott, 2010, p. 72). The client is in turn aided by the therapist in becoming as authentic as possible. Thus this authenticity would provide the
client with the ability to be true to themselves and their feelings. I find this to be useful in allowing the client to process their internal feelings,
externally.
According to Truscott (2010), "Therapists must be willing and able to listen without prejudice, judgment, or agenda if the client is to have any chance
of feeling truly understood and accepted. Positive feelings, negative feelings, and silence must be acceptable to the therapist" (p. 73). This is interesting
because it requires that the therapists become void of any judgments. To me this seems like a difficult task to accomplish because of the nature of
judgments. Understandably so, the therapist would automatically make judgments of the client, as a natural inclination even with the best intentions
against judgments.
So, what kind of a therapist must one be to establish a patient centered therapy?

Write an Essay on Confidentiality and the Boundaries of a...
Boundaries not only reflect a need for physical space, but, our core values, self respect and our need for safety and protection. They are invisible lines
that differentiate people from each other. The different forms or types of boundaries include physical, emotional, spiritual, financial, and relational.
The formation of boundaries in Counselling, or a helping interaction, is very important. Helping interactions provide people with an opportunity to help
deal with their difficulties, whatever they may be. It is a chance to be listened to and understood. As such, the helping relationship is an intimate one. It
is built around trust and support and offers the helpee (client), a place free from judgment. Within a helping interaction ... Show more content on
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Thus, boundaries allow the explorative process to continue. As the helpee may be not used to this kind of framework and unaware of the importance of
keeping the limits, it becomes helper's responsibility to set up and manage the boundaries as well as to recognize the dilemmas that are inherent within
them.
The agreement on the boundaries concerning therapeutic relationship is beneficial for both the helpee and helper. Boundaries preserve the therapeutic
relationship by ensuring that a helper understands the need to and can keep separate his personal and professional life. Counsellors, or helpers
who are able to maintain healthy boundaries do not carry the problems of their clients around with them during leisure hours. They know how to
say no, which allows them to keep a balance in their lives. A helper that takes care of himself and knows where to draw the line is in a position to
provide a higher standard of service to his helpees, than a helper who blurs the boundaries between personal and professional relationships and feels
overwhelmed as a result. Moreover, by making the distinction between a therapeutic relationship and social relationships, a helper is able to retain a
level of objectivity that a friend would struggle with if you went to him with a problem. Your friend may have a stake in the outcome of your problems
that a helper

Therapeutic Relationships And The Three Stages Associated...

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